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Cancer screening and prevention [keywords]
- Pharmaco and diet based prostate cancer prevention. [JOURNAL ARTICLE]
- Bull Cancer 2013 May 16.
In 2010, in France, 8,790 men died from prostate cancer despite a low and decreasing mortality rate. The individual risk/benefit ratio of prostate cancer screening is the focus of controversy and currently not in favor of a systematic screening program. Therefore, only prevention could reduce incidence, side effects of treatment and related mortality. Interestingly, prostate cancer prevention is also a field of controversy mainly about 5-alpha-reductase inhibitors. However, it could be expected that pharmaco- or diet-based prevention will be a huge tool for cancer control, even more for prostate cancer burden. This review comprehensively analyses which molecules or compounds could be used in preventive trials. With regard to pharmaco-prevention, three different kinds of drugs could be identified. First drugs, which aim at mainly or even solely reduce prostate cancer risk such as 5-alpha-reductase inhibitors and selective estrogen receptor modulators. Drugs, which aim at wider preventive impact such as: nonsteroidal anti-inflammatory drugs or difluoromethylornithine. Lastly, drugs for which reducing prostate cancer incidence is merely a side effect such as statins, metformin or histones desacetylase inhibitors. With regard to diet-based prevention, two main approaches could be identified: aliments and nutriments, on one hand, and vitamin and minerals, on the other. Interestingly if compounds reach experimental plausibility, natural foods or even global diet seem to have a higher impact. Lastly, besides assessment of efficacy, effectiveness required the critical step of compliance, which might actually be the weakest link of the prevention chain.
- Marvelous applications of quantum dots. [Journal Article]
- Eur Rev Med Pharmacol Sci 2013 May; 17(9):1141-8.
Nanotechnology is developed to convert research, prevention, and treatment of cancer through the novel diagnostic imaging techniques and therapies. In particular, the imaging nanotechnology has gained substantial momentum in recent years. The main progress in nanotechnology has led to the production of novel fluorescent probes named quantum dots (QDs). Quantum dots develop a revolution in the molecular tagging processes within research, in vivo and in vitro studies. Due to unique physical and chemical features of QD probes, new possible techniques of early cancer detection and therapeutic management are being surveyed. Quantum dots have also dissolved many of the restrictions of organic fluorophores and are a talented option as a research tool.This review addresses on the present status of research, preclinical applications and also future visions of quantum dots.
- Clinical characteristics of 274 non-small cell lung cancer patients in china. [Journal Article]
- Onkologie 2013; 36(5):248-54.
Background:The mortality from non-small cell lung cancer (NSCLC) in China is increasing, and studies about clinical characteristics of recent NSCLC are rare. The primary objective of this study was to explore clinical features in a large general hospital in Northwest China, and to determine risk factors for stage, pathology and survival, with a view to prevention and treatment of NSCLC as well as establishment and improvement of national medical insurance policies. Patients and
Methods:We retrospectively analyzed the characteristics of NSCLC patients (n = 274), as well as risk factors for advanced stage and squamous cell carcinoma (SCC). Survival features in different groups were analyzed, as well as risk factors of survival. Follow-up was at least 3 years.
Results:179 were male (65.3%); 136 had adenocarcinoma (49.6%) and 109 had SCC (39.8%); 186 (67.9%) had advanced-stage disease (IIIB-IV); 130 (47.4%) had smoking habits; 195 came from an urban area (71.2%); 69 had local urban resident basic medical insurance; 58% were younger than 60 years. Female, adenocarcinoma, rural patients were significantly younger than male, SCC, and urban patients. Pathology was the only independent risk factor for advanced stage. Age, sex, and smoking status were independent prognostic factors for SCC. The proportion of male SCC was higher than female SCC even without the influence of smoking. Without local urban resident basic medical insurance, higher stage and not having surgery, but not smoking status, were independent risk factors for lower median progression-free survival (PFS). Patients with adenocarcinoma and SCC in advanced stage accepting EGFR-TKI during treatment had a higher 1-year survival rate and longer overall survival (OS) compared with those never accepting EGFR-TKI. EGFR-TKI treatment and chemotherapy regimen numbers were independent risk factor for median OS in advanced adenocarcinoma and SCC patients.
Conclusion:More prevention and screening should be carried out for the female and rural population. EGFR-TKI could benefit advanced NSCLCs. China's medical insurance policy has some adverse effect on NSCLC survival calling for further improvement.
- [Colorectal cancer: screening and surveillance in inflammatory bowel diseases - consensus of the working group for inflammatory bowel diseases of the austrian society of gastroenterology and hepatology]. [English Abstract, Journal Article]
- Z Gastroenterol 2013 May; 51(5):450-7.
Patients with ulcerative colitis and Crohn's colitis are at increased risk of colorectal cancer (CRC). This risk is dependent on the duration and extent of disease, inflammatory activity and possible additional risk factors. Thus, the aim is to reduce this risk and to detect dysplastic and malignant lesions at an early stage. The working group for Inflammatory Bowel Diseases (IBD) of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) has developed consensus statements on the following topics: risk of colorectal cancer, screening and surveillance, procedure of surveillance colonoscopy, dysplasia and its management, and chemoprevention. This consensus is intended to increase awareness of the increased risk of CRC in IBD and to support a standardised approach in cancer prevention.
- Value-based healthcare in Lynch syndrome. [JOURNAL ARTICLE]
- Fam Cancer 2013 May 17.
Lynch syndrome (LS), one of the most frequent forms of hereditary colorectal cancer (CRC), is caused by a defect in one of the mismatch repair (MMR) genes. Carriers of MMR defects have a strongly increased risk of developing CRC and endometrial cancer. Over the last few years, value-based healthcare has been introduced as an approach to the cost-effective delivery of measurable patient value over complete cycles of care. This requires all involved stakeholders to formulate and validate 'patient value' for Lynch syndrome, as well as to identify targets and associated costs. The aim of this study was to develop a value-based care model for Lynch syndrome that can determine patient value and associated costs, and to design a coordinated care pathway from existing guidelines. All specialists in our hospital involved in the management of LS patients evaluated the care delivered to these patients at their department and formulated outcome measures relevant to patient value. Patients were then invited to complete a questionnaire that assessed the importance of these measures on a scale of 1-10. Six high-value outcomes were identified: (1) prevention of cancer or detection of early stage cancer (2) rapid results from MMR gene mutation testing (3) rapid investigation of the colon and uterus (4) no/little pain during colonoscopy and gynaecologic examination/biopsy (5) the offer of psychological help and (6) registration with the Dutch Lynch syndrome registry. A total of 38 (59 %) out of 62 patients completed the questionnaire. The relevance of all outcomes was confirmed by the patients and mean scores varied from 7.2 to 9.9. Patients underscored the relevance of both proper patient education and the efficiency of surveillance during their care cycle. Value-based care delivery for Lynch syndrome includes the implementation of six parameters related to prevention and early detection of cancer, a short cycle time and registration to ensure continuation of care. Estimated costs are <euro> 3320 for the first cycle of care (<euro> 3550 including gynaecologic surveillance) and approximately 720 per subsequent annual cycle (<euro> 950 including gynaecologic surveillance).
- Measuring the exposome: A powerful basis for evaluating environmental exposures and cancer risk. [JOURNAL ARTICLE]
- Environ Mol Mutagen 2013 May 16.
Advances in laboratory sciences offer much in the challenge to unravel the complex etiology of cancer and to therefore provide an evidence-base for prevention. One area where improved measurements are particularly important to epidemiology is exposure assessment; this requirement has been highlighted through the concept of the exposome. In addition, the ability to observe genetic and epigenetic alterations in individuals exposed to putative risk factors also affords an opportunity to elucidate underlying mechanisms of carcinogenesis, which in turn may allow earlier detection and more refined molecular classification of disease. In this context the application of omics technologies to large population-based studies and their associated biobanks raise exciting new avenues of research. This review considers the areas of genomics, transcriptomics, epigenomics and metabolomics and the evidence to date that people exposed to well-defined factors (for example, tobacco, diet, occupational exposures, environmental pollutants) have specific omics profiles. Although in their early stages of development these approaches show promising evidence of distinct exposure-derived biological effects and indicate molecular pathways that may be particularly relevant to the carcinogenic process subsequent to environmental and lifestyle exposures. Such an interdisciplinary approach is vital if the full benefits of advances in laboratory sciences and investments in large-scale prospective cohort studies are to be realized in relation to cancer prevention. Environ. Mol. Mutagen., 2013. © 2013 Wiley Periodicals, Inc.
- Associations among family history of cancer, cancer screening and lifestyle behaviors: a population-based study. [JOURNAL ARTICLE]
- Cancer Causes Control 2013 May 17.
PURPOSE:Some cancers are largely preventable through modification of certain behavioral risk factors and preventive screening, even among those with a family history of cancer. This study examined the associations between (1) family cancer history and cancer screening, (2) family history and cancer preventive lifestyle behaviors, and (3) cancer screening and lifestyle behaviors.
METHODS:Data were from the 2009 California Health Interview Survey (n = 12,603). Outcomes included screening for breast cancer (BC) and colorectal cancer (CRC) and six cancer preventive lifestyle behaviors, based on World Cancer Research Fund recommendations. Multivariate logistic regression analyses, stratified by gender and race-ethnicity, examined associations. Predicted probabilities of cancer screening by family cancer history, race-ethnicity, and sex were computed.
RESULTS:Family history of site-specific cancer-CRC for men and women, and BC for women-was associated with higher probability of cancer screening for most groups, especially for CRC, but was largely unrelated to other lifestyle behaviors. In the few cases in which family history was significantly associated with lifestyle-for example, physical activity among White and Latino males, smoking among White and Asian females-individuals with a family history had lower odds of adherence to recommendations than those with no family history. Greater overall adherence to lifestyle recommendations was associated with higher odds of up-to-date CRC screening among White and Asian males, and lower odds among Asian females (no significant association with BC screening); this relationship did not vary by family cancer history.
CONCLUSION:The fact that family history of cancer is not associated with better lifestyle behaviors may reflect shared behavioral risks within families, or the lack of knowledge about how certain lifestyle behaviors impact personal cancer risk. Findings can inform interventions aimed at lifestyle behavioral modification for individuals at increased cancer risk due to family history.
- Laboratory screening markers in gastroenterology - state of the art. [JOURNAL ARTICLE]
- Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2013 May 3.
INTRODUCTION:Screening tests for gastrointestinal diseases acceptable for population with a high sensitivity and high specificity can now be offered by clinical laboratories. This paper summarizes major recent advances in this area of laboratory medicine.
METHODS:Relevant articles published within the last 5 years in the NLM (National Library of Medicine) PubMed - Medline database covering the three gastrointestinal diseases - colorectal cancer, coeliac disease, and atrophic gastritis were included for this overview.
RESULTS:In Europe, colorectal cancer (CRCA) is the second most frequent malignant disease. Quantitative immunochemical analysis of the stool for haemoglobin provides the best screening test to date, with both sensitivity and specificity approaching 95%. Even though coeliac disease (CD) affects approximately 1% of the general population, it remains largely unrecognised. Recommended methods for screening currently involve the detection of IgA and IgG antibodies against tissue transglutaminase and deamidated gliadin peptide. Evaluations of screening are now discussed for other diseases of the gastrointestinal tract - such as chronic atrophic gastritis (CAG), and inflammatory bowel disease (IBD). Detection of infection by Helicobacter pylori and stomach-specific plasmatic biomarkers, especially pepsinogen I/II ratio, could help with the prevention of gastric carcinomas. The use of faecal calprotectin as a screening test could substantially reduce the number of invasive methods necessary for the diagnostic work-up of patients with IBD.
CONCLUSIONS:Screening tests for CRCA and CD have been used worldwide for many years. Screening strategies for gastrointestinal diseases are suggested in the text, based on recent basic science, clinical papers as well as our own experience.
- Simple pathological examination technique for detection of cancer located at the surgical margin of the stomach. [JOURNAL ARTICLE]
- Gastric Cancer 2013 May 17.