Recommendations on prevention and screening for colorectal cancer in Hong Kong.

Colorectal cancer is the commonest cancer in Hong Kong. The Cancer Expert Working Group on Cancer Prevention and Screening was established in 2002 under the Cancer Coordinating Committee to review local and international scientific evidence, assess and formulate local recommendations on cancer prevention and screening. At present, the Cancer Expert Working Group recommends that average-risk individuals aged 50 to 75 years and without significant family history consult their doctors to consider screening by: (1) annual or biennial faecal occult blood test, (2) sigmoidoscopy every 5 years, or (3) colonoscopy every 10 years. Increased-risk individuals with significant family history such as those with a first-degree relative diagnosed with colorectal cancer at age ≤60 years; those who have more than one first-degree relative diagnosed with colorectal cancer irrespective of age at diagnosis; or carriers of genetic mutations associated with familial adenomatous polyposis or Lynch syndrome should start colonoscopy screening earlier in life and repeat it at shorter intervals.

Recommendations on prevention and screening for breast cancer in Hong Kong.

In Hong Kong, breast cancer is the most common cancer among women and poses a significant health care burden. The Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) was set up in 2002 by the Cancer Coordinating Committee to review and assess local and international scientific evidence, and to formulate recommendations for cancer prevention and screening. After considering the local epidemiology, emerging scientific evidence, and local and overseas screening practices, the CEWG concluded that it was unclear whether population-based breast cancer screening did more harm than good in local asymptomatic women at average risk. The CEWG considers that there is insufficient evidence to recommend for or against population-based mammography screening for such individuals. Women who consider breast cancer screening should be adequately informed about the benefits and harms. The CEWG recommends that all women adopt primary preventive measures, be breast aware, and seek timely medical attention for suspicious symptoms. For women at high risk of breast cancer, such as carriers of confirmed BRCA1/2 deleterious mutations and those with a family history of breast cancer, the CEWG recommends that they seek doctor's advice for annual mammography screening and the age at which the process should commence. Additional annual screening by magnetic resonance imaging is recommended for confirmed BRCA1/2 mutation carriers or women who have undergone radiation therapy to the chest between the age of 10 and 30 years. Women at moderate risk of breast cancer should discuss with doctors the pros and cons of breast cancer screening before making an informed decision about mammography screening every 2 to 3 years.

Disparities of birth cohort effects on pancreatic cancer incidence between the United States and urban China.

BACKGROUND: Pancreatic cancer has been associated with lifestyle factors, but few comparative studies were conducted among countries of different culture and lifestyle habits. This study compared the trends of pancreatic cancer incidence and birth cohort effects in the United States and urban China and explored the potential discrepancies of risk patterns. MATERIALS AND METHODS: Age-standardized incidence rates (ASIRs) were calculated using data from national or regional cancer registries of the United States and two large cities of China (Shanghai, Hong Kong). The temporal trends of incidence were assessed by joinpoint regression. The effects of birth cohort and calendar period were identified through age-period-cohort modeling. RESULTS: The ASIR in the United States from 1976 to 2015 was 8.26/100 000, which was higher than that in Hong Kong (4.29/100 000) and Shanghai of China (6.63/100 000). Shanghai had lower incidence (4.41/100 000) in 1976-1980 but increased annually by 1.38% in males and 1.67% in females, with a sharper upward trend than the United States and Hong Kong. Males had higher risks than females, with a male-to-female ratio of 1.34, 1.44, and 1.37 in the United States, Hong Kong, and Shanghai, respectively. A significant and prominent increase in incidence rate was observed among successive generations in China particularly for Shanghai, but such a pattern was not apparent in the United States. CONCLUSIONS: The differences in pancreatic cancer incidence by sex may be multi-factorial involving known risk factors like tobacco smoking and alcohol consumption. The significant birth cohort effects among recent and early generations in the Shanghai population were in line with a society in socioeconomic transition and adoption of Western lifestyle mainly including consumption of calorie-rich foods and physical inactivity. Differences in these risk patterns will have implications on health care efforts and policies for cancer control.