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1.
JAMA Netw Open ; 4(4): e216454, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33843997

RESUMEN

Importance: COVID-19 has decreased colorectal cancer screenings. Objective: To estimate the degree to which expanding fecal immunochemical test-based colorectal cancer screening participation during the COVID-19 pandemic is associated with clinical outcomes. Design, Setting, and Participants: A previously developed simulation model was adopted to estimate how much COVID-19 may have contributed to colorectal cancer outcomes. The model included the US population estimated to have completed colorectal cancer screening pre-COVID-19 according the American Cancer Society. The model was designed to estimate colorectal cancer outcomes between 2020 and 2023. This analysis was completed between July and December 2020. Exposures: Adults screened for colorectal cancer and colorectal cancer cases detected by stage. Main Outcomes and Measures: Estimates of colorectal cancer outcomes across 4 scenarios: (1) 9 months of 50% colorectal cancer screenings followed by 21 months of 75% colorectal cancer screenings; (2) 18 months of 50% screening followed by 12 months of 75% screening; (3) scenario 1 with increased use of fecal immunochemical tests; and (4) scenario 2 with increased use of fecal immunochemical tests. Results: In our simulation model, COVID-19-related reductions in care utilization resulted in an estimated 1 176 942 to 2 014 164 fewer colorectal cancer screenings, 8346 to 12 894 fewer colorectal cancer diagnoses, and 6113 to 9301 fewer early-stage colorectal cancer diagnoses between 2020 and 2023. With an abbreviated period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 588 844 colorectal cancer screenings and 2836 colorectal cancer diagnoses, of which 1953 (68.9%) were early stage. In the event of a prolonged period of reduced colorectal cancer screenings, increasing fecal immunochemical test use was associated with an estimated additional 655 825 colorectal cancer screenings and 2715 colorectal cancer diagnoses, of which 1944 (71.6%) were early stage. Conclusions and Relevance: These results suggest that the increased use of fecal immunochemical tests during the COVID-19 pandemic was associated with increased colorectal cancer screening participation and more colorectal cancer diagnoses at earlier stages. If our estimates are borne out in real-world clinical practice, increasing fecal immunochemical test-based colorectal cancer screening participation during the COVID-19 pandemic could mitigate the consequences of reduced screening rates during the pandemic for colorectal cancer outcomes.


Asunto(s)
/complicaciones , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/normas , Evaluación de Resultado en la Atención de Salud/normas , Adulto , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Factores de Riesgo , Estados Unidos
2.
Medicine (Baltimore) ; 100(16): e25414, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33879671

RESUMEN

ABSTRACT: Single-cell RNA-seq has become a powerful tool to understand tumor cell heterogenicity. This study tried to screen prognosis-related genes in basal-like breast tumors and evaluate their correlations with cellular states at the single-cell level.Bulk RNA-seq data of basal-like tumor cases from The Cancer Genome Atlas-Breast Cancer (TCGA-BRCA) and single-cell RNA-seq from GSE75688 were retrospectively reviewed. Kaplan-Meier survival curves, univariate and multivariate analysis based on Cox regression model were conducted for survival analysis. Gene set enrichment analysis (GSEA) and single-cell cellular functional state analysis were performed.Twenty thousand five hundred thirty genes with bulk RNA-seq data in TCGA were subjected to screening. Preliminary screening identified 10 candidate progression-related genes, including CDH19, AQP5, SDR16C5, NCAN, TTYH1, XAGE2, RIMS2, GZMB, LY6D, and FAM3B. By checking their profiles using single-cell RNA-seq data, only CDH19, SDR16C5, TTYH1, and RIMS2 had expression in primary triple-negative breast cancer (TNBC) cells. Prognostic analysis only confirmed that RIMS2 expression was an independent prognostic indicator of favorable progression free survival (PFS) (HR: 0.78, 95%: 0.64-0.95, P  = .015). GSEA analysis showed that low RIMS2 group expression had genes significantly enriched in DNA Repair, and MYC Targets V2. Among the 89 basal-like cells, RIMS2 expression was negatively correlated with DNA repair and epithelial-to-mesenchymal transition (EMT).RIMS2 expression was negatively associated with DNA repair capability of basal-like breast tumor cells and might serve as an independent indicator of favorable PFS.


Asunto(s)
Neoplasias de la Mama/genética , Proteínas de la Membrana/genética , Neoplasias Basocelulares/genética , RNA-Seq , Proteínas de Unión al GTP rab3/genética , Adulto , Biomarcadores de Tumor/genética , Simulación por Computador , Reparación del ADN/genética , Bases de Datos Genéticas , Detección Precoz del Cáncer/métodos , Transición Epitelial-Mesenquimal/genética , Femenino , Regulación Neoplásica de la Expresión Génica/genética , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Pronóstico , Supervivencia sin Progresión , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Análisis de Supervivencia , Neoplasias de la Mama Triple Negativas/genética
3.
Acta Med Indones ; 53(1): 132-139, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33818416

RESUMEN

Colorectal cancer (CRC) is one of the top three leading causes of death in both men and women. However, screening can help detect and prevent CRC. Multiple guidelines recommend CRC screening using stool-based screening and direct visualization via colonoscopy. Anatomically, women have a longer total colonic length, especially in the transverse colon, which makes it redundant; thus it is more difficult to perform complete endoscopy in women. Women also have a higher risk of developing right-sided colon cancer of the flat and depressed type, which is harder to detect than the other types. Moreover, women are less likely to undergo colonoscopy due to embarrassment, especially when the procedure is performed by male gastroenterologists, and the lack of available female gastroenterologists further complicates the problem. The current COVID-19 pandemic also decreases patients' willingness to undergo screening due to the fear of contracting the COVID-19. Delay in diagnosis leads to more advanced tumors upon detection and ultimately decreases the survival rate, especially in women, as they have lower 1-year survival rate when CRC is detected in its later stages than in men. Innovative options for CRC screening have recently emerged, including colon capsule endoscopy, which can be performed in a clinic and may reduce the need for colonoscopy. However, sex-specific CRC screening guidelines and tools are not available. The objective of this review is to identify the barriers and challenges faced when performing screening colonoscopy in women, especially during the pandemic and to encourage the development of sex-specific CRC screening.


Asunto(s)
Colonoscopía , Neoplasias Colorrectales , Detección Precoz del Cáncer , Actitud Frente a la Salud , /prevención & control , Colonoscopía/métodos , Colonoscopía/psicología , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/psicología , Femenino , Humanos , Evaluación de Necesidades , Factores Sexuales
4.
Medicine (Baltimore) ; 100(9): e24934, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655959

RESUMEN

ABSTRACT: Oral cancer is one of the leading causes of cancer death, which are mostly preceded by oral potentially malignant disorders (OPMDs). Taiwanese government launched a free oral cancer screening program. The aim of this study was to analyze the malignant transformation rate of OPMDs.This study was based on national-wide oral screening databases. 3,362,232 people were enrolled. Patients clinically diagnosed with leukoplakia, erythroplakia, oral submucosal fibrosis (OSF), oral verrucous hyperplasia (OVH), and oral lichen planus (OLP), from 2010 to 2013, were identified. We followed up OPMD patients in cancer registry databases to analyze the malignant transformation rate.The malignant transformation rates from the highest to the lowest were: OVH > OSF > erythroplakia > OLP > leukoplakia. The malignant transformation rate was 24.55, 12.76, 9.75, 4.23, and 0.60 per 1000 person-years in the OVH, OSF, erythroplakia, leukoplakia, and comparison cohort. The hazard ratio was 8.19 times higher in the OPMD group compared with comparison cohort group, after age and habit adjustment. Female patients with OPMDs had a high risk of malignant transformation.Nationwide screening is very important for early diagnosis. OVH had the highest malignant transformation possibility. Female OPMD patients are a rare but have a relatively high malignant transformation rate.


Asunto(s)
Transformación Celular Neoplásica/patología , Detección Precoz del Cáncer/métodos , Mucosa Bucal/patología , Neoplasias de la Boca/epidemiología , Vigilancia de la Población/métodos , Lesiones Precancerosas , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Morbilidad/tendencias , Neoplasias de la Boca/patología , Taiwán/epidemiología
6.
Ginekol Pol ; 92(2): 165-173, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33751524

RESUMEN

The Polish Society of Colposcopy and Cervical Pathophysiology (PTKiPSM) together with the Polish Society of Gynecologists and Obstetricians (PTGiP) issued a final summary of interim guidelines for secondary cervical cancer prevention during the SARS-CoV-2 pandemic based on the analysis of the latest directional publications and the authors' own experiences. The aim of the summary is to facilitate the implementation of the most effective possible screening of cervical precancerous lesions and cervical cancer due to temporary significant limitation of screening as a consequence of the ongoing epidemiological threat. These final guidelines are taking into account the 2020 call of the World Health Organization (WHO) for global epidemiological elimination of cervical cancer. The guidelines supplement the interim guidelines of PTKiPSM and PTGiP announced in March 2020 on the possible deferral of diagnostic and therapeutic procedures in patients with abnormal screening tests results in secondary prevention of cervical cancer in current pandemic.


Asunto(s)
Colposcopía , Detección Precoz del Cáncer/métodos , Tamizaje Masivo/métodos , Prevención Secundaria , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Algoritmos , Femenino , Humanos , Pandemias , Polonia , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/prevención & control , Lesiones Precancerosas/cirugía , Neoplasias del Cuello Uterino/cirugía
7.
Methods Mol Biol ; 2265: 203-212, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33704716

RESUMEN

Early detection of cancer has been a goal of cancer research in general and melanoma research in particular (Birnbaum et al., Lancet Glob Health 6:e885-e893, 2018; Alendar et al., Bosnian J Basic Med Sci 9:77-80, 2009). Early detection of metastasis has been targeted as pivotal to increasing survival rates (Menezes et al., Adv Cancer Res 132:1-44, 2016). Melanoma, though curable in its early stages, has a dramatic decrease in survival rates once metastasis has occurred (Sharma et al., Biotechnol Adv 36:1063-1078, 2018). The transition to metastasis is not well understood and is an area of increasing interest. Metastasis is always premeditated by the shedding of circulating tumor cells (CTCs) from the primary tumor. The ability to isolate rare CTCs from the bloodstream has led to a host of new targets and therapies for cancer (Micalizzi et al., Genes Dev 31:1827-1840, 2017). Detection of CTCs also allows for disease progression to be tracked in real time while eliminating the need to wait for additional tumors to grow. Using a photoacoustic flowmeter, in which we induce ultrasonic responses from circulating melanoma cells (CMCs), we identify and quantify these cells in order to track disease progression. Additionally, these CMCs are captured and isolated allowing for future analysis such as RNA-Seq or microarray analysis.


Asunto(s)
Citometría de Flujo/métodos , Melanoma/diagnóstico , Células Neoplásicas Circulantes , Técnicas Fotoacústicas/instrumentación , Técnicas Fotoacústicas/métodos , Reología/instrumentación , Reología/métodos , Neoplasias Cutáneas/diagnóstico , Progresión de la Enfermedad , Detección Precoz del Cáncer/métodos , Citometría de Flujo/instrumentación , Biblioteca de Genes , Humanos , Inmunohistoquímica/métodos , Melanoma/sangre , Melanoma/genética , Melanoma/patología , Metástasis de la Neoplasia/diagnóstico , Metástasis de la Neoplasia/patología , Células Neoplásicas Circulantes/patología , Reacción en Cadena en Tiempo Real de la Polimerasa , Neoplasias Cutáneas/sangre , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/patología , Ultrasonografía/métodos
8.
Medicine (Baltimore) ; 100(8): e24955, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33663135

RESUMEN

ABSTRACT: To investigate the feasibility of arterial spin labeling (ASL) blood flow (BF) and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH).Sixty-three stage T1 NPC patients and benign NPLH patients underwent ASL on a 3.0-T magnetic resonance imaging system. BF histogram parameters were derived automatically, including the mean, median, maximum, minimum, kurtosis, skewness, and variance. Absolute values were obtained for skewness and kurtosis (absolute value of skewness [AVS] and absolute value of kurtosis [AVK], respectively). The Mann-Whitney U test, receiver operating characteristic curve, and multiple logistic regression models were used for statistical analysis.The mean, maximum, and variance of ASL BF values were significantly higher in early-stage NPC than in NPLH (all P < 0.0001), while the median and AVK values of early-stage NPC were also significantly higher than those of NPLH (all P < 0.001). No significant difference was found between the minimum and AVS values in early-stage NPC compared with NPLH (P = 0.125 and P = 0.084, respectively). The area under the curve (AUC) of the maximum was significantly higher than those of the mean and median (P < 0.05). The AUC of variance was significantly higher than those of the other parameters (all P < 0.05). Multivariate analysis showed that variance was the only independent predictor of outcome (P < 0.05).ASL BF and its histogram analysis could distinguish early-stage NPC from NPLH, and the variance value was a unique independent predictor.


Asunto(s)
Circulación Cerebrovascular , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Carcinoma Nasofaríngeo/diagnóstico por imagen , Estudios de Casos y Controles , Detección Precoz del Cáncer/métodos , Estudios de Factibilidad , Femenino , Humanos , Hiperplasia/diagnóstico por imagen , Enfermedades Linfáticas/diagnóstico por imagen , Masculino , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad
10.
Radiat Res ; 195(4): 397-400, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33577680

RESUMEN

In most studies on radiation workers, the incidence of thyroid cancer was determined to be higher than among the general population; this is generally assumed to be due to overdiagnosis through thyroid screening. However, there is a lack of evidence on the association between thyroid screening and increased thyroid cancer incidence in most occupational studies. In this study, we compared thyroid cancer screening rates between the general population and radiation workers with various occupations and examined the relationship between these rates and thyroid cancer incidence. We compared thyroid screening rates between radiation workers and the general population with age- and sex-standardized screening ratios (SSRs) using data from two national surveys conducted during 2015-2017 in Korea, and assessed the correlation between these ratios and age- and sex-standardized incidence ratios (SIRs) for thyroid cancer. Screening rates were higher among radiation workers than among the general population, with an overall SSR of 1.58 (95% confidence interval: 1.54-1.62). When various types of occupations were compared, those with an increased SSR also had an increased SIR. SSRs remained high even when the screening period was restricted to the year preceding the survey (the year after the establishment of guidelines for thyroid cancer screening aimed at reducing overdiagnosis). In conclusion, the increased incidence of thyroid cancer among radiation workers compared to that among the general population can be attributed mainly to increased thyroid screening rates. Additional efforts are needed to reduce unnecessary thyroid cancer screening in occupational populations, particularly in those with better access to healthcare, in terms of clinical rationale and for assessing the true increase in thyroid cancer incidence.


Asunto(s)
Neoplasias Inducidas por Radiación/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Neoplasias de la Tiroides/epidemiología , Adulto , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Inducidas por Radiación/etiología , Neoplasias Inducidas por Radiación/patología , Enfermedades Profesionales/patología , Dosis de Radiación , Medición de Riesgo , Factores de Riesgo , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/patología
11.
JAMA Netw Open ; 4(2): e2037546, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33606032

RESUMEN

Importance: Digital breast tomosynthesis (DBT) has reduced recall and increased cancer detection compared with digital mammography (DM), depending on women's age and breast density. Whether DBT screening access and use are equitable across groups of women based on race/ethnicity and socioeconomic characteristics is uncertain. Objective: To determine women's access to and use of DBT screening based on race/ethnicity, educational attainment, and income. Design, Setting, and Participants: This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, at which a total of 2 313 118 screening examinations were performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 13, 2019, to August 18, 2020. Exposures: Women's race/ethnicity, educational level, and community-level household income. Main Outcomes and Measures: Access to DBT (on-site access) at time of screening by examination year and actual use of DBT vs DM screening by years since facility-level DBT adoption (≤5 years). Results: Among the 2 313 118 screening examinations included in the analysis, the proportion of women who had DBT access at the time of their screening appointment increased from 11 558 of 354 107 (3.3%) in 2011 to 194 842 of 235 972 (82.6%) in 2017. In 2012, compared with White women, Black (relative risk [RR], 0.05; 95% CI, 0.03-0.11), Asian American (RR, 0.28; 95% CI, 0.11-0.75), and Hispanic (RR, 0.38; 95% CI, 0.18-0.80) women had significantly less DBT access, and women with less than a high school education had lower DBT access compared with college graduates (RR, 0.18; 95% CI, 0.10-0.32). Among women attending facilities with both DM and DBT available at the time of screening, Black women experienced lower DBT use compared with White women attending the same facility (RRs, 0.83 [95% CI, 0.82-0.85] to 0.98 [95% CI, 0.97-0.99]); women with lower educational level experienced lower DBT use (RRs, 0.79 [95% CI, 0.74-0.84] to 0.88 [95% CI, 0.85-0.91] for non-high school graduates and 0.90 [95% CI, 0.89-0.92] to 0.96 [95% CI, 0.93-0.99] for high school graduates vs college graduates); and women within the lowest income quartile experienced lower DBT use vs women in the highest income quartile (RRs, 0.89 [95% CI, 0.87-0.91] to 0.99 [95% CI, 0.98-1.00]) regardless of the number of years after facility-level DBT adoption. Conclusions and Relevance: In this cross-sectional study, women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use when available over time. Future efforts should address racial/ethnic, educational, and financial barriers to DBT screening.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Escolaridad , Grupos Étnicos/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/etnología , Renta/estadística & datos numéricos , Mamografía/estadística & datos numéricos , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Americanos Asiáticos/estadística & datos numéricos , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Disparidades en Atención de Salud/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Humanos , Mamografía/métodos , Persona de Mediana Edad , Clase Social , Estados Unidos
12.
Value Health ; 24(2): 206-215, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33518027

RESUMEN

OBJECTIVES: Metamodeling can address computational challenges within decision-analytic modeling studies evaluating many strategies. This article illustrates the value of metamodeling for evaluating colorectal cancer screening strategies while accounting for colonoscopy capacity constraints. METHODS: In a traditional approach, the best screening strategy was identified from a limited subset of strategies evaluated with the validated Adenoma and Serrated pathway to Colorectal CAncer model. In a metamodeling approach, metamodels were fitted to this limited subset to evaluate all potentially plausible strategies and determine the best overall screening strategy. Approaches were compared based on the best screening strategy in life-years gained compared with no screening. Metamodel runtime and accuracy was assessed. RESULTS: The metamodeling approach evaluated >40 000 strategies in <1 minute with high accuracy after 1 adaptive sampling step (mean absolute error: 0.0002 life-years) using 300 samples in total (generation time: 8 days). Findings indicated that health outcomes could be improved without requiring additional colonoscopy capacity. Obtaining similar insights using the traditional approach could require at least 1000 samples (generation time: 28 days). Suggested benefits from screening at ages <40 years require adequate validation of the underlying Adenoma and Serrated pathway to Colorectal CAncer model before making policy recommendations. CONCLUSIONS: Metamodeling allows rapid assessment of a vast set of strategies, which may lead to identification of more favorable strategies compared to a traditional approach. Nevertheless, metamodel validation and identifying extrapolation beyond the support of the original decision-analytic model are critical to the interpretation of results. The screening strategies identified with metamodeling support ongoing discussions on decreasing the starting age of colorectal cancer screening.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/métodos , Modelos Estadísticos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/economía , Análisis Costo-Beneficio , Detección Precoz del Cáncer/economía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Sangre Oculta , Años de Vida Ajustados por Calidad de Vida
14.
BMC Cancer ; 21(1): 205, 2021 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-33639868

RESUMEN

BACKGROUND: Oral cancer (OC) is usually diagnosed at advanced clinical stages due to its asymptomatic nature and absence of pathognomonic signs in its early development phase. Delayed diagnosis is one of the major causes of OC treatment failure and poor prognosis. Development of alternative diagnostic approaches are imperative for improving early detection and therapeutic success rates. Salivary cytokines (SC) have been studied as potential diagnostic biomarkers for OC and may represent a potential tool for improvement of its early detection. METHODS: In this systematic review and meta-analysis we identified SC studied as OC biomarkers by systematically reviewing the PubMed and Cochrane Library databases using the terms: "oral cancer", "cytokine", and "saliva", and also combined with "interleukin" or "interferon". Only case-control studies that measured SC by ELISA from treatment naïve patients were included in the qualitative review. For the meta-analysis were included all comparable studies that provided enough data (sample size, mean and standard deviation or standard error of the mean) for SC levels in OC patients, non-cancer controls and patients with oral potentially malignant disorders (OPMD), including leukoplakia. Comparisons with patients with oral lichen planus (OLP) and gingivitis were included in the qualitative analysis. RESULTS: A total of 28 articles (from 2004 to 2018) were included in the systematic review, describing 10 different SC, being IL-8 and IL-6 the most studied ones. SC levels were consistently higher among OC patients when compared to healthy controls and to patients with OPMD, OLP and gingivitis. Meta-analysis including 23 eligible studies showed that IL-8, IL-6, TNF-α, IL-1ß and IL-10 salivary levels were significantly higher in OC patients compared to controls; and that IL-8, IL-6, TNF-α and IL-1ß salivary levels were also higher in OC patients compared to individuals with OPMD. When compared to healthy controls, OPMD patients showed significantly higher IL-6 and TNF-α salivary levels. CONCLUSIONS: Our analyses showed that the salivary levels of some cytokines are consistently different among OC, OPMD and healthy patients, indicating that these SC may represent potential diagnostic biomarkers for OC and OPMD. Despite of that, SC levels were highly variable among studies, suggesting that further technical improvement and standardization for SC measurement by ELISA is needed in order to successfully translate these biomarkers to the clinical practice.


Asunto(s)
Biomarcadores de Tumor/análisis , Citocinas/análisis , Detección Precoz del Cáncer/métodos , Neoplasias de la Boca/química , Saliva/química , Diagnóstico Diferencial , Ensayo de Inmunoadsorción Enzimática , Gingivitis/diagnóstico , Humanos , Leucoplasia Bucal/diagnóstico , Liquen Plano Oral/diagnóstico , Neoplasias de la Boca/diagnóstico , Lesiones Precancerosas/diagnóstico
15.
South Med J ; 114(2): 77-80, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33537787

RESUMEN

OBJECTIVES: The amount of colorectal cancer (CRC) screening using the noninvasive fecal immunochemical test (FIT) at a federally qualified health center, Five Rivers Health Clinic (Dayton, Ohio), has been low historically. Our quality improvement (QI) project aimed to improve CRC screening adherence in eligible patients who opted for FIT. METHODS: Three hundred ninety-two patients with FIT orders for CRC were screened during an 11-month period. The preintervention group (pre-I) was enrolled from December 1, 2018 to May 31, 2019, and the postintervention group (post-I) from June 1, 2019 to October 31, 2019. Three interventions were used: resident physicians trained during clinic meetings regarding FIT education for patients, posters displayed in patient rooms outlining the benefits of CRC screening, and standardized US mail reminder letters sent to FIT patients. Patient demographics and clinical variables were collected along with return rate. RESULTS: The return rate for post-I was twice that of pre-I (74.4%, 95% confidence interval 64.6-82.3 vs 31.1, 95% confidence interval 26.2-36.6; P < 0.001). The pre-I/post-I groups did not differ on demographic and clinical characteristics, and, except for race, none of these variables was associated with returning the FIT screening card. CONCLUSIONS: The compliance rate for FIT completion and return more than doubled among our clinic patients after using a three-component QI intervention. Except for a difference in race, the lack of association between demographic and clinical characteristics with either pre-I/post-I group or return/no return of the FIT card leads us to conclude that our QI program for increasing FIT compliance is effective. Other settings where CRC screening is a prominent component of preventive care may benefit from adopting a similar QI intervention.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/estadística & datos numéricos , Sangre Oculta , Pacientes Ambulatorios/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Mejoramiento de la Calidad/estadística & datos numéricos , Instituciones de Atención Ambulatoria , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/normas , Femenino , Promoción de la Salud/métodos , Promoción de la Salud/normas , Humanos , Masculino , Persona de Mediana Edad , Ohio
16.
Acta Obstet Gynecol Scand ; 100(4): 794-801, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33560520

RESUMEN

INTRODUCTION: Cervical cancer screening coverage rate is <5% in Sub-Saharan Africa and <2% in French- speaking African countries. In 2016, we implemented strategies to improve cervical cancer screening in Bamako, the "Weekend70 program". The present study objectives are to determine the effect of this program on women's participation in cervical cancer screening in Bamako, and to estimate the cervical cancer screening coverage rate in Bamako. MATERIAL AND METHODS: From 1 January 2016 to 31 July 2020, we conducted an operational research by developing several strategies to improve the cervical cancer screening coverage rate among adolescents and women ≥15 years old in Bamako, Mali. The strategies consisted of awareness-raising activities, strengthening of screening practices in healthcare facilities and cost-free cervical cancer screening during the weekend. Descriptive statistics were presented. The cervical cancer coverage rate was calculated by dividing the number of women screened by the total number of women ≥20 years old, based on Mali demographic data. RESULTS: The total number of women screened was 289 924. Residents from Bamako represented 91.9% (266 436/289 924) vs 8.1% (23 488/289 924) who lived outside Bamako. The mean age was 33.2 (± 11.5) years old. Around 46.1% of participants attending the cervical cancer screening were between 30 and 49 years old (World Health Organization prioritized target age for cervical cancer screening). Women ≥60 years old represented <5%. Cervical cancer screening participation increased significantly, from <800 women screened per week before the implementation of the program to a peak of 4100 women screened per week during the "Weekend70 program". Overall, the cervical cancer screening coverage rates at the end of the study among women ≥20 years old was 47.3%, and 56.9% in the WHO target population. CONCLUSION: In an impoverished context, a multi-component strategy significantly increases cervical cancer screening participation.


Asunto(s)
Detección Precoz del Cáncer/métodos , Promoción de la Salud , Tamizaje Masivo/métodos , Neoplasias del Cuello Uterino/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Malí , Persona de Mediana Edad
17.
Cancer Causes Control ; 32(4): 401-407, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33559768

RESUMEN

Globally, the highest cervical cancer mortality rates are found in East Africa. Visual inspection with acetic acid (VIA)-based screening in resource-poor settings has been shown to decrease the proportion of women presenting with late-stage cervical cancer, a process known as clinical downstaging. The only cancer treatment center in Tanzania, Ocean Road Cancer Institute (ORCI) in Dar es Salaam, opened a VIA-based cervical cancer screening program in 2002. We reviewed 6,676 medical records of cervical cancer patients at the ORCI from 2002-2011 to 2014-2018 for stage at diagnosis and screening status, among other variables. We investigated whether clinical downstaging occurred in this period among women screened at the ORCI, when compared to unscreened women. Our results indicated that the proportion of women presenting with late-stage cervical cancer among women screened at the ORCI decreased by 27.7% over the 16-year period (χ2 = 16.99; p = 0.0002). Among unscreened women, a non-significant 13.2% decrease in late-stage disease was observed (χ2 = 1.74; p = 0.4179). Our results suggest clinical downstaging occurred among women screened at the ORCI over the 16-year period, and this difference may be attributed to the screening program as the same decrease in stage was not observed among unscreened women during the same time period. At present, less than one percent of Tanzanian women receive yearly cervical cancer screenings. Access to screening through expansion of the ORCI screening clinic and the creation of more clinics should be prioritized.


Asunto(s)
Neoplasias del Cuello Uterino/diagnóstico , Ácido Acético , Adulto , Anciano , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Tamizaje Masivo/métodos , Persona de Mediana Edad , Estadificación de Neoplasias , Tanzanía , Neoplasias del Cuello Uterino/patología
18.
Int J Mol Sci ; 22(3)2021 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-33530491

RESUMEN

Oral cancer is one of the most common cancers worldwide. Despite easy access to the oral cavity and significant advances in treatment, the morbidity and mortality rates for oral cancer patients are still very high, mainly due to late-stage diagnosis when treatment is less successful. Oral cancer has also been found to be the most expensive cancer to treat in the United States. Early diagnosis of oral cancer can significantly improve patient survival rate and reduce medical costs. There is an urgent unmet need for an accurate and sensitive molecular-based diagnostic tool for early oral cancer detection. Fourier transform infrared spectroscopy has gained increasing attention in cancer research due to its ability to elucidate qualitative and quantitative information of biochemical content and molecular-level structural changes in complex biological systems. The diagnosis of a disease is based on biochemical changes underlying the disease pathology rather than morphological changes of the tissue. It is a versatile method that can work with tissues, cells, or body fluids. In this review article, we aim to summarize the studies of infrared spectroscopy in oral cancer research and detection. It provides early evidence to support the potential application of infrared spectroscopy as a diagnostic tool for oral potentially malignant and malignant lesions. The challenges and opportunities in clinical translation are also discussed.


Asunto(s)
Biomarcadores de Tumor , Neoplasias de la Boca/diagnóstico , Espectroscopía Infrarroja por Transformada de Fourier , Animales , Susceptibilidad a Enfermedades , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/normas , Histocitoquímica , Humanos , Neoplasias de la Boca/etiología , Neoplasias de la Boca/metabolismo , Clasificación del Tumor/métodos , Clasificación del Tumor/normas , Estadificación de Neoplasias/métodos , Estadificación de Neoplasias/normas , Transducción de Señal , Espectroscopía Infrarroja por Transformada de Fourier/métodos , Análisis Espectral/métodos , Análisis Espectral/normas , Microambiente Tumoral
20.
Medicine (Baltimore) ; 100(3): e23934, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545965

RESUMEN

BACKGROUND: Conventional white-light imaging endoscopy (C-WLI) had a significant number of misdiagnosis in early gastric cancer (EGC), and magnifying endoscopy (ME) combined with different optical imaging was more accurate in the diagnosis of EGC. This study aimed to evaluate the accuracy of ME and compare the accuracy of ME with different optical imaging in detecting EGC. METHODS: A comprehensive literature search was conducted to identify all relevant studies. Pair-wise meta-analysis was conducted to evaluate the accuracy of ME, and Bayesian network meta-analysis was performed to combine direct and indirect evidence and estimate the relative effects. RESULTS: Eight prospective studies were identified with a total of 5948 patients and 3 optical imaging in ME (ME with WLI (M-WLI), ME with narrow-band imaging (M-NBI), and ME with blue laser imaging (M-BLI)). Pair-wise meta-analysis showed a higher accuracy of ME than C-WLI (OR: 2.97, 95% CI: 1.68∼5.25). In network meta-analysis, both M-NBI and M-BLI were more accurate than M-WLI (OR: 2.56, 95% CI: 2.13∼3.13; OR: 3.13, 95% CI: 1.85∼5.71). There was no significant difference between M-NBI and M-BLI. CONCLUSION: ME was effective in improving the detecting rate of EGC, especially with NBI or BLI.


Asunto(s)
Endoscopía/métodos , Neoplasias Gástricas/diagnóstico , Detección Precoz del Cáncer/métodos , Endoscopía/normas , Endoscopía/estadística & datos numéricos , Humanos , Metaanálisis en Red , Oportunidad Relativa , Estudios Prospectivos , Neoplasias Gástricas/fisiopatología
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