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1.
BMJ ; 367: l5383, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31578177

RESUMO

OBJECTIVE: To estimate benefits and harms of different colorectal cancer screening strategies, stratified by (baseline) 15-year colorectal cancer risk. DESIGN: Microsimulation modelling study using MIcrosimulation SCreening ANalysis-Colon (MISCAN-Colon). SETTING: A parallel guideline committee (BMJ Rapid Recommendations) defined the time frame and screening interventions, including selection of outcome measures. POPULATION: Norwegian men and women aged 50-79 years with varying 15-year colorectal cancer risk (1-7%). COMPARISONS: Four screening strategies were compared with no screening: biennial or annual faecal immunochemical test (FIT) or single sigmoidoscopy or colonoscopy at 100% adherence. MAIN OUTCOME MEASURES: Colorectal cancer mortality and incidence, burdens, and harms over 15 years of follow-up. The certainty of the evidence was assessed using the GRADE approach. RESULTS: Over 15 years of follow-up, screening individuals aged 50-79 at 3% risk of colorectal cancer with annual FIT or single colonoscopy reduced colorectal cancer mortality by 6 per 1000 individuals. Single sigmoidoscopy and biennial FIT reduced it by 5 per 1000 individuals. Colonoscopy, sigmoidoscopy, and annual FIT reduced colorectal cancer incidence by 10, 8, and 4 per 1000 individuals, respectively. The estimated incidence reduction for biennial FIT was 1 per 1000 individuals. Serious harms were estimated to be between 3 per 1000 (biennial FIT) and 5 per 1000 individuals (colonoscopy); harms increased with older age. The absolute benefits of screening increased with increasing colorectal cancer risk, while harms were less affected by baseline risk. Results were sensitive to the setting defined by the guideline panel. Because of uncertainty associated with modelling assumptions, we applied a GRADE rating of low certainty evidence to all estimates. CONCLUSIONS: Over a 15 year period, all screening strategies may reduce colorectal cancer mortality to a similar extent. Colonoscopy and sigmoidoscopy may also reduce colorectal cancer incidence, while FIT shows a smaller incidence reduction. Harms are rare and of similar magnitude for all screening strategies.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/normas , Programas de Rastreamento/normas , Modelos Estatísticos , Idoso , Colonoscopia/efeitos adversos , Colonoscopia/normas , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Incidência , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Noruega/epidemiologia , Sangue Oculto , Avaliação de Processos e Resultados (Cuidados de Saúde)/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Sigmoidoscopia/efeitos adversos , Sigmoidoscopia/normas , Sigmoidoscopia/estatística & dados numéricos , Análise de Sobrevida
2.
BMJ ; 367: l5515, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31578196

RESUMO

CLINICAL QUESTION: Recent 15-year updates of sigmoidoscopy screening trials provide new evidence on the effectiveness of colorectal cancer screening. Prompted by the new evidence, we asked: "Does colorectal cancer screening make an important difference to health outcomes in individuals initiating screening at age 50 to 79? And which screening option is best?" CURRENT PRACTICE: Numerous guidelines recommend screening, but vary on recommended test, age and screening frequency. This guideline looks at the evidence and makes recommendations on screening for four screening options: faecal immunochemical test (FIT) every year, FIT every two years, a single sigmoidoscopy, or a single colonoscopy. RECOMMENDATIONS: These recommendations apply to adults aged 50-79 years with no prior screening, no symptoms of colorectal cancer, and a life expectancy of at least 15 years. For individuals with an estimated 15-year colorectal cancer risk below 3%, we suggest no screening (weak recommendation). For individuals with an estimated 15-year risk above 3%, we suggest screening with one of the four screening options: FIT every year, FIT every two years, a single sigmoidoscopy, or a single colonoscopy (weak recommendation). With our guidance we publish the linked research, a graphic of the absolute harms and benefits, a clear description of how we reached our value judgments, and linked decision aids. HOW THIS GUIDELINE WAS CREATED: A guideline panel including patients, clinicians, content experts and methodologists produced these recommendations using GRADE and in adherence with standards for trustworthy guidelines. A linked systematic review of colorectal cancer screening trials and microsimulation modelling were performed to inform the panel of 15-year screening benefits and harms. The panel also reviewed each screening option's practical issues and burdens. Based on their own experience, the panel estimated the magnitude of benefit typical members of the population would value to opt for screening and used the benefit thresholds to inform their recommendations. THE EVIDENCE: Overall there was substantial uncertainty (low certainty evidence) regarding the 15-year benefits, burdens and harms of screening. Best estimates suggested that all four screening options resulted in similar colorectal cancer mortality reductions. FIT every two years may have little or no effect on cancer incidence over 15 years, while FIT every year, sigmoidoscopy, and colonoscopy may reduce cancer incidence, although for FIT the incidence reduction is small compared with sigmoidoscopy and colonoscopy. Screening related serious gastrointestinal and cardiovascular adverse events are rare. The magnitude of the benefits is dependent on the individual risk, while harms and burdens are less strongly associated with cancer risk. UNDERSTANDING THE RECOMMENDATION: Based on benefits, harms, and burdens of screening, the panel inferred that most informed individuals with a 15-year risk of colorectal cancer of 3% or higher are likely to choose screening, and most individuals with a risk of below 3% are likely to decline screening. Given varying values and preferences, optimal care will require shared decision making.


Assuntos
Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/normas , Programas de Rastreamento/normas , Sangue Oculto , Sigmoidoscopia/estatística & dados numéricos , Idoso , Colonoscopia/normas , Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Avaliação de Processos e Resultados (Cuidados de Saúde)/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Sigmoidoscopia/normas , Fatores de Tempo
3.
Pan Afr Med J ; 33: 144, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565116

RESUMO

Introduction: Breast cancer is one of the most common cancers and cause of death among women globally. Mortality due to breast cancer was higher in lower (LMICs) and middle-income countries than high income countries (HICs) mostly due to lack of timely detection and treatment. There was limited evidence related to breast cancer screening practice among women in Eastern Ethiopia. Therefore, the aim of this study was to assess breast cancer screening practice and its associated factors among women in this area. Methods: A community based descriptive cross-sectional study design was conducted among 422 randomly selected women in Kersa district, Eastern Ethiopia using systematic sampling. Data were collected using pretested interviewer administered questionnaire. Logistic regression was used to analyse the association between the dependent and independent variables. Results: The overall breast cancer screening practice among women was 6.9%. Women with the age of 26 years and above were 2.3 times more likely to have breast cancer screening practice as compared to women with age of 20-25 years (AOR=2.3; 95% CI: 1.4, 3.7), and women who had good knowledge on breast cancer risk factors were 3.4 times more likely to had breast cancer screening as compared to their counterpart (AOR=3.4; 95% CI: 1.3, 9.4). The women who had ever heard about breast cancer screening were 2.8 times more likely to have breast cancer screening as compared to those who had never heard about breast cancer screening (AOR=2.8; 95% CI: 1.2, 6.5). Conclusion: The overall breast cancer screening practice was very low among women in the study area. Age and women's knowledge towards breast cancer risk factors and breast cancer screening information were identified as important factors for breast cancer screening practice.


Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/métodos , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/métodos , Adulto , Fatores Etários , Idoso , Estudos Transversais , Etiópia , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
4.
Z Gastroenterol ; 57(9): 1051-1058, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31525797

RESUMO

BACKGROUND AND AIM: Colorectal cancer (CRC) screening can effectively reduce cancer-associated mortality. In Germany, individuals over the age of 50 or 55 have access to CRC screening services. However, utilization rates are persistently low, particular in the male population. This observational study investigates the effect of standard versus gender-specific invitation letters on utilization of CRC screening services. METHODS: We analyzed utilization rates of individuals who were insured by a large health insurance fund in Bavaria, Germany. Persons who became eligible for CRC screening received a standard (2013-2014) or a gender-specific invitation letter (2015-2016). We compared utilization rates within 6 months after receipt of the invitation letter using billing codes of the health insurance fund. RESULTS: Invitation letters were sent to 49 535 individuals, of which 48.8 % were gender-specific. The overall utilization rate did not differ between recipients of the standard versus gender-specific invitation letter (11.6 % vs 11.1 %; RR: 0.97 [0.92-1.02], p = 0.19). However, uptake of screening colonoscopy was significantly higher among recipients of gender-specific invitations (2.9 % vs 3.5 %; RR: 1.21 [1.04-1.39], p = 0.01), whereas utilization of fecal occult blood tests declined (10.4 % vs 9.7 %; RR: 0.93 [0.88-0.99], p = 0.016). CONCLUSIONS: Gender-specific design of invitation letters can modify the patients' preference for specific CRC screening services and increase the acceptance of screening colonoscopy.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Participação do Paciente/estatística & dados numéricos , Colonoscopia , Neoplasias Colorretais/prevenção & controle , Feminino , Alemanha , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Sangue Oculto
6.
Medicine (Baltimore) ; 98(35): e16970, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464941

RESUMO

This study aimed to determine the feasibility of vaginal/cervical nurse-assisted self-sampling (NASS) and the agreement between human papilloma virus (HPV) tests on self-samples versus clinician-taken (CT) specimens.Women participated voluntarily for cervical cancer screening at St. Aklesia Memorial Hospital. Eighty-three women provided a total of 166 coupled self-taken and CT specimens collected. Specimens were stored at room temperature for a maximum of 10 months and analyzed using validated the RIATOL qPCR HPV genotyping test, a quantitative polymerase chain reaction (qPCR) high-throughput HPV E6, E7 assay. The average age of the participating women was 32 years. Seventy-three women (87.9%) felt that NASS was easy to use. An overall HPV, high-risk (HR) HPV, and low-risk HPV prevalence was 22.7% (15/66), 18.2% (12/66), and 6.1% (4/66), respectively. The overall HR HPV prevalence was 17.2% (NASS) and 15.5% (CT). The most prevalent HPV type was HPV51; HPV 16 was only detected in 1 woman (CT+NASS) and HPV18 only in 1 woman (CT). The overall measurement agreement between self-taken and CT samples was moderate with a kappa value of 0.576 (P < .001). Lifetime partnered with >2 men were associated with HR HPV positivity (P < .001). There was a strong statistical association between HR HPV positivity and visual inspection with acetic acid- positive (P < .001). The NASS for HPV testing could be seen as an alternative option and might be acceptable to Ethiopian women. The overall HR HPV prevalence was comparable with Sub-Saharan countries in the general population.


Assuntos
Detecção Precoce de Câncer/métodos , Infecções por Papillomavirus/diagnóstico , Manejo de Espécimes/métodos , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/métodos , Adulto , Idoso , Etiópia/epidemiologia , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/genética , Reação em Cadeia da Polimerase em Tempo Real , Sensibilidade e Especificidade , Adulto Jovem
7.
Arch Virol ; 164(11): 2699-2706, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31435867

RESUMO

Recently, a clinical need for an improved human papilloma virus (HPV) test that covers a broad range of genotypes has emerged as a valuable primary screening tool for cervical lesions. The liquid bead microarray (LBMA) assay is a recently developed high-throughput platform covering a broad range of genotypes. Here, we compared the clinical performance of two recently developed LBMA assays, GeneFinderTM HPV Liquid Bead Microarray (GeneFinder) and CareGENETM HPV genotyping kit-O (CareGENE), in the Korean general population. A total of 3,148 cervical swabs were tested by the GeneFinder and CareGENE assays. Cases with discrepant results between the two assays were subjected to direct sequencing as a reference method for evaluating the performance of the two LBMA assays. Among all swabs tested, 12.6% showed HPV positivity, and the prevalent HPV genotypes were HPV53, 70, 16, 39, and 51, in that order. The concordance rates between the two assays for the detection of HPV and for genotyping were 96.6% (kappa = 0.836) and 94.5% (kappa = 0.779), respectively. The two LBMA assays showed comparable sensitivity and specificity for HPV detection (GeneFinder: sensitivity 94.4% and specificity 98.7%, CareGENE: sensitivity 89.8% and specificity 99.6%) and for genotyping (GeneFinder: sensitivity 91.0% and specificity 96.6%, CareGENE: sensitivity 90.2% and specificity 99.1%). This is the first demonstration that CareGENE has comparable clinical performance to GeneFinder, which has been established to show excellent performance for screening HPV in previous studies. Both LBMA platforms are thus considered to be valuable tools for HPV detection and genotyping to improve cervical screening in the general population.


Assuntos
Alphapapillomavirus/genética , Detecção Precoce de Câncer/métodos , Ensaios de Triagem em Larga Escala/métodos , Análise em Microsséries/métodos , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alphapapillomavirus/classificação , Alphapapillomavirus/isolamento & purificação , Feminino , Técnicas de Genotipagem , Humanos , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Neoplasias do Colo do Útero/virologia , Adulto Jovem
8.
Presse Med ; 48(7-8 Pt 1): 825-831, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31447337

RESUMO

Diagnosis criteria have been revised in 2014 and allow the treatment of some asymptomatic patients. Since 2015, a new prognostic score includes tumor plasma cells chromosomal abnormalities. It helps in the distinction between "standard risk" and "high risk" myelomas. Scanner, MRI and Pet Scan are the radiological reference exams to evaluate bone involvement. Alkylating agents, immunomodulators, proteasome inhibitors, and monoclonal antibodies became the most important antitumoral treatments. Risk notion will become more and more important for therapeutic choices. These choices will depend on residual disease evaluation. The next decade will be the immunotherapies development decade.


Assuntos
Detecção Precoce de Câncer/tendências , Oncologia/tendências , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/terapia , Terapias em Estudo/tendências , Anticorpos Monoclonais/uso terapêutico , Terapia Combinada/tendências , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/normas , Humanos , Fatores Imunológicos/uso terapêutico , Imunoterapia/métodos , Imunoterapia/tendências , Oncologia/métodos , Oncologia/normas , Mieloma Múltiplo/patologia , Guias de Prática Clínica como Assunto , Prognóstico , Terapias em Estudo/métodos
9.
J Surg Oncol ; 120(5): 858-863, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31368175

RESUMO

Currently, colorectal cancers accounted for the second-highest number of cancer deaths in the US. Hereditary syndromes, strong family history, and inflammatory bowel disease are all conditions that confer predisposition risks. In hereditary syndromes, screening must be more frequent and start earlier. With familial risk, screening should depend on the age of cancer onset and number of affected relatives. For inflammatory bowel disease, surveillance should depend on duration, severity, and extent of colitis.


Assuntos
Neoplasias do Colo/diagnóstico , Detecção Precoce de Câncer/métodos , Predisposição Genética para Doença , Neoplasias Retais/diagnóstico , Neoplasias do Colo/epidemiologia , Neoplasias do Colo/genética , Humanos , Prevalência , Neoplasias Retais/epidemiologia , Neoplasias Retais/genética , Fatores de Risco
10.
J Surg Oncol ; 120(5): 831-846, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31373005

RESUMO

Cancers of the esophagus and stomach remain important causes of mortality worldwide, in large part because they are most often diagnosed at advanced stages. Thus, it is imperative that we identify and treat these cancers in earlier stages. Due to significant heterogeneity in incidence and risk factors for these cancers, it has been challenging to develop standardized screening recommendations. This review summarizes the current recommendations for screening populations at high risk of developing esophagogastric cancers.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias Esofágicas/diagnóstico , Predisposição Genética para Doença , Neoplasias Gástricas/diagnóstico , Neoplasias Esofágicas/epidemiologia , Neoplasias Esofágicas/genética , Humanos , Prevalência , Fatores de Risco , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/genética
11.
J Surg Oncol ; 120(5): 882-890, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31432526

RESUMO

Soft tissue sarcomas (STS) are a rare and diverse group of tumors that affect both adult and pediatric populations. This review discusses current screening recommendations for populations at increased risk for STS, including those with genetic predispositions. We also review surveillance guidelines for those at risk for recurrence following curative-intent surgery.


Assuntos
Detecção Precoce de Câncer/métodos , Predisposição Genética para Doença , Recidiva Local de Neoplasia/diagnóstico , Vigilância da População , Cuidados Pós-Operatórios , Sarcoma/cirurgia , Humanos , Recidiva Local de Neoplasia/epidemiologia , Prevalência , Fatores de Risco , Sarcoma/epidemiologia , Sarcoma/genética
12.
Medicine (Baltimore) ; 98(31): e16690, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374056

RESUMO

This study investigated the clinicopathologic factors associated with 2-[F]fluoro-2-deoxy-D-glucose (F-FDG) uptake of early gastric cancer (EGC) and used them to design a clinical scoring method to predict FDG-avidity of EGC.Two hundred twenty-nine retrospectively enrolled patients underwent preoperative F-FDG positron emission tomography/computed tomography (PET/CT). Histologic information was obtained by gastrectomy (n = 195) or endoscopic mucosal dissection (n = 34). The association between clinicopathologic factors and F-FDG uptake by the primary tumor was determined. The results were used to develop a clinical scoring method.F-FDG uptake was detected in 49 (17.5%) patients. According to univariate analysis, location, gross type, World Health Organization classification, Lauren classification, size, depth of invasion, and lymphatic invasion were significant variables affecting F-FDG uptake (all P < .05). According to multivariate analysis, location (lower 3rd, P = .035), gross type (0-I, 0-IIa, P < .001), size (≥2.5 cm, P = .026), and depth of invasion (submucosa, P = .007) were significantly associated with FDG-avidity. A clinical scoring system, ranged from 0 to 4, was developed by giving one score to 4 independent variables. A cut-off value of 2.5 showed good prediction of FDG-avidity in EGCs, with a sensitivity and specificity of 65.0% and 85.2%, respectively.F-FDG uptake by EGC depends on location, gross type, size, and depth of invasion of the primary tumor. A clinical scoring system based on clinicopathologic variables can predict the FDG-avidity of primary tumors in patients with EGC.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Fluordesoxiglucose F18/farmacocinética , Compostos Radiofarmacêuticos/farmacocinética , Neoplasias Gástricas/diagnóstico por imagem , Adenocarcinoma/patologia , Adulto , Idoso , Detecção Precoce de Câncer/métodos , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos/administração & dosagem , Estudos Retrospectivos , Neoplasias Gástricas/patologia
13.
Gene ; 714: 143993, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31330238

RESUMO

BACKGROUND: Recently, disagreements remain in increasing evidence about the potential value of circulating cell-free DNA (cfDNA) as a noninvasive diagnostic biomarker for ovarian cancer (OC). Here, this update meta-analysis was performed to further assess the diagnostic performance of circulating cfDNA in discriminating OC from non-cancerous individuals. METHODS: We performed a systemic literature search of PubMed, Embase, Web of Science, Cochrane Library, OVID, Chinese National Knowledge Infrastructure (CNKI) and Wanfang databases to obtain 22 eligible articles including a total of 1125 patients and 1244 controls. The pooled sensitivity, specificity, diagnostic odds ratio (DOR) and area under receiver operating characteristics curves (AUROC) of the included studies for cfDNA in diagnosing OC patients were used to estimate the diagnostic value. The clinical utility of cfDNA was evaluated by Fagan nomogram. Heterogeneity was explored utilizing subgroup analysis and meta-regression. RESULTS: The pooled sensitivity and specificity were 73% and 90%, the DOR and AUROC were 25.29 and 0.90, respectively. Subgroup analyses and meta-regression, according to patients' region, study design, clinical stage, specimen types, detection indicators, simple size, publication year revealed there were no significant sources of heterogeneity. Additionally, subgroup analyses showed qualitative detection (methylation detection); TNM stage I-IV, publication year 2011-2018, serum-based cfDNA assays exhibited better diagnostic performance as compared to quantitative detection, TNM stage III-IV, publication year 2002-2010; plasma-based cfDNA assays, and more participants and prospective studies manifested superior diagnostic accuracy. The result of sensitivity analysis indicated no study exclusively contributed to the heterogeneity and Deeks' funnel plot suggested no evidence of significant publication bias. CONCLUSIONS: Our meta-analysis found the qualitative detection (methylation); TNM stage I-IV, publication year 2011-2018 were related to more effective diagnostic accuracy for OC. However, serum-based cell-free DNA detection should be cautiously interpreted due to unclear factors. Hence, further large-scale longitudinal studies are required to validate the diagnostic potential of cell-free DNA. The present study provides to accrue knowledge of cell-free DNA levels for future researches.


Assuntos
Biomarcadores Tumorais/sangue , Ácidos Nucleicos Livres/sangue , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/patologia , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Razão de Chances , Sensibilidade e Especificidade
14.
Vet Clin North Am Small Anim Pract ; 49(5): 781-791, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31280902

RESUMO

Molecular diagnostics have revolutionized human oncology to allow early detection, targeted therapy, monitoring throughout treatment, and evidence of recurrence. By identifying genetic signatures associated with cancers, liquid biopsy techniques have been developed to diagnose and monitor cancer in noninvasive or minimally invasive ways. These techniques offer new opportunities for improving cancer screening, diagnosis, and monitoring the impact of therapy on the patients over time. Liquid biopsy also drives drug development programs. Similar diagnostics hold promise for comparable results in the veterinary field. Several noninvasive/minimally invasive techniques have been described in veterinary medicine that could be referred to as liquid biopsy.


Assuntos
Doenças do Cão/diagnóstico , Biópsia Líquida/veterinária , Neoplasias/veterinária , Animais , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/genética , Carcinoma de Células de Transição/veterinária , Doenças do Cão/tratamento farmacológico , Doenças do Cão/genética , Cães , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/veterinária , Feminino , Humanos , Leucemia/diagnóstico , Leucemia/veterinária , Biópsia Líquida/métodos , Linfoma/diagnóstico , Linfoma/tratamento farmacológico , Linfoma/veterinária , Masculino , Terapia de Alvo Molecular/veterinária , Mutação , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Neoplasias/genética , Neoplasias Uretrais/diagnóstico , Neoplasias Uretrais/genética , Neoplasias Uretrais/veterinária , Neoplasias da Bexiga Urinária/veterinária
15.
Gut ; 68(9): 1545-1575, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31278206

RESUMO

Gastric adenocarcinoma carries a poor prognosis, in part due to the late stage of diagnosis. Risk factors include Helicobacter pylori infection, family history of gastric cancer-in particular, hereditary diffuse gastric cancer and pernicious anaemia. The stages in the progression to cancer include chronic gastritis, gastric atrophy (GA), gastric intestinal metaplasia (GIM) and dysplasia. The key to early detection of cancer and improved survival is to non-invasively identify those at risk before endoscopy. However, although biomarkers may help in the detection of patients with chronic atrophic gastritis, there is insufficient evidence to support their use for population screening. High-quality endoscopy with full mucosal visualisation is an important part of improving early detection. Image-enhanced endoscopy combined with biopsy sampling for histopathology is the best approach to detect and accurately risk-stratify GA and GIM. Biopsies following the Sydney protocol from the antrum, incisura, lesser and greater curvature allow both diagnostic confirmation and risk stratification for progression to cancer. Ideally biopsies should be directed to areas of GA or GIM visualised by high-quality endoscopy. There is insufficient evidence to support screening in a low-risk population (undergoing routine diagnostic oesophagogastroduodenoscopy) such as the UK, but endoscopic surveillance every 3 years should be offered to patients with extensive GA or GIM. Endoscopic mucosal resection or endoscopic submucosal dissection of visible gastric dysplasia and early cancer has been shown to be efficacious with a high success rate and low rate of recurrence, providing that specific quality criteria are met.


Assuntos
Adenocarcinoma/diagnóstico , Detecção Precoce de Câncer/métodos , Lesões Pré-Cancerosas/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/microbiologia , Adenocarcinoma/cirurgia , Biomarcadores Tumorais/sangue , Gerenciamento Clínico , Progressão da Doença , Medicina Baseada em Evidências/métodos , Gastrite Atrófica/diagnóstico , Gastrite Atrófica/microbiologia , Gastrite Atrófica/cirurgia , Gastroscopia/métodos , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , Lesões Pré-Cancerosas/microbiologia , Lesões Pré-Cancerosas/cirurgia , Medição de Risco/métodos , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/cirurgia
16.
J Surg Oncol ; 120(5): 820-830, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286529

RESUMO

The approach to screening patients at high risk for breast cancer has thus far been challenging to standardize, given limited high-level evidence in this population. The approach has evolved given the development of more effective screening modalities, including digital breast mammography, magnetic resonance imaging, and other emerging technologies. This review will discuss identification of high-risk patients, approaches to genetic counseling and testing, and evidence behind screening modalities and algorithms in this special population.


Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/métodos , Predisposição Genética para Doença , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Feminino , Humanos , Prevalência , Fatores de Risco
17.
J Surg Oncol ; 120(5): 847-850, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31309559

RESUMO

Cancers of the hepatobiliary tract are highly fatal, prompting the need for early detection to provide treatment and decrease the mortality rate. Screening patients for hepatobiliary cancers can provide early detection, but it is not feasible or efficient to screen all patients. Therefore, it is important to consider the known risk factors for each hepatobiliary cancer which creates a smaller population that is amenable to screening.


Assuntos
Neoplasias do Sistema Biliar/diagnóstico , Carcinoma Hepatocelular/diagnóstico , Detecção Precoce de Câncer/métodos , Predisposição Genética para Doença , Neoplasias Hepáticas/diagnóstico , Neoplasias do Sistema Biliar/epidemiologia , Neoplasias do Sistema Biliar/genética , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/genética , Humanos , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/genética , Prevalência , Fatores de Risco
18.
J Surg Oncol ; 120(5): 851-857, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31309569

RESUMO

Pancreatic cancer remains leading cause of cancer-related death in the United States. Patients with familial pancreas cancer, hereditary pancreatitis, known genetic mutations, and syndromes are deemed high risk for the development of pancreas cancer. Guidelines exist to help facilitate early diagnosis and treatment and these will be reviewed. Pancreatic cancer remains a leading cause of cancer-related death in the United States. Patients with familial pancreatic cancer, hereditary pancreatitis, known genetic mutations, and syndromes are deemed high risk for the development of pancreas cancer. Guidelines have been made to help facilitate early diagnosis and treatment for these patients and these will be reviewed. The exact timing of initial screening depends not only on the individual risk factors but consists of endoscopic ultrasound and magnetic resonance cholangiopancreatography. The frequency of screening depends largely on the findings of initial imaging and the patient's clinical status. We suggest that providers make themselves knowledgeable of current screening recommendations and appropriately apply them. Further critical evaluation of ongoing research is necessary to amend these recommendations as more data and genetic testing becomes available.


Assuntos
Detecção Precoce de Câncer/métodos , Predisposição Genética para Doença , Neoplasias Pancreáticas/diagnóstico , Humanos , Neoplasias Pancreáticas/epidemiologia , Neoplasias Pancreáticas/genética , Prevalência , Fatores de Risco
19.
J Surg Oncol ; 120(5): 864-872, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31355450

RESUMO

In the era of advanced cancer genomics, our recognition of hereditary cancer mutations continues to increase. Two of these conditions, which carry an increased risk of female cancers including endometrial, ovarian, breast, are hereditary breast and ovarian cancer syndrome and Lynch syndrome. Risk-reducing surgery, such as mastectomy, salpingo-oophorectomy, and hysterectomy may decrease cancer risk for mutation carriers. Background, indications, techniques, and consequences of these surgical procedures are reviewed.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias do Endométrio/diagnóstico , Predisposição Genética para Doença , Síndromes Neoplásicas Hereditárias/diagnóstico , Neoplasias Ovarianas/diagnóstico , Procedimentos Cirúrgicos Operatórios/métodos , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Síndromes Neoplásicas Hereditárias/epidemiologia , Síndromes Neoplásicas Hereditárias/genética , Síndromes Neoplásicas Hereditárias/cirurgia , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/cirurgia , Prevalência , Fatores de Risco
20.
Medicine (Baltimore) ; 98(30): e16517, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348264

RESUMO

BACKGROUND: Prostate cancer (PCa) is common, with it being the 2nd most prevalent cancer in men worldwide and the 6th leading cause of death in men. Screening for any type of cancer aims to increase the chances of successful treatment through early detection of the disease. There were some systematic reviews (SRs) evaluated the diagnostic value of biomarkers for the diagnosis of PCa and no studies have been conducted to analyze the quality of these SRs. We are not clear which kind of marker is the best choice. Thus, this study aims to assess the methodologic quality of the SRs and reanalyze the published data based on SRs for the biomarkers to find the optimal biomarker for the early diagnosis of PCa. METHODS: We performed a systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library and to identify relevant SRs from inception to April 2019. Diagnostic accuracy studies included any type of single biomarker or combined biomarkers aimed at evaluating the diagnostic value is considered eligible for this overview. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) instrument will be used to evaluate the risk of bias of the included SRs. Standard pairwise meta-analysis and adjusted indirect comparison will be used to compare the diagnostic value of different biomarkers. RESULTS: The results of this study will be submitted to a peer-reviewed journal for publication. CONCLUSION: This study will reanalyze the published data based on SRs. We hope that the results will help find a biomarker with the superior diagnostic performance for the diagnosis of PCa. PROSPERO REGISTRATION NUMBER: CRD42019125880.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias da Próstata/diagnóstico , Biomarcadores Tumorais , Humanos , Masculino , Meta-Análise em Rede , Projetos de Pesquisa , Literatura de Revisão como Assunto , Sensibilidade e Especificidade
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