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Ayre SK, Johnston EA, Bourdaniotis XE, Zajdlewicz L, Beesley VL, Pole JD, Hansen A, Gasper H, Cossio D, Lock G, Goodwin BC. From many voices, one question: Community co-design of a population-based qualitative cancer research study. PLoS One 2024; 19:e0309361. [PMID: 39186739 PMCID: PMC11346942 DOI: 10.1371/journal.pone.0309361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 08/11/2024] [Indexed: 08/28/2024] Open
Abstract
PURPOSE This study formed the development stage of a population-based survey aiming to: (i) understand the needs and experiences of people affected by cancer in Queensland, Australia and (ii) recruit a pool of participants for ongoing cancer survivorship research. The current study aimed to co-design and test a single qualitative survey question and study invitation materials to maximise acceptability of, and participation in, the survey and future research. METHODS Fifty-two community members, including cancer survivors and caregivers, participated across 15 co-design workshops and 20 pretest interviews. During workshops, participants generated and refined ideas for an open-ended survey question and provided feedback on a study invitation letter. The use of a single, open-ended question aims to minimise participant burden while collecting rich information about needs and experiences. The research team then shortlisted the question ideas and revised study invitation materials based on workshop feedback. Next, using interviews, community members were asked to respond to a shortlisted question to test its interpretability and relevance and to review revised invitation materials. Content analysis of participant feedback was used to identify principles for designing study materials. RESULTS Principles for designing qualitative survey questions were identified from participant feedback, including define the question timeframe and scope; provide reassurance that responses are valid and valued; and use simple wording. Principles for designing study invitation materials were also identified, including communicate empathy and sensitivity; facilitate reciprocal benefit; and include a 'human element'. The qualitative survey question and study invitation materials created using these principles were considered relevant and acceptable for use in a population-based survey. CONCLUSIONS Through community consultation and co-design, this study identified principles for designing qualitative data collection and invitation materials for use in cancer survivorship research. These principles can be applied by other researchers to develop study materials that are sensitive to the needs and preferences of community members.
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Affiliation(s)
- Susannah K. Ayre
- Cancer Council Queensland, Brisbane, Queensland, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Elizabeth A. Johnston
- Cancer Council Queensland, Brisbane, Queensland, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | | | - Vanessa L. Beesley
- Psychedelic Medicine and Supportive Care Lab, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jason D. Pole
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Aaron Hansen
- Icon Cancer Centre, Brisbane, Queensland, Australia
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Harry Gasper
- Toowoomba Base Hospital, Toowoomba, Queensland, Australia
| | - Danica Cossio
- Cancer Alliance Queensland, Brisbane, Queensland, Australia
| | - Gemma Lock
- Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Belinda C. Goodwin
- Cancer Council Queensland, Brisbane, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Signal V, Smith M, Costello S, Davies A, Dawkins P, Jackson CGCA, Koea J, Whitehead J, Gurney J. Indigenous access to clinical services along the lung cancer treatment pathway: a review of current evidence. Cancer Causes Control 2024:10.1007/s10552-024-01904-1. [PMID: 39150625 DOI: 10.1007/s10552-024-01904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Lung cancer is a deadly cancer. Early diagnosis and access to timely treatment are essential to maximizing the likelihood of survival. Indigenous peoples experience enduring disparities in lung cancer survival, and disparities in access to and through lung cancer services is one of the important drivers of these disparities. In this manuscript, we aimed to examine the current evidence on disparities in Indigenous access to services along the lung cancer treatment pathway. METHODS A narrative literature review was conducted for all manuscripts and reports published up until July 20, 2022, using Medline, Scopus, Embase, and Web of Science. Following the identification of eligible literature, full-text versions were scanned for relevance for inclusion in this review, and relevant information was extracted. After scanning 1,459 documents for inclusion, our final review included 36 manuscripts and reports that included information on lung cancer service access for Indigenous peoples relative to non-Indigenous peoples. These documents included data from Aotearoa New Zealand, Australia, Canada, and the USA (including Hawai'i). RESULTS Our review found evidence of disparities in access to, and the journey through, lung cancer care for Indigenous peoples. Disparities were most obvious in access to early detection and surgery, with inconsistent evidence regarding other components of the pathway. CONCLUSION These observations are made amid relatively scant data in a global sense, highlighting the need for improved data collection and monitoring of cancer care and outcomes for Indigenous peoples worldwide. Access to early detection and guideline-concordant treatment are essential to addressing enduring disparities in cancer survival experienced by Indigenous peoples globally.
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Affiliation(s)
- Virginia Signal
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand
| | - Moira Smith
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand
| | | | - Anna Davies
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand
| | - Paul Dawkins
- Te Whatu Ora - Counties Manukau, Auckland, New Zealand
| | | | | | | | - Jason Gurney
- University of Otago Wellington, Newtown, PO Box 7343, Wellington, 6242, New Zealand.
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Fleming C, Harji D, Fernandez B, François MO, Assenat V, Gilles P, Clément M, Robert G, Denost Q. Feasibility of a tailored operative strategy from organ preservation to pelvic exenteration for cT4 rectal cancer depending on neoadjuvant response. Int J Colorectal Dis 2024; 39:123. [PMID: 39085478 PMCID: PMC11291515 DOI: 10.1007/s00384-024-04675-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE Improvements in neoadjuvant therapy for locally advanced cT4 rectal cancer have led to improved tumour response and thus a variety of suitable management strategies. The aim of this study was to report management and outcomes of patients with cT4 rectal cancer undergoing a spectrum of treatment strategies from organ preservation (OP) to pelvic exenteration (PE). METHODS Patients who underwent elective treatment for cT4 rectal cancer between 2016 and 2021 were included. All patients were treated with curative intent. Surgical management was adapted to tumour response. Kaplan-Meier curves were generated to compare 3-year overall survival (3y-OS), local recurrence (3y-LR) and distant metastases (3y-DM) between different strategies. RESULTS Among 152 patients included, 13 (8%) underwent OP, 71 (47%) TME and 68 (45%) APR/PE. The median follow-up was 31.3 months. Patients undergoing OP had a lower tumour pretreatment (p < 0.001). Compared to patients with TME, those with APR/PE had a higher rate of ypT4 (p = 0.001) with a lower R0 rate (p = 0.044). The 3y-OS and 3y-DM were 78% and 15.1%, respectively, without significant differences. The 3y-LR was 6.6%, and patients with OP had a significantly worse 3y-local regrowth compared to 3y-LR in patients with TME and APR/PE (30.2% vs. 5.4% vs. 2%, p = 0.008). CONCLUSION cT4 tumours may be suitable for the full spectrum of rectal cancer management from organ preservation to pelvic exenteration depending on tumour response to neoadjuvant therapy. However, careful attention is required in OP as local regrowth in up to 30% of cases reinforces the need for sustained active surveillance in Watch&Wait programmes.
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Affiliation(s)
- Christina Fleming
- Bordeaux Colorectal Institute, Clinique Tivoli, 220 Rue Mandron, 33000, Bordeaux, France.
- Department of Digestive Surgery, Colorectal Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France.
- Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Deena Harji
- Bordeaux Colorectal Institute, Clinique Tivoli, 220 Rue Mandron, 33000, Bordeaux, France
- Department of Digestive Surgery, Colorectal Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Benjamin Fernandez
- Department of Digestive Surgery, Colorectal Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Marc-Olivier François
- Bordeaux Colorectal Institute, Clinique Tivoli, 220 Rue Mandron, 33000, Bordeaux, France
| | - Vincent Assenat
- Bordeaux Colorectal Institute, Clinique Tivoli, 220 Rue Mandron, 33000, Bordeaux, France
| | - Pasticier Gilles
- Department of Urologic Surgery, Clinique Tivoli, Bordeaux, France
| | - Michiels Clément
- Department of Urologic Surgery, Clinique Tivoli, Bordeaux, France
| | - Grégoire Robert
- Department of Urologic Surgery, CHU Bordeaux University Hospital, Bordeaux, France
| | - Quentin Denost
- Bordeaux Colorectal Institute, Clinique Tivoli, 220 Rue Mandron, 33000, Bordeaux, France.
- Department of Digestive Surgery, Colorectal Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France.
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Aynalem ZB, Adal AB, Ayele TF, Bayeh GM, Yeshiwas AG, Dessie TM, Tsega TD. Mortality rate and predictors of colorectal cancer patients in Ethiopia: a systematic review and meta-analysis. BMC Cancer 2024; 24:821. [PMID: 38987683 PMCID: PMC11234545 DOI: 10.1186/s12885-024-12597-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION The incidence of colorectal cancer (CRC) has been increasing in Sub-Saharan countries, including Ethiopia. However, the real mortality rate for CRC patients in Ethiopia has not been established. Therefore, this systematic review and meta-analysis aimed to determine the overall mortality rate and identify predictors among CRC patients in Ethiopia. METHODS PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar were searched to identify relevant articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. The quality of the included studies was assessed using the Newcastle-Ottawa Scale Critical Appraisal checklist. A random effect model was used to estimate the pooled mortality rate and adjusted hazard ratio (AHR). Publication bias was assessed using funnel plots and Egger's regression test, while heterogeneity was evaluated through the Cochran Q test and I2 statistics. RESULTS After reviewing 74 articles, only 7 studies met the criteria and were included in the analysis. The analysis revealed that the overall mortality rate among CRC patients in Ethiopia was 40.5% (95% confidence interval [CI]: 32.05, 48.87) while the survival rates at 1 year, 3 years, and 5 years were 82.3% (95% CI: 73.33, 91.31), 48.8% (95% CI: 43.35, 54.32), and 26.6% (95% CI: 21.26, 31.91) respectively. Subgroup analysis indicated that studies conducted after 2017 had higher mortality rates compared to those studied earlier (43.0% vs. 38.2%). Older age (AHR: 1.89, 95% CI: 1.27, 2.82); being married (AHR: 2.53, 95% CI: 1.79, 3.57); having comorbidities (AHR: 1.84, 95% CI: 1.45, 2.35); having high CEA levels (AHR: 2.06, CI: 1.35, 3.13); being in stage II (AHR: 4.13, 95% CI: 1.85, 9.22), III (AHR: 8.62, 95% CI: 3.88, 19.15), and IV (AHR: 8.06, CI: 2.89, 22.49) were the most important predictors. CONCLUSION In Ethiopia, the mortality rate among individuals diagnosed with CRC is high, with two out of five patients dying from this disease. Age, marital status, CEA level, comorbidities, and cancer stage were identified as predictors of mortality in CRC patients. Therefore, early detection and screening should be prioritized, particularly for older patients, those who are married, have comorbidities, elevated CEA levels, and advanced cancer stages.
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Affiliation(s)
- Zewdu Bishaw Aynalem
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Abebaw Bires Adal
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Temesgien Fentahun Ayele
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Gashaw Melkie Bayeh
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Almaw Genet Yeshiwas
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tadesse Miretie Dessie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tilahun Degu Tsega
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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Park C, Kim K, Kim Y, Zhu R, Hain L, Seferovic H, Kim MH, Woo HJ, Hwang H, Lee SH, Kim S, Lee JE, Hinterdorfer P, Ko K, Park S, Oh YJ. Plant-Derived Anti-Human Epidermal Growth Factor Receptor 2 Antibody Suppresses Trastuzumab-Resistant Breast Cancer with Enhanced Nanoscale Binding. ACS NANO 2024; 18:16126-16140. [PMID: 38764224 PMCID: PMC11210341 DOI: 10.1021/acsnano.4c00360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 05/21/2024]
Abstract
Traditional monoclonal antibodies such as Trastuzumab encounter limitations when treating Human Epidermal Growth Factor Receptor 2 (HER2)-positive breast cancer, particularly in cases that develop resistance. This study introduces plant-derived anti-HER2 variable fragments of camelid heavy chain domain (VHH) fragment crystallizable region (Fc) KEDL(K) antibody as a potent alternative for overcoming these limitations. A variety of biophysical techniques, in vitro assays, and in vivo experiments uncover the antibody's nanoscale binding dynamics with transmembrane HER2 on living cells. Single-molecule force spectroscopy reveals the rapid formation of two robust bonds, exhibiting approximately 50 pN force resistance and bond lifetimes in the second range. The antibody demonstrates a specific affinity for HER2-positive breast cancer cells, including those that are Trastuzumab-resistant. Moreover, in immune-deficient mice, the plant-derived anti-HER2 VHH-FcK antibody exhibits superior antitumor activity, especially against tumors that are resistant to Trastuzumab. These findings underscore the plant-derived antibody's potential as an impactful immunotherapeutic strategy for treating Trastuzumab-resistant HER2-positive breast cancer.
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Affiliation(s)
- Chanyong Park
- School
of Mechanical Engineering, Sungkyunkwan
University, Suwon 16419, Korea
| | - Kibum Kim
- Department
of Medicine, Medical Research Institute, College of Medicine, Chung-Ang University, Seoul 06974, Korea
| | - Yerin Kim
- Department
of Medicine, Medical Research Institute, College of Medicine, Chung-Ang University, Seoul 06974, Korea
| | - Rong Zhu
- Department
of Applied Experimental Biophysics, Institute of Biophysics, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Lisa Hain
- Department
of Applied Experimental Biophysics, Institute of Biophysics, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Hannah Seferovic
- Department
of Applied Experimental Biophysics, Institute of Biophysics, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Min-Hyeok Kim
- School
of Mechanical Engineering, Sungkyunkwan
University, Suwon 16419, Korea
| | - Hyun Joo Woo
- Major
of Nano-Bioengineering, College of Life Sciences and Bioengineering, Incheon National University, Incheon 22012, Korea
| | - Hyunju Hwang
- Department
of Medicine, Medical Research Institute, College of Medicine, Chung-Ang University, Seoul 06974, Korea
| | - Seung Ho Lee
- Major
of Nano-Bioengineering, College of Life Sciences and Bioengineering, Incheon National University, Incheon 22012, Korea
| | - Sangmin Kim
- Department
of Breast Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Jeong Eon Lee
- Division
of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Peter Hinterdorfer
- Department
of Applied Experimental Biophysics, Institute of Biophysics, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Kisung Ko
- Department
of Medicine, Medical Research Institute, College of Medicine, Chung-Ang University, Seoul 06974, Korea
| | - Sungsu Park
- School
of Mechanical Engineering, Sungkyunkwan
University, Suwon 16419, Korea
| | - Yoo Jin Oh
- Department
of Applied Experimental Biophysics, Institute of Biophysics, Johannes Kepler University Linz, 4040 Linz, Austria
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Grønnemose RB, Hansen PS, Worsøe Laursen S, Gerke O, Kjellberg J, Lykkegaard J, Thye-Rønn C, Høilund-Carlsen PF, Thye-Rønn P. Risk of cancer and serious disease in Danish patients with urgent referral for serious non-specific symptoms and signs of cancer in Funen 2014-2021. Br J Cancer 2024; 130:1304-1315. [PMID: 38409600 PMCID: PMC11014902 DOI: 10.1038/s41416-024-02620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND In 2011, as the first European country, Denmark introduced the non-organ-specific cancer patient pathway (CPP) for patients presenting with non-specific symptoms and signs of cancer (NSSC). The proportion of patients with cancer over time is unknown. METHODS A retrospective cohort study of all patients with a NSSC-CPP investigational course in the province of Funen to the Diagnostic Centre in Svendborg from 2014 to 2021 was performed to evaluate the proportion of patients with cancer and serious disease over time. RESULTS A total of 6698 patients were referred to the NSSC-CPP of which 20.2% had cancer. While the crude referral rate increased from 114 per 100,000 people in 2014 and stabilised to around 214 in 2017-2021, the cancer detection rate of the total yearly new cancers in Funen diagnosed through the NSSC-CPP in DC Svendborg increased from 3 to 6%. CONCLUSIONS With now high and stable conversion and crude referral rates, the NSSC-CPP is one of the largest CPPs in Denmark as measured by the number of new cancer cases found. Similar urgent referral programmes in other countries might fill an unmet medical need for patients presenting with serious non-specific symptoms and signs of cancer in general practice.
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Affiliation(s)
| | - Per Syrak Hansen
- Diagnostic Centre, Svendborg Hospital, Odense University Hospital, Svendborg, Denmark
| | | | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jakob Kjellberg
- VIVE, The Danish Centre for Social Science Research, Copenhagen, Denmark
| | - Jesper Lykkegaard
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Clara Thye-Rønn
- Diagnostic Centre, Svendborg Hospital, Odense University Hospital, Svendborg, Denmark
| | | | - Peter Thye-Rønn
- Diagnostic Centre, Svendborg Hospital, Odense University Hospital, Svendborg, Denmark.
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Dantas AAG, de Oliveira NPD, Costa GAB, Martins LFL, Dos Santos JEM, Migowski A, de Camargo Cancela M, de Souza DLB. Multilevel analysis of social determinants of advanced stage colorectal cancer diagnosis. Sci Rep 2024; 14:9667. [PMID: 38671078 PMCID: PMC11053035 DOI: 10.1038/s41598-024-60449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
The advanced stage at diagnosis of colorectal cancer (CRC) may be related to individual factors, socioeconomic conditions, and healthcare service availability. The objective of the study was to analyze the prevalence of advanced stage CRC at the time of diagnosis and its association with individual, contextual, socioeconomic, and healthcare service indicators. An observational, cross-sectional study was conducted, analyzing cases of malignant neoplasms of the colon and rectum in individuals of both sexes, aged between 18 and 99 years, diagnosed between 2010 and 2019 in Brazil (n = 69,047). Data were collected from the Hospital Cancer Registry (HCR), Atlas of Human Development in Brazil, and from the National Registry of Health Institutions (NRHI). A Multilevel Poisson Regression model with random intercept was used. The prevalence of advanced stage CRC at diagnosis was 65.6%. Advanced stage was associated with older age groups prevalence ratio (PR) 4.40 and younger age groups (PR 1.84), low Human Development Index (HDI) (PR 1.22), and low density of family health strategy teams (PR 1.10). The study highlights the unequal distribution of social determinants of health in the diagnosis CRC in Brazil, revealing the need to evaluate and redirect public policies aimed at improving early detection and prevention of CRC in the country.
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Affiliation(s)
| | | | - Guilherme Augusto Barcello Costa
- Graduate Program in Oncology, Research and Innovation Coordination, National Cancer Institute (INCA), Ministry of Health, Rio de Janeiro, RJ, Brazil
| | - Luís Felipe Leite Martins
- Surveillance and Situation Analysis Division, Prevention and Surveillance Coordination (CONPREV), National Cancer Institute (INCA), Ministry of Health, Rio de Janeiro, RJ, Brazil
| | - Jonas Eduardo Monteiro Dos Santos
- Surveillance and Situation Analysis Division, Prevention and Surveillance Coordination (CONPREV), National Cancer Institute (INCA), Ministry of Health, Rio de Janeiro, RJ, Brazil
| | - Arn Migowski
- Division of Clinical Research and Technological Development, Research and Innovation Coordination, National Cancer Institute (INCA), Ministry of Health, Rio de Janeiro, RJ, Brazil
- Professional Master's Program in Health Technology Assessment, Education and Research Coordination, National Institute of Cardiology (INC), Ministry of Health, Rio de Janeiro, RJ, Brazil
| | - Marianna de Camargo Cancela
- Graduate Program in Oncology, Research and Innovation Coordination, National Cancer Institute (INCA), Ministry of Health, Rio de Janeiro, RJ, Brazil
| | - Dyego Leandro Bezerra de Souza
- Graduate Program in Public Health, Federal University of Rio Grande do Norte - UFRN, Natal, RN, Brazil.
- Methodology, Methods, Models and Results in Health and Social Sciences Research Group (M3O), Faculty of Health Sciences and Well-Being. Health and Social Care Research Center (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.
- Public Health Department, Graduate Program in Public Health, Federal University of Rio Grande do Norte, 1787 Senador Salgado Filho Ave., Lagoa Nova, Natal, RN, 59010-000, Brazil.
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Schmidt P, Lindemeyer J, Raut P, Schütz M, Saniternik S, Jönsson J, Endepols H, Fischer T, Quaas A, Schlößer HA, Thelen M, Grüll H. Multiparametric Characterization of the DSL-6A/C1 Pancreatic Cancer Model in Rats. Cancers (Basel) 2024; 16:1535. [PMID: 38672617 PMCID: PMC11049193 DOI: 10.3390/cancers16081535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The DSL-6A/C1 murine pancreatic ductal adenocarcinoma (PDAC) tumor model was established in Lewis rats and characterized through a comprehensive multiparametric analysis to compare it to other preclinical tumor models and explore potential diagnostic and therapeutical targets. DSL-6A/C1 tumors were histologically analyzed to elucidate PDAC features. The tumor microenvironment was studied for immune cell prevalence. Multiparametric MRI and PET imaging were utilized to characterize tumors, and 68Ga-FAPI-46-targeting cancer-associated fibroblasts (CAFs), were used to validate the histological findings. The histology confirmed typical PDAC characteristics, such as malformed pancreatic ductal malignant cells and CAFs. Distinct immune landscapes were identified, revealing an increased presence of CD8+ T cells and a decreased CD4+ T cell fraction within the tumor microenvironment. PET imaging with 68Ga-FAPI tracers exhibited strong tracer uptake in tumor tissues. The MRI parameters indicated increasing intralesional necrosis over time and elevated contrast media uptake in vital tumor areas. We have demonstrated that the DSL-6A/C1 tumor model, particularly due to its high tumorigenicity, tumor size, and 68Ga-FAPI-46 sensitivity, is a suitable alternative to established small animal models for many forms of preclinical analyses and therapeutic studies of PDAC.
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Affiliation(s)
- Patrick Schmidt
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, 50937 Cologne, Germany; (P.S.); (J.L.); (P.R.); (M.S.); (S.S.); (J.J.)
| | - Johannes Lindemeyer
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, 50937 Cologne, Germany; (P.S.); (J.L.); (P.R.); (M.S.); (S.S.); (J.J.)
| | - Pranali Raut
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, 50937 Cologne, Germany; (P.S.); (J.L.); (P.R.); (M.S.); (S.S.); (J.J.)
| | - Markus Schütz
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, 50937 Cologne, Germany; (P.S.); (J.L.); (P.R.); (M.S.); (S.S.); (J.J.)
- Faculty of Mathematics and Natural Sciences, Department of Chemistry, University of Cologne, 50937 Cologne, Germany
| | - Sven Saniternik
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, 50937 Cologne, Germany; (P.S.); (J.L.); (P.R.); (M.S.); (S.S.); (J.J.)
- Faculty of Mathematics and Natural Sciences, Department of Chemistry, University of Cologne, 50937 Cologne, Germany
| | - Jannika Jönsson
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, 50937 Cologne, Germany; (P.S.); (J.L.); (P.R.); (M.S.); (S.S.); (J.J.)
| | - Heike Endepols
- Faculty of Medicine and University Hospital of Cologne, Institute of Radiochemistry and Experimental Molecular Imaging, University of Cologne, 50937 Cologne, Germany;
- Faculty of Medicine and University Hospital of Cologne, Department of Nuclear Medicine, University of Cologne, 50937 Cologne, Germany;
- Nuclear Chemistry, Institute of Neuroscience and Medicine (INM-5), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Thomas Fischer
- Faculty of Medicine and University Hospital of Cologne, Department of Nuclear Medicine, University of Cologne, 50937 Cologne, Germany;
| | - Alexander Quaas
- Faculty of Medicine and University Hospital of Cologne, Institute of Pathology, University of Cologne, 50937 Cologne, Germany;
| | - Hans Anton Schlößer
- Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (H.A.S.); (M.T.)
- Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Martin Thelen
- Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (H.A.S.); (M.T.)
| | - Holger Grüll
- Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, University of Cologne, 50937 Cologne, Germany; (P.S.); (J.L.); (P.R.); (M.S.); (S.S.); (J.J.)
- Faculty of Mathematics and Natural Sciences, Department of Chemistry, University of Cologne, 50937 Cologne, Germany
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de Chiffre JMD, Ormstrup TE, Kusk MW, Hess S. Patients from general practice with non-specific cancer symptoms: a retrospective study of symptoms and imaging. BJGP Open 2024; 8:BJGPO.2023.0058. [PMID: 37604580 PMCID: PMC11169995 DOI: 10.3399/bjgpo.2023.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/10/2023] [Accepted: 07/23/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Patients with non-specific symptoms or signs of cancer (NSSC) present a challenge as they are a heterogeneous population who are not candidates for fast-track work-up in an organ-specific cancer pre-planned pathway (CPP). Denmark has a cancer pre-planned pathway for this population (NSSC-CPP), but several issues remain unclarified, for example, distribution and significance of symptoms and findings, and choice of imaging. AIM To investigate symptoms, cancer diagnoses, and diagnostic yield of computed tomography (CT) and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients on NSSC-CPP to improve the overall diagnostic process. DESIGN & SETTING A retrospective medical chart review in a 1-year consecutive cohort (2020). METHOD A total of 802 referrals were reviewed for diagnostic imaging in patients with NSSP from general practices, specialist practices, or the local hospital diagnostic centre responsible for NSSC-CPP. RESULTS The study included 248 patients; 21% had cancer, most frequently gastrointestinal cancer (27%). The most frequent symptom was weight loss (56%). CT had a sensitivity of 85%, specificity of 87%, positive predictive value (PPV) of 65%, and negative predictive value (NPV) of 96%. For 18F-FDG-PET/CT, the numbers were sensitivity 82%, specificity 62%, PPV 33%, and NPV 94%. Patients frequently underwent subsequent examinations following initial imaging. CONCLUSION The findings were in accordance with the literature. Patients with NSSC had a cancer prevalence of 21%, most frequently gastrointestinal. The most frequent symptom was weight loss and, even as the only symptom, it is a potential marker for cancer. CT and 18F-FDG-PET/CT were sensitive with high NPV, whereas PPV was superior in CT. Better stratification by symptoms or findings is an obvious focus point for future studies to further optimise the NSSC-CPP work-up strategy.
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Affiliation(s)
- Jonas Michele Dorph de Chiffre
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Tina Elisabeth Ormstrup
- Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Martin Weber Kusk
- Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Esbjerg, Denmark
- IRIS - Imaging Research Initiative Southwest, University Hospital of Southern Denmark, Esbjerg, Denmark
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Søren Hess
- Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Esbjerg, Denmark
- IRIS - Imaging Research Initiative Southwest, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
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Lin J, Temperley HC, Larkins K, Waters C, Chong KL, Maida J, Proud D, Burgess A, Heriot A, Smart P, Mohan H. Evaluating the Educational Value of Cancer Registries - a Systematic Review and Thematic Analysis. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:194-203. [PMID: 38146032 DOI: 10.1007/s13187-023-02394-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/27/2023]
Abstract
Cancer registries encompass a broad array of functions that underpin cancer control efforts. Despite education being fundamental to improving patient outcomes, little is known regarding the educational value of cancer registries. This review will evaluate the educational value of cancer registries for key stakeholders as reported within published literature and identify opportunities for enhancing their educational value. Four databases (Ovid Medline, Embase, CINAHL and Web of Science) were searched using a predefined search strategy in keeping with the PRISMA statement. Data was extracted and synthesised in narrative format. Themes and frequency of discussion of educational content were explored using thematic content analysis. From 952 titles, ten eligible studies were identified, highlighting six stakeholder groups. Educational outcomes were identified relating to clinicians (6/10), researchers (5/10), patients (4/10), public health organisations (3/10), medical students (1/10) and the public (1/10). Cancer registries were found to educationally benefit key stakeholders despite educational value not being a key focus of any study. Deliberate efforts to harness the educational value of cancer registries should be considered to enable data-driven quality improvement, with the vast amount of data promising ample educational benefit.
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Affiliation(s)
- James Lin
- Department of Colorectal Surgery, Austin Health, Heidelberg, Victoria, Australia.
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Hugo C Temperley
- Department of Cancer Surgery, St. John of God Midland Hospital, Perth, Australia
- Department of Surgery, Fiona Stanley Hospital, Perth, Australia
| | - Kirsten Larkins
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Caitlin Waters
- Department of Surgery, Fiona Stanley Hospital, Perth, Australia
| | - Kit Loong Chong
- Department of Colorectal Surgery, Austin Health, Heidelberg, Victoria, Australia
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Jack Maida
- Department of Colorectal Surgery, Austin Health, Heidelberg, Victoria, Australia
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - David Proud
- Department of Colorectal Surgery, Austin Health, Heidelberg, Victoria, Australia
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Adele Burgess
- Department of Colorectal Surgery, Austin Health, Heidelberg, Victoria, Australia
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Alexander Heriot
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Philip Smart
- Department of Colorectal Surgery, Austin Health, Heidelberg, Victoria, Australia
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Mohan
- Department of Colorectal Surgery, Austin Health, Heidelberg, Victoria, Australia
- Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
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Tsai MH, Cabral DN, Grunert C, Moore JX. Colorectal cancer survival disparities in the five regions of Georgia. PLoS One 2024; 19:e0301027. [PMID: 38547204 PMCID: PMC10977806 DOI: 10.1371/journal.pone.0301027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/08/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND/OBJECTIVE The objective of this study was to examine 5-year colorectal cancer survival rates. We also determined whether demographics, tumor characteristics, and treatment modality were associated with 5-year CRC survival in the Clayton, West Central, East Central, Southeast, and Northeast Georgia regions because the significant higher CRC mortality rates in these regions in comparison to the overall rates in the State of Georgia. METHODS We conducted a retrospective cohort analysis using data from the 1975-2016 Surveillance, Epidemiology, and End Results program aggregated CRC patients to these five regions. Five-year CRC survival was calculated and stratified by the five regions of Georgia, using the Kaplan-Meier method with log-rank test. Cox proportional hazard regression was used to examine the mentioned association in these five regions. RESULTS Among 11,023 CRC patients, 5-year CRC survival was lowest in Clayton (65.9%) compared to the West Central (69.0%), East Central (68.2%), Southeast (70.5%), and Northeast regions (69.5%) (p-value = 0.02). In multivariable analysis, greater risk of CRC death was found in the Clayton region compared to the West Central (HR, 1.12; 95%, 1.00-1.25) region when adjusting for demographics, tumor characteristics, and treatment modality. Among Clayton Georgians, age of 75+ years (HR, 2.13; 95%, 1.56-2.89), grade 3 & 4 tumors (HR, 2.22; 95%, 1.64-3.00), and distant stage (HR, 20.95; 95%, 15.99-27.45) were negatively associated with CRC survival. CONCLUSION We observed place-based differences in CRC survival with significantly lower survival rates in the Clayton region. Factors associated with higher risk of CRC death include older age at diagnosis, high-grade tumors, and distant stage CRC among Clayton Georgians. Our study provides important evidence to all relevant stakeholders in furthering the development of culturally tailored CRC screening interventions aimed at CRC early detection and improved outcomes.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Augusta University, Augusta, Georgia, United States of America
- Georgia Prevention Institute, Augusta University, Augusta, Georgia, United States of America
| | - Daramola N. Cabral
- Department of Health, Human Services, and Public Policy, College of Health Sciences and Human Services, California State University, Monterey Bay, Seaside, California, United States of America
- African Caribbean Cancer Consortium, Philadelphia, Pennsylvania, United States of America
| | - Caitlyn Grunert
- Department of Health Management and Policy, University of Kentucky, Lexington, Kentucky, United States of America
| | - Justin X. Moore
- Center for Health Equity Transformation, Department of Behavioral Science, Department of Internal Medicine, Markey Cancer Center, University of Kentucky College of Medicine, Lexington, Kentucky, United States of America
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12
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Loft LH, Pedersen LH, Bigaard J, Bojesen SE. Attitudes towards risk-stratified breast cancer screening: a population-based survey among 5,001 Danish women. BMC Cancer 2024; 24:347. [PMID: 38504201 PMCID: PMC10949660 DOI: 10.1186/s12885-024-12083-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/04/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The individual woman's risk of being diagnosed with breast cancer can now be estimated more precisely, and screening can be stratified accordingly. The risk assessment requires that women are willing to provide a blood test, additional personal information, to know their risk, and alter screening intervals. This study aimed to investigate Danish women's attitudes towards risk-stratified breast cancer screening. METHODS An online, cross-sectional survey was conducted among Danish women aged 52-67 years. We used logistic regression analyses to assess how personal characteristics were associated with the women's attitudes. RESULTS 5,001 women completed the survey (response rate 44%) of which 74% approved of risk estimation to potentially alter their screening intervals. However, only 42% would accept an extended screening interval if found to have low breast cancer risk, while 89% would accept a reduced interval if at high risk. The main determinants of these attitudes were age, education, screening participation, history of breast cancer, perceived breast cancer risk and to some extent breast cancer worry. CONCLUSION This study indicates that women are positive towards risk-stratified breast cancer screening. However, reservations and knowledge among subgroups of women must be carefully considered and addressed before wider implementation of risk-stratified breast cancer screening in a national program.
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Affiliation(s)
- Louise Hougaard Loft
- Prevention and Information Dept, Danish Cancer Society, Strandboulevarden 49, DK-2100, Copenhagen, Denmark
| | - Line Hjøllund Pedersen
- Prevention and Information Dept, Danish Cancer Society, Strandboulevarden 49, DK-2100, Copenhagen, Denmark
- Science to Society Dept, Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Janne Bigaard
- Prevention and Information Dept, Danish Cancer Society, Strandboulevarden 49, DK-2100, Copenhagen, Denmark.
| | - Stig Egil Bojesen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospitals, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Jayakumar R, Dash MK, Gulati S, Pandey A, Trigun SK, Joshi N. Preliminary data on cytotoxicity and functional group assessment of a herb-mineral combination against colorectal carcinoma cell line. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2024; 21:61-70. [PMID: 38016708 DOI: 10.1515/jcim-2023-0221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/01/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVES The invasive screening methods and the late stage diagnosis of colorectal carcinoma (CRC) are contributing for the devastative prognosis. The gradual shift of the disease pattern among younger generations requires the implementation of phytochemicals and traditional medicines. Arkeshwara rasa (AR) is a herb-mineral combination of Tamra bhasma/incinerated copper ashes and Dwigun Kajjali/mercury sulphide levigated with Calotropis procera leaf juice, Plumbago zeylanica root decoction and the decoction of three myrobalans (Terminalia chebula, Terminalia bellerica, Emblica Officinalis decoction)/Triphala decoction. METHODS The SW-480 cell line was checked for the cytotoxicity and the cell viability criteria with MTT(3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide) assay. The acridine orange/ethidium bromide (AO/EtBr) assay revealed the depth of apoptosis affected cells in the fluorescent images. The FTIR analysis exhibited the graphical spectrum of functional groups within the compound AR. RESULTS The IC50 from the 10-7 to 10-3 concentrations against SW-480 cells was 40.4 μg/mL. The staining of AO/EtBr was performed to visualize live and dead cells and it is evident from the result that number of apoptotic cells increases at increasing concentration of AR. The single bond with stretch vibrations of O-H and N-H are more concentrated in the 2,500-3,200 cm-1 and 3,700-4,000 cm-1 of the spectra whereas, the finger print region carries the O-H and S=O type peaks. CONCLUSIONS The AR shows strong cyto-toxicity against the SW-480 cells by inducing apoptosis. It also modulates cellular metabolism with the involvement of functional groups which antagonizes the strong acids. Moreover, these effects need to be analyzed further based in the in vivo and various in vitro models.
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Affiliation(s)
- Remya Jayakumar
- Department of Rasa Shastra and Bhaishajya Kalpana, Banaras Hindu University, Varanasi, India
| | - Manoj Kumar Dash
- Department of Rasa Shastra and Bhaishajya Kalpana, Government Ayurveda College, Raipur, Chhattisgarh, India
| | - Saumya Gulati
- Department of Rasa Shastra and Bhaishajya Kalpana, Babu Yugraj Singh Ayurvedic Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Akanksha Pandey
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Surendra Kumar Trigun
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Namrata Joshi
- Department of Rasa Shastra and Bhaishajya Kalpana, Banaras Hindu University, Varanasi, India
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Cao Y, Wu C, Ma L. Lysine demethylase 5B (KDM5B): A key regulator of cancer drug resistance. J Biochem Mol Toxicol 2024; 38:e23587. [PMID: 38014925 DOI: 10.1002/jbt.23587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/17/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
Chemoresistance, a roadblock in the chemotherapy process, has been impeding its effective treatment. KDM5B, a member of the histone demethylase family, has been crucial in the emergence and growth of malignancies. More significantly, KDM5B has recently been linked closely to cancer's resistance to chemotherapy. In this review, we explain the biological properties of KDM5B, its function in the emergence and evolution of cancer treatment resistance, and our hopes for future drug resistance-busting combinations involving KDM5B and related targets or medications.
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Affiliation(s)
- Yaquan Cao
- College of Basic Medicine and Forensic Medicine, Henan University of Science and Technology, Luoyang, China
| | - Chunli Wu
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Liying Ma
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, School of Pharmaceutical Science and Institute of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, China
- Key Laboratory of Cardio-Cerebrovascular Drug, China Meheco Topfond Pharmaceutical Company, Zhumadian, China
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15
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Bi J, Tuo J, Xiao Y, Tang D, Zhou X, Jiang Y, Ji X, Tan Y, Yuan H, Xiang Y. Observed and relative survival trends of lung cancer: A systematic review of population-based cancer registration data. Thorac Cancer 2024; 15:142-151. [PMID: 37986711 PMCID: PMC10788469 DOI: 10.1111/1759-7714.15170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Using the published survival statistics from cancer registration or population-based studies, we aimed to describe the global pattern and trend of lung cancer survival. METHODS By searching SinoMed, PubMed, Web of Science, EMBASE, and SEER, all survival analyses from cancer registration or population-based studies of lung cancer were collected by the end of November 2022. The survival rates were extracted by sex, period, and country. The observed, relative, and net survival rates of lung cancer were applied to describe the pattern and time changes from the late 1990s to the early 21st century. RESULTS Age-standardized 5-year relative/net survival rate of lung cancer was typically low, with 10%-20% for most regions. The highest age-standardized relative/net survival rate was observed in Japan (32.9%, 2010-2014), and the lowest was in India (3.7%, 2010-2014). In most countries, the five-year age-standardized relative/net survival rates of lung cancer were higher in females and younger people. The patients with adenocarcinoma had a better prognosis than other groups. In China, the highest 5-year overall relative/net survival rates were 27.90% and 31.62% in men and women in Jiangyin (2012-2013). CONCLUSION Over the past decades, the prognosis of lung cancer has gradually improved, but significant variations were also observed globally. Worldwide, a better prognosis of lung cancer can be observed in females and younger patients. It is essential to compare and evaluate the histological or stage-specific survival rates of lung cancer between different regions in the future.
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Affiliation(s)
- Jing‐Hao Bi
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jia‐Yi Tuo
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yu‐Xuan Xiao
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Dan‐Dan Tang
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xiao‐Hui Zhou
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yu‐Fei Jiang
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xiao‐Wei Ji
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yu‐Ting Tan
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Hui‐Yun Yuan
- Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Yong‐Bing Xiang
- Department of Epidemiology & State Key Laboratory of Systems Medicine for Cancer, Shanghai Cancer Institute, Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
- School of Public HealthShanghai Jiaotong University School of MedicineShanghaiChina
- Renji HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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Booth S, Mozumder SI, Archer L, Ensor J, Riley RD, Lambert PC, Rutherford MJ. Using temporal recalibration to improve the calibration of risk prediction models in competing risk settings when there are trends in survival over time. Stat Med 2023; 42:5007-5024. [PMID: 37705296 PMCID: PMC10946485 DOI: 10.1002/sim.9898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/31/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023]
Abstract
We have previously proposed temporal recalibration to account for trends in survival over time to improve the calibration of predictions from prognostic models for new patients. This involves first estimating the predictor effects using data from all individuals (full dataset) and then re-estimating the baseline using a subset of the most recent data whilst constraining the predictor effects to remain the same. In this article, we demonstrate how temporal recalibration can be applied in competing risk settings by recalibrating each cause-specific (or subdistribution) hazard model separately. We illustrate this using an example of colon cancer survival with data from the Surveillance Epidemiology and End Results (SEER) program. Data from patients diagnosed in 1995-2004 were used to fit two models for deaths due to colon cancer and other causes respectively. We discuss considerations that need to be made in order to apply temporal recalibration such as the choice of data used in the recalibration step. We also demonstrate how to assess the calibration of these models in new data for patients diagnosed subsequently in 2005. Comparison was made to a standard analysis (when improvements over time are not taken into account) and a period analysis which is similar to temporal recalibration but differs in the data used to estimate the predictor effects. The 10-year calibration plots demonstrated that using the standard approach over-estimated the risk of death due to colon cancer and the total risk of death and that calibration was improved using temporal recalibration or period analysis.
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Affiliation(s)
- Sarah Booth
- Biostatistics Research Group, Department of Population Health SciencesUniversity of LeicesterLeicesterUK
| | - Sarwar I. Mozumder
- Biostatistics Research Group, Department of Population Health SciencesUniversity of LeicesterLeicesterUK
- Oncology Biometrics Statistical Innovation, AstraZenecaCambridgeUK
| | - Lucinda Archer
- Institute of Applied Health Research, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Joie Ensor
- Institute of Applied Health Research, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Richard D. Riley
- Institute of Applied Health Research, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Paul C. Lambert
- Biostatistics Research Group, Department of Population Health SciencesUniversity of LeicesterLeicesterUK
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Mark J. Rutherford
- Biostatistics Research Group, Department of Population Health SciencesUniversity of LeicesterLeicesterUK
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Yuan D, Zhu H, Wang T, Zhang Y, Zheng X, Qu Y. Development and validation of an individualized gene expression-based signature to predict overall survival of patients with high-grade serous ovarian carcinoma. Eur J Med Res 2023; 28:465. [PMID: 37884970 PMCID: PMC10604403 DOI: 10.1186/s40001-023-01376-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND High-grade serious ovarian carcinoma (HGSOC) is a subtype of ovarian cancer with a different prognosis attributable to genetic heterogeneity. The prognosis of patients with advanced HGSOC requires prediction by genetic markers. This study systematically analyzed gene expression profile data to establish a genetic marker for predicting HGSOC prognosis. METHODS The RNA-seq data set and information on clinical follow-up of HGSOC were retrieved from Gene Expression Omnibus (GEO) database, and the data were standardized by DESeq2 as a training set. On the other hand, HGSOC RNA sequence data and information on clinical follow-up were retrieved from The Cancer Genome Atlas (TCGA) as a test set. Additionally, ovarian cancer microarray data set was obtained from GEO as the external validation set. Prognostic genes were screened from the training set, and characteristic selection was performed using the least absolute shrinkage and selection operator (LASSO) with 80% re-sampling for 5000 times. Genes with a frequency of more than 2000 were selected as robust biomarkers. Finally, a gene-related prognostic model was validated in both the test and GEO validation sets. RESULTS A total of 148 genes were found to be significantly correlated with HGSOC prognosis. The expression profile of these genes could stratify HGSOC prognosis and they were enriched to multiple tumor-related regulatory pathways such as tyrosine metabolism and AMPK signaling pathway. AKR1B10 and ANGPT4 were obtained after 5000-time re-sampling by LASSO regression. AKR1B10 was associated with the metastasis and progression of several tumors. In this study, Cox regression analysis was performed to create a 2-gene signature as an independent prognostic factor for HGSOC, which has the ability to stratify risk samples in all three data sets (p < 0.05). The Gene Set Enrichment Analysis (GSEA) discovered abnormally active REGULATION_OF_AUTOPHAGY and OLFACTORY_TRANSDUCTION pathways in the high-risk group samples. CONCLUSION This study resulted in the creation of a 2-gene molecular prognostic classifier that distinguished clinical features and was a promising novel prognostic tool for assessing the prognosis of HGSOC. RiskScore was a novel prognostic model which might be effective in guiding accurate prognosis of HGSOC.
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Affiliation(s)
- Dandan Yuan
- Department of Obstertrics and Gynecology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Hong Zhu
- Department of Gynecological Oncology, Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, 200000, China
| | - Ting Wang
- Department of Hepatological Surgery, The Third Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yang Zhang
- Department of Obstertrics and Gynecology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Xin Zheng
- Department of Gynecology, The First Hospital of Jiaxing City, Jiaxing, 314000, China
| | - Yanjun Qu
- Department of Obstertrics and Gynecology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
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Wanner M, Syleouni M, Karavasiloglou N, Limam M, Bastiaannet E, Korol D, Rohrmann S. Time-trends and age and stage differences in 5-year relative survival for common cancer types by sex in the canton of Zurich, Switzerland. Cancer Med 2023; 12:18165-18175. [PMID: 37525622 PMCID: PMC10524019 DOI: 10.1002/cam4.6392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Survival trends help to evaluate the progress made to reduce the burden of cancer. The aim was to estimate the trends in 5-year relative survival of patients diagnosed with breast, prostate, lung, colorectal cancer and skin melanoma in the time periods 1980-1989, 1990-1999, 2000-2009 and 2010-2015 in the Canton of Zurich, Switzerland. Furthermore, we investigated relative survival differences by TNM stage and age group. METHODS Data from the Cancer Registry of Zurich was used from 1980 to and including 2015, including incident cases of breast (N = 26,060), prostate (N= 23,858), colorectal (N= 19,305), lung cancer (N= 16,858) and skin melanoma (N= 9780) with follow-up until 31 December 2020. The cohort approach was used to estimate 5-year relative survival. RESULTS The 5-year relative survival increased significantly between 1980 and 1989, and 2010 and2015: from 0.70 to 0.89 for breast, from 0.60 to 0.92 for prostate, from 0.09 to 0.23 (men) and from 0.10 to 0.27 (women) for lung, from 0.46 to 0.66 (men) and from 0.48 to 0.68 (women) for colorectal cancer, and from 0.74 to 0.94 (men) and from 0.86 to 0.96 (women) for skin melanoma. Survival for stage IV tumors was considerably lower compared to lower-staged tumors for all cancer types. Furthermore, relative survival was similar for the age groups <80 years but lower for patients aged 80 years and older. CONCLUSION The observed increasing trends in survival are encouraging and likely reflect raised awareness around cancer, improved diagnostic methods, and improved treatments. The fact that stage I tumor patients have generally high relative survival reflects the efforts made regarding early detection.
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Affiliation(s)
- Miriam Wanner
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
| | - Maria‐Eleni Syleouni
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
- Epidemiology, Biostatistics and Prevention InstituteUniversity of ZurichZurichSwitzerland
| | - Nena Karavasiloglou
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
- Epidemiology, Biostatistics and Prevention InstituteUniversity of ZurichZurichSwitzerland
- European Food Safety AuthorityParmaItaly
| | - Manuela Limam
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
| | - Esther Bastiaannet
- Epidemiology, Biostatistics and Prevention InstituteUniversity of ZurichZurichSwitzerland
| | - Dimitri Korol
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
| | - Sabine Rohrmann
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, Institute of Pathology and Molecular PathologyUniversity Hospital ZurichZurichSwitzerland
- Epidemiology, Biostatistics and Prevention InstituteUniversity of ZurichZurichSwitzerland
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19
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Reddavid R, Sofia S, Puca L, Moro J, Ceraolo S, Jimenez-Rodriguez R, Degiuli M. Robotic Rectal Resection for Rectal Cancer in Elderly Patients: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:5331. [PMID: 37629373 PMCID: PMC10456068 DOI: 10.3390/jcm12165331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Rectal cancer is estimated to increase due to an expanding aging population, thus affecting elderly patients more frequently. The optimal surgical treatment for this type of patient remains controversial because they are often excluded from or underrepresented in trials. This meta-analysis aimed to evaluate the feasibility and the safety of robotic surgery in elderly patients (>70 years old) undergoing curative treatment for rectal cancer. Studies comparing elderly (E) and young (Y) patients submitted to robotic rectal resection were searched on PubMed, Embase, and the Cochrane Library. Data regarding surgical oncologic quality, post-operative, and survival outcomes were extracted. Overall, 322 patients underwent robotic resection (81 in the E group and 241 in the Y group) for rectal cancer. No differences between the two groups were found regarding distal margins and the number of nodes yielded (12.70 in the E group vs. 14.02 in the Y group, p = 0.16). No differences were found in conversion rate, postoperative morbidity, mortality, and length of stay. Survival outcomes were only reported in one study. The results of this study suggest that elderly patients can be submitted to robotic resection for rectal cancer with the same oncologic surgical quality offered to young patients, without increasing postoperative mortality and morbidity.
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Affiliation(s)
- Rossella Reddavid
- University of Turin, Department of Oncology, Division of Surgical Oncology and Digestive Surgery, San Luigi University Hospital, 10043 Turin, Italy; (S.S.); (L.P.); (J.M.)
| | - Silvia Sofia
- University of Turin, Department of Oncology, Division of Surgical Oncology and Digestive Surgery, San Luigi University Hospital, 10043 Turin, Italy; (S.S.); (L.P.); (J.M.)
| | - Lucia Puca
- University of Turin, Department of Oncology, Division of Surgical Oncology and Digestive Surgery, San Luigi University Hospital, 10043 Turin, Italy; (S.S.); (L.P.); (J.M.)
| | - Jacopo Moro
- University of Turin, Department of Oncology, Division of Surgical Oncology and Digestive Surgery, San Luigi University Hospital, 10043 Turin, Italy; (S.S.); (L.P.); (J.M.)
| | - Simona Ceraolo
- Nursing Degree Program, Department of Clinical and Biological Sciences, University of Turin, 10124 Torino, Italy;
| | | | - Maurizio Degiuli
- University of Turin, Department of Oncology, Division of Surgical Oncology and Digestive Surgery, San Luigi University Hospital, 10043 Turin, Italy; (S.S.); (L.P.); (J.M.)
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20
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Ding XS, Hua YC, Han BX, An J, Zhou LL, Xu WR, Shi H, Zheng XX, Shi WW, Li XY. The prognostic value of cancer stage-associated genes in clear cell renal cell carcinoma. Am J Transl Res 2023; 15:5145-5158. [PMID: 37692936 PMCID: PMC10492068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Clear cell renal cell carcinoma (ccRCC) is a highly prevalent subtype of malignant renal tumor, but unfortunately, the survival rate remains unsatisfactory. The aim of the present study is to explore genomic features that are correlated with cancer stage, allowing for the identification of subgroups of ccRCC patients with high risk of unfavorable outcomes and enabling prompt intervention and treatment. METHODS We compared the gene expression levels across ccRCC patients with diverse cancer stages from The Cancer Genome Atlas (TCGA) database, which revealed characteristic genes associated with tumor stage. We then extracted prognostic genes and used least absolute shrinkage selection operator (LASSO) regression to select four genes for feature extraction and the construction of a prognostic risk model. RESULTS We have identified a total of 171 differentially expressed genes (DEGs) that are closely linked to the tumor stage of ccRCC through difference analysis. A prognostic risk model constructed based on the expression levels of ZIC2, TFAP2A-AS1, ITPKA, and SLC16A12 holds significant prognostic value in ccRCC. The results of the functional enrichment analysis imply that the DEGs are mainly involved in the regulation of immune-related signaling pathways, and therefore may have a significant function in immune system regulation of ccRCC. CONCLUSIONS Our study has successfully identified significant DEGs between high- and low-staging groups of ccRCC using bioinformatics methods. The construction of a prognostic risk model based on the expression levels of ZIC2, TFAP2A-AS1, ITPKA, and SLC16A12 has displayed promising prognostic significance, indicating its valuable potential for clinical application.
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Affiliation(s)
- Xiao-Sheng Ding
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
| | - Yi-Chun Hua
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
| | - Bing-Xuan Han
- Department of Physical Education, Shanxi Medical UniversityTaiyuan 030001, Shanxi, China
| | - Juan An
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
| | - Li-Li Zhou
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
| | - Wei-Ran Xu
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
| | - Hui Shi
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
| | - Xi-Xi Zheng
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
| | - Wei-Wei Shi
- Department of Oncology, PLA General HospitalBeijing 100853, China
| | - Xiao-Yan Li
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing 100070, China
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21
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Zhang L, Tang T, Liu L, Li C, Li Y, Geng C. Effect of tumor-infiltrating lymphocytes depending on the presence of postmastectomy radiotherapy on the prognosis in pT1-2N1M0 breast cancer. Front Oncol 2023; 13:1175965. [PMID: 37601690 PMCID: PMC10436467 DOI: 10.3389/fonc.2023.1175965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Background Currently, it remains unclear regarding the association between tumor-infiltrating lymphocytes (TILs) and the efficacy of postoperative radiotherapy in primary tumors. Here we attempted to investigate the effect of TILs depending on the presence of postmastectomy radiotherapy (PMRT) on the prognosis in pT1-2N1M0 breast cancer. Methods The clinical data of pT1-2N1M0 breast cancer patients undergoing mastectomy and axillary lymph node dissection were retrospectively analyzed. The effect of TILs on the prognosis was assessed based on the infiltration degree (low: TILs ≤10%, high: TILs >10%), and then the prognosis of patients with low and high infiltration of TILs was analyzed based on presence or absence of PMRT. Results Totally 213 patients were eligible for the study, including 162 cases of low infiltration and 51 of high infiltration. High-infiltration patients tended to be ER/PR-negative, HER2-positive, and have high histological grade. The infiltration in triple-negative and HER2-positive subtypes was higher compared with Luminal A subtype. Regarding local-regional recurrence-free survival, recurrence-free survival, and overall survival (OS) rates, the differences were all inapparent whether in high- and low-infiltration patients or in high-infiltration patients with/without PMRT. Compared with those without PMRT, low-infiltration patients with PMRT showed a significantly increased OS rate (92.8% vs. 80.0%, p=0.023). Multivariate analysis further confirmed PMRT as an independent predicator of OS in low-infiltration patients (HR: 0.228, 95%CI: 0.081-0.644, p=0.005). Conclusion High infiltration of TILs in pT1-2N1M0 breast cancer may be associated with clinicopathological factors. Low-infiltration patients, but not high-infiltration patients, may derive survival benefits from PMRT.
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Affiliation(s)
| | | | | | | | | | - Cuizhi Geng
- Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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22
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Leong DP, Cirne F, Aghel N, Baro Vila RC, Cavalli GD, Ellis PM, Healey JS, Whitlock R, Khalaf D, Mian H, Jolly SS, Mehta SR, Dent S. Cardiac Interventions in Patients With Active, Advanced Solid and Hematologic Malignancies: JACC: CardioOncology State-of-the-Art Review. JACC CardioOncol 2023; 5:415-430. [PMID: 37614581 PMCID: PMC10443114 DOI: 10.1016/j.jaccao.2023.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 08/25/2023] Open
Abstract
Invasive cardiac interventions are recommended to treat ST-segment elevation myocardial infarction, non-ST-segment elevation acute coronary syndromes, multivessel coronary disease, severe symptomatic aortic stenosis, and cardiomyopathy. These recommendations are based on randomized controlled trials that historically included few individuals with active, advanced malignancies. Advanced malignancies represent a significant competing risk for mortality, and there is limited evidence to inform the risks and benefits of invasive cardiac interventions in affected patients. We review the benefit conferred by invasive cardiac interventions; the periprocedural considerations; the contemporary survival expectations of patients across several types of active, advanced malignancy; and the literature on cardiovascular interventions in these populations. Our objective is to develop a rational framework to guide clinical recommendations on the use of invasive cardiac interventions in patients with active, advanced cancer.
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Affiliation(s)
- Darryl P. Leong
- The Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Filipe Cirne
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nazanin Aghel
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Peter M. Ellis
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Jeff S. Healey
- The Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Richard Whitlock
- The Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Dina Khalaf
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Hira Mian
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Sanjit S. Jolly
- The Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Shamir R. Mehta
- The Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Susan Dent
- Duke Cancer Institute, Department of Medicine, Duke University, Durham, North Carolina, USA
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23
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Tufvesson Stiller H, Schmitt-Egenolf M, Fohlin H, Uppugunduri S. Patient reported experiences of Swedish patients being investigated for cancer during the Covid-19 pandemic. Support Care Cancer 2023; 31:416. [PMID: 37354327 DOI: 10.1007/s00520-023-07897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/21/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Patient reported experiences in individuals being investigated for cancer have been recorded in a nationwide survey in Sweden, providing an opportunity to assess the impact of the Covid-19-pandemic. MATERIAL AND METHODS Questionnaires from 45920 patients were analyzed to assess the experience of being investigated for cancer. Data from before the Covid-19-pandemic (2018-2019) was compared to data acquired during the pandemic (2020-2021), using chi-square and Wilcoxon rank sum tests. Both, patients who were cleared from suspicion of cancer and those who were diagnosed with cancer were included. RESULTS Fewer patients in total visited health services during the pandemic. However, patients that did seek help did so to a similar extent during as prior to the pandemic. Patient waiting time was perceived to be shorter during the pandemic and judged as neither too long nor too short by most patients. The emotional support to patients improved during the pandemic, whereas the support to next of kin declined. A majority of patients received the results from the investigation in a meeting with the physician. Although there was a preference for receiving results in a meeting with the physician, the pandemic has brought an increasing interest in receiving results by phone. CONCLUSION Swedish cancer healthcare has shown resilience during the Covid-19-pandemic, maintaining high patient satisfaction while working under conditions of extraordinary pressure. Patients became more open to alternatives to physical "in person" health care visits which could lead to more digital visits in the future. However, support to significant others demands special attention.
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Affiliation(s)
- Helena Tufvesson Stiller
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
- Regional Cancer Center Southeast, Linköping, Sweden.
| | | | - Helena Fohlin
- Regional Cancer Center Southeast, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Srinivas Uppugunduri
- Regional Cancer Center Southeast, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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24
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Díaz-Fernández A, Ferapontov A, Vendelbo MH, Ferapontova EE. Electrochemical Cellulase-Linked ELASA for Rapid Liquid Biopsy Testing of Serum HER-2/ neu. ACS MEASUREMENT SCIENCE AU 2023; 3:226-235. [PMID: 37360033 PMCID: PMC10288612 DOI: 10.1021/acsmeasuresciau.2c00067] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 06/28/2023]
Abstract
Non-invasive liquid biopsy assays for blood-circulating biomarkers of cancer allow both its early diagnosis and treatment monitoring. Here, we assessed serum levels of protein HER-2/neu, overexpressed in a number of aggressive cancers, by the cellulase-linked sandwich bioassay on magnetic beads. Instead of traditional antibodies we used inexpensive reporter and capture aptamer sequences, transforming the enzyme-linked immuno-sorbent assay (ELISA) into an enzyme-linked aptamer-sorbent assay (ELASA). The reporter aptamer was conjugated to cellulase, whose digestion of nitrocellulose film electrodes resulted in the electrochemical signal change. ELASA, optimized relative aptamer lengths (dimer vs monomer and trimer), and assay steps allowed 0.1 fM detection of HER-2/neu in the 10% human serum in 1.3 h. Urokinase plasminogen activator and thrombin as well as human serum albumin did not interfere, and liquid biopsy analysis of serum HER-2/neu was similarly robust but 4 times faster and 300 times cheaper than both electrochemical and optical ELISA. Simplicity and low cost of cellulase-linked ELASA makes it a perspective diagnostic tool for fast and accurate liquid biopsy detection of HER-2/neu and of other proteins for which aptamers are available.
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Affiliation(s)
- Ana Díaz-Fernández
- Interdisciplinary
Nanoscience Center (iNANO), Faculty of Natural Sciences, Aarhus University, Gustav Wieds Vej 14, 8000 Aarhus C, Denmark
| | - Alexey Ferapontov
- Interdisciplinary
Nanoscience Center (iNANO), Faculty of Natural Sciences, Aarhus University, Gustav Wieds Vej 14, 8000 Aarhus C, Denmark
| | - Mikkel Holm Vendelbo
- Department
of Nuclear Medicine & PET Centre, Aarhus
University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
- Department
of Biomedicine, Aarhus University, Høegh-Guldbergs Gade 10, 8000 Aarhus C, Denmark
| | - Elena E. Ferapontova
- Interdisciplinary
Nanoscience Center (iNANO), Faculty of Natural Sciences, Aarhus University, Gustav Wieds Vej 14, 8000 Aarhus C, Denmark
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25
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Taylor C, McGale P, Probert J, Broggio J, Charman J, Darby SC, Kerr AJ, Whelan T, Cutter DJ, Mannu G, Dodwell D. Breast cancer mortality in 500 000 women with early invasive breast cancer diagnosed in England, 1993-2015: population based observational cohort study. BMJ 2023; 381:e074684. [PMID: 37311588 PMCID: PMC10261971 DOI: 10.1136/bmj-2022-074684] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To describe long term breast cancer mortality among women with a diagnosis of breast cancer in the past and estimate absolute breast cancer mortality risks for groups of patients with a recent diagnosis. DESIGN Population based observational cohort study. SETTING Routinely collected data from the National Cancer Registration and Analysis Service. PARTICIPANTS All 512 447 women registered with early invasive breast cancer (involving only breast and possibly axillary nodes) in England during January 1993 to December 2015, with follow-up to December 2020. MAIN OUTCOME MEASURES Annual breast cancer mortality rates and cumulative risks by time since diagnosis, calendar period of diagnosis, and nine characteristics of patients and tumours. RESULTS For women with a diagnosis made within each of the calendar periods 1993-99, 2000-04, 2005-09, and 2010-15, the crude annual breast cancer mortality rate was highest during the five years after diagnosis and then declined. For any given time since diagnosis, crude annual breast cancer mortality rates and risks decreased with increasing calendar period. Crude five year breast cancer mortality risk was 14.4% (95% confidence interval 14.2% to 14.6%) for women with a diagnosis made during 1993-99 and 4.9% (4.8% to 5.0%) for women with a diagnosis made during 2010-15. Adjusted annual breast cancer mortality rates also decreased with increasing calendar period in nearly every patient group, by a factor of about three in oestrogen receptor positive disease and about two in oestrogen receptor negative disease. Considering just the women with a diagnosis made during 2010-15, cumulative five year breast cancer mortality risk varied substantially between women with different characteristics: it was <3% for 62.8% (96 085/153 006) of women but ≥20% for 4.6% (6962/153 006) of women. CONCLUSIONS These five year breast cancer mortality risks for patients with a recent diagnosis may be used to estimate breast cancer mortality risks for patients today. The prognosis for women with early invasive breast cancer has improved substantially since the 1990s. Most can expect to become long term cancer survivors, although for a few the risk remains appreciable.
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Affiliation(s)
- Carolyn Taylor
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Oxford University Hospitals, Oxford, UK
| | - Paul McGale
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jake Probert
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - John Broggio
- National Disease Registration Service (NDRS), NHS England, Birmingham, UK
| | - Jackie Charman
- National Disease Registration Service (NDRS), NHS England, Birmingham, UK
| | - Sarah C Darby
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Amanda J Kerr
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Timothy Whelan
- Department of Oncology, McMaster University and Juravinski Cancer Centre, Hamilton, ON Canada
| | - David J Cutter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Oxford University Hospitals, Oxford, UK
| | - Gurdeep Mannu
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David Dodwell
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Oxford University Hospitals, Oxford, UK
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Michas A, Michas B, Tsitsibis A, Tsoukalas N. Molecular Screening for Urothelial Cancer: How Close We Are? Glob Med Genet 2023; 10:101-104. [PMID: 37228870 PMCID: PMC10205394 DOI: 10.1055/s-0043-1768958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Early detection of urothelial cancer offers the potential for effective and successful treatment. Despite previous efforts, currently, there is not a well-validated, recommended screening program in any country. This integrative, literature-based review provides details on how recent molecular advances may further advance early tumor detection. The minimally invasive liquid biopsy is capable of identifying tumor material in human fluid samples from asymptomatic individuals. Circulating tumor biomarkers (cfDNA, exosomes, etc.) are very promising and are attracting the interest of numerous studies for the diagnosis of early-stage cancer. However, this approach definitely needs to be refined before clinical implementation. Nevertheless, despite the variety of current obstacles that require further research, the prospect of identifying urothelial carcinoma by a single urine or blood test seems truly intriguing.
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Affiliation(s)
- Athanasios Michas
- Department of Oncology, 401 General Army Hospital of Athens, 401 Geniko Stratiotiko Nosokomeio Athenon, Athina, Greece
| | - Basileios Michas
- Department of Oncology, 401 General Army Hospital of Athens, 401 Geniko Stratiotiko Nosokomeio Athenon, Athina, Greece
| | - Anastasios Tsitsibis
- Department of Oncology, 401 General Army Hospital of Athens, 401 Geniko Stratiotiko Nosokomeio Athenon, Athina, Greece
| | - Nikolaos Tsoukalas
- Department of Oncology, 401 General Army Hospital of Athens, 401 Geniko Stratiotiko Nosokomeio Athenon, Athina, Greece
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27
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Muranen TA, Morra A, Khan S, Barnes DR, Bolla MK, Dennis J, Keeman R, Leslie G, Parsons MT, Wang Q, Ahearn TU, Aittomäki K, Andrulis IL, Arun BK, Behrens S, Bialkowska K, Bojesen SE, Camp NJ, Chang-Claude J, Czene K, Devilee P, Domchek SM, Dunning AM, Engel C, Evans DG, Gago-Dominguez M, García-Closas M, Gerdes AM, Glendon G, Guénel P, Hahnen E, Hamann U, Hanson H, Hooning MJ, Hoppe R, Izatt L, Jakubowska A, James PA, Kristensen VN, Lalloo F, Lindeman GJ, Mannermaa A, Margolin S, Neuhausen SL, Newman WG, Peterlongo P, Phillips KA, Pujana MA, Rantala J, Rønlund K, Saloustros E, Schmutzler RK, Schneeweiss A, Singer CF, Suvanto M, Tan YY, Teixeira MR, Thomassen M, Tischkowitz M, Tripathi V, Wappenschmidt B, Zhao E, Easton DF, Antoniou AC, Chenevix-Trench G, Pharoah PDP, Schmidt MK, Blomqvist C, Nevanlinna H. PREDICT validity for prognosis of breast cancer patients with pathogenic BRCA1/2 variants. NPJ Breast Cancer 2023; 9:37. [PMID: 37173335 PMCID: PMC10182045 DOI: 10.1038/s41523-023-00546-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
We assessed the PREDICT v 2.2 for prognosis of breast cancer patients with pathogenic germline BRCA1 and BRCA2 variants, using follow-up data from 5453 BRCA1/2 carriers from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and the Breast Cancer Association Consortium (BCAC). PREDICT for estrogen receptor (ER)-negative breast cancer had modest discrimination for BRCA1 carrier patients overall (Gönen & Heller unbiased concordance 0.65 in CIMBA, 0.64 in BCAC), but it distinguished clearly the high-mortality group from lower risk categories. In an analysis of low to high risk categories by PREDICT score percentiles, the observed mortality was consistently lower than the expected mortality, but the confidence intervals always included the calibration slope. Altogether, our results encourage the use of the PREDICT ER-negative model in management of breast cancer patients with germline BRCA1 variants. For the PREDICT ER-positive model, the discrimination was slightly lower in BRCA2 variant carriers (concordance 0.60 in CIMBA, 0.65 in BCAC). Especially, inclusion of the tumor grade distorted the prognostic estimates. The breast cancer mortality of BRCA2 carriers was underestimated at the low end of the PREDICT score distribution, whereas at the high end, the mortality was overestimated. These data suggest that BRCA2 status should also be taken into consideration with tumor characteristics, when estimating the prognosis of ER-positive breast cancer patients.
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Affiliation(s)
- Taru A Muranen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
- Research Program in Systems Oncology, Department of Biochemistry and Developmental Biology, University of Helsinki, Helsinki, Finland.
| | - Anna Morra
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sofia Khan
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Genetics, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Individualized Drug Therapy Research Program, University of Helsinki, Helsinki, Finland
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland
| | - Daniel R Barnes
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Michael T Parsons
- Population Health Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Kristiina Aittomäki
- Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Banu K Arun
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katarzyna Bialkowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicola J Camp
- Department of Internal Medicine and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Susan M Domchek
- Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - D Gareth Evans
- Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University Hospital Foundation NHS Trust, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Clinical Genetics Service, Manchester Centre for Genomic Medicine, Manchester University Hospitals Foundation Trust, Manchester, UK
- Manchester Breast Centre, Oglesby Cancer Research Centre, The Christie, University of Manchester, Manchester, UK
| | - Manuela Gago-Dominguez
- Health Research Institute of Santiago de Compostela Foundation (FIDIS), SERGAS, Cancer Genetics and Epidemiology Group Santiago de Compostela, Santiago de Compostela, Spain
| | - Montserrat García-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gord Glendon
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Pascal Guénel
- Team "Exposome and Heredity", CESP, Gustave Roussy, INSERM, University Paris-Saclay, UVSQ, Villejuif, France
| | - Eric Hahnen
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Helen Hanson
- SouthWest Thames Centre for Genomics, St George's University Hospital's NHS Foundation Trust, London, UK
| | - Maartje J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Reiner Hoppe
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Louise Izatt
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Paul A James
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Vessela N Kristensen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Fiona Lalloo
- Clinical Genetics Service, Manchester Centre for Genomic Medicine, Manchester University Hospitals Foundation Trust, Manchester, UK
| | - Geoffrey J Lindeman
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Cancer Biology and Stem Cells Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Arto Mannermaa
- Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
| | - Sara Margolin
- Department of Oncology, Stockholm South General Hospital (Södersjukhuset), Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - William G Newman
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM ETS - The AIRC Institute of Molecular Oncology, Milan, Italy
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Miquel Angel Pujana
- Translational Research Laboratory, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | | | - Karina Rønlund
- Department of Clinical Genetics, University Hospital of Southern Denmark, Vejle Hospital, Vejle, Denmark
| | | | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Andreas Schneeweiss
- National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
- Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Christian F Singer
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Maija Suvanto
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Yen Yen Tan
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odence C, Denmark
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Vishakha Tripathi
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Barbara Wappenschmidt
- Center for Familial Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Integrated Oncology (CIO), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emily Zhao
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Menon U, Gentry-Maharaj A, Burnell M, Ryan A, Kalsi JK, Singh N, Dawnay A, Fallowfield L, McGuire AJ, Campbell S, Skates SJ, Parmar M, Jacobs IJ. Mortality impact, risks, and benefits of general population screening for ovarian cancer: the UKCTOCS randomised controlled trial. Health Technol Assess 2023:1-81. [PMID: 37183782 PMCID: PMC10542866 DOI: 10.3310/bhbr5832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Background Ovarian and tubal cancers are lethal gynaecological cancers, with over 50% of the patients diagnosed at advanced stage. Trial design Randomised controlled trial involving 27 primary care trusts adjacent to 13 trial centres based at NHS Trusts in England, Wales and Northern Ireland. Methods Postmenopausal average-risk women, aged 50-74, with intact ovaries and no previous ovarian or current non-ovarian cancer. Interventions One of two annual screening strategies: (1) multimodal screening (MMS) using a longitudinal CA125 algorithm with repeat CA125 testing and transvaginal scan (TVS) as second line test (2) ultrasound screening (USS) using TVS alone with repeat scan to confirm any abnormality. The control (C) group had no screening. Follow-up was through linkage to national registries, postal follow-up questionnaires and direct communication with trial centres and participants. Objective To assess comprehensively risks and benefits of ovarian cancer screening in the general population. Outcome Primary outcome was death due to ovarian or tubal cancer as assigned by an independent outcomes review committee. Secondary outcomes included incidence and stage at diagnosis of ovarian and tubal cancer, compliance, performance characteristics, harms and cost-effectiveness of the two screening strategies and a bioresource for future research. Randomisation The trial management system confirmed eligibility and randomly allocated participants using computer-generated random numbers to MMS, USS and C groups in a 1:1:2 ratio. Blinding Investigators and participants were unblinded and outcomes review committee was masked to randomisation group. Analyses Primary analyses were by intention to screen, comparing separately MMS and USS with C using the Versatile test. Results 1,243,282 women were invited and 205,090 attended for recruitment between April 2001 and September 2005. Randomised 202,638 women: 50,640 MMS, 50,639 USS and 101,359 C group. Numbers analysed for primary outcome 202,562 (>99.9%): 50,625 (>99.9%) MMS, 50,623 (>99.9%) USS, and 101,314 (>99.9%) C group. Outcome Women in MMS and USS groups underwent 345,570 and 327,775 annual screens between randomisation and 31 December 2011. At median follow-up of 16.3 (IQR 15.1-17.3) years, 2055 women developed ovarian or tubal cancer: 522 (1.0% of 50,625) MMS, 517 (1.0% of 50,623) USS, and 1016 (1.0% of 101314) in C group. Compared to the C group, in the MMS group, the incidence of Stage I/II disease was 39.2% (95% CI 16.1 to 66.9) higher and stage III/IV 10.2% (95% CI -21.3 to 2.4) lower. There was no difference in stage in the USS group. 1206 women died of the disease: 296 (0.6%) MMS, 291 (0.6%) USS, and 619 (0.6%) C group. There was no significant reduction in ovarian and tubal cancer deaths in either MMS (p = 0.580) or USS (p = 0.360) groups compared to the C group. Overall compliance with annual screening episode was 80.8% (345,570/420,047) in the MMS and 78.0% (327,775/420,047) in the USS group. For ovarian and tubal cancers diagnosed within one year of the last test in a screening episode, in the MMS group, the sensitivity, specificity and positive predictive values were 83.8% (95% CI 78.7 to 88.1), 99.8% (95% CI 99.8 to 99.9), and 28.8% (95% CI 25.5 to 32.2) and in the USS group, 72.2% (95% CI 65.9 to 78.0), 99.5% (95% CI 99.5 to 99.5), and 9.1% (95% CI 7.8 to 10.5) respectively. The final within-trial cost-effectiveness analysis was not undertaken as there was no mortality reduction. A bioresource (UKCTOCS Longitudinal Women's Cohort) of longitudinal outcome data and over 0.5 million serum samples including serial annual samples in women in the MMS group was established and to date has been used in many new studies, mainly focused on early detection of cancer. Harms Both screening tests (venepuncture and TVS) were associated with minor complications with low (8.6/100,000 screens MMS; 18.6/100,000 screens USS) complication rates. Screening itself did not cause anxiety unless more intense repeat testing was required following abnormal screens. In the MMS group, for each screen-detected ovarian or tubal cancer, an additional 2.3 (489 false positives; 212 cancers) women in the MMS group had unnecessary false-positive (benign adnexal pathology or normal adnexa) surgery. Overall, 14 (489/345,572 annual screens) underwent unnecessary surgery per 10,000 screens. In the USS group, for each screen-detected ovarian or tubal cancer, an additional 10 (1630 false positives; 164 cancers) underwent unnecessary false-positive surgery. Overall, 50 (1630/327,775 annual screens) women underwent unnecessary surgery per 10,000 screens. Conclusions Population screening for ovarian and tubal cancer for average-risk women using these strategies should not be undertaken. Decreased incidence of Stage III/IV cancers during multimodal screening did not translate to mortality reduction. Researchers should be cautious about using early stage as a surrogate outcome in screening trials. Meanwhile the bioresource provides a unique opportunity to evaluate early cancer detection tests. Funding Long-term follow-up UKCTOCS (2015-2020) - National Institute for Health and Care Research (NIHR HTA grant 16/46/01), Cancer Research UK, and The Eve Appeal. UKCTOCS (2001-2014) - Medical Research Council (MRC) (G9901012/G0801228), Cancer Research UK (C1479/A2884), and the UK Department of Health, with additional support from The Eve Appeal. Researchers at UCL were supported by the NIHR UCL Hospitals Biomedical Research Centre and by MRC Clinical Trials Unit at UCL core funding (MR_UU_12023).
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Affiliation(s)
- Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Matthew Burnell
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Andy Ryan
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Jatinderpal K Kalsi
- Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Naveena Singh
- Department of Cellular Pathology, Barts Health NHS Trust, London, UK
| | - Anne Dawnay
- Department of Clinical Biochemistry, Barts Health NHS Service Trust, London, UK
| | - Lesley Fallowfield
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | | | | | - Steven J Skates
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Mahesh Parmar
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Ian J Jacobs
- Department of Women's Health, University of New South Wales, Sydney, NSW, Australia
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Bourne JE, Foster C, Forte C, Aning J, Potter S, Hart EC, Armstrong MEG. Study protocol for two pilot randomised controlled trials aimed at increasing physical activity using electrically assisted bicycles to enhance prostate or breast cancer survival. Pilot Feasibility Stud 2023; 9:68. [PMID: 37095588 PMCID: PMC10124052 DOI: 10.1186/s40814-023-01293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND In 2020, 1.4 and 2.3 million new cases of prostate cancer and breast cancer respectively were diagnosed globally. In the UK, prostate cancer is the most common male cancer, while breast cancer is the most common female cancer. Engaging in physical activity (PA) is a key component of treatment. However, rates of PA are low in these clinical populations. This paper describes the protocol of CRANK-P and CRANK-B, two pilot randomised controlled trials, involving an e-cycling intervention aimed at increasing PA in individuals with prostate cancer or breast cancer respectively. METHODS These two trials are single-centre, stratified, parallel-group, two-arm randomised waitlist-controlled pilot trials in which forty individuals with prostate cancer (CRANK-P) and forty individuals with breast cancer (CRANK-B) will be randomly assigned, in a 1:1 allocation ratio, to an e-cycling intervention or waitlist control. The intervention consists of e-bike training with a certified cycle instructor, followed by the provision of an e-bike for 12 weeks. Following the intervention period, participants in the e-bike condition will be directed to community-based initiatives through which they can access an e-bike. Data will be collected at baseline (T0), immediately post intervention (T1) and at 3-month follow-up (T2). In addition, in the intervention group, data will be collected during the intervention and follow-up periods. Quantitative and qualitative methods will be used. The primary objectives are to determine effective recruitment strategies, establish recruitment and consent rates, adherence and retention in the study, and determine the feasibility and acceptability of the study procedures and intervention. The potential impact of the intervention on clinical, physiological and behavioural outcomes will be assessed to examine intervention promise. Data analyses will be descriptive. DISCUSSION The findings from these trials will provide information on trial feasibility and highlight the potential of e-cycling as a strategy to positively impact the health and behaviour of individuals with prostate cancer and breast cancer. If appropriate, this information can be used to design and deliver a fully powered definitive trial. TRIAL REGISTRATION CRANK-B: [ISRCTN39112034]. CRANK-P [ISRCTN42852156]. Registered [08/04/2022] https://www.isrctn.com .
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Chloe Forte
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Jonathan Aning
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK
| | - Shelley Potter
- Bristol Breast Care Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK
- Bristol Medical School, Translational Health Sciences, University of Bristol, 5 Tyndall Avenue, Bristol, BS8 1UD, UK
| | - Emma C Hart
- Biomedical Sciences Building, School of Physiology, Pharmacology & Neuroscience, University of Bristol, University Walk, Bristol, BS8 1TD, UK
| | - Miranda E G Armstrong
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
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30
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Habbous S, Barisic A, Homenauth E, Kandasamy S, Forster K, Eisen A, Holloway C. Estimating the incidence of breast cancer recurrence using administrative data. Breast Cancer Res Treat 2023; 198:509-522. [PMID: 36422755 DOI: 10.1007/s10549-022-06812-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Breast cancer is the most common cancer among women, but most cancer registries do not capture recurrences. We estimated the incidence of local, regional, and distant recurrences using administrative data. METHODS Patients diagnosed with stage I-III primary breast cancer in Ontario, Canada from 2013 to 2017 were included. Patients were followed until 31/Dec/2021, death, or a new primary cancer diagnosis. We used hospital administrative data (diagnostic and intervention codes) to identify local recurrence, regional recurrence, and distant metastasis after primary diagnosis. We used logistic regression to explore factors associated with developing a distant metastasis. RESULTS With a median follow-up 67 months, 5,431/45,857 (11.8%) of patients developed a distant metastasis a median 23 (9, 42) months after diagnosis of the primary tumor. 1086 (2.4%) and 1069 (2.3%) patients developed an isolated regional or a local recurrence, respectively. Patients with distant metastatic disease had a median overall survival of 15.4 months (95% CI 14.4-16.4 months) from the time recurrence/metastasis was identified. In contrast, the median survival for all other patients was not reached. Patients were more likely to develop a distant metastasis if they had more advanced stage, greater comorbidity, and presented with symptoms (p < 0.0001). Trastuzumab halved the risk of recurrence [OR 0.53 (0.45-0.63), p < 0.0001]. CONCLUSION Distant metastasis is not a rare outcome for patients diagnosed with breast cancer, translating to an annual incidence of 2132 new cases (17.8% of all breast cancer diagnoses). Overall survival remains high for patients with locoregional recurrences, but was poor following a diagnosis of a distant metastasis.
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Affiliation(s)
- Steven Habbous
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada.
- Department of Epidemiology & Biostatistics, Western University, London, ON, N6A 5C1, Canada.
| | - Andriana Barisic
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Esha Homenauth
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Sharmilaa Kandasamy
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Katharina Forster
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
| | - Andrea Eisen
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
- Department of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, M4Y 1H1, Canada
| | - Claire Holloway
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, ON, M5G2L3, Canada
- Department of Surgery, University of Toronto, Toronto, ON, M5T1P5, Canada
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31
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Wang R, Lian J, Wang X, Pang X, Xu B, Tang S, Shao J, Lu H. Survival rate of colorectal cancer in China: A systematic review and meta-analysis. Front Oncol 2023; 13:1033154. [PMID: 36937415 PMCID: PMC10020492 DOI: 10.3389/fonc.2023.1033154] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
Background This study aims to comprehensively summarize the colorectal survival rate in China. Method: In PubMed and Web of Science, keywords such as "colorectal cancer", "survival" and "China" were used to search literatures in the past 10 years. Random effect models were selected to summarize 1-year, 3-year, and 5-year survival rates, and meta-regression and subgroup analyses were performed on the included studies. Results A total of 16 retrospective and prospective studies providing survival rates for colorectal cancer in China were included. The 1-year, 3-year, and 5-year survival rates of colorectal cancer in China were 0.79, 0.72 and 0.62, respectively. In the included studies, the 5-year survival rates of stage I (5474 cases), stage II (9215 cases), stage III (8048 cases), and stage IV (4199 cases) colorectal cancer patients were 0.85, 0.81, 0.57 and 0.30, respectively. Among them, the 5-year survival rates of colorectal cancer were 0.82, 0.76, 0.71, 0.67, 0.66, 0.65 and 0.63 in Tianjin, Beijing, Guangdong, Shandong, Liaoning, Zhejiang and Shanghai, respectively. Conclusion The 5-year survival rate in China is close to that of most European countries, but still lower than Japan and South Korea, and the gap is gradually narrowing. Region, stage, differentiation, pathological type, and surgical approach can affect 5-year survival in colorectal cancer. Systematic review registration https://www.crd.york.ac.uk/prospero/ identifier, CRD42022357789.
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Affiliation(s)
| | | | | | | | | | | | | | - Haibo Lu
- Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, China
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Jenkins C, Woods F, Chandler S, Carter K, Jenkins R, Cunningham A, Nelson K, Still R, Walters JA, Gwynn N, Chea W, Harford R, O'Neill C, Hepburn J, Hill I, Wilkes H, Fegan G, Dunstan P, Harris DA. A novel blood based triage test for colorectal cancer in primary care: a pilot study. BJGP Open 2023; 7:BJGPO.2022.0077. [PMID: 36332909 DOI: 10.3399/bjgpo.2022.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/02/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The majority of colorectal cancers (CRCs) are detected after symptomatic presentation to primary care. Given the shared symptoms of CRC and benign disorders, it is challenging to manage the risk of missed diagnosis. Colonoscopy resources cannot keep pace with increasing demand. There is a pressing need for access to simple triage tools in primary care to help prioritise patients for referral. AIM To evaluate the performance of a novel spectroscopy-based CRC blood test in primary care. DESIGN & SETTING Mixed-methods pilot study of test performance and GP focus group discussions in South Wales. METHOD Patients on the urgent suspected cancer (USC) pathway were recruited for the Raman spectroscopy (RS) test coupled to machine learning classification ('Raman-CRC') to identify CRC within the referred population. Qualitative focus group work evaluated the acceptability of the test in primary care by thematic analysis of focus group theorising. RESULTS A total of 532 patients aged ≥50 years referred on the USC pathway were recruited from 27 GP practices. Twenty-nine patients (5.0%) were diagnosed with CRC. Raman-CRC identified CRC with sensitivity 95.7%, specificity 69.3% with area under curve (AUC) of 0.80 compared with colonoscopy as the reference test (248 patients). Stage I and II cancers were detected with 78.6% sensitivity. Focus group themes underlined the convenience of a blood test for the patient and the test's value as a risk assessment tool in primary care. CONCLUSION The findings support this novel, non-invasive, blood-based method to prioritise those patients most likely to have CRC. Raman-CRC may accelerate access to diagnosis with potential to improve cancer outcomes.
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Affiliation(s)
- Cerys Jenkins
- Physics Department, College of Science, Centre for NanoHealth, Swansea University, Swansea, UK
| | - Freya Woods
- Physics Department, College of Science, Centre for NanoHealth, Swansea University, Swansea, UK
| | - Susan Chandler
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Kym Carter
- Swansea University Medical School, Swansea University, Swansea, UK
- Swansea Trials Unit, Swansea University, Swansea, UK
| | - Rhys Jenkins
- Physics Department, College of Science, Centre for NanoHealth, Swansea University, Swansea, UK
| | | | | | - Rachel Still
- Department of Laboratory Medicine, of Medical Biochemistry, Swansea Bay University Health Board, Swansea, UK
| | - Jenna A Walters
- Department of Laboratory Medicine, of Medical Biochemistry, Swansea Bay University Health Board, Swansea, UK
| | - Non Gwynn
- Department of Laboratory Medicine, of Medical Biochemistry, Swansea Bay University Health Board, Swansea, UK
| | - Wilson Chea
- Department of Colorectal Surgery, Swansea Bay University Health Board, Swansea Bay University Health Board, Morriston Hospital, Swansea, UK
| | - Rachel Harford
- Research and Development Department Swansea Bay University Health Board, Institute of Life Science 2, Swansea University, Swansea, UK
| | - Claire O'Neill
- Swansea University Medical School, Swansea University, Swansea, UK
- Swansea Trials Unit, Swansea University, Swansea, UK
| | - Julie Hepburn
- Public Involvement Community, Health and Care Research Wales, Cardiff, UK
| | - Ian Hill
- Public Involvement Community, Health and Care Research Wales, Cardiff, UK
| | | | - Greg Fegan
- Swansea University Medical School, Swansea University, Swansea, UK
- Swansea Trials Unit, Swansea University, Swansea, UK
| | - Peter Dunstan
- Physics Department, College of Science, Centre for NanoHealth, Swansea University, Swansea, UK
| | - Dean A Harris
- Department of Colorectal Surgery, Swansea Bay University Health Board, Swansea Bay University Health Board, Morriston Hospital, Swansea, UK
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Pung L, Moorin R, Trevithick R, Taylor K, Chai K, Garcia Gewerc C, Ha N, Smith S. Determining cancer stage at diagnosis in population-based cancer registries: A rapid scoping review. FRONTIERS IN HEALTH SERVICES 2023; 3:1039266. [PMID: 36926511 PMCID: PMC10012750 DOI: 10.3389/frhs.2023.1039266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/03/2023] [Indexed: 03/18/2023]
Abstract
Introduction Population-based cancer registries are the main source of data for population-level analysis of cancer stage at diagnosis. This data enables analysis of cancer burden by stage, evaluation of screening programs and provides insight into differences in cancer outcomes. The lack of standardised collection of cancer staging in Australia is well recognised and is not routinely collected within the Western Australia Cancer Registry. This review aimed to explore how cancer stage at diagnosis is determined in population-based cancer registries. Methods This review was guided by the Joanna-Briggs Institute methodology. A systematic search of peer-reviewed research studies and grey literature from 2000 to 2021 was conducted in December 2021. Literature was included if peer-reviewed articles or grey literature sources used population-based cancer stage at diagnosis, and were published in English between 2000 and 2021. Literature was excluded if they were reviews or only the abstract was available. Database results were screened by title and abstract using Research Screener. Full-texts were screened using Rayyan. Included literature were analysed using thematic analysis and managed through NVivo. Results The findings of the 23 included articles published between 2002 and 2021 consisted of two themes. (1) "Data sources and collection processes" outlines the data sources used, as well as the processes and timing of data collection utilised by population-based cancer registries. (2) "Staging classification systems" reveals the staging classification systems employed or developed for population-based cancer staging, including the American Joint Committee on Cancer's Tumour Node Metastasis and related systems; simplified systems classified into localised, regional, and distant categories; and miscellaneous systems. Conclusions Differences in approaches used to determine population-based cancer stage at diagnosis challenge attempts to make interjurisdictional and international comparisons. Barriers to collecting population-based stage at diagnosis include resource availability, infrastructure differences, methodological complexity, interest variations, and differences in population-based roles and emphases. Even within countries, disparate funding sources and funder interests can challenge the uniformity of population-based cancer registry staging practices. International guidelines to guide cancer registries in collecting population-based cancer stage is needed. A tiered framework of standardising collection is recommended. The results will inform integrating population-based cancer staging into the Western Australian Cancer Registry.
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Affiliation(s)
- Li Pung
- School of Population Health, Curtin University, Perth, WA, Australia.,Public Health, North Metropolitan Health Service, Perth, WA, Australia
| | - Rachael Moorin
- School of Population Health, Curtin University, Perth, WA, Australia.,School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Richard Trevithick
- Department of Health, Western Australia Cancer Registry, Clinical Excellence Division, Perth, WA, Australia
| | - Karen Taylor
- Cancer Network WA, North Metropolitan Health Service, Perth, WA, Australia
| | - Kevin Chai
- School of Population Health, Curtin University, Perth, WA, Australia
| | | | - Ninh Ha
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Stephanie Smith
- School of Population Health, Curtin University, Perth, WA, Australia
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Lawler M, Davies L, Oberst S, Oliver K, Eggermont A, Schmutz A, La Vecchia C, Allemani C, Lievens Y, Naredi P, Cufer T, Aggarwal A, Aapro M, Apostolidis K, Baird AM, Cardoso F, Charalambous A, Coleman MP, Costa A, Crul M, Dégi CL, Di Nicolantonio F, Erdem S, Geanta M, Geissler J, Jassem J, Jagielska B, Jonsson B, Kelly D, Kelm O, Kolarova T, Kutluk T, Lewison G, Meunier F, Pelouchova J, Philip T, Price R, Rau B, Rubio IT, Selby P, Južnič Sotlar M, Spurrier-Bernard G, van Hoeve JC, Vrdoljak E, Westerhuis W, Wojciechowska U, Sullivan R. European Groundshot-addressing Europe's cancer research challenges: a Lancet Oncology Commission. Lancet Oncol 2023; 24:e11-e56. [PMID: 36400101 DOI: 10.1016/s1470-2045(22)00540-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years. We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research. This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis; treatment modalities such as radiotherapy and surgery; and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis. Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda. Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average 10-year survival for all European cancer patients by 2035.
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Affiliation(s)
- Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK.
| | - Lynne Davies
- International Cancer Research Partnership, International House, Cardiff, UK
| | - Simon Oberst
- Organisation of European Cancer Institutes, Brussels, Belgium
| | - Kathy Oliver
- International Brain Tumour Alliance, Tadworth, UK; European Cancer Organisation Patient Advisory Committee, Brussels, Belgium
| | - Alexander Eggermont
- Faculty of Medicine, Utrecht University Medical Center, Utrecht, Netherlands; Princess Máxima Centrum, Utrecht, Netherlands
| | - Anna Schmutz
- International Agency for Cancer Research, Lyon, France
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Peter Naredi
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tanja Cufer
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ajay Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK; Institute of Cancer Policy, King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matti Aapro
- Genolier Cancer Center, Genolier, Switzerland
| | - Kathi Apostolidis
- Hellenic Cancer Federation, Athens, Greece; European Cancer Patient Coalition, Brussels, Belgium
| | - Anne-Marie Baird
- Lung Cancer Europe, Bern, Switzerland; Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Fatima Cardoso
- Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Andreas Charalambous
- European Cancer Organisation Brussels, Brussels, Belgium; Department of Nursing, Cyprus University of Technology, Limassol, Cyprus; Department of Oncology, University of Turku, Turku, Finland
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Csaba L Dégi
- Faculty of Sociology and Social Work, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Federica Di Nicolantonio
- Department of Oncology, University of Turin, Turin, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Sema Erdem
- European Cancer Organisation Patient Advisory Committee, Europa Donna, Istanbul, Türkiye
| | - Marius Geanta
- Centre for Innovation in Medicine and Kol Medical Media, Bucharest, Romania
| | - Jan Geissler
- Patvocates and CML Advocates Network, Leukaemie-Online (LeukaNET), Munich, Germany
| | | | - Beata Jagielska
- Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Olaf Kelm
- International Agency for Research on Cancer, Lyon, France
| | | | - Tezer Kutluk
- Faculty of Medicine & Cancer Institute, Hacettepe University, Ankara, Türkiye
| | - Grant Lewison
- Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
| | | | | | - Thierry Philip
- Organisation of European Cancer Institutes, Brussels, Belgium; Institut Curie, Paris, France
| | - Richard Price
- European Cancer Organisation Brussels, Brussels, Belgium
| | - Beate Rau
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Peter Selby
- School of Medicine, University of Leeds, Leeds, UK
| | | | | | - Jolanda C van Hoeve
- Organisation of European Cancer Institutes, Brussels, Belgium; Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Eduard Vrdoljak
- Department of Oncology, University Hospital Center Split, School of Medicine, University of Split, Split, Croatia
| | - Willien Westerhuis
- Organisation of European Cancer Institutes, Brussels, Belgium; Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | | | - Richard Sullivan
- Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
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Gouliaev A, Rasmussen TR, Malila N, Fjellbirkeland L, Löfling L, Jakobsen E, Dalton SO, Christensen NL. Lung cancer registries in Denmark, Finland, Norway and Sweden: a comparison and proposal for harmonization. Acta Oncol 2023; 62:1-7. [PMID: 36718556 DOI: 10.1080/0284186x.2023.2172687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Lung cancer is the leading cause of cancer-related death in all Nordic countries which, though similar in demographics and healthcare systems, have noticeable differences in lung cancer survival. Historically, Denmark and Finland have had higher lung cancer incidences and lower survival than Norway and Sweden. All four countries have national cancer registries. Data in these registries are often compared, but their full potential as a source of learning across the Nordic countries is impeded by differences between the registries. In this paper, we describe and compare the Nordic registries on lung cancer-specific data and discuss how a more harmonized registration practice could increase their usefulness as a source for mutual learning and quality improvements. METHODS We describe and compare the characteristics of data on lung cancer cases from registries in Denmark, Finland, Norway and Sweden. Moreover, we compare the results from the latest annual reports and specify how data may be acquired from the registries for research. RESULTS Denmark has a separate clinical lung cancer registry with more detailed data than the other Nordic countries. Finland and Norway report lung cancer survival as relative survival, whereas Denmark and Sweden report overall survival. The Danish Lung Cancer Registry and the Swedish Cancer Registry do not receive data from the Cause of Death registries in contrast to the Finnish Cancer Registry and the Cancer Registry of Norway. CONCLUSION The lung cancer registries in Denmark, Finland, Norway and Sweden have high level of completeness. However, several important differences between the registries may bias comparative analyses.
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Affiliation(s)
- A Gouliaev
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - T R Rasmussen
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - N Malila
- The Finnish Cancer Registry, Cancer Society of Finland, Helsinki, Finland
| | - L Fjellbirkeland
- Department of Respiratory Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - L Löfling
- Department of Research, Cancer Registry of Norway, Oslo, Norway, formerly affiliated with Department of Medicine, SOLNA Karolinska Institutet, Solna, Sweden
| | - E Jakobsen
- Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
| | - S O Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.,Danish Research Center for Equality in Cancer (COMPAS), Department for Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - N L Christensen
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
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Vedsted P, Weller D, Zalounina Falborg A, Jensen H, Kalsi J, Brewster D, Lin Y, Gavin A, Barisic A, Grunfeld E, Lambe M, Malmberg M, Turner D, Harland E, Hawryluk B, Law RJ, Neal RD, White V, Bergin R, Harrison S, Menon U. Diagnostic pathways for breast cancer in 10 International Cancer Benchmarking Partnership (ICBP) jurisdictions: an international comparative cohort study based on questionnaire and registry data. BMJ Open 2022; 12:e059669. [PMID: 36521881 PMCID: PMC9756230 DOI: 10.1136/bmjopen-2021-059669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES A growing body of evidence suggests longer time between symptom onset and start of treatment affects breast cancer prognosis. To explore this association, the International Cancer Benchmarking Partnership Module 4 examined differences in breast cancer diagnostic pathways in 10 jurisdictions across Australia, Canada, Denmark, Norway, Sweden and the UK. SETTING Primary care in 10 jurisdictions. PARTICIPANT Data were collated from 3471 women aged >40 diagnosed for the first time with breast cancer and surveyed between 2013 and 2015. Data were supplemented by feedback from their primary care physicians (PCPs), cancer treatment specialists and available registry data. PRIMARY AND SECONDARY OUTCOME MEASURES Patient, primary care, diagnostic and treatment intervals. RESULTS Overall, 56% of women reported symptoms to primary care, with 66% first noticing lumps or breast changes. PCPs reported 77% presented with symptoms, of whom 81% were urgently referred with suspicion of cancer (ranging from 62% to 92%; Norway and Victoria). Ranges for median patient, primary care and diagnostic intervals (days) for symptomatic patients were 3-29 (Denmark and Sweden), 0-20 (seven jurisdictions and Ontario) and 8-29 (Denmark and Wales). Ranges for median treatment and total intervals (days) for all patients were 15-39 (Norway, Victoria and Manitoba) and 4-78 days (Sweden, Victoria and Ontario). The 10% longest waits ranged between 101 and 209 days (Sweden and Ontario). CONCLUSIONS Large international differences in breast cancer diagnostic pathways exist, suggesting some jurisdictions develop more effective strategies to optimise pathways and reduce time intervals. Targeted awareness interventions could also facilitate more timely diagnosis of breast cancer.
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Affiliation(s)
- Peter Vedsted
- Department for Clinical Medicine, Aarhus Universitet, Aarhus, Denmark
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
| | - David Weller
- General Practice, University of Edinburgh, Edinburgh, UK
| | - Alina Zalounina Falborg
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
| | - Henry Jensen
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus C, Denmark
| | - Jatinderpal Kalsi
- Gynaecological Cancer Research Centre, University College London, London, UK
| | - David Brewster
- Scottish Registry, Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Anna Gavin
- N Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | | | - Eva Grunfeld
- Department of Family and Community Medicine, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Mats Lambe
- University Hospital, Regional Cancer Centre of Central Sweden, Uppsala, Sweden
| | - Martin Malmberg
- Department of Oncology, Lund University Hospital, Lund, Sweden
| | - Donna Turner
- Population Oncology, Cancer Care Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Harland
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Breann Hawryluk
- Patient Navigation, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Rebecca-Jane Law
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | | | - Victoria White
- CBRC, Cancer Council Victoria, Melbourne, Victoria, Australia
- Deakin University Faculty of Health, Burwood, Victoria, Australia
| | - Rebecca Bergin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | | | - Usha Menon
- Women's Cancer, University College London, London, UK
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37
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General practice-based cancer research publications: a bibliometric analysis 2013-2019. Br J Gen Pract 2022; 73:e133-e140. [PMID: 36702582 PMCID: PMC9762764 DOI: 10.3399/bjgp.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 09/09/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND General practice plays a critical role in the prevention, diagnosis, management, and survivorship care of patients with cancer. Mapping research outputs over time provides valuable insights into the evolving role of general practice in cancer care. AIM To describe and compare the distribution of cancer in general practice research publications by country, cancer type, area of the cancer continuum, author sex, and journal impact factor. DESIGN AND SETTING A bibliometric analysis using a systematic approach to identify publications. METHOD MEDLINE and Embase databases were searched for studies published between 2013 and 2019, which reported on cancer in general practice. Included studies were mapped to the cancer continuum framework. Descriptive statistics were used to present data from the included studies. RESULTS A total of 2798 publications were included from 714 journals, spanning 79 countries. The publication rate remained stable over this period. Overall, the US produced the most publications (n = 886, 31.7%), although, per general population capita, Denmark produced nearly 10 times more publications than the US (20.0 publications per million compared with 2.7 publications per million). Research across the cancer continuum varied by country, but, overall, most studies focused on cancer screening, diagnosis, and survivorship. More than half of included studies used observational study designs (n = 1523, 54.4%). Females made up 66.5% (n = 1304) of first authors, but only 47.0% (n = 927) of last authors. CONCLUSION Cancer in general practice is a stable field where research is predominantly observational. There is geographical variation in the focus of cancer in general practice research, which may reflect different priorities and levels of investment between countries. Overall, these results support future consideration of how to improve under-represented research areas and the design, conduct, and translation of interventional research.
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Ye C, Leslie WD, Al-Azazi S, Yan L, Lix LM, Czaykowski P, Singh H. Fractures and long-term mortality in cancer patients: a population-based cohort study. Osteoporos Int 2022; 33:2629-2635. [PMID: 36036268 DOI: 10.1007/s00198-022-06542-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/30/2022] [Indexed: 11/28/2022]
Abstract
UNLABELLED We assessed post-fracture mortality in a population-based cohort of 122,045 individuals with cancers. Major fractures (hip, vertebrae, humerus, and forearm) were associated with early and long-term increased all-cause mortality. INTRODUCTION Currently, there are no population-based data among cancer patients on post-fracture mortality risk across a broad range of cancer diagnoses. Our objective was to estimate the association of fracture with mortality in cancer survivors. METHODS Using Manitoba Cancer Registry data from the province of Manitoba, Canada, we identified all women and men with cancer diagnosed between January 1, 1987, and March 31, 2014. We then linked cancer data to provincial healthcare administrative data and ascertained fractures after cancer diagnosis and mortality to March 31, 2015. Hazard ratios for all-cause mortality in those with versus without fracture were estimated from time-dependent Cox proportional hazards models adjusted for multiple covariates. RESULTS The study cohort consisted of 122,045 cancer patients (median age 68 years, IQR 58-77, 49.2% female). During the median follow-up of 5.8 years from cancer diagnosis, we ascertained 7120 (5.8%) major fractures. All fracture sites, except for the forearm, were associated with increased mortality risk, even after multivariable adjustment. Excess mortality risk associated with a major fracture was greatest in the first year after fracture (HR 2.42, 95% CI 2.30-2.54) and remained significant > 5 years after fracture (HR 1.60, 95% CI 1.50-1.70) and for fractures occurring > 10 years after cancer diagnosis (HR 1.93, 95% CI 1.79-2.07). CONCLUSION Fractures among cancer patients are associated with increased all-cause mortality. This excess risk is greatest in the first year and persists more than 5 years post-fracture; increased risk is also noted for fractures occurring up to and beyond 10 years after cancer diagnosis.
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Affiliation(s)
- Carrie Ye
- University of Alberta, Edmonton, Canada.
| | | | | | - Lin Yan
- University of Manitoba, Winnipeg, Canada
| | - Lisa M Lix
- University of Manitoba, Winnipeg, Canada
| | - Piotr Czaykowski
- University of Manitoba, Winnipeg, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
| | - Harminder Singh
- University of Manitoba, Winnipeg, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
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Hassen HY, Hussien FM, Hassen AM, Dewau R, Amsalu ET, Limenih MA, Berhe NM, Kassaw NA, Sisay BG, Manzar MD. Survival pattern of colorectal cancer in Sub-Saharan Africa: A systematic review and meta-analysis. Cancer Epidemiol 2022; 81:102276. [PMID: 36257176 DOI: 10.1016/j.canep.2022.102276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 12/03/2022]
Abstract
Cancer incidence is relatively low in sub-Saharan Africa (SSA), however, prognosis is expected to be poor in comparison with high-income countries. Comprehensive evidence is limited on the survival pattern of colorectal cancer patients in the region. We conducted a systematic review and meta-analysis to investigate the pattern of colorectal cancer survival in the region and to identify variation across countries and over time. We searched international databases MEDLINE, Scopus, Embase, Web of Science, ProQuest, CINAHL, and Google Scholar to retrieve studies that estimated survival from colorectal cancer in SSA countries from inception to December 31, 2021 without language restriction. Due to between-study heterogeneity, we performed a random-effects meta-analysis to pool survival rates. To identify study-level sources of variation, we performed subgroup analysis and meta-regression. Results are reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020 guideline and the protocol was registered in PROSPERO database (CRD42021246935). 23 studies involving 10,031 patients were included in the review, of which, 20 were included in the meta-analysis. The meta-analysis results showed that the pooled 1-, 2-, 3-, 4-, and 5-year survival rates in SSA were 0.74 (95% CI, 0.66-0.81), 0.50 (95% CI, 0.41-0.58), 0.36 (95% CI, 0.27-0.47), 0.31 (95% CI, 0.22-0.42), and 0.28 (95% CI, 0.19-0.38) respectively. Subgroup analyses indicated that the survival rate varied according to year of study, in which those conducted in recent decades showed relatively better survival. The 5-year survival was higher in middle-income SSA countries (0.31; 95%CI: 0.17-0.49) than low-income countries (0.20; 95%CI: 0.11-0.35), however, the difference was not statistically significant. In conclusion, survival from colorectal cancer is low in sub-Saharan Africa compared to other regions. Thus, intervention strategies to improve screening, early diagnosis and treatment of colorectal cancer should be developed and implemented to improve survival in the region.
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Affiliation(s)
- Hamid Y Hassen
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium.
| | - Foziya M Hussien
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Anissa M Hassen
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Erkihun T Amsalu
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Miteku A Limenih
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Neamin M Berhe
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Nigussie A Kassaw
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Binyam G Sisay
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
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40
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Non-Invasive Biomarkers for Early Lung Cancer Detection. Cancers (Basel) 2022; 14:cancers14235782. [PMID: 36497263 PMCID: PMC9739091 DOI: 10.3390/cancers14235782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/27/2022] Open
Abstract
Worldwide, lung cancer (LC) is the most common cause of cancer death, and any delay in the detection of new and relapsed disease serves as a major factor for a significant proportion of LC morbidity and mortality. Though invasive methods such as tissue biopsy are considered the gold standard for diagnosis and disease monitoring, they have several limitations. Therefore, there is an urgent need to identify and validate non-invasive biomarkers for the early diagnosis, prognosis, and treatment of lung cancer for improved patient management. Despite recent progress in the identification of non-invasive biomarkers, currently, there is a shortage of reliable and accessible biomarkers demonstrating high sensitivity and specificity for LC detection. In this review, we aim to cover the latest developments in the field, including the utility of biomarkers that are currently used in LC screening and diagnosis. We comment on their limitations and summarise the findings and developmental stages of potential molecular contenders such as microRNAs, circulating tumour DNA, and methylation markers. Furthermore, we summarise research challenges in the development of biomarkers used for screening purposes and the potential clinical applications of newly discovered biomarkers.
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Muehlberg F, Kornfeld M, Zange L, Ghani S, Reichardt A, Reichardt P, Schulz‐Menger J. Early myocardial oedema can predict subsequent cardiomyopathy in high-dose anthracycline therapy. ESC Heart Fail 2022; 10:616-627. [PMID: 36404640 PMCID: PMC9871709 DOI: 10.1002/ehf2.14232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/06/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022] Open
Abstract
AIMS This study aims to assess subclinical changes in functional and morphologic myocardial MR parameters very early into a repetitive high-dose anthracycline treatment (planned cumulative dose >650 mg/m2 ), which may predict subsequent development of anthracycline-induced cardiomyopathy (aCMP). METHODS Thirty sarcoma patients with previous exposition of 300-360 mg/m2 doxorubicin-equivalent chemotherapy who were planned for a second treatment of anthracycline-based chemotherapy (360 mg/m2 doxorubicin-equivalent) were recruited. Enrolled individuals received three CMR studies (before treatment, 48 h after first anthracycline treatment and upon completion of treatment). Native T1 mapping (MOLLI 5s(3s)3s), T2 mapping, and extracellular volume (ECV) maps were acquired in addition to a conventional CMR with SSFP-cine imaging at 1.5 T. Patients were given 0.2 mmol/kg gadoteridol for ECV quantification and LGE imaging. Blood samples for cardiac biomarkers were obtained before each scan. Development of relevant aCMP was defined as drop of left ventricular ejection fraction (LVEF) by >10% compared with baseline. RESULTS Twenty-three complete datasets were available for analysis. Median treatment time was 20.7 ± 3.0 weeks. Eight patients developed aCMP with LVEF reduction >10% until end of chemotherapy. Baseline LVEF was not different between patients with and without subsequent aCMP. Patients with aCMP had decreased LV mass upon completion of therapy (99.4 ± 26.5 g vs. 90.3 ± 24.8 g; P = 0.02), whereas patients without aCMP did not show a change in LV mass (91.5 ± 20.0 g vs. 89.0 ± 23.6 g; P > 0.05). On strain analysis, GLS (-15.3 ± 1.3 vs. -13.4 ± 1.6; P = 0.02) and GCS (-16.7 ± 2.1 vs. -14.9 ± 2.6; P = 0.04) were decreased in aCMP patients upon completion of therapy, whereas non-aCMP individuals showed no change in GLS (-15.4 ± 3.3 vs. -15.4 ± 3.4; P = 0.97). When assessed 48 h after first dose of anthracyclines, patients with subsequent aCMP had significantly elevated myocardial T2 times compared with before therapy (53.0 ± 2.8 ms vs. 49.3 ± 5.2 ms, P = 0.02) than patients who did not develop aCMP (50.7 ± 5.1 ms vs. 51.1 ± 3.9 ms, P > 0.05). Native T1 times decreased at 48 h after first dose irrespective of development of subsequent aCMP (1020.2 ± 28.4 ms vs. 973.5 ± 40.3 ms). Upon completion of therapy, patients with aCMP had increased native T1 compared with baseline (1050.8 ± 17.9 ms vs. 1022.4 ± 22.0 ms; P = 0.01), whereas non-aCMP patients did not (1034.5 ± 46.6 ms vs. 1018.4 ± 29.7 ms; P = 0.15). No patient developed new myocardial scars or compact myocardial fibrosis under chemotherapy. Cardiac biomarkers were elevated independent of development of aCMP. CONCLUSIONS With high cumulative anthracycline doses, early increase of T2 times 48 h after first treatment with anthracyclines can predict the development of subsequent aCMP after completion of chemotherapy. Early drop of native T1 times occurs irrespective of development of aCMP in high-dose anthracycline therapy.
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Affiliation(s)
- Fabian Muehlberg
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center – a joint cooperation between the Charité Medical Faculty and the Max‐Delbrück Center for Molecular Medicine; and HELIOS Hospital Berlin Buch, Department of Cardiology and Nephrology, DZHK (German Center for Cardiovascular Research) partner siteBerlinGermany
| | - Markus Kornfeld
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center – a joint cooperation between the Charité Medical Faculty and the Max‐Delbrück Center for Molecular Medicine; and HELIOS Hospital Berlin Buch, Department of Cardiology and Nephrology, DZHK (German Center for Cardiovascular Research) partner siteBerlinGermany
| | - Leonora Zange
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center – a joint cooperation between the Charité Medical Faculty and the Max‐Delbrück Center for Molecular Medicine; and HELIOS Hospital Berlin Buch, Department of Cardiology and Nephrology, DZHK (German Center for Cardiovascular Research) partner siteBerlinGermany
| | - Saeed Ghani
- Department for Interdisciplinary Oncology and Sarcoma CenterHELIOS Hospital Berlin‐BuchBerlinGermany
| | - Annette Reichardt
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center – a joint cooperation between the Charité Medical Faculty and the Max‐Delbrück Center for Molecular Medicine; and HELIOS Hospital Berlin Buch, Department of Cardiology and Nephrology, DZHK (German Center for Cardiovascular Research) partner siteBerlinGermany
| | - Peter Reichardt
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center – a joint cooperation between the Charité Medical Faculty and the Max‐Delbrück Center for Molecular Medicine; and HELIOS Hospital Berlin Buch, Department of Cardiology and Nephrology, DZHK (German Center for Cardiovascular Research) partner siteBerlinGermany
| | - Jeanette Schulz‐Menger
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center – a joint cooperation between the Charité Medical Faculty and the Max‐Delbrück Center for Molecular Medicine; and HELIOS Hospital Berlin Buch, Department of Cardiology and Nephrology, DZHK (German Center for Cardiovascular Research) partner siteBerlinGermany
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Torregrosa C, Chorin F, Beltran EEM, Neuzillet C, Cardot-Ruffino V. Physical Activity as the Best Supportive Care in Cancer: The Clinician's and the Researcher's Perspectives. Cancers (Basel) 2022; 14:5402. [PMID: 36358820 PMCID: PMC9655932 DOI: 10.3390/cancers14215402] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 08/11/2023] Open
Abstract
Multidisciplinary supportive care, integrating the dimensions of exercise alongside oncological treatments, is now regarded as a new paradigm to improve patient survival and quality of life. Its impact is important on the factors that control tumor development, such as the immune system, inflammation, tissue perfusion, hypoxia, insulin resistance, metabolism, glucocorticoid levels, and cachexia. An increasing amount of research has been published in the last years on the effects of physical activity within the framework of oncology, marking the appearance of a new medical field, commonly known as "exercise oncology". This emerging research field is trying to determine the biological mechanisms by which, aerobic exercise affects the incidence of cancer, the progression and/or the appearance of metastases. We propose an overview of the current state of the art physical exercise interventions in the management of cancer patients, including a pragmatic perspective with tips for routine practice. We then develop the emerging mechanistic views about physical exercise and their potential clinical applications. Moving toward a more personalized, integrated, patient-centered, and multidisciplinary management, by trying to understand the different interactions between the cancer and the host, as well as the impact of the disease and the treatments on the different organs, this seems to be the most promising method to improve the care of cancer patients.
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Affiliation(s)
- Cécile Torregrosa
- Oncologie Digestive, Département d’Oncologie Médicale Institut Curie, Université Versailles Saint-Quentin—Université Paris Saclay, 35, rue Dailly, 92210 Saint-Cloud, France
- Département de Chirurgie Digestive et Oncologique, Hôpital Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris, 9 avenue Charles de Gaulle, 92100 Boulogne Billancourt, France
| | - Frédéric Chorin
- Laboratoire Motricité Humaine, Expertise, Sport, Santé (LAMHESS), HEALTHY Graduate School, Université Côte d’Azur, 06205 Nice, France
- Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06205 Nice, France
| | - Eva Ester Molina Beltran
- Oncologie Digestive, Département d’Oncologie Médicale Institut Curie, Université Versailles Saint-Quentin—Université Paris Saclay, 35, rue Dailly, 92210 Saint-Cloud, France
| | - Cindy Neuzillet
- Oncologie Digestive, Département d’Oncologie Médicale Institut Curie, Université Versailles Saint-Quentin—Université Paris Saclay, 35, rue Dailly, 92210 Saint-Cloud, France
- GERCOR, 151 rue du Faubourg Saint-Antoine, 75011 Paris, France
| | - Victoire Cardot-Ruffino
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Department of Immunology, Harvard Medical School, Boston, MA 02215, USA
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Fantin A, Gruppo M, De Simoni O, Lonardi S, Cristofori C, Morbin T, Peserico G, Grillo S, Masier A, Franco M, Pilati P, Guzzinati S, Zorzi M, Rugge M. Impact of Microscopic Confirmation on Therapeutic Management of Pancreatic Cancer Patients: Lessons from an Italian Regional Tumor Registry. Cancers (Basel) 2022; 14:5372. [PMID: 36358790 PMCID: PMC9658973 DOI: 10.3390/cancers14215372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Incidence of pancreatic cancer (PC) is increasing worldwide and is set to become the second leading cause of cancer-related death in 2040 with a poor 5-year overall survival (OS). The aim of this study was to analyze the impact of microscopic diagnosis of PC (MiDPC) on diagnostic−therapeutic management and outcome. Methods: The Veneto region (north-eastern Italy) has been covered by a cancer registry (CR) since 1987. Clinical and oncological data about all cases of PC in the Veneto region from 1987 were extracted from the Veneto CR database. Results: In 2018, 1340 incident cases of PC in the Veneto population were registered (4.1% of all malignant tumors), with an increasing trend in females and stable incidence in males. Five-year OS in patients with PC was 8%. The percentage of MiDPC increased from 44% in 2010 to 60% in 2018 (p = 0.001). MiDPC was higher among patients aged < 75 years old (84.4%) compared to those aged ≥75 years old (38.9%), p = 0.001. Between 2010 and 2018, a significant increase in biopsy on the primary neoplasm (24.9% vs. 13%, p < 0.001) was reported. Patients with MiDPC had higher 5-year survival than patients with no MiDPC (12.9% vs. 1.2%, p < 0.001). Conclusions: The implementation of MiDPC was essential to improve diagnostic−therapeutic pathways and consequently the survival of PC patients.
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Affiliation(s)
- Alberto Fantin
- Department of Gastroenterology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Mario Gruppo
- Unit of Surgical Oncology of Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Ottavia De Simoni
- Unit of Surgical Oncology of Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Sara Lonardi
- Medical Oncology Unit 3, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Chiara Cristofori
- Department of Gastroenterology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Tiziana Morbin
- Department of Gastroenterology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Giulia Peserico
- Department of Gastroenterology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Sabina Grillo
- Department of Gastroenterology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Annalisa Masier
- Department of Gastroenterology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Monica Franco
- Department of Gastroenterology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Pierluigi Pilati
- Unit of Surgical Oncology of Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | | | - Manuel Zorzi
- Veneto Tumor Registry, Azienda Zero, 35128 Padua, Italy
| | - Massimo Rugge
- Veneto Tumor Registry, Azienda Zero, 35128 Padua, Italy
- Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padua, 35128 Padua, Italy
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Van Poppel H, Battisti NML, Lawler M, Kolarova T, Daly J, Rizvi K, Greene R, Buyens G, Oliver K, Price R, Osmanovic N, Venegoni E. European Cancer Organisation's Inequalities Network: Putting Cancer Inequalities on the European Policy Map. JCO Glob Oncol 2022; 8:e2200233. [PMID: 36252165 PMCID: PMC9812450 DOI: 10.1200/go.22.00233] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Hendrik Van Poppel
- European Association of Urology, Arnhem, the Netherlands,Katholieke Universiteit Leuven, Leuven, Belgium
| | - Nicolò Matteo Luca Battisti
- International Society of Geriatric Oncology, Châtelaine, Switzerland,The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Mark Lawler
- Queens University Belfast, Belfast, Northern Ireland
| | | | | | | | - Robert Greene
- HungerNdThirst Foundation, Amsterdam, the Netherlands
| | | | - Kathy Oliver
- International Brain Tumour Alliance, Tadworth Surrey, UK
| | | | | | - Enea Venegoni
- European Cancer Organisation, Brussels, Belgium,Enea Venegoni, Rue de la Science 41, 1000, Brussels, B-1040, Belgium; e-mail:
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Elgoraish A, Alnory A. Associated predictor covariates of cervical cancer stage and impact on survival at Khartoum oncology hospital, Sudan. F1000Res 2022; 10:114. [PMID: 36312527 PMCID: PMC9585357 DOI: 10.12688/f1000research.43590.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Cervical cancer can be invasive and advanced at diagnosis causing devastating suffering and premature death. The cancer stage at presentation is related to survival evaluation and several factors determine stage. The aim of the study was to examine predictors covariates associated with cervical cancer stage at diagnosis and its impact on patient prognosis and survival. Methods: This retrospective cross-sectional study was carried out at Khartoum oncology hospital, Sudan. Participants were 239 cervical cancer patients diagnosed and treated between 2011-2015. Patients’ pathological and socio-demographic data were extracted from their medical files and survival times were calculated from follow-up. Chi-square, Kaplan-Meier, Log-rank test and Cox regression model were used to examine relationships between demographic and clinical variables and survival outcome. Results: The mean age of the participants was 56.91 years and the majority were ≥45 years. Cancer survival analysis showed that the stage at diagnosis had limited association with socio-demographic factors, except where patients reside. Multivariate regression using the Cox proportional hazard model confirmed strongly that stage (p=0.035), chemotherapy (p=0.000) and radiotherapy (p=0.001) were the most likely predictor covariates of patient prognosis and survival time. Conclusions: The results of this study suggest cancer stage at diagnosis and certain treatments are the most important factors impacting the prognosis and survival of patients with cervical cancer. Early detection and vaccination of women against HPV infection provide enormous opportunities for early diagnosis, more effective treatment and better chances of survival.
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Affiliation(s)
- Amanda Elgoraish
- Epidemiology, Tropical Medicine Research Institute, National Centre for Research, Khartoum, Khartoum, P.O. Box 1304, Sudan
| | - Ahmed Alnory
- Applied Statistics and Demography, Faculty of Economics and Rural Development, University of Gezira, Medani, Gezira, P.O. Box 20, Sudan
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Abstract
The prevalence of breast cancer currently ranks first among Chinese women with malignant tumors, occurring during premenopausal childbearing age in more than 60% of patients. With the increasing age of women at childbirth, the wide application of assisted reproductive technology (ART) and the rejuvenation of tumor patients, the prevalence of breast cancer occurring during pregnancy (PrBC) is gradually increasing. There are many domestic and foreign expert consensus articles and guidelines on fertility preservation for children and patients of childbearing age with malignant tumors, but there is a lack of expert consensus or guidelines on fertility preservation for patients with PrBC. Considering the uniqueness of PrBC patients, there is an urgent need for a standardized suggestion regarding their fertility preservation. The Committee of Fertility Protection and Preservation of China Association for the Promotion of Health Science and Technology together with the Chinese Society of Gynecological Endocrinology affiliated with the International Society of Gynecological Endocrinology (CSGE-ISGE) organized relevant experts from different disciplines to formulate this consensus to guide fertility preservation of PrBC patients.
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Affiliation(s)
- Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Women's Health, University of Tuebingen, University Women's Hospital and Research Centre for Women's Health, Tuebingen, Germany
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Torkki P, Leskelä RL, Bugge C, Torfadottir JE, Karjalainen S. Cancer-related costs should be allocated in a comparable way-benchmarking costs of cancer in Nordic countries 2012-2017. Acta Oncol 2022; 61:1216-1222. [PMID: 36151990 DOI: 10.1080/0284186x.2022.2124883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND High costs of cancer, and especially the increase in treatment costs, have raised concerns about the financial sustainability of publicly funded health care systems around the world. As cancers get more prevalent with age, treatment costs are expected to keep rising with aging populations. The objective of the study is to analyze the changes in cost of cancer care broken down into separate cost components and outcomes of cancer treatment in the Nordic countries 2012-2017. MATERIALS AND METHODS We estimated direct costs of cancer based on retrospective data from national registers: outpatient care and inpatient care in primary care and specialized care as well as medicine costs. The number of cancer cases and survival data was obtained from NORDCAN. Cancer was defined as ICD-10 codes C00-C97. RESULTS Healthcare costs of cancer in real terms increased in all countries: CAGR was between 1 and 6% depending on the country. Medicine costs have increased rapidly (37-125%) in all countries during the observation period. In Finland and Denmark, inpatient care costs have decreased, whereas in Iceland, Norway, and Sweden, they have increased, although the number of inpatient days has decreased everywhere. The age-standardized cancer mortality has decreased constantly over time. CONCLUSION Cancer care in Nordic countries has significant differences in both cost structures and in the development of cost drivers, indicating differences in the organization of care and different focus in health policy. It is important to compare the cancer care costs internationally on a detailed level to understand the reasons for cost development. The registration of cost data, especially medicine costs, should be more standardized to enable better cost and outcomes comparisons between countries in the future.
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Affiliation(s)
- Paulus Torkki
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Riikka-Leena Leskelä
- Department of Public Health, University of Helsinki, Helsinki, Finland.,NHG Finland Ltd., Helsinki, Finland
| | - Christoffer Bugge
- Oslo Economics AS, Oslo, Norway.,Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
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Menon U, Weller D, Falborg AZ, Jensen H, Butler J, Barisic A, Knudsen AK, Bergin RJ, Brewster DH, Cairnduff V, Fourkala EO, Gavin AT, Grunfeld E, Harland E, Kalsi J, Law RJ, Lin Y, Turner D, Neal RD, White V, Harrison S, Reguilon I, Lynch C, Vedsted P. Diagnostic routes and time intervals for ovarian cancer in nine international jurisdictions; findings from the International Cancer Benchmarking Partnership (ICBP). Br J Cancer 2022; 127:844-854. [PMID: 35618787 PMCID: PMC9427750 DOI: 10.1038/s41416-022-01844-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 01/21/2022] [Accepted: 05/04/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND International Cancer Benchmarking Partnership Module 4 reports the first international comparison of ovarian cancer (OC) diagnosis routes and intervals (symptom onset to treatment start), which may inform previously reported variations in survival and stage. METHODS Data were collated from 1110 newly diagnosed OC patients aged >40 surveyed between 2013 and 2015 across five countries (51-272 per jurisdiction), their primary-care physicians (PCPs) and cancer treatment specialists, supplement by treatment records or clinical databases. Diagnosis routes and time interval differences using quantile regression with reference to Denmark (largest survey response) were calculated. RESULTS There were no significant jurisdictional differences in the proportion diagnosed with symptoms on the Goff Symptom Index (53%; P = 0.179) or National Institute for Health and Care Excellence NG12 guidelines (62%; P = 0.946). Though the main diagnosis route consistently involved primary-care presentation (63-86%; P = 0.068), onward urgent referral rates varied significantly (29-79%; P < 0.001). In most jurisdictions, diagnostic intervals were generally shorter and other intervals, in particular, treatment longer compared to Denmark. CONCLUSION This study highlights key intervals in the diagnostic pathway where improvements could be made. It provides the opportunity to consider the systems and approaches across different jurisdictions that might allow for more timely ovarian cancer diagnosis and treatment.
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Affiliation(s)
- Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK.
| | - David Weller
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Henry Jensen
- Research Unit for General Practice, Aarhus, Denmark
| | - John Butler
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Anne Kari Knudsen
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo, Norway
- University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rebecca J Bergin
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - David H Brewster
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
- Scottish Cancer Registry, Edinburgh, UK
| | - Victoria Cairnduff
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | - Evangelia Ourania Fourkala
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Anna T Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | - Eva Grunfeld
- Health Services Research Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Elizabeth Harland
- Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Canada
| | - Jatinderpal Kalsi
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Rebecca-Jane Law
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - Yulan Lin
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo, Norway
| | - Donna Turner
- Population Oncology, Cancer Care Manitoba, Winnipeg, Canada
| | - Richard D Neal
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Victoria White
- School of Psychology Deakin University, Geelong, VIC, Australia
- Centre for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Samantha Harrison
- International Cancer Benchmarking Partnership, Cancer Research UK, Stratford, UK
| | - Irene Reguilon
- International Cancer Benchmarking Partnership, Cancer Research UK, Stratford, UK
| | - Charlotte Lynch
- International Cancer Benchmarking Partnership, Cancer Research UK, Stratford, UK
| | - Peter Vedsted
- International Cancer Benchmarking Partnership, Cancer Research UK, Stratford, UK
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Morris M, Seguin M, Landon S, McKee M, Nolte E. Exploring the Role of Leadership in Facilitating Change to Improve Cancer Survival: An Analysis of Experiences in Seven High Income Countries in the International Cancer Benchmarking Partnership (ICBP). Int J Health Policy Manag 2022; 11:1756-1766. [PMID: 34380203 PMCID: PMC9808244 DOI: 10.34172/ijhpm.2021.84] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 07/12/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The differences in cancer survival across countries and over time are well recognised, with progress varying even among high-income countries with comparable health systems. Previous research has examined several possible explanations, but the role of leadership in systems providing cancer care has attracted little attention. As part of the International Cancer Benchmarking Partnership (ICBP), this study looked at diverse aspects of leadership to identify drivers of change and opportunities for improvement across seven high-income countries. METHODS Key informants in 13 jurisdictions were interviewed: Australia (2 states), Canada (3 provinces), Denmark, Ireland, New Zealand, Norway and United Kingdom (4 countries). Participants represented a range of stakeholders at different tiers of the system. They were recruited through a combination of purposive and 'snowball' strategies and participated in semi-structured telephone interviews. Interview transcripts were analysed thematically drawing on the World Health Organization (WHO) health systems framework and previous work analysing national cancer control programmes (NCCPs). RESULTS Several facets of leadership were perceived as important for improving outcomes. These included political leadership to initiate and maintain progress, intellectual leadership to support those engaged in local implementation of national policies and drive change, and a coherent vision from leaders at different levels of the system. Clinical leadership was also viewed as vital for translating policy into action. CONCLUSION Certain aspects of cancer care leadership emerged as underpinning and sustaining improvements, such as appointing a central agency, involving clinicians at every stage, ensuring strong leadership of cancer care with a consistent political mandate. Improving cancer outcomes is challenging and complex, but it is unlikely to be achieved without effective leadership, both political and clinical.
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Affiliation(s)
- Melanie Morris
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
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Olfatbakhsh A, Heidari L, Omidi Z, Hashemi EOS, Ansari M, Mozaffarian S, Haghighat S. Long-term Survival and Prognostic Factors of Breast Cancer. ARCHIVES OF IRANIAN MEDICINE 2022; 25:609-616. [PMID: 37543886 PMCID: PMC10685763 DOI: 10.34172/aim.2022.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/22/2021] [Indexed: 08/07/2023]
Abstract
BACKGROUND Breast cancer survival rate is an important index for assessment of treatment effect in reducing the mortality. Weaimed to determine the fifteen-year survival rate for breast cancer at a referral center in Iran and its correlated factors. METHODS This survival study enrolled patients with breast cancer who referred to Motamed Cancer Institute (MCI) from 1998 to2016. The survival rate was calculated using the Kaplan-Meier method. The relationship of demographic, clinical and therapeuticfactors with overall survival (OS) was studied using Cox's proportional hazard model. RESULTS Totally, 3443 patients were studied. Their mean age and follow-up period were 47.7 (±11.43) years and 61.66 (±52.1)months, respectively. The median follow-up time was 48.4 months (range: 1-413 months), 49.7% of the patients had high schoolor higher education, and 71.3% presented in the early stage of the disease. Death occurred in 505 (14.7%) of the patients. Theoverall 2-, 5-, 7-, 10- and 15-year survival rates were 93%, 82%, 78%, 74%, and 66%, respectively. Lymph node involvement(HR=2.07; 95% CI: 1.38-3.09), tumor size≥5 cm (HR=2.83; 95% CI: 1.59-2.04), being single/divorced/widowed (HR=1.65;95% CI: 1.13-2.4), and education level CONCLUSION The five-year breast cancer survival rate in this study was higher than reported by some other studies in Iran, whichcould be due to the multidisciplinary treatment approach in MCI. Tumor size and lymph node involvement as indicators ofdelayed diagnosis may affect breast cancer survival, even though their true effect due to lead-time bias should be considered. Thecorrelation of education level with survival confirms the importance of awareness and the need to establish strategies for earlydiagnosis in Iranian women.
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Affiliation(s)
- Asiie Olfatbakhsh
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Leila Heidari
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Zahra Omidi
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | | | - Maryam Ansari
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Samaneh Mozaffarian
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Shahpar Haghighat
- Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
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