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Pereira LFF, dos Santos RS, Bonomi DO, Franceschini J, Santoro IL, Miotto A, de Sousa TLF, Chate RC, Hochhegger B, Gomes A, Schneider A, de Araújo CA, Escuissato DL, Prado GF, Costa-Silva L, Zamboni MM, Ghefter MC, Corrêa PCRP, Torres PPTES, Mussi RK, Muglia VF, de Godoy I, Bernardo WM. Lung cancer screening in Brazil: recommendations from the Brazilian Society of Thoracic Surgery, Brazilian Thoracic Association, and Brazilian College of Radiology and Diagnostic Imaging. J Bras Pneumol 2024; 50:e20230233. [PMID: 38536982 PMCID: PMC11095927 DOI: 10.36416/1806-3756/e20230233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/13/2023] [Indexed: 05/18/2024] Open
Abstract
Although lung cancer (LC) is one of the most common and lethal tumors, only 15% of patients are diagnosed at an early stage. Smoking is still responsible for more than 85% of cases. Lung cancer screening (LCS) with low-dose CT (LDCT) reduces LC-related mortality by 20%, and that reduction reaches 38% when LCS by LDCT is combined with smoking cessation. In the last decade, a number of countries have adopted population-based LCS as a public health recommendation. Albeit still incipient, discussion on this topic in Brazil is becoming increasingly broad and necessary. With the aim of increasing knowledge and stimulating debate on LCS, the Brazilian Society of Thoracic Surgery, the Brazilian Thoracic Association, and the Brazilian College of Radiology and Diagnostic Imaging convened a panel of experts to prepare recommendations for LCS in Brazil. The recommendations presented here were based on a narrative review of the literature, with an emphasis on large population-based studies, systematic reviews, and the recommendations of international guidelines, and were developed after extensive discussion by the panel of experts. The following topics were reviewed: reasons for screening; general considerations about smoking; epidemiology of LC; eligibility criteria; incidental findings; granulomatous lesions; probabilistic models; minimum requirements for LDCT; volumetric acquisition; risks of screening; minimum structure and role of the multidisciplinary team; practice according to the Lung CT Screening Reporting and Data System; costs versus benefits of screening; and future perspectives for LCS.
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Affiliation(s)
- Luiz Fernando Ferreira Pereira
- . Serviço de Pneumologia, Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
| | - Ricardo Sales dos Santos
- . Serviço de Cirurgia Torácica, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
- . Programa ProPulmão, SENAI CIMATEC e SDS Healthline, Salvador (BA) Brasil
| | - Daniel Oliveira Bonomi
- . Departamento de Cirurgia Torácica, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
| | - Juliana Franceschini
- . Programa ProPulmão, SENAI CIMATEC e SDS Healthline, Salvador (BA) Brasil
- . Fundação ProAR, Salvador (BA) Brasil
| | - Ilka Lopes Santoro
- . Disciplina de Pneumologia, Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil
| | - André Miotto
- . Disciplina de Cirurgia Torácica, Departamento de Cirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP) Brasil
| | - Thiago Lins Fagundes de Sousa
- . Serviço de Pneumologia, Hospital Universitário Alcides Carneiro, Universidade Federal de Campina Grande - UFCG - Campina Grande (PB) Brasil
| | - Rodrigo Caruso Chate
- . Serviço de Radiologia, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
| | - Bruno Hochhegger
- . Department of Radiology, University of Florida, Gainesville (FL) USA
| | - Artur Gomes
- . Serviço de Cirurgia Torácica, Santa Casa de Misericórdia de Maceió, Maceió (AL) Brasil
| | - Airton Schneider
- . Serviço de Cirurgia Torácica, Hospital São Lucas, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - César Augusto de Araújo
- . Programa ProPulmão, SENAI CIMATEC e SDS Healthline, Salvador (BA) Brasil
- . Departamento de Radiologia, Faculdade de Medicina da Bahia - UFBA - Salvador (BA) Brasil
| | - Dante Luiz Escuissato
- . Departamento de Clínica Médica, Universidade Federal Do Paraná - UFPR - Curitiba (PR) Brasil
| | | | - Luciana Costa-Silva
- . Serviço de Diagnóstico por Imagem, Instituto Hermes Pardini, Belo Horizonte (MG) Brasil
| | - Mauro Musa Zamboni
- . Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro (RJ) Brasil
- . Centro Universitário Arthur Sá Earp Neto/Faculdade de Medicina de Petrópolis -UNIFASE - Petrópolis (RJ) Brasil
| | - Mario Claudio Ghefter
- . Serviço de Cirurgia Torácica, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
- . Serviço de Cirurgia Torácica, Hospital do Servidor Público Estadual, São Paulo (SP) Brasil
| | | | | | - Ricardo Kalaf Mussi
- . Serviço de Cirurgia Torácica, Hospital das Clínicas, Universidade Estadual de Campinas - UNICAMP - Campinas (SP) Brasil
| | - Valdair Francisco Muglia
- . Departamento de Imagens Médicas, Oncologia e Hematologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - USP - Ribeirão Preto (SP) Brasil
| | - Irma de Godoy
- . Disciplina de Pneumologia, Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu (SP) Brasil
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Amaya-Nieto J, Torres G, Buitrago G. Prevalence of lung cancer in Colombia and a new diagnostic algorithm using health administrative databases: A real-world evidence study. PLoS One 2023; 18:e0269079. [PMID: 36897924 PMCID: PMC10004567 DOI: 10.1371/journal.pone.0269079] [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: 05/12/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
Reliable, timely and detailed information on lung cancer prevalence, mortality and costs from middle-income countries is essential to policy design. Thus, we aimed to develop an electronic algorithm to identify lung cancer prevalent patients in Colombia by using administrative claims databases, as well as to estimate prevalence rates by age, sex and geographic region. We performed a cross-sectional study based on national claim databases in Colombia (Base de datos de suficiencia de la Unidad de Pago por Capitación and Base de Datos Única de Afiliados) to identify lung cancer prevalent patients in 2017, 2018 and 2019. Several algorithms based on the presence or absence of oncological procedures (chemotherapy, radiotherapy and surgery) and a minimum number of months that each individual had lung cancer ICD-10 codes were developed. After testing 16 algorithms, those with the closest prevalence rates to those rates reported by aggregated official sources (Global Cancer Observatory and Cuenta de Alto Costo) were selected. We estimated prevalence rates by age, sex and geographic region. Two algorithms were selected: i) one algorithm that was defined as the presence of ICD-10 codes for 4 months or more (the sensitive algorithm); and ii) one algorithm that was defined by adding the presence of at least one oncological procedure (the specific algorithm). The estimated prevalence rates per 100,000 inhabitants ranged between 11.14 and 18.05 for both, the contributory and subsidized regimes over years 2017, 2018 and 2019. These rates in the contributory regime were higher in women (15.43, 15.61 and 17.03 per 100,000 for years 2017, 2018 and 2019), over 65-years-old (63.45, 56.92 and 61.79 per 100,000 for years 2017, 2018 and 2019) who lived in Central, Bogota and Pacific regions. Selected algorithms showed similar aggregated prevalence estimations to those rates reported by official sources and allowed us to estimate prevalence rates in specific aging, regional and gender groups for Colombia by using national claims databases. These findings could be useful to identify clinical and economical outcomes related to lung cancer patients by using national individual-level databases.
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Affiliation(s)
- Javier Amaya-Nieto
- Department of Research and Innovation, Hospital Universitario Nacional de Colombia, Bogotá, Colombia
- Health Systems and Services Research Group, Universidad Nacional de Colombia, Bogotá, Colombia
- Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá, Colombia
- * E-mail:
| | - Gabriel Torres
- Health Systems and Services Research Group, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Giancarlo Buitrago
- Department of Research and Innovation, Hospital Universitario Nacional de Colombia, Bogotá, Colombia
- Health Systems and Services Research Group, Universidad Nacional de Colombia, Bogotá, Colombia
- Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá, Colombia
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Horgan D, Mia R, Erhabor T, Hamdi Y, Dandara C, Lal JA, Domgue JF, Ewumi O, Nyawira T, Meyer S, Kondji D, Francisco NM, Ikeda S, Chuah C, De Guzman R, Paul A, Reddy Nallamalla K, Park WY, Tripathi V, Tripathi R, Johns A, Singh MP, Phipps ME, Dube F, Whittaker K, Mukherji D, Rasheed HMA, Kozaric M, Pinto JA, Doral Stefani S, Augustovski F, Aponte Rueda ME, Fujita Alarcon R, Barrera-Saldana HA. Fighting Cancer around the World: A Framework for Action. Healthcare (Basel) 2022; 10:2125. [PMID: 36360466 PMCID: PMC9690702 DOI: 10.3390/healthcare10112125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 09/05/2023] Open
Abstract
Tackling cancer is a major challenge right on the global level. Europe is only the tip of an iceberg of cancer around the world. Prosperous developed countries share the same problems besetting Europe-and the countries and regions with fewer resources and less propitious conditions are in many cases struggling often heroically against a growing tide of disease. This paper offers a view on these geographically wider, but essentially similar, challenges, and on the prospects for and barriers to better results in this ceaseless battle. A series of panels have been organized by the European Alliance for Personalised Medicine (EAPM) to identify different aspects of cancer care around the globe. There is significant diversity in key issues such as NGS, RWE, molecular diagnostics, and reimbursement in different regions. In all, it leads to disparities in access and diagnostics, patients' engagement, and efforts for a better understanding of cancer.
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Affiliation(s)
- Denis Horgan
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Rizwana Mia
- Grants, Innovation & Product Development, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town 7505, South Africa
| | - Tosan Erhabor
- Medical Laboratory Science Council of Nigeria (MLSCN), Durumi, Abuja 900110, Nigeria
| | - Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis 1002, Tunisia
- Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis 1002, Tunisia
| | - Collet Dandara
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Jonathan A. Lal
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
- Institute for Public Health Genomics, Department of Genetics and Cell Biology, GROW School of Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Joel Fokom Domgue
- Departments of Epidemiology, and Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX 77030, USA
- Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde VF7W+4M9, Cameroon
| | - Oladimeji Ewumi
- Freelance Health Care, Life Sciences, Medical Artificial Intelligence Content Writer, Lagos 100253, Nigeria
| | - Teresia Nyawira
- National Commission for Science, Technology and Innovation in Kenya (NACOSTI), Nairobi 00100, Kenya
| | | | - Dominique Kondji
- Health & Development Communication, Building Capacities for Better Health in Africa, Yaounde P.O. Box 2032, Cameroon
| | - Ngiambudulu M. Francisco
- Grupo de Investigação Microbiana e Imunológica, Instituto Nacional de Investigação em Saúde (National Institute for Health Research), Luanda 3635, Angola
| | - Sadakatsu Ikeda
- Department of Precision Cancer Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Chai Chuah
- Singularity University, P.O. Box 165, Gold Coast, QLD 4227, Australia
| | - Roselle De Guzman
- Oncology and Pain Management Section, Manila Central University–Filemon D. Tanchoco Medical Foundation Hospital, Caloocan 1400, Philippines
| | - Anupriya Paul
- Department of Mathematics and Statistics, Faculty of Science, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | | | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Centre, Sungkyunkwan University, Seoul 06351, Korea
| | - Vijay Tripathi
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Ravikant Tripathi
- Ministry of Labor, Health Department Government of India, New Delhi 110001, India
| | - Amber Johns
- Garvan Institute of Medical Research and the Kinghorn Cancer Centre, Cancer Division, Sydney, NSW 2010, Australia
| | - Mohan P. Singh
- Centre of Biotechnology, University of Allahabad, Allahabad 211002, India
| | - Maude E. Phipps
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Selangor, Malaysia
| | - France Dube
- Astra Zeneca, 1800 Concord Pike, Wilmington, DE 19803, USA
| | | | - Deborah Mukherji
- Global Health Institute, American University of Beirut, Beirut VFXP+7QF, Lebanon
- Department of Hematology/Oncology, American University of Beirut Medical Centre, Beirut P.O. Box 11-0236, Lebanon
| | | | - Marta Kozaric
- European Alliance for Personalised Medicine, 1040 Brussels, Belgium
| | - Joseph A. Pinto
- Centre for Basic and Translational Research, Auna Ideas, Lima 15036, Peru
| | | | - Federico Augustovski
- Health Technology Assessment and Health Economics, Department of the Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires C1056ABH, Argentina
| | | | - Ricardo Fujita Alarcon
- Centro de Genética y Biología Molecular, Universidad de San Martín de Porres, Lima 15024, Peru
| | - Hugo A. Barrera-Saldana
- Innbiogem SC/Vitagenesis SA at National Laboratory for Services of Research, Development, and Innovation for the Pharma and Biotech Industries (LANSEIDI) of CONACyT Vitaxentrum Group, Monterrey 64630, Mexico
- Schools of Medicine and Biology, Autonomous University of Nuevo Leon, Monterrey 66451, Mexico
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Martin C, Cuello M, Barajas O, Recondo G, Aruachan S, Perroud H, Sena S, Bonilla C, Orlandi F, Berutti S, Garcia Cocco V, Gomez A, Korbenfeld E, Zapata M, Cundom J, Orellana E, Goncalves S, Reinhold F. Real-world evaluation of molecular testing and treatment patterns for EGFR mutations in non-small cell lung cancer in Latin America. Mol Clin Oncol 2021; 16:6. [PMID: 34881026 PMCID: PMC8647188 DOI: 10.3892/mco.2021.2439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022] Open
Abstract
Lung cancer is a leading cause of cancer-related deaths in Latin America, with non-small cell lung cancer (NSCLC) being the most prevalent. The current study aimed to report real-world data on epidermal growth factor receptor (EGFR) mutational testing and treatment regimens at diagnosis and progression in patients with metastatic NSCLC across four Latin American countries (Argentina, Chile, Colombia and Uruguay). A retrospective, multicenter, observational study was conducted in patients with NSCLC using medical records from participating countries. The study population was categorized into two cohorts: Cohort 1 comprised of newly diagnosed, treatment-naïve patients with stage IV NSCLC; and cohort 2 comprised of stage IV NSCLC EGFR mutation (EGFRm)-positive patients who had progressed after first- or second-generation EGFR-tyrosine kinase inhibitor (TKI) treatment. Measures included demographic variables, health characteristics, treatment regimen, molecular testing rate and turnaround time at diagnosis and at progression for cohorts 1 and 2, respectively. Descriptive statistics were used to summarize all study measures. Of the 462 patients enrolled, 431 were newly diagnosed or treatment naïve with metastatic NSCLC. In cohort 1, the majority of patients with private health insurance (57.31%) underwent molecular diagnosis while only 41.3% of patients within the public sector had access to testing. The average molecular testing rate in cohort 1 varied across countries, with Argentina having the highest testing rate (79%) and Uruguay the lowest (27.63%). EGFRm was observed in 22% of patients. Cohort 2 comprised 31 patients who had progressed after first- or second-generation EGFR-TKI treatment and of these, only 22 (70.97%) underwent testing after progression. Access to molecular testing is still a challenge impacting the choice of first-line treatment in Latin American patients with NSCLC. These findings underline the unmet needs of ensuring early diagnosis, molecular profiling and use of correct treatment to alleviate NSCLC burden in the region.
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Affiliation(s)
- Claudio Martin
- Department of Clinical Oncology, Institute Alexander Fleming, Buenos Aires C1426ANZ, Argentina
| | - Mauricio Cuello
- Department of Oncology, Hospital of Clinics, Montevideo 11600, Uruguay
| | - Olga Barajas
- Department of Medical Oncology, Arturo Lopez Perez Foundation, Santiago 7500000, Chile
| | - Gonzalo Recondo
- Department of Thoracic Oncology, Medical education and Clinical Research Centre, University Institute (CEMIC), Buenos Aires C1431FWO, Argentina
| | - Sandra Aruachan
- Department of Clinical Oncology, High Technology Medical Institute Oncomedica, Monteria 23001, Colombia
| | - Herman Perroud
- Department of Clinical Oncology, Women's Health Centre, Rosario 2000, Argentina
| | - Susana Sena
- Department of Clinical Oncology; German Hospital, Buenos Aires PC C1118AAT, Argentina
| | - Carlos Bonilla
- Clinical Oncology Unit, National Cancer Institute of Colombia, Bogotá 110411, Colombia
| | - Francisco Orlandi
- Department of Clinical Oncology, Orlandi Oncology, Providencia 7500713, Chile
| | - Susana Berutti
- Department of Clinical Oncology, Italian Hospital of La Plata, La Plata B1900AXI, Argentina
| | | | - Alvaro Gomez
- Department of Medical Oncology, Hemato-oncologos SA, Cali 760042, Colombia
| | - Ernesto Korbenfeld
- Department of Medical Oncology, British Hospital of Buenos Aires, Buenos Aires C1280AEB, Argentina
| | - Maycos Zapata
- Department of Medical Oncology, Cancer Institute Las Americas, Antioquia 050025, Colombia
| | - Juan Cundom
- Department of Medical Oncology, Lanari Institute, University of Buenos Aires, Buenos Aires C1427ARN, Argentina
| | - Eric Orellana
- Department of Clinical Oncology, Clinic Santa Maria, Santiago 7500000, Chile
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Shi P, Zhang J, Li X, Li W, Li H, Fu P. Long non-coding RNA NORAD inhibition upregulates microRNA-323a-3p to suppress tumorigenesis and development of breast cancer through the PUM1/eIF2 axis. Cell Cycle 2021; 20:1295-1307. [PMID: 34125645 PMCID: PMC8331030 DOI: 10.1080/15384101.2021.1934627] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/25/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) are known to competitively bind with microRNAs (miRNAs) to participate in human cancers. We aim to explore the role of non-coding RNA activated by DNA damage (NORAD) binding to miR-323a-3p in breast cancer (BC) with the involvement of pumilio RNA-binding family member 1 (PUM1)/eukaryotic initiation factor 2 (eIF2) axis. Expression of NORAD, miR-323a-3p and PUM1 in tissues and cell lines was detected, and the correlation between NORAD expression and clinicopathological features of BC patients was analyzed. The screened cell line was respectively transfected with altered NORAD or miR-323a-3p to reveal their roles in viability, migration, invasion and apoptosis of BC cells in vitro. The tumor growth in vivo was observed in nude mice. The binding relationships among NORAD, miR-323a-3p and PUM1 were analyzed, and the regulatory role of NORAD and miR-323a-3p in the eIF2 signaling pathway was assessed. NORAD and PUM1 were upregulated and miR-323a-3p was downregulated in BC. High NORAD expression indicated a poor prognosis of BC patients. NORAD inhibition or miR-323a-3p elevation inhibited malignant behaviors of BC cells. The in vivo assay revealed that NORAD inhibition or miR-323a-3p elevation inhibited tumor growth as well. MiR-323a-3p inhibition reversed the role of NORAD knockdown in the biological functions of BC cells while silencing PUM1 reversed the influence of NORAD overexpression on BC cells. NORAD bound with miR-323a-3p and miR-323a-3p targeted PUM1. NORAD and miR-323a-3p functioned through the PUM1/eIF2 axis. NORAD inhibition or miR-323a-3p elevation suppresses the development of BC through the PUM1/eIF2 axis.
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Affiliation(s)
- Pengfei Shi
- Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiaming Zhang
- Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xun Li
- Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenhuan Li
- Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hai Li
- Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Peng Fu
- Department of Thyroid and Breast Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Li R, Zhang M, Cheng Y, Jiang X, Tang H, Wang L, Chen T, Chen B. Using Population-Based Cancer Registration Data and Period Analysis to Accurately Assess and Predict 5-Year Relative Survival for Lung Cancer Patients in Eastern China. Front Oncol 2021; 11:661012. [PMID: 34046354 PMCID: PMC8144707 DOI: 10.3389/fonc.2021.661012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/09/2021] [Indexed: 11/28/2022] Open
Abstract
Background The assessment of long-term survival of lung cancer patients based on data from population-based caner registries, using period analysis, was scarce in China. We aimed to accurately assess the long-term survival of lung cancer patients, and to predict the long-term survival in the future, using cancer registry data from Taizhou City, eastern China. Methods Four cancer registries with high-quality data were selected. Patients diagnosed with lung cancer during 2004–2018 were included. The long-term survival was evaluated using period analysis, with further stratification by sex, age at diagnosis and region. Additionally, projected 5-year relative survival (RS) of lung cancer patients for 2019-2023 was evaluated, using model-based period analysis. Results The 5-year RS of lung cancer patients diagnosed during 2014–2018 was 40.2% (31.5% for men and 56.2% for women). A moderate age gradient was observed for the period estimate, with the estimate decreasing from 50.5 to 26.5% in the age group of 15–44 years and ≥75 years, respectively. The 5-year RS of urban area was higher than that of rural area (52.3% vs. 38.9%). The overall projected 5-year RS of lung cancer patients was 52.7% for 2019–2023, with estimate of 43.0 and 73.2% for men and women, respectively. A moderate age gradient was also observed for the projected estimate. Moreover, estimate reached nearly 50% for rural and urban areas. Conclusion Period analysis tended to provide the up-to-date and precise survival estimates for lung cancer patients, which is worth further application, and provides important evidence for prevention and intervention of lung cancer.
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Affiliation(s)
- Runhua Li
- Department of Cancer Prevention/Experimental Research Center, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Min Zhang
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Yongran Cheng
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Xiyi Jiang
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Huijuan Tang
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Liangyou Wang
- Department of Non-Communicable Chronic Disease Control and Prevention, Taizhou Center for Disease Control and Prevention, Taizhou, China
| | - Tianhui Chen
- Department of Cancer Prevention/Experimental Research Center, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Bicheng Chen
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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The challenges of implementing low-dose computed tomography for lung cancer screening in low- and middle-income countries. NATURE CANCER 2020; 1:1140-1152. [PMID: 35121933 DOI: 10.1038/s43018-020-00142-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/09/2020] [Indexed: 12/12/2022]
Abstract
Lung cancer accounts for an alarming human and economic burden in low- and middle-income countries (LMICs). Recent landmark trials from high-income countries (HICs) by demonstrating that low-dose computed tomography (LDCT) screening effectively reduces lung cancer mortality have engendered enthusiasm for this approach. Here we examine the effectiveness and affordability of LDCT screening from the viewpoint of LMICs. We consider resource-restricted perspectives and discuss implementation challenges and strategies to enhance the feasibility and cost-effectiveness of LDCT screening in LMICs.
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Guan Y, Ren M, Guo D, He Y. [Research Progress on Lung Cancer Screening]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 23:954-960. [PMID: 32819054 PMCID: PMC7679225 DOI: 10.3779/j.issn.1009-3419.2020.101.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
肺癌是世界上最常见的恶性肿瘤,其5年生存率仅为19.7%,严重威胁人类健康。肺癌筛查是降低肺癌死亡率的有效措施,已有的研究证明用低剂量螺旋计算机断层扫描(low-dose computed tomography, LDCT)进行筛查可降低20%的肺癌死亡,目前国际和国内均建议进行肺癌筛查。研究肺癌筛查的发展现状有助于我们明确肺癌的高危人群,探索合理的筛查方案,提高筛查的成本效益,减轻经济负担。因此本文就肺癌筛查现状、肺癌筛查的成本效益以及存在的问题综述如下。
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Affiliation(s)
- Yazhe Guan
- Cancer Institute, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Meng Ren
- Cancer Institute, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Dongli Guo
- Cancer Institute, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Yutong He
- Cancer Institute, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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9
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Maklouf-Quirós A, Simithy J, Ragoobar K, Flores-Siles V, Ramos-Esquivel A, Villamil K, Chacón-Araya M. Barriers to lung cancer referral, diagnosis, and treatment in Central America and the Caribbean: the health professionals' perspectives. Support Care Cancer 2020; 29:751-757. [PMID: 32458113 DOI: 10.1007/s00520-020-05532-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/14/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To identify the perspectives from healthcare providers about the limitations in referral, diagnosis, and treatment of lung cancer (LC) patients. METHODS A cross-sectional study through an Internet-based survey was addressed to physicians of multidisciplinary teams in charge of LC patients from Cuba, Curacao, Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Jamaica, Panama, and Trinidad and Tobago. The questions focused on physicians' perspectives concerning waiting times and the availability of diagnostic and staging procedures in their settings, as well as the access to systemic therapies and continuous medical education (CME). RESULTS A total of 152 physicians responded to the online questionnaire (response rate 24.9%). Delays in biopsy results were the main barrier for LC diagnosis as identified by 48.2% of the respondents, followed by patients not being referred in time (31.3%), delays for staging procedures (11.4%), and time taken for biopsy (9%). Almost one-half of physicians perceived that patients are diagnosed in advanced stages. A total of 29 respondent physicians (19.1%) reported limited access to immunohistochemical or genetic analysis for common mutations. Although 73 physicians (48.0%) confirmed that their centers provided radiotherapy and systemic therapy for their patients, immunotherapy was not available in the institutions of 30 physicians (19.7%). A total of 42 practitioners (27.6%) reported that they did not have access to CME on LC topics due to working or budget restrictions. CONCLUSIONS This study revealed among respondents the main barriers for an appropriate management of LC patients in the Central American and Caribbean Region. Further studies must validate these findings.
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Affiliation(s)
- Aziza Maklouf-Quirós
- Medical Affairs Department, Roche Central America and the Caribbean, Heredia, Costa Rica
| | - Johayra Simithy
- Medical Affairs Department, Roche Central America and the Caribbean, Heredia, Costa Rica
| | - Kavita Ragoobar
- Medical Affairs Department, Roche Central America and the Caribbean, Heredia, Costa Rica
| | - Vivian Flores-Siles
- Medical Affairs Department, Roche Central America and the Caribbean, Heredia, Costa Rica
| | - Allan Ramos-Esquivel
- Department of Pharmacology, School of Medicine, University of Costa Rica, P.O. Box 2082, San Pedro, San José, Costa Rica.
| | - Karen Villamil
- Medical Affairs Department, Roche Central America and the Caribbean, Heredia, Costa Rica
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10
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Hillyer GC, Mapanga W, Jacobson JS, Graham A, Mmoledi K, Makhutle R, Osei-Fofie D, Mulowayi M, Masuabi B, Bulman WA, Neugut AI, Joffe M. Attitudes toward tobacco cessation and lung cancer screening in two South African communities. Glob Public Health 2020; 15:1537-1550. [PMID: 32406331 DOI: 10.1080/17441692.2020.1761425] [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: 12/24/2022]
Abstract
Among men in South Africa, the prevalence of tobacco smoking is as high as 33%. Although smoking is responsible for most lung cancer in South Africa, occupational and environmental exposures contribute greatly to risk. We conducted a tobacco and lung cancer screening needs assessment and administered surveys to adults who smoked >100 cigarettes in their lifetime in Johannesburg (urban) and Kimberley (rural). We compared tobacco use, risk exposure, attitudes toward and knowledge of, and receptivity to cessation and screening, by site. Of 324 smokers, nearly 85% of current smokers had a <30 pack-year history of smoking; 58.7% had tried to stop smoking ≥1 time, and 78.9% wanted to quit. Kimberley smokers more often reported being advised by a healthcare provider to stop smoking (56.5% vs. 37.3%, p=0.001) than smokers in Johannesburg but smokers in Johannesburg were more willing to stop smoking if advised by their doctor (72.9% vs. 41.7%, p<0.001). Findings indicate that tobacco smokers in two geographic areas of South Africa are motivated to stop smoking but receive no healthcare support to do so. Developing high risk criteria for lung cancer screening and creating tobacco cessation infrastructure may reduce tobacco use and decrease lung cancer mortality in South Africa.
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Affiliation(s)
- Grace C Hillyer
- Mailman School of Public Health, Columbia University, New York, NY, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - Witness Mapanga
- Non-Communicable Diseases Research (NCDR) Division of the Wits Health Consortium, University of Witwatersrand, Johannesburg, South Africa
| | - Judith S Jacobson
- Mailman School of Public Health, Columbia University, New York, NY, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - Anita Graham
- Non-Communicable Diseases Research (NCDR) Division of the Wits Health Consortium, University of Witwatersrand, Johannesburg, South Africa
| | - Keletso Mmoledi
- Non-Communicable Diseases Research (NCDR) Division of the Wits Health Consortium, University of Witwatersrand, Johannesburg, South Africa
| | - Raynolda Makhutle
- Non-Communicable Diseases Research (NCDR) Division of the Wits Health Consortium, University of Witwatersrand, Johannesburg, South Africa
| | | | | | | | - William A Bulman
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Alfred I Neugut
- Mailman School of Public Health, Columbia University, New York, NY, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA.,Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Maureen Joffe
- Non-Communicable Diseases Research (NCDR) Division of the Wits Health Consortium, University of Witwatersrand, Johannesburg, South Africa
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11
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Shankar A, Saini D, Dubey A, Roy S, Bharati SJ, Singh N, Khanna M, Prasad CP, Singh M, Kumar S, Sirohi B, Seth T, Rinki M, Mohan A, Guleria R, Rath GK. Feasibility of lung cancer screening in developing countries: challenges, opportunities and way forward. Transl Lung Cancer Res 2019; 8:S106-S121. [PMID: 31211111 DOI: 10.21037/tlcr.2019.03.03] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lung cancer is the leading cause of all cancer deaths worldwide, comprising 18.4% of all cancer deaths. Low-dose computed tomography (LDCT) has shown mortality benefit in various trials and now a standard tool for lung cancer screening. Most researches have been carried out in developed countries where lung cancer incidence and mortality is very high. There is an increasing trend in lung cancer incidence in developing countries attributed to tobacco smoking and various environmental and occupational risk factors. Implementation of lung cancer screening is challenging, so organised lung cancer screening is practically non-existent. There are numerous challenges in implementing such programs ranging from infrastructure, trained human resources, referral algorithm to cost and psychological trauma due to over-diagnosis. Pulmonary tuberculosis and other chest infections are important issues to be addressed while planning for lung cancer screening in developing countries. Burden of these diseases is very high and can lead to over-diagnosis in view of cut off of lung nodule size in various studies. Assessment of high risk cases for lung cancer is difficult as various forms of smoking make quantification non-uniform and difficult. Lung cancer screening targets only high risk population unlike screening programs for other cancers where entire population is targeted. There is a need of lung cancer screening for high risk cases as it saves life. Tobacco control and smoking cessation remain the most important long term intervention to decrease morbidity and mortality from lung cancer in developing countries. There is no sufficient evidence supporting the introduction of population-based screening for lung cancer in public health services.
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Affiliation(s)
- Abhishek Shankar
- Preventive Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Deepak Saini
- Indian Society of Clinical Oncology, Delhi, India
| | - Anusha Dubey
- Indian Society of Clinical Oncology, Delhi, India
| | - Shubham Roy
- Indian Society of Clinical Oncology, Delhi, India
| | - Sachidanand Jee Bharati
- Oncoanaesthesia and Palliative Medicine, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Navneet Singh
- Pulmonary Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Chandra Prakash Prasad
- Medical Oncology (Lab), Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Mayank Singh
- Medical Oncology (Lab), Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Sunil Kumar
- Surgical Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Bhawna Sirohi
- Medical Oncology, Max Institute of Cancer Care, Delhi, India
| | - Tulika Seth
- Clinical Hematology, All India Institute of Medical Sciences, Delhi, India
| | - Minakshi Rinki
- Biotechnology, Swami Shraddhanand College, Delhi University, Delhi, India
| | - Anant Mohan
- Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, Delhi, India
| | - Randeep Guleria
- Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, Delhi, India
| | - Goura Kishor Rath
- Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
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