Additional Cancer Cases Research Articles

Exploring the Prospective of Curcumin-loaded Nanomedicine in Brain Cancer Therapy: An Overview of Recent Updates and Patented Nanoformulations.

Cancer is a complex, one of the fatal non-communicable diseases, and its treatment has enormous challenges, with variable efficacy of traditional anti-cancer agents. By 2025, it is expected that 420 million additional cases of cancer will be diagnosed yearly. However, among various types of cancer, brain cancer treatment is most difficult due to the presence of blood-brain barriers. Nowadays, phytoconstituents are gaining popularity because of their biosafety and low toxicity to healthy cells. This article reviews various aspects related to curcumin for brain cancer therapeutics, including epidemiology, the role of nanotechnology, and various challenges for development and clinical trials. Furthermore, it elaborates on the prospects of curcumin for brain cancer therapeutics. In this article, our objective is to illuminate the anti-cancer potential of curcumin for brain cancer therapy. Moreover, it also explores how to defeat its constraints of clinical application because of poor bioavailability, stability, and rapid metabolism. This review also emphasizes the possibility of curcumin for the cure of brain cancer using cuttingedge biotechnological methods based on nanomedicine. This review further highlights the recent patents on curcumin-loaded nanoformulations for brain cancer. Overall, this article provides an overview of curcumin's potential in brain cancer therapy by considering challenges to be overwhelmed and future prospective. Moreover, this review summarizes the reported literature on the latest research related to the utility of curcumin in brain cancer therapy and aims to provide a reference for advanced investigation on brain cancer treatment.

Health impact and cost effectiveness of implementing gender-neutral HPV vaccination in Japan

Objective To assess the public health impact and cost effectiveness of gender-neutral vaccination (GNV) versus female-only vaccination (FOV) with human papillomavirus (HPV) vaccination in Japan. Methods We modeled the public health impact and cost effectiveness of GNV versus FOV to prevent HPV-associated diseases in Japan over the next 100 years. We used one-way sensitivity analyses to examine the impact of varying key model input parameters and conducted scenario analyses to explore the effects of varying the vaccination coverage rate (VCR) of each cohort. Results In the base-case analysis, GNV averted additional cancer cases (17,228 female/6,033 male) and deaths (1,892 female/1,849 male) compared to FOV. When all HPV-associated diseases were considered, GNV had an incremental cost-effectiveness ratio of ¥4,732,320 (US$35,987)/quality-adjusted life year gained compared to FOV. The model was most sensitive to the discount rate and the disutility associated with HPV-related diseases. GNV had greater relative public health benefits when the female VCR was lower and was cost effective at a female VCR of 30%. Conclusions Immediate implementation of GNV would reduce the disease burden and mortality associated with HPV in Japan, and would be cost effective compared to FOV if the female VCR remains low (30%).

Public health risk associated with the co-occurrence of aflatoxin B1 and ochratoxin A in spices, herbs, and nuts in Lebanon.

Aflatoxin B1 and ochratoxin A are mycotoxins produced by filamentous fungi that attack crops on field and storage. Both mycotoxins present a risk on public health since aflatoxin B1 is a hepatotoxic and hepatocarcinogenic agent while ochratoxin A can be nephrotoxic. Those mycotoxins can be found in several food items including spices, herbs, and nuts. In Lebanon, few studies address aflatoxin B1 and ochratoxin A contamination in spices, herbs, and nuts. So, the aim of this study is to investigate the concentrations of those two mycotoxins particularly in spices and herbs and the concentration of aflatoxin B1 in nuts, and to determine the dietary exposure of the Lebanese population and their possible attribution to liver cancer and renal damage. In this work, a total of 198 samples of spices, herbs, and nuts were collected from different sites. Aflatoxin B1 and ochratoxin A were quantified using immune-affinity columns. A food frequency questionnaire was used to quantify the consumption of spices, herbs, and nuts in Lebanon. Exposure to aflatoxin B1 and ochratoxin A was calculated accordingly and liver and kidney cancer risks were evaluated. Aflatoxin B1 was respectively found in 100, 20.4, and 98.6% of the spices, herbs, and nuts samples, while ochratoxin A was found in 100 and 44.4% of spices and herbs, respectively. Aflatoxin B1 was found at mean concentration of 0.97, 0.27, and 0.40 μg/kg in spices, herbs, and nuts, respectively while ochratoxin A was found at mean concentrations of 38.8 and 1.81 μg/kg in spices and herbs, respectively. Aflatoxin B1 occurrence was shown to be associated in this study with 0.017 additional cancer cases per 100,000 persons per year, and ochratoxin A weekly exposure was shown to be 5.04 ng/kg bw less than the Provisional Tolerable Weekly Intake of 100 ng/kg bw which indicates low risk of renal damage from spices and herbs consumption. The consumption of spices, herbs, and nuts in Lebanon could lead to an increase in health risks associated with aflatoxin B1 and ochratoxin A, specifically spices. The reported occurrence may be directly related to poor storage conditions.

Machine Learning for Risk Prediction of Oesophago-Gastric Cancer in Primary Care: Comparison with Existing Risk-Assessment Tools.

Simple SummaryOesophago-gastric cancer is one of the commonest cancers worldwide, yet it can be particularly difficult to diagnose given that initial symptoms are often non-specific and routine screening is not available. Cancer risk-assessment tools, which calculate cancer risk based on symptoms and other risk factors present in the primary care record, can aid decisions on referrals for cancer investigations, facilitating earlier diagnosis. Diagnosing common cancers earlier could help improve survival rates. Using UK primary care electronic health record data, we compared five different machine learning techniques for probabilistic classification of cancer patients against a current widely used UK primary care cancer risk-assessment tool. The machine learning algorithms outperformed the current risk-assessment tool, with a higher overall accuracy and an ability to reasonably identify 11–25% more cancer patients. We conclude that machine-learning-based risk-assessment tools could help better identify suitable patients for further investigation and support earlier diagnosis.Oesophago-gastric cancer is difficult to diagnose in the early stages given its typical non-specific initial manifestation. We hypothesise that machine learning can improve upon the diagnostic performance of current primary care risk-assessment tools by using advanced analytical techniques to exploit the wealth of evidence available in the electronic health record. We used a primary care electronic health record dataset derived from the UK General Practice Research Database (7471 cases; 32,877 controls) and developed five probabilistic machine learning classifiers: Support Vector Machine, Random Forest, Logistic Regression, Naïve Bayes, and Extreme Gradient Boosted Decision Trees. Features included basic demographics, symptoms, and lab test results. The Logistic Regression, Support Vector Machine, and Extreme Gradient Boosted Decision Tree models achieved the highest performance in terms of accuracy and AUROC (0.89 accuracy, 0.87 AUROC), outperforming a current UK oesophago-gastric cancer risk-assessment tool (ogRAT). Machine learning also identified more cancer patients than the ogRAT: 11.0% more with little to no effect on false positives, or up to 25.0% more with a slight increase in false positives (for Logistic Regression, results threshold-dependent). Feature contribution estimates and individual prediction explanations indicated clinical relevance. We conclude that machine learning could improve primary care cancer risk-assessment tools, potentially helping clinicians to identify additional cancer cases earlier. This could, in turn, improve survival outcomes.

Assessment of the carcinogenic risk in workers operating diesel-fueled vehicles

Introduction. The strategic goal of healthcare development based on the maximum use of all possible resources is currently the formation of a system that unites medical institutions working within the framework of a single information regulation, a single expert and hygienic control. At the end of the reporting year 2021, the number of patients under dispensary supervision amounted to 3,940,529 people. Of these, the proportion of people of working age is 33.9%. The availability of a developed system of diagnostics and oncological care for the working population should be accompanied by measures to predict the risk of developing oncological pathology. The purpose of the study. To identify the features of assessing the indicator of carcinogenic risk in workers operating vehicles on diesel fuel. Materials and methods. The object of the study is employees of locomotive crews carrying out the transportation process on diesel-fueled locomotives (diesel locomotives), with different service life. The list of pollutants entering the air of the working area is determined in accordance with the “EMEP Manual/EEA on the inventory of emissions of pollutants 1.A.3.c. Railways”. Quantitative indices of the concentration of pollutants were obtained by the calculation method (UPRZA) “Ecologist” (version 4.6.7 “Calculation of dispersion taking into account the development of MRR-2017”). The assessment of the pollution level was carried out in accordance with the SanPiN. 1.2.3685-21 “Hygienic standards and requirements for ensuring the safety and (or) harmlessness of environmental factors for humans”. Reference concentrations are determined in accordance with P 2.1.10.1920-04. The calculation of health loss risk indices was carried out in accordance with the Guidelines No. 2.2.1766-03 dated 06/24/2003 and MP 2.1.9.003-03. Results. Calculations made it possible to determine the amount of pollutants likely to enter the body of employees of locomotive crews operating diesel locomotives with different service life. To establish that the daily dose of pollutants entering the body of workers of locomotive crews operating new locomotives is 7,244 mg/kg, for workers operating diesel locomotives after major repairs 1.1368 mg/kg. Some of the analyzed substances have a carcinogenic effect. The calculation of the carcinogenic risk showed that when working on locomotives with a long service life and undergoing major repairs, the risk is 5.2∙10-3, which indicates that 52 additional cases of cancer per 10,000 employees of locomotive crews are likely to form annually in such a group. When operating new diesel locomotives, the carcinogenic risk is 3.8∙10-3, i.e. 38 additional cases of cancer per 10,000 employees of locomotive crews (1.5 times less). Limitations. Features of calculations of pollutants in the air of the working area for various types of vehicles. Conclusion. The gain in the number of people with oncological pathology, a fairly large proportion of whom are of working age, implies not only the creation of an advanced system of diagnosis and medical care for cancer patients, but also the improvement of measures for predicting the risk of developing oncological pathology. A promising direction for improving the method of assessing the indicator of carcinogenic risk in workers operating diesel-fueled vehicles (railway, automobile, marine) is to take into account the full list of pollutants entering the air of the working area with exhaust gases. Currently, only substances with a predominant mass fraction in emissions are accounted for. At the same time, a complex of heavy metal compounds and poly aromatic hydrocarbons has a carcinogenic effect, which are practically not controlled in the air of the working area due to the complexity of sampling and the high cost of analytical studies. This problem can be solved by using the calculation method, an example of which is given in this paper.

Dietary Exposure and Risk Assessment of Mycotoxins in Thyme and Thyme-Based Products Marketed in Lebanon.

This study aimed at evaluating the incidence of aflatoxin B1 (AFB1) and ochratoxin A (OTA) in thyme and thyme-based products, related dietary exposure, and cancer risk for regular and high consumption. A total of 160 samples were collected, and 32 composite samples were analyzed. AFB1 and OTA were respectively found in 84% (27/32) and 38% (12/32) of the samples. AFB1 exceeded the limits in 41% (13/32) and 25% (8/32) of the samples according to the Lebanese and European standards, respectively. OTA was unacceptable in only 6% (2/32) and 3% (1/32) of the samples according to the Lebanese and European standards, respectively. AFB1 and OTA daily exposure was shown to be 4.270 and 1.345 ng/kg bw/day, respectively. AFB1 was shown to be associated with 0.41 and 0.35 additional cancer cases per 100,000 persons per year for regular consumption, respectively; while for high consumption, an increase of 0.911 and 0.639 cancer cases per 100,000 person per year was noted, respectively. The margin of exposure (MOE) for OTA was >10,000 for the non-neoplastic effect and >200 for the neoplastic effect, representing no toxicological concerns for consumers.

Prevalence of elevated Anti-p53 in Chinese patients with upper gastrointestinal or colorectal cancer.

The monitoring of anti-p53 auto-antibodies in the peripheral blood has been used in cancer management; however, their clinical significance alone is limited. This pilot study aimed to describe the prevalence of elevated anti-p53 in newly diagnosed or recurrent upper gastrointestinal cancer or colorectal cancer in Chinese subjects. It also evaluated whether the addition of anti-p53 to a set of established tumor markers would allow for the detection of additional cancer cases than when using these markers alone. A total of 573 subjects, including 187 healthy individuals, 169 patients with upper gastrointestinal cancer and 217 patients with colorectal cancer were included in this observational, prospective study. All subjects were required to provide up to 10 mL of blood. The following biomarkers were measured: anti-p53, carcinoembryonic antigen, cancer antigen (CA)19-9, and CA72-4. At the cutoff of 0.02 µg/mL, the sensitivity of anti-p53 in early-stage upper gastrointestinal cancer and colorectal cancer was 8.16% and 26.4%, and in late-stage disease was 7.81 and 28.0%, respectively. The specificity of anti-p53 in the healthy cohort at this cutoff was 98.4%. By adding anti-p53 to other tumor markers, the sensitivities were increased by 8.88%-9.47% in upper gastrointestinal cancer, and by 18.06%-25.00% in colorectal cancer; specificities decreased by 1%-2%. The addition of anti-p53 to established tumor markers may improve their diagnostic value for patients with colorectal cancer.

Modeling the health and economic implications of adopting a 1-dose 9-valent human papillomavirus vaccination regimen in a high-income country setting: An analysis in the United Kingdom

Although no human papillomavirus (HPV) vaccine is indicated for single-dose administration, some observational evidence suggests that a 1-dose regimen might reduce HPV infection risk to that achieved with 2 doses. This study estimated the potential health and economic outcomes associated with switching from a 2-dose HPV vaccination program for girls and boys aged 13–14 years to an off-label 9-valent (9vHPV), 1-dose regimen, accounting for the uncertainty of the effectiveness and durability of a single dose. A dynamic HPV transmission infection and disease model was adapted to the United Kingdom and included a probabilistic sensitivity analysis using estimated distributions for duration of protection of 1-dose and degree of protection of 1 relative to 2 doses. One-way sensitivity analyses of key inputs were performed. Outcomes included additional cancer and disease cases and the difference in net monetary benefit (NMB). The 1-dose program was predicted to result in 81,738 additional HPV-related cancer cases in males and females over 100 years compared to the 2-dose program, ranging from 36,673 to 134,347 additional cases (2.5% and 97.5% quantiles, respectively), and had a 7.8% probability of being cost-effective at the £20,000/quality-adjusted life years willingness-to-pay (WTP) threshold. In one-way sensitivity analyses, the number of additional cancer cases was sensitive to the median of the duration of protection distribution and coverage rates. The differences in NMBs were sensitive to the median of the duration of protection distribution, dose price and discount rate, but not coverage variations. Across sensitivity analyses, the probability of 1 dose being cost-effective vs 2 doses was < 50% at the standard WTP threshold. Adoption of a 1-dose 9vHPV vaccination program resulted in more vaccine-preventable HPV-related cancer and disease cases in males and females, introduced substantial uncertainty in health and economic outcomes, and had a low probability of being cost-effective compared to the 2-dose program.

Human health risk assessment for PAHs, phthalates, elements, PCDD/Fs, and DL-PCBs in PM2.5 and for NMVOCs in two East-Mediterranean urban sites under industrial influence

This study evaluates the carcinogenic and the non-carcinogenic health risks related to non-methane volatile organic compounds (NMVOCs) and elements, dioxins, furans, dioxin-like polychlorobiphenyls, phthalates and polycyclic aromatic hydrocarbons in PM2.5 samples collected during a one-year field campaign in two urban industrial areas in the East Mediterranean region. The health risk was assessed for the three exposure pathways (ingestion, inhalation and dermal contact) and for different age categories (newborns, children, adolescents, and adults). The non-carcinogenic risk calculated for the different species showed that benzene and n-heptane explained 78–94% of the total hazard index (HI) for NMVOCs at both sites. The total HI for NMVOCs varied between 2.9 and 26.8 at Zouk and between 0.8 and 6.6 at Fiaa for adults and newborns respectively exceeding the recommended USEPA limit of 1 for most age categories. PM2.5-bound elements had values higher than the recommended USEPA limit for newborns with Mn, Pb, V, and Ni as the major contributors. The other species under study presented moderate risk values. The lifetime cancer risk due only to the exposure to NMVOCs was 170 and 46 times higher than the threshold limit at Zouk and Fiaa, respectively. PM2.5-bound PAHs, As, Co, Cr(VI), Ni and V concentrations showed lifetime cancer risk exceeding the threshold limit of 10−6 with 58 and 28 additional cancer cases per million habitats at Zouk and Fiaa, respectively. To our knowledge, this assessment is a first evaluating the health risk of several classes of compounds from both particulate and gas phases.

Обґрунтування регіональної програми моніторингу за якістю атмосферного повітря у Дніпропетровській області

The air quality monitoring system in industrial cities is one of the systems for responding to risk factors in the public health system. The purpose of the study is, on the basis of a hygienic assessment of carcinogenic and non-carcinogenic risks from exposure to specific pollutants in the cities of Dnipro, Kamenskoye, Kryvyi Rih, to substantiate a program for regional monitoring of atmospheric air quality. Materials and methods. To achieve this goal, the results of air quality studies in the largest industrial cities of the Dnipropetrovsk region – Dnipro, Kryvyi Rih and Kamenskoe for the period 2005-2019 were analyzed in terms of phenol, formaldehyde, benzene, xylene and toluene, and carcinogenic and non-carcinogenic risks to public health were calculated in these cities. Results and discussion. According to the results of the study, individual carcinogenic risks in all three cities in terms of formaldehyde are medium, and in terms of benzene are high. The population carcinogenic risk ranges from 200-269 additional cases of cancer from exposure to formaldehyde and 3727-4426 additional cases of cancer from chronic inhalation exposure to benzene. The calculation of non-carcinogenic risks identified the priority specific air pollutants in the cities under study, as well as the main target organs. So the main systems that are influenced by the action of the studied chemicals are the central nervous system, the general development of the body and the blood system. Based on the risk assessment, it was established that it is necessary to include the Kamenskoye metro station for regional monitoring. It is necessary to include all pollutants from List A to the minimum list of investigated chemicals, and for the city of Dnipro and Kamenskoye it is additionally necessary to carry out studies of phenol, formaldehyde and toluene and in the city of Kryvyi Rih – formaldehyde and toluene. The mechanism of data processing and interaction between the subjects of monitoring has been substantiated for the timely identification of risks and the development of necessary preventive measures for risk management. Conclusion. It was found that carcinogenic and non-carcinogenic risks in industrial cities of the Dnipropetrovsk region are not acceptable. The existing monitoring system does not fully comply with the current requirements. The minimum program of the regional air quality monitoring system in the Dnipropetrovsk region has been scientifically substantiated

JUSTIFICATION OF RISK-ORIENTED ASSESSMENT SYSTEM FOR ASSESSING THE IMPACT OF ATMOSPHERIC AIR POLLUTION ON POPULATION HEALTH BASED ON ASSESSMENT OF BENZENE LEVEL IN KAMIANSKE

Air pollution in industrial cities is one of the sources of the formation of non-infectious diseases of the population. Timely identification and application of preventive measures makes it possible to control and reduce the incidence rate of the population of technogenically loaded settlements.&#x0D; Purpose of the study. on the basis of a hygienic assessment of the concentration of benzene in the atmospheric air of Kamianske, substantiate the need for a risk-oriented approach to assessing the impact of the environment on the health of the population.&#x0D; Materials and research methods. Based on the monitoring studies carried out for the period 2016-2020. carried out a hygienic assessment of the quality of atmospheric benzene content in. Kamenskoe. The calculation and assessment of carcinogenic risks and analysis of the current regulatory levels in Ukraine have been carried out.&#x0D; Results. According to the results of the research, the tendency to increase the content of benzene in the atmospheric air of Kamianske was revealed. In 2020, the MPC was exceeded. Carcinogenic risk (CR) in Kamianske is unacceptable and requires the development of measures to reduce or eliminate the risk. The population carcinogenic risk (PCR) for city residents is 906 additional cancer cases. The analysis of the obtained results showed that the analysis of air pollution in comparison with the maximum concentration limit, which for benzene is 1.5 mg / m3 for maximum single concentrations and 0.1 mg / m3 for average daily concentrations, does not allow to identify public health hazards in time. and develop the necessary set of preventive measures, in contrast to the risk assessment system.&#x0D; Conclusions. The tendency to increase the concentrations of benzene in the air in Kamyanske has been established. It is proved that the calculated carcinogenic risk is unacceptable for the population of an industrial city. The necessity of calculation and risk assessment for timely identification, risk assessment and development of preventive measures is substantiated. The use of risk assessment techniques allows to identify potentially dangerous effects for the population affected by the actual concentrations of benzene within the MPC.

Aflatoxin B1 and ochratoxin A in imported and Lebanese wheat and -products

ABSTRACT AFB1 and OTA are produced in food products due to climatic conditions like temperature and humidity. In Lebanon, few studies address AFB1 and OTA contamination in wheat and wheat products. In this study, a total of 312 samples of wheat and wheat products were collected from different sites, including port, silos, mills, and supermarkets were analysed. Wheat and wheat products consumption in Lebanon was quantified using a food frequency questionnaire. Exposure to AFB1 and OTA was calculated and liver and kidney cancer risk were evaluated. Results showed that AFB1 and OTA were, respectively, found in 65.7% and 100% of the samples, with 0.6% and 17.6% exceeding the maximum limit set by the European Commission. AFB1 was shown to be associated with 0.076 additional cancer cases per 100,000 persons per year and OTA weekly exposure was shown to be 53.2 ng/kg bw, which is less than the Provisional Tolerable Weekly Intake of 100 ng/kg bw.

Pesticide residues in fruit juice in Serbia: Occurrence and health risk estimates

The occurrence of pesticide residues in food and the consequent health risks attract considerable attention. The current study comprised 139 samples of fruit juice present on the Serbian market. Out of 69 pesticide active substances analysed by liquid chromatography tandem mass spectrometry with electrospray ionisation, 19 were detected, ranging from 0.001 to 0.629 mg/kg, most frequently these were carbendazim, acetamiprid and pyrimethanil. Almost 60 % of 71.2 % of positive samples contained multiple residues, up to 6. Residues of unapproved pesticides were detected in 2.9 % of samples, while the percentage of samples not in compliance with the permitted maximum levels was 2.2 %. The probability of exceeding the toxicological reference value was insignificant for any of the pesticides assessed in any of the consumer groups considered, with the exception of adolescents acutely exposed to carbofuran (113 % of ARfD). Chronic cumulative exposure to triazole pesticides showed very low risk, regardless of the applied approach - Hazard Index or Relative Potency Factors, used to scale the exposure relative to cyproconazole as the index compound for hepatotoxic effects. An estimate of the lifetime cancer risk attributable to the presence of carcinogenic pesticides in fruit juice was sufficiently protective, corresponding to a total of 0.013 additional cancer cases annually.

Groundwater hydrogeochemistry and probabilistic health risk assessment through exposure to arsenic-contaminated groundwater of Meghna floodplain, central-east Bangladesh

A clear understanding of various hydrogeochemical processes is essential for the protection of groundwater quality, which is a prime concern in Bangladesh. The present study deals with the geochemistry of groundwater at various depths to investigate the hydrogeochemical processes controlling the water quality of Meghna floodplain, the sources and mechanisms of arsenic (As) liberation, and the estimation of carcinogenic and non-carcinogenic health risks (using probabilistic and deterministic approaches) to the adults and children of the Comilla district, central-east Bangladesh. The groundwaters were generally of Ca–Mg–HCO3 type, and water-sediment interaction was the dominant factor in evolving the chemical signatures. The dissolution of carbonates, weathering of silicates, and cation exchange processes governed the major ion chemistry. Dissolved As concentration ranged from 0.002 to 0.36 mg/L and Monte Carlo simulation-based probabilistic estimation of cancer risk suggested that; (1) ~ 83% of the waters exceeded the higher end of the acceptable limit of 1 × 10−4; (2) the probability of additional cases of cancer in every 10,000 adults and children were on average ~9 and ~5, respectively; (3) adults were more susceptible than children; and (4) ingestion was the main pathway of As poisoning and the contribution of dermal contact was negligible (<1%). According to sensitivity analysis, the duration of exposure to As and its concentration in groundwater posed the greatest impact on cancer risk assessment. However, hydrogeochemical investigations on the sources and mobilization mechanisms of As suggested that the reductive dissolution of Fe and Mn oxyhydroxides was the principal process of As release in groundwater. The oxidation of pyrite and competitive exchange of fertilizer-derived phosphate for the sorbed As were not postulated as the plausible explanation for As liberation.

Occurrence of aflatoxin M1 in raw, pasteurized, UHT cows’ milk, and dairy products in Lebanon

In this study, a total amount of 868 samples of raw cows' milk, pasteurized and UHT cows’ milk, and dairy products were analyzed for their AFM1 content. Milk and dairy consumption in Lebanon was evaluated through a food frequency questionnaire, and accordingly the exposure to AFM1 and its association with liver cancer risk in Lebanese population were evaluated. Results showed contamination in raw milk, pasteurized and UHT milk, and dairy products at a range of 0.011–0.440 μg/l, 0.013–0.219 μg/L, and 0.015–7.350 μg/L respectively; with 28%, 54.5%, and 45.5% respectively of samples with AFM1 above maximum tolerable limit (MTL) set by the European Commission. AFM1 consumption was shown to be associated with 0.0041 additional cancer cases per 100,000 persons per year. Based on these results, milk and dairy consumption in Lebanon can be considered hazardous and may present a significant risk on the health of the Lebanese population especially children.

Can mammogram readers swiftly and effectively learn to interpret first post-contrast acquisition subtracted (FAST) MRI, a type of abbreviated breast MRI?: a single centre data-interpretation study.

To assess whether NHS breast screening programme (NHSBSP) mammogram readers could effectively interpret first post-contrast acquisition subtracted (FAST) MRI, for intended use in screening for breast cancer. Eight NHSBSP mammogram readers from a single centre (four who also read breast MRI (Group 1) and four who do not (Group 2)) were given structured FAST MRI reader training (median 4 h: 32 min). They then prospectively interpreted 125 FAST MRIs (250 breasts: 194 normal and 56 cancer) comprising a consecutive series of screening MRIs enriched with additional cancer cases from 2015, providing 2000 interpretations. Readers were blinded to other readers' opinions and to clinical information. Categorisation followed the NHSBSP MRI reporting categorisation, with categories 4 and 5 considered indicative of cancer. Diagnostic accuracy (reference standard: histology or 2 years' follow-up) and agreement between readers were determined. The accuracy achieved by Group 2 (847/1000 (85%; 95% confidence interval (CI) 82-87%)) was 5% less than that of Group 1 (898/1000 (90%; 95% CI 88-92)). Good inter-reader agreement was seen between both Group 1 readers (κ = 0.66; 95% CI 0.61-0.71) and Group 2 readers (κ = 0.63; 95% CI 0.58-0.68). The median time taken to interpret each FAST MRI was Group 1: 34 s (range 3-351) and Group 2: 77 s (range 11-321). Brief structured training enabled multiprofessional mammogram readers to achieve similar accuracy at FAST MRI interpretation to consultant radiologists experienced at breast MRI interpretation. FAST MRI could be feasible from a training-the-workforce perspective for screening within NHSBSP.

Carcinogenic risk assessment of benzene from the oil and gas field.

Introduction and objective: In 2012 actual concentrations of benzene in the villages (9,000 people) near one of the largest in the world oil and gas condensate fields (Kazakhstan, Central Asia) were several times higher than expected model-based concentrations. Therefore a human health risk assessment from benzene was made with a focus on carcinogenic incidence determination. Additional cancer cases were derived from the benzene concentrations and turned into an economic damage to the state. Materials and methods: Annual population cancerogenic risk was derived with the use of Human health risk assessment methodology as described in the Guidance by Rahmanin et al. Economic damage from additional cancer cases was defined with a newly developed method with socio-economic characteristics of Kazakhstan taken into account. Results: In 2012, additional carcinogenic morbidity from benzene emissions totaled 0.1 case per 9,000 people. Human health economic damage from benzene caused by the activity of the abovementioned facility was estimated at $4,530. As seen from this exact study, the results of modeling and monitoring of one and the same facility may greatly differ. Therefore holding the cancerogenic risk assessment on an annual basis is a necessity and it must be made mandatorily, on a legal basis, not only in this exact region, but whenever an industrial facility runs its operations associated with the air pollution.

Radioactive impacts on nekton species in the Northwest Pacific and humans more than one year after the Fukushima nuclear accident

This study investigated the radioactive impacts on 10 nekton species in the Northwest Pacific more than one year after the Fukushima Nuclear Accident (FNA) from the two perspectives of contamination and harm. Squids were especially used for the spatial and temporal comparisons to demonstrate the impacts from the FNA. The radiation doses to nekton species and humans were assessed to link this radioactivity contamination to possible harm. The total dose rates to nektons were lower than the ERICA ecosystem screening benchmark of 10μGy/h. Further dose-contribution analysis showed that the internal doses from the naturally occurring nuclide 210Po were the main dose contributor. The dose rates from 134Cs, 137Cs, 90Sr and 110mAg were approximately three or four orders of magnitude lower than those from naturally occurring radionuclides. The 210Po-derived dose was also the main contributor of the total human dose from immersion in the seawater and the ingestion of nekton species. The human doses from anthropogenic radionuclides were ~ 100 to ~ 10,000 times lower than the doses from naturally occurring radionuclides. A morbidity assessment was performed based on the Linear No Threshold assumptions of exposure and showed 7 additional cancer cases per 100,000,000 similarly exposed people. Taken together, there is no need for concern regarding the radioactive harm in the open ocean area of the Northwest Pacific.

Cost-effectiveness analysis of AS04-adjuvanted human papillomavirus 16/18 vaccine compared with human papillomavirus 6/11/16/18 vaccine in the Philippines, with the new 2-dose schedule

ABSTRACTCervical cancer (CC) is the second leading cause of cancer death among Filipino women. Human papillomavirus (HPV) vaccination protects against CC. Two vaccines (AS04-HPV-16/18 and 4vHPV) are approved in the Philippines; they were originally developed for a 3-dose (3D) administration and have recently been approved in a 2-dose schedule (2D). This study aims to evaluate the cost-effectiveness of HPV vaccination of 13-year-old Filipino girls, in addition to current screening, in the new 2D schedule. An existing static lifetime, one-year cycle Markov cohort model was adapted to the Philippine settings to simulate the natural history of low-risk and oncogenic HPV infection, the effects of screening and vaccination of a 13-year-old girls cohort vaccinated with either the 2D-AS04-HPV-16/18 or 2D-4vHPV assuming a 100% vaccination coverage. Incremental cost, quality-adjusted life year (QALY) and cost-effectiveness were derived from these estimates. Input data were obtained from published sources and Delphi panel, using country-specific data where possible. Sensitivity analyses were performed to assess the robustness of the model. The model estimated that 2D-AS04-HPV-16/18 prevented 986 additional CC cases and 399 CC deaths (undiscounted), as well as 555 increased QALY (discounted), and save 228.1 million Philippine pesos (PHP) compared with the 2D-4vHPV. In conclusion, AS04-HPV-16/18 is shown to be dominant over 4vHPV in the Philippines, with greater estimated health benefits and lower costs.

Supplemental Screening for Breast Cancer in Women With Dense Breasts: A Systematic Review for the U.S. Preventive Services Task Force.

Screening mammography has lower sensitivity and specificity in women with dense breasts, who experience higher breast cancer risk. To perform a systematic review of reproducibility of Breast Imaging Reporting and Data System (BI-RADS) density categorization and test performance and clinical outcomes of supplemental screening with breast ultrasonography, magnetic resonance imaging (MRI), and digital breast tomosynthesis (DBT) in women with dense breasts and negative mammography results. MEDLINE, PubMed, EMBASE, and Cochrane database from January 2000 to July 2015. Studies reporting BI-RADS density reproducibility or supplemental screening results for women with dense breasts. Quality assessment and abstraction of 24 studies from 7 countries; 6 studies were good-quality. Three good-quality studies reported reproducibility of BI-RADS density; 13% to 19% of women were recategorized between "dense" and "nondense" at subsequent screening. Two good-quality studies reported that sensitivity of ultrasonography for women with negative mammography results ranged from 80% to 83%; specificity, from 86% to 94%; and positive predictive value (PPV), from 3% to 8%. The sensitivity of MRI ranged from 75% to 100%; specificity, from 78% to 94%; and PPV, from 3% to 33% (3 studies). Rates of additional cancer detection with ultrasonography were 4.4 per 1000 examinations (89% to 93% invasive); recall rates were 14%. Use of MRI detected 3.5 to 28.6 additional cancer cases per 1000 examinations (34% to 86% invasive); recall rates were 12% to 24%. Rates of cancer detection with DBT increased by 1.4 to 2.5 per 1000 examinations compared with mammography alone (3 studies). Recall rates ranged from 7% to 11%, compared with 7% to 17% with mammography alone. No studies examined breast cancer outcomes. Good-quality evidence was sparse. Studies were small and CIs were wide. Definitions of recall were absent or inconsistent. Density ratings may be recategorized on serial screening mammography. Supplemental screening of women with dense breasts finds additional breast cancer but increases false-positive results. Use of DBT may reduce recall rates. Effects of supplemental screening on breast cancer outcomes remain unclear. Agency for Healthcare Research and Quality.