Average Cancer Risk Research Articles

Adenoma Detection Rate in Average-Risk Population: An Observational Consecutive Retrospective Study.

Although colonoscopy is considered the most effective tool for reducing colorectal cancer-related morbidity, the age at which average-risk individuals begin colonoscopic screening is undetermined. This study aimed to compare the adenoma and advanced adenoma detection rates according to age and sex in a large average-risk population in the rural areas of Eastern China. This observational, single-center, retrospective study included patients with average colorectal cancer risk and examined the adenoma and advanced adenoma detection rates using age intervals of 5years. We also compared the size and age of patients with and without advanced adenoma. We included 18928 patients with a median age of 54 years (range 15-90years), including 10143 men and 8785 women. The adenoma and advanced adenoma detection rates were 17.08% and 5.24%, respectively, and increased with age in the whole population. The adenoma detection rates increased from 8.97% (aged 40-44) to 14.98% (aged 45-49) and 6.24% (aged 45-49) to 11.00% (aged 50-54) in men and women (both P < .001), respectively. The advanced adenoma detection rates increased from 2.19% (aged 40-44) to 4.76% (aged 45-49) and 1.89% (aged 45-49) to 3.13% (aged 50-54) in men (P = .002) and women (P = .056), respectively. Patients with advanced adenomas were significantly older than those with non-advanced adenomas (P < .001). The tumors in the advanced adenoma group were significantly larger than those in the non-advanced adenoma group (P < .001). The adenoma and advanced adenoma detection rates increased significantly in average-risk population aged 45years and older, especially in men.

ASSESSMENT OF INDOOR AND OUTDOOR RADIATION DOSE LEVELS IN DELTA STATE POLYTECHNIC, OGWASHI-UKU, DELTA STATE, NIGERIA

This study assessed the indoor and outdoor radiation dose levels of twelve (12) laboratories of Delta State Polytechnic, Ogwashi-Uku using a handheld inspector survey meter and estimation revealed that the average BIR, average annual equivalent dose rate (EDR), average annual absorbed dose rate (ADR), average annual effective dose equivalent (AEDE), average excess lifetime cancer risk (ELCR) is 0.0116 mR/hr, 0.9733 mSv/yr, 100.69 nGy/hr, 0.4940 mSv/yr and 1.755. Dose to organs showed that the testes received the highest dose, while the liver received the lowest dose indoors and outdoors respectively. In general, indoor and outdoor BIR, ED, AD, and AEDE values ​​are less than the recommended limit of unity (1 mSv/yr) for public exposure (ICRP). ELCR for indoor and outdoor is above the world permissible limit of 0.29×10-3. The calculated ELCR in the study area is 1:29719 (about 33 in 1 million) indoors and 1:115735 (9 in 1 million) outdoors. Although the average value for ELCR in this study is high further analysis and studies need to be carried out to ascertain the risk of staff and students to cancer.

Changes in mammography screening in Ontario and Alberta following national guideline dissemination: an interrupted time series analysis.

Background:In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years. Methods:We conducted an interrupted time series analysis using administrative data to examine bilateral mammography use before and after a release of a national breast screening guideline. Women aged 40 to 74 years living in Ontario or Alberta from 30th November 2008 to 30th November 2014 were included. Strata included age, region of residence, neighbourhood income quintile, immigration status, and education level. Results:In both provinces, mammography use rates were lower in the post-intervention period (527 vs. 556 and 428 vs. 465/1000 women in Ontario and Alberta, respectively). In Ontario, mammography trends decreased following guideline release to align with recommendations for women aged 40 to 74 (decrease of 2.21/1000 women, SE 0.26/1000, p<0.0001). In Alberta, mammography trends decreased for women aged 40 to 49 years (3/1000 women, SE 0.32, p<0.001) and 50 to 69 (2.9/1000 women, SE 0.79, p<0.001), but did not change for women aged 70 to 74 (0.7/1000 women, SE 1.23, p=0.553). In both provinces, trends in mammography use rates were sustained for up to three years after guideline release. Conclusions:We observed a decrease in screening for women aged 40-49. Additional research to explore whether shared decision making was used to optimize guideline-concordant screening for women aged 50-74 is needed.

Association of Premenopausal Bilateral Oophorectomy With Parkinsonism and Parkinson Disease

The association of premenopausal bilateral oophorectomy with parkinsonism and Parkinson disease (PD) remains controversial. To assess whether women who underwent premenopausal bilateral oophorectomy were at increased risk of parkinsonism and PD and whether the associations varied by age at oophorectomy and by receipt of estrogen replacement therapy. This cohort study used data from a combination of 2 independent cohort studies, the Mayo Clinic Cohort Study of Oophorectomy and Aging 1 and 2, which were based on the Rochester Epidemiology Project medical records-linkage system. A population-based sample of 5499 women from Olmsted County, Minnesota, were included; of those, 2750 women underwent bilateral oophorectomy for a benign indication before spontaneous menopause between January 1, 1950, and December 31, 2007 (oophorectomy cohort), and 2749 age-matched women who did not undergo bilateral oophorectomy were randomly sampled from the general population (reference cohort). Data were analyzed from March 1 to April 30, 2022. The date of oophorectomy was considered the index date for both groups. Medical record documentation of bilateral oophorectomy abstracted from a medical records-linkage system (Rochester Epidemiology Project). Incidence and risk of parkinsonism or PD, with diagnoses confirmed by in-person examination or medical record review. Among 5499 participants (median [IQR] age, 45.0 [40.0-48.0] years; 5312 [96.6%] White), 2750 women (2679 White [97.4%]) underwent bilateral oophorectomy at a median age of 45.0 years (IQR, 40.0-48.0 years), and 2749 women (2633 White [95.8%]) with a median age of 45.0 years (IQR, 40.0-48.0 years) at the index date were included in the reference cohort. Bilateral oophorectomy was associated with an increased risk of parkinsonism overall (hazard ratio [HR], 1.59; 95% CI, 1.02-2.46) and in women younger than 43 years at oophorectomy (HR, 7.67; 95% CI, 1.77-33.27). There was a pattern of increasing risk with younger age at the time of oophorectomy using 4 age strata (≥50 years: HR, 1.43 [95% CI, 0.50-4.15]; 46-49 years: HR, 1.55 [95% CI, 0.79-3.07]; 40-45 years: HR, 1.36 [95% CI, 0.64-2.89]; <40 years: HR, 8.82 [95% CI, 1.08-72.00]; P = .02 for trend). The number needed to harm was 53 women overall and 27 women younger than 43 years at the time of oophorectomy. Bilateral oophorectomy was also associated with an increased risk of PD in women younger than 43 years at oophorectomy (HR, 5.00; 95% CI, 1.10-22.70), with a number needed to harm of 48 women. Among women who underwent oophorectomy at 45 years and younger, the risk was lower in women who received estrogen after the procedure and through age 50 years compared with women who did not. For parkinsonism, the HRs were 1.72 (95% CI, 0.54-5.53) vs 2.05 (95% CI, 0.80-5.23); for PD, the HRs were 1.53 (95% CI, 0.29-8.23) vs 2.75 (95% CI, 0.84-9.04). However, the differences were not significant. In this study, premenopausal women who underwent bilateral oophorectomy before age 43 years had an increased risk of parkinsonism and PD compared with women who did not undergo bilateral oophorectomy. These findings suggest that a reduction in the practice of prophylactic bilateral oophorectomy in premenopausal women at average risk of ovarian cancer may have substantial benefit for reducing the risk of parkinsonism and PD.

An updated counseling framework for moderate-penetrance colorectal cancer susceptibility genes

With the recent guideline change for individuals at average risk for colorectal cancer (CRC) to initiate colonoscopy at the age of 45 years, there is a need to provide an updated counseling framework for individuals with variants in moderate-penetrance CRC susceptibility genes. Population age-specific incidence rates for CRC were obtained from the 2014-2018 US Surveillance, Epidemiology, and End Results Program cancer statistics. Average-risk multipliers derived from a systematic meta-analysis were used to calculate the 5-year and cumulative lifetime risks for specific genetic variants associated with a moderate risk for CRC: NM_007194.4(CHEK2):c.1100del (p.Thr367fs), NM_007194.4(CHEK2):c.470T>C (p.Ile157Thr), NM_000038.6(APC):c.3920T>A (p.Ile1307Lys) and monoallelic MUTYH. When an individual at average risk would initiate colonoscopy at age 45 years, a CRC risk of 0.39% is reached. For CHEK2 1100delC, CHEK2 I157T, and APC I1307K heterozygotes, this same level of risk is reached (or nearly reached) by age 40 to 45 years. For individuals with a monoallelic MUTYH variant, the CRC risk is 0.46% by age 45 to 49 years, similar to individuals at average risk. These updated calculations support recommendations to initiate earlier colonoscopy surveillance for CHEK2 and APC I1307K germline variant heterozygotes. However, earlier surveillance is not indicated for individuals with monoallelic MUTYH germline variants in the absence of family history.

Association of disability with long-term noncompliance of breast cancer screening.

118 Background: Although the U.S. Preventive Services Task Force (USPSTF) recommends a biennial screening mammography for women aged 50 to 74 years at average risk for breast cancer, 24.6% of screening-eligible women do not follow the recommendation. Very little is known regarding the association between various types of disabilities and subsequent breast cancer screening behaviors following the initiation of screening mammography. This study examines the association of disability with short-term vs. long-term noncompliance of having a mammogram. Methods: Using data from 2016, 2018, and 2020 Behavioral Risk Factor Surveillance System annual surveys, we constructed the study cohort of women aged 55 to 74 years who did not have a cancer history and who received a mammogram at least once in the past. Outcomes are short-term (2 years) and long-term (5 years) noncompliance of USPSTF recommendations. Key independent variables are six binary variables of standard functional disability conditions (hearing, vision, cognition, ambulation, self-care, and independent living) in the first model and a categorized total number of disabilities (0, 1, 2, ≥3) in the second model. We employed a multivariable logistic regression model, adjusting individuals’ socio-demographics, general health status, chronic conditions, health risk factors, and metropolitan statistical areas (MSA), and accounting for complex survey design. Results: Among the study cohort (n = 232,143; weighted n = 29,358,431), 18.1% and 7.1% of women reported not having mammography in the past two and five years, respectively, representing short- vs. long-term noncompliance. Of the study cohort, 32.8% had any type of disability (ambulation 22.7%, cognition 11.0%, independent living 8.8%). Notably, the long-term noncompliance rate was highest among women with a disability and residing in non-MSA (10.2%). In multivariable analysis, while only disability in independent living was associated with short-term noncompliance (odds ratio [OR] 1.28; 95% confidence interval [CI] 1.15-1.42), disability in independent living (OR 1.34; 95% CI 1.18-1.52), vision (OR 1.15; 95% CI 1.01-1.32) and ambulation (OR 1.12; 95% CI 1.01-1.24) were all significantly associated with long-term noncompliance. Women with ≥3 disabilities were 1.64 times more likely to be non-compliant in the long term, and the association of disability with noncompliance was more pronounced in non-MSA. Conclusions: This study provides the first empirical evidence on the positive association between disability and screening noncompliance, especially in the long term. It suggests disability could aggravate disparities in timely access to cancer screening, particularly in non-MSA. Understanding how various types of disabilities affect screening behavior is a critical step for public health efforts in cancer prevention and control through identifying vulnerable subgroups for targeted interventions.

S2078 Multicentric, Synchronous Colon Cancer in the Rectum, Sigmoid and Cecum in an Elderly Female

Introduction: Multicentric tumors are more common in genetically-linked cancers. In most instances, tumor occurrence in a different location is due to recurrence of the malignancy. Our case illustrates a rare endoscopic finding of 3 distinct and synchronous adenocarcinomas of the rectum, sigmoid colon, and cecum in an otherwise healthy elderly female at an average risk for colorectal cancer. Case Description/Methods: An 81-year-old female with no medical history presented to the hospital with constipation and diffuse intermittent abdominal pain for 4 months. She had been self-medicating at home with over-the-counter laxatives but recently reported that she was not experiencing relief. She denied any prior endoscopy or family history of colorectal cancer. On admission, her vital signs were normal and her physical exam was significant for diffuse abdominal tenderness to palpation. Digital rectal examination revealed a non-tender, hard mass in the left lateral wall of the rectum. Her complete blood count and comprehensive metabolic panels were normal. Iron studies were also unremarkable. A computed tomography (CT) scan of the abdomen and pelvis showed thickening in the sigmoid colon and the rectum with scattered subcentimeter lymph nodes. On colonoscopy, she was found to have 3 partially-obstructing, malignant-appearing lesions located in the rectum, proximal sigmoid, and cecum. Biopsies of all 3 sites revealed adenocarcinoma. Immunohistochemistry for DNA mismatch repair proteins (MMR) showed intact MLH1, MSH2, MSH6, PMS2 genes. She underwent a laparoscopic total colectomy with end ileostomy, with pathological staging revealing pT3 N0 for the sigmoid tumor and pT4a N2b for the cecal tumor. She was planned for neoadjuvant chemoradiation therapy in anticipation for future robotic proctectomy for treatment of the rectal tumor (Figure 1). Discussion: Synchronous colorectal cancers pose a distinct challenge in terms of management and treatment. The extent of surgical resection and the use of chemoradiation depends on the location, number of lesions, and lymph node involvement. Our patient was an interesting case as she presented later in life and her only symptom was constipation. She was an average risk patient, had otherwise normal labs, and HNPCC/lynch syndrome-related cancers were excluded on the basis of normal immunohistochemistry testing.Figure 1.: Partially-obstructing malignant lesions in the (A) rectum, (B) proximal sigmoid, and (C) cecum.

Assessment of Arsenic Contamination in Groundwater and Associated Human Health Risk

Drinking water contamination by arsenic (As) is of significant concern due to its potential cause of cancer and arsenicosis. In this study, out of the 200 samples (n = 200), the mean As concentrations ranged from below detection limit (BDL) to 3.30, 4.81, 4.42 and 3.85 µg L−1 in small residential, roadside, industrial and household areas, respectively. From 200 total samples, 9% of the groundwater samples showed As levels higher than the WHO safe guideline limit of 10 μg L−1. Human health risk was assessed using average daily intake (ADD), hazard quotient (HQ) and cancer risk (CR) values which were found to be greater than the recommended values by the United States Environmental Protection Agency (1.0 and 10−6) for health risk assessment. The CR were ranged from 0–5.7 × 10−1, 4.0 × 10−1, 2.0 × 10−1 and 1.0 × 10−1 in small residential areas for children, adolescents, males and females, respectively. In roadside areas, the values ranged from 0–2.8 × 10−1, 4.0 × 10−1, 2.0 × 10−1 and 2.8 × 10−1 for children, adolescents, males and females, while 0–5.9 × 10−1, 4.1 × 10−1, 2.1 × 10−1 and 1.6 × 10−1 in industrial areas and 0–8.0 × 10−1, 2.91 × 10−1, 2.6 × 10−1 and 3.9 × 10−1 were calculated in household sites. All the CR values were found to be exceeding the US-EPA limit (10−6) recommending that the people in the study area are more prone to carcinogenic risk. Overall, it was concluded that due to presence of As in drinking water, these areas tend to be at higher cancer risks. To provide safe drinking water for the people living in these As-affected areas, urgent remedial and management steps are required.

Assessment of cause-specific mortality and disability-adjusted life years (DALYs) induced by exposure to inorganic arsenic through drinking water and foodstuffs in Iran

The health risk and burden of disease induced by exposure to inorganic arsenic (iAs) through drinking water and foodstuffs in Iran were assessed. The iAs levels in drinking water and foodstuffs (15 food groups) in the country were determined through systematic review of three international databases (PubMed, Scopus, and Web of Science) and meta-analysis. Based on the results of the systematic review and meta-analysis, the average iAs levels in drinking water and all the food groups at the national level were lower than the maximum permissible levels. The total average non-carcinogenic risk of dietary exposure to iAs in terms of hazard index (HI) was 3.4. The average incremental lifetime cancer risk (ILCR) values of dietary exposure to iAs were determined to be 1.5 × 10−3 for skin cancer, 1.0 × 10−3 for lung cancer, and 4.0 × 10−4 for bladder cancer. Over two-thirds of the non-carcinogenic and carcinogenic risk of dietary exposure to iAs was attributed to bread and cereals, drinking water, and rice. The total annual cancer incidence, deaths, disability-adjusted life years (DALYs), death rate, and DALY rate (per 100,000 people) were assessed to be 3347 (95 % uncertainty interval: 1791 to 5999), 1302 (697 to 2336), 72,606 (38,833 to 130,228), 1.6 (0.87 to 2.9), and 91 (49 to 160). The contribution of mortality in the attributable burden of disease was 95.1 %. The contributions of the causes in the attributable burden of disease were 72 % for lung cancer, 16 % for bladder cancer, and 12 % for skin cancer. Due to the significant attributable burden of disease, national and subnational action plans consisting of multi-disciplinary approaches for risk management of dietary exposure to iAs, especially for the higher arsenic-affected areas and high-risk population groups in the country are recommended.

Measurement of Indoor-Outdoor Carbonyls in Three Different Universities Located in the Metropolitan Zone of Mexico Valley during the First Period of Confinements Due to COVID-19

Carbonyl concentrations in indoor-outdoor air were measured at three urban sites in the Metropolitan Zone of Mexico Valley (MZMV) during the first period of confinements due to COVID-19; the exposure for people living in indoor environments was also assessed. Indoor and outdoor samples were simultaneously collected sequentially with Sep-Pack DNPH-Silica cartridges. Formaldehyde, acetaldehyde, acetone, propionaldehyde, butyraldehyde and acrolein were quantified according to the US-EPA TO-11A method. Acrolein and acetone were the most abundant carbonyls in indoor air, with average concentrations of 55.5 µg m−3 and 46.4 µg m−3, respectively, followed by formaldehyde (29.1 µg m−3), acetaldehyde (21.4 µg m−3) and butyraldehyde (7.31 µg m−3). Propionaldehyde was not detected. Acetone was the dominant carbonyl in outdoor samples with an average concentration of 8.4 µg m−3, followed by formaldehyde (2.8 µg m−3) and acetaldehyde (0.7 µg m−3). Butyraldehyde and acrolein were not detected in outdoor air. Indoor/outdoor (I/O) ratios showed that indoor sources prevail for most aldehydes. Statistical analysis of simple correlations showed that the measured carbonyls were influenced by the presence of indoor sources. The average cancer risk coefficients (LTCR) for formaldehyde and acetaldehyde and the non-cancer risk coefficients (HQ) for acrolein and formaldehyde were higher than the recommended limits, which should be a cause for public concern.

Predictors of colorectal cancer screening intention based on the integrated theory of planned behavior among the average-risk individuals

BackgroundThis study aimed to determine the predictors of colorectal cancer screening intention based on the integrated theory of planned behavior among average -risk individuals in Urmia. Identifying these predictors will help design and implement various interventions, including educational interventions, according to the needs of this group, thereby taking a step towards improving the colorectal cancer screening index.MethodsThe present cross-sectional study was performed on 410 individuals at average risk of colorectal cancer referring to the comprehensive health services centers of Urmia in Iran. The data collection tool was a researcher-made questionnaire consisting of two parts. The first part captured the demographic information and medical history of the participants. The second part involved questions designed based on constructs of motivational phase of health action process approach, and theory of planned behavior, as well as behavioral intent to perform colorectal cancer screening. Data analysis was performed using SPSS software.ResultsOutcome expectancies, risk perception, action self-efficacy, and normative beliefs, respectively had the largest impact and were significant and positive predictors of colorectal cancer screening intention. The study’s conceptual framework explained about 36% of the variance of behavioral intention among the average-risk individuals in Urmia.ConclusionsConstructs of motivational phase of health action process approach, and theory of planned behavior are valuable and appropriate to identify the factors affecting the intention to undergo colorectal cancer screening as well as to design and implement educational interventions in this field. The four constructs of outcome expectancies, risk perception, action self-efficacy, and normative beliefs are suggested to be integrated into all educational interventions designed and implemented to improve the colorectal cancer screening index.

Groundwater arsenic poisoning in a primary educational institution: health risks to school-going children

This study aimed to estimate arsenic (As) and iron (Fe) content in tubewell water (n = 58) in primary educational institutions and subsequently assess the health risks to school-going children. Results described that the As concentration ranged between 0.002 and 0.994 mg L−1 with an average value of 0.044 mg L−1; which exceeded the World Health Organization (WHO) provisional guideline value of 0.01 mg L−1. Similarly, the Fe content varied from 0.05 to 10 mg L−1 averaging to 2.84 mg L−1. Samples of 55.17% contained a greater As concentration than 0.01 mg L−1 and 18.97% greater than Bangladesh drinking water quality (BDWQ) standard of 0.05 mg L−1, respectively. Meanwhile, 75.86% of samples contained a higher Fe concentration than the maximum Bangladesh permissible limit of 1 mg L−1. Health risk assessment indicated that girls are more vulnerable than boys are. The average hazard quotients (HQs) for As intake through drinking water were 6.01 ± 17.85 and 7.41 ± 22.03 for boys and girls, respectively, implying non-carcinogenic health risks to both genders. The HQs for Fe intake were less than threshold value of 1 indicating no health issues may arise from Fe intake alone. However, consumption of As and Fe may trigger health risks to students as indicated by the hazard index (HI), which was higher than 1. The average cancer risk (CR) values for both boys (0.0027 ± 0.008) and girls (0.0033 ± 0.0099) exceeded the threshold limit of 10–6–10–4, suggesting a possibility of lifetime cancer risks to the school-going children. Consequently, school authorities should find alternative ways to ensure safe drinking water for school-going children to avoid possible cancer and non-cancer health risks through consumption of As-poisoning water.

Using Online Colorectal Cancer Risk Calculators to Guide Screening Decision-Making

BackgroundSeveral online calculators estimate colorectal cancer risk, but their consistency is unknown. Our objectives were to quantify the variation in predicted risk and to determine which calculators are best used in the clinical setting. MethodsWe used the Google search engine to identify online colorectal cancer risk calculators and assessed the output of each for 3 hypothetical screening scenarios (low-, average-, and high-risk), varied by age (50, 62, 75 years), sex, and race (Black, White), with risk levels based on risk-appropriate values for variables in each model. Estimated risks for models within a given scenario were rated as consistent or inconsistent based on comparison with either the absolute magnitude of difference or average lifetime risk of colorectal cancer. Summary statistics for consistent and inconsistent estimates were compared using chi-square and Fisher's exact tests. ResultsWe identified 5 online colorectal cancer risk calculators. Inconsistencies were found in none of 5-year, 19% of 10-year, and 81% of lifetime colorectal cancer risk estimate comparisons (P < .001). For a 50-year-old, 22% of risk estimate comparisons were inconsistent, vs 33% for a 62-year-old, and 36% for a 75-year-old (P = 0.14). ConclusionsOnline colorectal cancer risk models are more consistent in predicting colorectal cancer risk for 5- and 10-year time frames compared with lifetime. For a US population, the National Cancer Institute's Colorectal Cancer Risk Assessment Tool is a rigorously developed calculator that can be used in the clinical setting to provide 5-year and lifetime risk estimates.

Breast cancer screening in average and high-risk women.

Breast cancer is the most common cancer among females worldwide with rising incidence. In the United States, screening mammography and advances in therapy have lowered mortality by 41% since 1990. Screening mammography is supported by randomized control trials (RCT), observational studies, and computer model data. Digital breast tomosynthesis is a new technology that addresses limitations in mammography resulting from overlapping breast tissue, improving its sensitivity and specificity. Patients at high risk for breast cancer include those with a ≥20% lifetime risk, high-risk germline mutation, or history of thoracic radiation treatment between 10-30 years of age. Such patients are recommended to undergo annual screening mammography and adjunctive annual screening breast MRI. Patients unable to undergo MRI may undergo whole breast ultrasound or contrast-enhanced mammography. Pregnant and lactating patients at average risk for breast cancer are recommended to undergo age-appropriate screening mammography.

Ovarian Function in Patients Who Underwent Opportunistic Bilateral Salpingectomy during Hysterectomy

Objective(s): To provide additional data and to inform all women at average risk of ovarina cancer, undergoing a benign gynecological laparoscopic procedure about the Pro’s and the Con’s of opportunistic bilateral salpingectomy (OBS). Mechanism: Risk reducing salpingo-oophorectomy to prevent epithelial ovarian cancer (EOC) is associated with decreased quality of life and increased overall mortality. OBS has emerged as a primary prevention of ovarian cancer through a paradigm shift in which fallopian tubes are often the cause of ovarian cancer rather than the ovaries themselves. Findings in Brief: Causal relationship of salpingectomy and reduced risk of ovarian cancer has not been proven yet. There are several population-based studies that showed bilateral salpingectomy reduced risk of EOC by 42–67%, but there also is a study that suggest increased risk of ovarian cancer after salpingectomy. As for risk of surgical complications, several cohort studies have demonstrated that there was no increase in rates of hospital readmission, blood transfusion, day of hospital stay. However, recent meta-analysis stated that there were insufficient data to assess any difference in both intraoperative and postoperative complication rates. The procedure of salpingectomy can disrupt blood supply to the ovary. Data of reproductive outcome after assisted reproductive technologies such as in vitro fertilization and embryo transfer (IVF-ET) are conflicting. Some studies suggest that salpingectomy did not compromise the outcome of IVF-ET, but other studies found that salpingectomy may lead to decreased ovarian reserve after salpingectomy. For patients who do not wish fertility, data on the effect of OBS during hysterectomy suggest that changes in serum ovarian reserve markers were not different between OBS group and control group. Conclusions: Bilateral salpingectomy should be considered at the time of abdominal or pelvic for women at average risk of ovarian cancer. However, physicians should discuss the protective benefit of bilateral salpingectomy against ovarian cancer and controversial data on ovarian reserve.

Incidence and survival of multiple primary cancers in United States women (349)

Incidence and survival of multiple primary cancers in United States women (349)

ASSOCIATION OF NATURAL KILLER CELLS ACTIVITY WITH THE INCIDENCE OF COLORECTAL NEOPLASIA AT SCREENING

Relevance: Increased natural killer cell (NK cells) activity reduces colorectal cancer (CRC) risk. Previously published studies examined the association of NK cells and CRC prevalence in individuals at high cancer risk.&#x0D; The study aimed to study the relationship between NK cell activity and the incidence of advanced adenomas (AA) and CRC in a population with average cancer risk.&#x0D; Methods: The activity of NK cells was assessed by enzyme immunoassay (ELISA) of blood in participants of average risk with a&#x0D; measurement range of 25-2500 pg/mL. The level of NK cells below 200 pg/mL was defined as pathological. The informativeness of&#x0D; the diagnostic test for determining NK cell activity was assessed using indicators such as sensitivity, specificity, negative and positive&#x0D; predictive value, and clinical utility index. The probability coefficient for the development of colorectal cancer was calculated using&#x0D; logistic regression.&#x0D; Results: NK cell activity was assessed in 354 persons of average risk (mean age – 59 years; 36% men). The diagnostic accuracy of&#x0D; NK cells determination for CRC and AA was 76% and 72%, respectively, and the negative predictive value was 96%. The NK cell test&#x0D; demonstrated a good negative clinical utility index for CRC and AA (0.66 and 0.74, respectively). Individuals with low NK cell levels were&#x0D; seven times more likely to be diagnosed with CRC (95% CI 2.3-20.3; p&lt;0.001). NK cell levels were higher in men compared to women&#x0D; (549 pg/mL vs 500 pg/mL) and lower in smokers (412 pg/mL versus 544 pg/mL), non-athletic participants (413 pg/mL versus 654 pg/mL),&#x0D; in people who abuse alcohol (389 pg/ml versus 476 pg/ml).&#x0D; Conclusion: Our study shows that a high level of NK cells can potentially exclude CRC and AA in individuals with average cancer risk

ASSOCIATION OF NATURAL KILLER CELLS ACTIVITY WITH THE INCIDENCE&#x0D; OF COLORECTAL NEOPLASIA AT SCREENING

Relevance: Increased natural killer cells (NK cells) activity is associated with reduced colorectal cancer (CRC) risk. Previously published&#x0D; studies examined the association of NK cells and CRC prevalence in individuals at high cancer risk.&#x0D; The purpose was to study the relationship between NK cell activity and the incidence of advanced adenomas (AA) and CRC in a population&#x0D; with average cancer risk.&#x0D; Methods: The activity of NK cells was assessed by enzyme immunoassay (ELISA) of blood in participants of average risk with a measurement&#x0D; range of 25-2500 pg/ml. The level of NK cells below 200 pg/ml was defined as pathological. The informativeness of the diagnostic test for determining NK cell activity was assessed using indicators such as sensitivity, specificity, negative and positive predictive value, and clinical utility index.&#x0D; The probability coefficient for the development of colorectal cancer was calculated using logistic regression.&#x0D; Results: The activity of NK cells was assessed in 354 persons of average risk (mean age 59 years; 36% of them men). The diagnostic accuracy&#x0D; of NK cells determination for CRC and AA was 76% and 72%, respectively, and the negative predictive value was 96%. The NK cell test demonstrated a good negative clinical utility index for CRC and AA (0.66 and 0.74, respectively). Individuals with low levels of NK cells were seven times&#x0D; more likely to be diagnosed with CRC (95% CI 2.3-20.3; p&lt;0.001). NK cell levels were higher in men compared to women (549 pg/mL vs 500 pg/&#x0D; mL) and lower in smokers (412 pg/mL versus 544 pg/mL), non-athletic participants (413 pg/mL versus 654 pg / ml), in people who abuse alcohol&#x0D; (389 pg/ml versus 476 pg/ml).&#x0D; Conclusion: Our study shows that a high level of NK cells can potentially exclude CRC and AA in individuals with average cancer risk

Arsenic contamination and potential health risk to primary school children through drinking water sources

Arsenic exposure through drinking water is a serious public health concern in the southern province of Pakistan. Little information on As exposure to children at school settings is available in Pakistan. The current study aimed to assess arsenic contamination through drinking water sources and estimate its health risk to the children, the potentially malnourished Pakistan population. We used risk assessment models to estimate the hazard quotient index and lifetime cancer risk. Spatial data analysis methods were used to investigate the spatial pattern of As contamination and its relationship with the area's hydrogeology. Across the 423 sampled schools, the drinking water exceeded the WHO permissible limits (19.6% for arsenic and 15% for iron). The arsenic's average incremental lifetime cancer risk (ILCR) exceeded the USEPA permissible limit. The arsenic hotspots were mainly located in the central districts. The present study's findings elaborate that the reduction is the controlling phenomenon in the lower Indus basin in the active flood plains, which is the primary source of fresh groundwater in Sindh and pH-induced dissolution is the second phenomenon observed only in the irrigated area, especially at the boundary of the hotspots. These findings are helpful to inform policymakers on measures to ensure prior treatment of As in the drinking water for the schools in areas adjacent to the riverbank.

Monitored air pollutants from waste-to-energy facilities in China: Human health risk, and buffer distance assessment

China is progressively using incineration to manage municipal solid waste (MSW). However, the associated air pollution and health risks have received little attention. Furthermore, the current buffer protection may no longer significantly mitigate people's exposure to harmful air pollutants. Consequently, this study explores the emission characteristics of five monitored pollutants PM, SO2, NOx, CO, and HCl, as well as heavy metals generated by 510 incineration plants. The hazard index (HI) assessment included Cd, As, Cr, Ni, Pb, and Hg, whereas the cancer risk (CR) included Cd, As, Cr, and Ni. Our results show a decreasing trend in the total emissions of PM, SO2, and CO from 2015 to 2020. At 1 km downwind, the national average HI was 1.06, slightly above the recommended HI threshold (HI ≤ 1). In addition, the national average CR was beyond the safe level of 1 × 10−4 (CR = 5.69 × 10−3). The multicriteria decision tool, RAFSI, indicates 1.5 km as the best alternative buffer protection distance for an acceptable risk level. This finding suggests a potential reevaluation of the minimum buffer distance.