Cancer Diagnostic Procedures Research Articles

Assessing Oral Cancer Awareness Among Dental Students in Van Province, Turkey

Objective: The aim of this study was to assess and compare oral cancer awareness among 3rd year and 5th year undergraduate dental students in Faculty of Dentistry, Van Yüzüncü Yıl University. Methods: A validated questionnaire testing oral cancer awareness was distributed to third and fifth year dental students at Faculty of Dentistry, Van Yüzüncü Yıl University. A total of 140 students participated in this survey. Knowledge of oral cancer risk factors and diagnostic procedures, dental students' attitudes towards oral cancers, management practices related to oral cancer and sources of oral cancer information were evaluated using 25 questions. The level of significance was set at p

The Impact of the COVID-19 Pandemic on Incidence and Short-Term Survival for Common Solid Tumours in the United Kingdom: A Cohort Analysis.

The COVID-19 pandemic profoundly affected healthcare systems and patients. There is a need to comprehend the collateral effects of the pandemic on non-communicable diseases. We examined the impact of the pandemic on short-term survival for common solid tumours, including breast, colorectal, head and neck, liver, lung, oesophageal, pancreatic, prostate, and stomach cancer in the UK. This was a population-based cohort study of electronic health records from the UK primary care Clinical Practice Research Datalink GOLD database. In sum, 12,259,744 eligible patients aged ≥18 years with ≥1 year's history identified from January 2000 to December 2022 were included. We estimated age-standardised incidence and short-term (one- and two-year) survival for several common cancers from 2000 to 2019 (in five-year strata) and compared these to 2020-2022 using the Kaplan-Meier method. Incidence decreased for most cancers in 2020 and recovered to different extents in 2021-2022. Short-term survival improved for most cancers between 2000 and 2019, but then declined, albeit minimally, for those diagnosed in 2020-2022. This was most pronounced for colorectal cancer, with one-year survival falling from 78.8% (95% CI 78%-79.6%) in 2015-2019 to 77% (95% CI 75.6-78.3%) for those diagnosed in 2020-2022. Short-term survival for many cancers was impacted, albeit minimally, by the pandemic in the UK, with reductions in survivorship from colorectal cancer equivalent to returning to the mortality seen in the first decade of the 2000s. While data on longer-term survival are needed to fully comprehend the impact of COVID-19 on cancer care, our findings illustrate the need for an urgent and substantial commitment from the UK National Health Service to address the existing backlog in cancer screening and diagnostic procedures to improve cancer care and mortality.

COVID-related disruptions to colorectal cancer screening, diagnosis, and treatment could increase cancer Burden in Australia and Canada: A modelling study.

COVID-19 disrupted cancer control worldwide, impacting preventative screening, diagnoses, and treatment services. This modelling study estimates the impact of disruptions on colorectal cancer cases and deaths in Canada and Australia, informed by data on screening, diagnosis, and treatment procedures. Modelling was used to estimate short- and long-term effects on colorectal cancer incidence and mortality, including ongoing impact of patient backlogs. A hypothetical mitigation strategy was simulated, with diagnostic and treatment capacities increased by 5% from 2022 to address backlogs. Colorectal cancer screening dropped by 40% in Canada and 6.3% in Australia in 2020. Significant decreases to diagnostic and treatment procedures were also observed in Australia and Canada, which were estimated to lead to additional patient wait times. These changes would lead to an estimated increase of 255 colorectal cancer cases and 1,820 colorectal cancer deaths in Canada and 234 cases and 1,186 deaths in Australia over 2020-2030; a 1.9% and 2.4% increase in mortality, respectively, vs a scenario with no screening disruption or diagnostic/treatment delays. Diagnostic and treatment capacity mitigation would avert 789 and 350 deaths in Canada and Australia, respectively. COVID-related disruptions had a significant impact on colorectal cancer screening, diagnostic, and treatment procedures in Canada and Australia. Modelling demonstrates that downstream effects on disease burden could be substantial. However, backlogs can be managed and deaths averted with even small increases to diagnostic and treatment capacity. Careful management of resources can improve patient outcomes after any temporary disruption, and these results can inform targeted approaches early detection of cancers.

Auto-BCS: A Hybrid System for Real-Time Breast Cancer Screening from Pathological Images.

Breast cancer is recognized as a prominent cause of cancer-related mortality among women globally, emphasizing the critical need for early diagnosis resulting improvement in survival rates. Current breast cancer diagnostic procedures depend on manual assessments of pathological images by medical professionals. However, in remote or underserved regions, the scarcity of expert healthcare resources often compromised the diagnostic accuracy. Machine learning holds great promise for early detection, yet existing breast cancer screening algorithms are frequently characterized by significant computational demands, rendering them unsuitable for deployment on low-processing-power mobile devices. In this paper, a real-time automated system "Auto-BCS" is introduced that significantly enhances the efficiency of early breast cancer screening. The system is structured into three distinct phases. In the initial phase, images undergo a pre-processing stage aimed at noise reduction. Subsequently, feature extraction is carried out using a lightweight and optimized deep learning model followed by extreme gradient boosting classifier, strategically employed to optimize the overall performance and prevent overfitting in the deep learning model. The system's performance is gauged through essential metrics, including accuracy, precision, recall, F1 score, and inference time. Comparative evaluations against state-of-the-art algorithms affirm that Auto-BCS outperforms existing models, excelling in both efficiency and processing speed. Computational efficiency is prioritized by Auto-BCS, making it particularly adaptable to low-processing-power mobile devices. Comparative assessments confirm the superior performance of Auto-BCS, signifying its potential to advance breast cancer screening technology.

COVID-19 Pandemisinin Meme Kanseri Tarama ve Tanı Sürecine Etkisi

Aim: The COVID-19 pandemic has caused delays in breast cancer screening and diagnostic procedures. The aim of this research was to compare the status of breast cancer screenings and newly diagnosed breast cancer cases during the pandemic compared to the pre-pandemic period.
 Material and method: This retrospective study included patients with screening mammography, imaging-guided biopsies, and newly diagnosed breast cancer from March 2020– February 2021 (during-COVID-19) were compared with March 2019–February 2020 (pre-COVID-19). We compared numbers and distribution over time of mammography and biopsies between the time periods. In the breast cancer group; the stage at diagnosis and histopathological features of the tumor were also compared.
 Results: Compared to pre-pandemic mammography scans, a 44% decrease was observed in total during pandemic, the most significant being in April (-98%) and May (-93%). While there was a significant decrease in the number of biopsies in April (-100%) and May (-69%), it was seen that there was no decrease in the pandemic period when the whole year was looked at with a rebound increase that started with 29% in June. In the breast cancer group, there was a significant increase in the number of patients who were metastatic at the time of diagnosis compared to the pre-pandemic period (p=0.001). No significant difference was observed between the two groups in terms of tumor grade, hormone receptor status, or HER2 positivity (p>0.05).
 Conclusions: In this study, it was observed that both screening and diagnosis processes in breast cancer were significantly affected during the COVID-19 pandemic. It was observed that the delay in admission to the hospital in the first months of the pandemic resulted in an increase in patients who were metastatic at the time of diagnosis.

Benefits and harms of breast cancer screening: Cohort study of breast cancer mortality and overdiagnosis.

Quantifying the benefits and harms of breast cancer screening accurately is important for planning and evaluating screening programs and for enabling women to make informed decisions about participation. However, few cohort studies have attempted to estimate benefit and harm simultaneously. We aimed to quantify the impact of mammographic screening on breast cancer mortality and overdiagnosis using a cohort of women invited to attend Australia's national screening program, BreastScreen. In a cohort of 41,330 women without prior breast cancer diagnosis, screening, or diagnostic procedures invited to attend BreastScreen Western Australia in 1994-1995, we estimated the cumulative risk of breast cancer mortality and breast cancer incidence (invasive and ductal carcinoma in situ) from age 50 to 85 years for attenders and non-attenders. Data were obtained by linking population-based state and national health registries. Breast cancer mortality risks were estimated from a survival analysis that accounted for competing risk of death from other causes. Breast cancer risk for unscreened women was estimated by survival analysis, while accounting for competing causes of death. For screened women, breast cancer risk was the sum of risk of being diagnosed at first screen, estimated using logistic regression, and risk of diagnosis following a negative first screen estimated from a survival analysis. For every 1,000 women 50 years old at first invitation to attend BreastScreen, there were 20 (95% CI 12-30) fewer breast cancer deaths and 25 (95% CI 15-35) more breast cancers diagnosed for women who attended than for non-attendees by age 85. Of the breast cancers diagnosed in screened women, 21% (95% CI 13%-27%) could be attributed to screening. The estimated ratio of benefit to harm was consistent with, but slightly less favourable to screening than most other estimates from cohort studies. Women who participate in organised screening for breast cancer in Australia have substantially lower breast cancer mortality, while some screen-detected cancers may be overdiagnosed.

Impact of the systematic introduction of tomosynthesis on breast biopsies: 10 years of results

Digital Breast Tomosynthesis (DBT) is a cutting-edge technology introduced in recent years as an in-depth analysis of breast cancer diagnostics. Compared with 2D Full-Field Digital Mammography, DBT has demonstrated greater sensitivity and specificity in detecting breast tumors. This work aims to quantitatively evaluate the impact of the systematic introduction of DBT in terms of Biopsy Rate and Positive Predictive Values for the number of biopsies performed (PPV-3). For this purpose, we collected 69,384 mammograms and 7894 biopsies, of which 6484 were Core Biopsies and 1410 were stereotactic Vacuum-assisted Breast Biopsies (VABBs), performed on female patients afferent to the Breast Unit of the Istituto Tumori “Giovanni Paolo II” of Bari from 2012 to 2021, thus, in the period before, during and after the systematic introduction of DBT. Linear regression analysis was then implemented to investigate how the Biopsy Rate had changed over the 10 year screening. The next step was to focus on VABBs, which were generally performed during in-depth examinations of mammogram detected lesions. Finally, three radiologists from the institute’s Breast Unit underwent a comparative study to ascertain their performances in terms of breast cancer detection rates before and after the introduction of DBT. As a result, it was demonstrated that both the overall Biopsy Rate and the VABBs Biopsy Rate significantly decreased following the introduction of DBT, with the diagnosis of an equal number of tumors. Besides, no statistically significant differences were observed among the three operators evaluated. In conclusion, this work highlights how the systematic introduction of DBT has significantly impacted the breast cancer diagnostic procedure, by improving the diagnostic quality and thereby reducing needless biopsies, resulting in a consequent reduction in costs.

Disparities in prostate cancer

Despite substantial advances in early detection/prevention and treatments, and improved outcomes in recent decades, prostate cancer continues to disproportionately affect Black men and is the secondleading cause of cancer death in this subgroup. Black men are substantially more likely to develop prostate cancer and are twice as likely to die from the disease compared with White men. In addition, Black men are younger at diagnosis and face a higher risk of aggressive disease relative to White men. Striking racial disparities endure along the continuum of prostate cancer care, including screening, genomic testing, diagnostic procedures, and treatment modalities. The underlying causes of these inequalities are complex and multifactorial and involve biological factors, structural determinants of equity (i.e., public policy, structural and systemic racism, economic policy), social determinants of health (including income, education, and insurance status, neighborhood/physical environment, community/social context, and geography), and health care factors. The objective of this article is to review the sources of racial disparities in prostate cancer and to propose actionable recommendations to help address these inequities and narrow the racial gap.

ICD-11 adjustment disorder following diagnostic procedures of prostate cancer: A 12-month follow-up study

ObjectiveThe medical procedures in diagnosing or treating prostate cancer may impair adjustment and quality of life. The current prospective study aimed to evaluate the trajectories of symptoms of ICD-11 adjustment disorder in patients diagnosed vs. non-diagnosed with prostate cancer before (T1), after diagnostic procedures (T2), and at 12-month follow-up (3). MethodsIn total, 96 male patients were recruited before prostate cancer diagnostic procedures. The mean age of the study participants at baseline was 63.5 (SD = 8.4), ranging from 47 to 80 years; 64% were diagnosed with prostate cancer. Adjustment disorder symptoms were measured using the Brief Adjustment Disorder Measure (ADNM-8). ResultsThe prevalence of ICD-11 adjustment disorder was 15% at T1, 13% at T2, and 3% at T3. The effect of cancer diagnosis was not significant on adjustment disorder. A medium main effect for time was detected on adjustment symptom severity, F(2, 134) = 19.26, p < .001, partial η2 = 0.223, with symptoms significantly lower at 12-month follow-up, compared to T1 and T2, p < .001. ConclusionsThe study's findings reveal the increased levels of adjustment difficulties in males undergoing the diagnostic process of prostate cancer.

Estimating time and transportation costs associated with lung cancer screening and diagnostic lung procedures in Taiwan: a cross-sectional survey in a medical centre

ObjectivesEarlier research has evaluated the non-medical costs after lung cancer diagnosis. This study estimated the time costs and transportation costs associated with low-dose CT (LDCT) screening and diagnostic lung procedures...

Machine Learning and Real-World Data to Predict Lung Cancer Risk in Routine Care.

This study used machine learning to develop a 3-year lung cancer risk prediction model with large real-world data in a mostly younger population. Over 4.7 million individuals, aged 45 to 65 years with no history of any cancer or lung cancer screening, diagnostic, or treatment procedures, with an outpatient visit in 2013 were identified in Optum's de-identified Electronic Health Record (EHR) dataset. A least absolute shrinkage and selection operator model was fit using all available data in the 365 days prior. Temporal validation was assessed with recent data. External validation was assessed with data from Mercy Health Systems EHR and Optum's de-identified Clinformatics Data Mart Database. Racial inequities in model discrimination were assessed with xAUCs. The model AUC was 0.76. Top predictors included age, smoking, race, ethnicity, and diagnosis of chronic obstructive pulmonary disease. The model identified a high-risk group with lung cancer incidence 9 times the average cohort incidence, representing 10% of patients with lung cancer. Model performed well temporally and externally, while performance was reduced for Asians and Hispanics. A high-dimensional model trained using big data identified a subset of patients with high lung cancer risk. The model demonstrated transportability to EHR and claims data, while underscoring the need to assess racial disparities when using machine learning methods. This internally and externally validated real-world data-based lung cancer prediction model is available on an open-source platform for broad sharing and application. Model integration into an EHR system could minimize physician burden by automating identification of high-risk patients.

Volume-awareness and outlier-suppression co-training for weakly-supervised MRI breast mass segmentation with partial annotations

Segmenting breast mass from magnetic resonance imaging (MRI) scans is an important step in the breast cancer diagnostic procedure for physicians and computer-aided diagnosis systems. Sufficient high-quality annotation is essential for establishing an automatic segmentation model, particularly for MRI breast masses with complex backgrounds and various sizes. In this study, we have proposed a novel approach for training an MRI breast mass segmentation network with partial annotations and reinforcing it with two weakly supervised constraint losses. Specifically, following three user-friendly partial annotation methods were designed to alleviate annotation costs: single-slice, orthogonal slice, and interval slice annotations. With the guidance of partial annotations, we first introduced a volume awareness loss that supports the additional constraint for masses with various scales. Moreover, to reduce false-positive predictions, we proposed an end-to-end differentiable outlier-suppression loss to suppress noise activation outside the target during training. We validated our method on 140 patients. The Dice similarity coefficient (DSC) of the proposed three partial annotation methods are 0.674, 0.835, and 0.837 respectively. Quantitative and qualitative evaluations demonstrate that our method can achieve competitive performance compared to state-of-the-art methods with complete annotations.

Clinical symptoms and conditions leading to metastatic non–small cell lung cancer diagnosis in patients with and without targeted mutations.

401 Background: This study compares patient characteristics, clinical conditions, the prevalence and timing of lung cancer symptoms, and diagnostic procedures from onset to mNCSLC diagnosis for patients with and without targetable mutations. Methods: This was a retrospective claims analysis of Medicare Advantage and commercially insured adult mNSCLC patients (11/01/2012 - 01/31/2020) with continuous health plan enrollment (24 months pre-index and ≥2 months post-index) around the index date (mNSCLC diagnosis). Patients on targeted therapy post-diagnosis were assigned to the targeted group (TG); non-targeted group (NTG) otherwise. Twenty pre-specified lung cancer related symptoms, baseline comorbidities, and diagnostic procedures were examined in the pre-index period. Results: The study comprised 2,940 patients (TG: 390; NTG: 2,550); TG had lower mean age (65.8yrs vs 69.2yrs; p &lt; 0.001), more females (59.5% vs 50.6%; p = 0.001), and lower tobacco use (55.9% vs 92.5%; p &lt; 0.001). Mean TG Charlson score was 1.37 in the TG vs 1.93 in the NTG; p &lt; 0.001. There were no significant differences in prevalence of any lung cancer related symptoms (TG 81.8% vs NTG 83.5%; p = 0.4). When comparing the 20 individual, pre-specified lung cancer related symptoms (cough, dyspnea, hemoptysis, etc.), there were also no significant differences between the study cohorts. For patients with symptoms, the mean times from the first symptom to mNSCLC diagnosis were similar (TG: 339.3 days; NTG: 363.1 days; p = 0.13)(Table). There were significant differences in the proportion of patients with comorbidities between study cohorts (TG 64.4% vs NTG 73.5%; p &lt; 0.001). Among patients within TG, there was higher prevalence of pleural effusion (22.1% vs 12.6%; p &lt; 0.001) and lower prevalence of COPD (17.7% vs 50.8%; p &lt; 0.001). For diagnostic procedures, patients in TG had fewer imaging procedures than NTG (Chest x-ray 67.7% vs. 74.1%; p = 0.008, CT scan 57.2% vs 63.5%; p = 0.016, PET scan 19.0% vs 27.1%; p &lt; 0.001); and a longer mean time from first symptom to first imaging procedure (TG: 220 days; NTG: 184 days; p = 0.015)(Table). Conclusions: Patients with and without targetable mutations may differ by some patient characteristics, but they may not differ by presentation and type of lung cancer related symptoms leading up to diagnosis.[Table: see text]

Advanced diagnosis technologies for HER2 breast cancer markers

Every year, the number of persons diagnosed with cancer depressive. As a result, cancer diagnosis is extremely crucial. Malignant tumor markers have become an important aspect of clinical tumor assessment, and different cancer cells have different markers. With the advancement of molecular biology technology, it is now possible to use it to diagnose, monitor, assess prognosis, forecast metastasis, and predict recurrence risk in malignant cancers. Breast cancer is the most frequent cancer among women, and the number of women diagnosed with it has been higher in many cancers. Histiocytic tumor markers in breast cancer include ER and PR, HER2,BRCA1 and BRCA2. Breast cancer can be categorized and treated using several markers, such as functional subtype HER-2 positive, and triple negative. As a result, precisely detecting the subtype of breast cancer is critical because it allows patients to receive the most effective treatment. HER2 is found in 30% of individuals diagnosed, with a poor prognosis and a significant recurrence rate. FISH, IHC, CISH, Dual ISH, and NGS are all common methods for detecting HER2 breast cancer. In this review, some of the most common HER2 breast cancer diagnostic procedures are summarized.

Ethnic and Racial Inequities in Cancer Screening During the COVID-19 Pandemic: a multi-site observational study in the United States

Introduction The total impact of the current COVID-19 pandemic on cancer screenings and diagnostic procedures by race and ethnicity has not yet been fully characterized. Methods In this study, we compared the ethnic and racial differences in cancer screening for breast, colon, and prostate cancer and compared them to population-level SARS-CoV2 infection rates in the United States between January 2019 and January 2021. Results A significant reduction in all screening activities was observed between March and May of 2020, with the largest relative decline in April during the initial SARS-CoV2 surge. In that month, screening mammography declined by 80% overall, with the relative largest decline among Black individuals (90%). A higher proportion of Black individuals received diagnostic mammography in April 2020. However, between June 2020 and January 2021, there was a relative increase in diagnostic mammograms observed across all groups. There was also a relative reduction in colon cancer screening, with the largest decline in April 2020 among Black individuals (75%). The largest relative reduction in PSA screening was in Hispanic individuals (66%). During the examined study period, surgical resections for breast, colon, and prostate resections were reduced and remained lower than baseline through 2020. The reduction in breast, colon, and prostate cancer screening coincided with the first surge of the SARS-CoV2 infections, but not with the second. There was a small reduction in breast and colon cancer screening with the third surge. Conclusions Differential inequities in cancer screening and diagnoses were observed by race and ethnicity and corresponded primarily to the initial surge of SARS-CoV2.

Trends in breast and prostate cancer screening and diagnostic procedures during the COVID-19 pandemic in central Massachusetts

PurposeWe calculated rates of breast and prostate cancer screening and diagnostic procedures performed during the COVID-19 pandemic through December 2021 compared to the same months in 2019 in a large healthcare provider group in central Massachusetts.MethodsWe included active patients of the provider group between January 2019 and December 2021 aged 30–85 years. Monthly rates of screening mammography and digital breast tomosynthesis, breast MRI, total prostate specific antigen (PSA), and breast or prostate biopsy per 1,000 people were compared by year overall, by age, and race/ethnicity. Completed procedures were identified by relevant codes in electronic health record data.ResultsRates of screening mammography, tomosynthesis, and PSA testing reached the lowest levels in April–May 2020. Breast cancer screening rates decreased 43% in March and 99% in April and May 2020, compared to 2019. Breast cancer screening rates increased gradually beginning in June 2020 through 2021, although more slowly in Black and Hispanic women and in women aged 75–85. PSA testing rates decreased 34% in March, 78% in April, and 53% in May 2020, but rebounded to pre-pandemic levels by June 2020; trends were similar across groups defined by age and race/ethnicity.ConclusionThe observed decline in two common screening procedures during the COVID-19 pandemic reflects the impact of the pandemic on cancer early detection and signals potential downstream effects on the prognosis of delayed cancer diagnoses. The slower rate of return for breast cancer screening procedures in certain subgroups should be investigated to ensure all women return for routine screenings.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10552-022-01616-4.

Potential of Zinc Oxide Nanoparticles as an Anticancer Agent: A Review

According to reports, one of the leading causes of mortality is cancer. Over the years, numerous approaches have been devised to lessen chronic pain and death as well as to elevate the quality of life. However, a scarcity persists in the effectiveness of cancer treatments. Early cancer identification and medication delivery with excellent specificity to reduce toxicities are two critical elements in ensuring effective cancer treatment. As a result of severe systemic toxicities and issues with current cancer diagnostic and treatment procedures, alternative nanotechnology-based techniques are being employed to improve detection and minimize disease severity. Nanotechnology has shown promising breakthroughs in cancer therapy by eliminating tumours with minimal damage to surrounding healthy cells. Since zinc is one of the necessary trace elements found in large amounts in human body tissues, zinc oxide nanoparticles (ZnO NPs) are said to be the most cost-effective and have the least hazardous characteristics of all metal oxide nanoparticles. In addition, ZnO NPs have several biological uses, notably in the field of drug administration. In this review, we tried to explore the advantage of ZnO NPs in the biomedical field, particularly in the treatment of cancer which can help to facilitate future research progress.

Analysis of breast cancer classification robustness with radiomics feature extraction and deep learning techniques

AbstractBreast cancer and breast imaging diagnostic procedures are typically carried out using a variety of imaging modalities, including mammography, MRI, and ultrasound. However, ultrasound and mammography have limitations and MRI is recognized as better than other procedures. Recent computational approaches, such as radiomics, applied to image analysis have shown remarkable progress in lowering diagnostic difficulties. This research analysed the robustness of breast tumour classification with feature extraction (radiomics) and a featureless method (deep learning). The proposal consists of two stages: the first stage introduced and explored radiomics‐based steps. A total of 111 tumour lesions were used to derive 74 radiomic features consisting of shape, and three separate second‐order metrics. Associations of these features were used to classify tumour lesions with four different kernels from support vector machine algorithm. In the confusion matrix analysis, the SVM‐RBF kernel developed optimal diagnostic efficiency with a maximum test accuracy of 97.06% on the combination of feature analysis. The second stage developed with deep learning techniques (InceptionV3 and CNN‐SVM). A total of 2998 images were used to create the models. In this portion, the CNN‐SVM model achieved the highest accuracy, 95.28%, with an AUC of 0.974, where the pre‐trained InceptionV3 achieved an AUC of only 0.932. Finally, the obtained result in both stages was discussed together and other related studies.

СУЩЕСТВУЮЩИЕ И ПОТЕНЦИАЛЬНЫЕ ВОЗМОЖНОСТИ САЛИВАДИАГНОСТИКИ РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ

Currently used methods of laboratory diagnostics of breast cancer (BC) and related diagnostic procedures are not perfect. Nowadays, there exists a restricted amount of information proving the application of salivary biomarkers as diagnostic instruments for BC. This review presents the research results in the field of salivary diagnostics in BC. The most well studied biomarkers of BC in mixed saliva are: epidermal growth factor, caner antigen 15-3, epidermal growth factor receptor HER2/neu. Some publications suggest that it is appropriate to use saliva as an alternative to blood to detect gene mutations in BRCA1/2 when searching for hereditary forms of BC. It was shown that determination of salivary peroxidase, advanced glycation end products, total antioxidant status and malone dialdegid can be of signifi- cant importance in non-invasive diagnostics of BC. As a further possibility for early diagnosis of BC, it is considered to use profile analysis of free amino acids in saliva, transcriptomic biomarkers - mRNA CSTA, TPT1, IGF2BP1, GRM1, GRIK1, H6PD, MDM4, S100A8 and proteomicо biomarker - carboanhydrase VI, polyamines as well as a number of metabolic proteins. It is assumed that analysis of saliva can become as useful in laboratory diagnostics of BC as analy sis of blood biomarkers. Moreover, research and description of constellations of analyzed blood and saliva biochemical and genetic values in BC are not only of a scientific interest, but are also of practical utility in order to improve laboratory diagnostics methods for this disease. Relationship between biochemical and genetic factors of saliva and blood, as well as the future use of their most informative constellations for early diagnosis of BC becomes currently a subject of detailed scientific research, which is proved by the facts provided in this review.

Abstract PO-250: Impact of age, race, and family history on COVID-19 related changes in breast cancer screening among the Boston Mammography Cohort Study

Abstract The COVID-19 pandemic has placed an unprecedented burden on the healthcare system, disrupting routine care including breast cancer screening. We used data from 2392 women without a history of breast cancer enrolled in the Boston Mammography Cohort Study (BMCS) to investigate whether subgroups defined by age, race, or family history of breast cancer: 1) experienced greater declines in screening or diagnostic imaging during the lockdown; or 2) had slower rebound during reopening. In this interrupted time series analysis, we used Poisson regression with robust standard errors to model expected monthly rates of breast cancer screening and diagnostic imaging from January 2019 through December 2020. We defined the pre-COVID-19 period as January 1, 2019, to February 29, 2020; the lockdown period as March 1 to May 30, 2020; and the reopening period as June 1 to December 31, 2020. We examined changes in trends overall and tested for the difference in trends by age (&amp;lt;50 vs ≤50), race (white vs non-white), and first-degree family history of breast cancer (yes or no). The mean monthly rate of breast cancer screening in the BMCS cohort was 45 per 1000 people during the pre-COVID-19 period, 7 per 1000 people during the lockdown period, and 50 per 1000 people during the reopening period. The mean monthly rate of breast cancer diagnostic imaging was 6 per 1000 people during the pre-COVID-19 period, 3 per 1000 people during the lockdown period, and 6 per 1000 people during the reopening period. During the pre-COVID-19 period, those who are age 50 or older had 5.3% higher monthly trend in breast cancer screening rates (p=0.005) and 9.8% higher monthly trend in diagnostic imaging rates (p=0.0389). During the lockdown period, those who were age 50 or older had a lower monthly trend in breast cancer screening rates compared to those who were younger than 50 (p&amp;lt;0.0001), while those who were white and those with family history have higher monthly trends of breast cancer screening rates compared to their respective counterparts (p&amp;lt;0.0001). During the reopening phase, those who are age 50 or older have 18.5% lower monthly trend in breast cancer screening rates in comparison to those who are younger than 50 (p=0.0008) and those who were white have 36.2% higher monthly trend in breast cancer diagnostic procedure rates in comparison to those who are non-white (p=0.018). Overall, we observed a significant decline in breast cancer screening rates with the advent of the COVID-19 pandemic. For the most part, screening and diagnostic imaging rates during the reopening phase equaled or exceeded those of the pre-COVID-19 period. However, the rate of return to screening was lower in women age 50 or older and the rebound in diagnostic imaging was lower in non-white women. Careful attention must be paid as the COVID-19 recovery continues to ensure equitable resumption of care. Future work will examine other factors including insurance status, breast cancer risk scores, and geographic location. Citation Format: Naiyu Chen, David Cheng, Mollie Barnard, Natalie C. DuPre, Rulla M. Tamimi, Erica T. Warner. Impact of age, race, and family history on COVID-19 related changes in breast cancer screening among the Boston Mammography Cohort Study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-250.