Cancer In Asymptomatic Adults Research Articles

Abstract 6088: Predicting the risk of any-type cancer in asymptomatic adults using noninvasive glycosaminoglycan profiling

Abstract Background: Early detection of cancers through screening can reduce mortality. However, screening excludes individuals not considered at an increased risk of developing cancer, as determined by age, sex, or tobacco use. No molecular biomarker is routinely used to predict risk. Here, we investigated urine glycosaminoglycan profiles (GAGomes) as noninvasive biomarkers for any-cancer risk prediction. Methods: In this population-based case-control study, we included adults aged over 18 years from the Lifelines Cohort Study, Netherlands who were presumed healthy at baseline. All cases who self-reported any-type cancer or died by the 5-year study visit were confirmed in the Dutch Cancer Registry and matched 1:3 to randomly selected controls (1:1 for the interim analysis). We first developed a logistic regression reference model, including age, sex, and clinical variables to predict any-type cancer. Next, we added urine GAGomes (as a single aggregate score) to the model and assessed model improvement using the likelihood ratio test. We categorized the output of the saturated model (clinical variables plus urine GAGome score) into four groups based on bespoke specificity cut-offs: low-, moderate-, intermediate-, and high-risk. We estimated odds-ratios (ORs) for their association with any-type cancer compared to the moderate-risk group, as well as their sensitivity across subsets. Using the so-estimated OR in the high-risk group, we calculated the minimum pre-test 5-year absolute risk needed to reclassify an adult into a post-test 5-year absolute risk >3.00%. Results: In the interim analysis, we included 2054 adults (median age = 51 years, 57% females). Of them, 924 were diagnosed with any-type cancer over a 6 year-follow-up period (median time to diagnosis = 1.4 years). Urine GAGomes were found to be independent risk factors when added to the reference model, explaining 27% of the variance (Nagelkerke R2 = 0.26 vs. 0.21, p < 0.0001). The ORs in the low-, intermediate-, and high-risk groups were 0.05 (95% CI: 0.02-0.13 p < 0.0001), 5.31 (95% CI: 3.84-7.48, p < 0.0001) and 27.6 (95% CI: 14.3 - 51.6, p < 0.0001), respectively. The high-risk group detected +80% more cancers than the reference model at the same specificity (99.29%), particularly in situ and stage I (+204% and +64%) and among those aged 50-69 (+247%). Adults with a pre-test 5-year absolute risk > 0.25% returning a high-risk group would be reclassified to a post-test 5-year absolute risk > 3.00% for any-type cancer. Conclusion: Implementing urine GAGomes as a strategy for risk-stratified targeted screening could identify adults with increased risk of any-type cancer who are currently excluded from screening. Citation Format: Francesco Gatto. Predicting the risk of any-type cancer in asymptomatic adults using noninvasive glycosaminoglycan profiling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6088.

Cost-Effectiveness Analysis of Ultrasound Screening for Thyroid Cancer in Asymptomatic Adults.

Objectives: This study evaluated the long-term cost-effectiveness of ultrasound screening for thyroid cancer compared with non-screening in asymptomatic adults.Methods: Applying a Markov decision-tree model with effectiveness and cost data from literature, we compared the long-term cost-effectiveness of the two strategies: ultrasound screening and non-screening for thyroid cancer. A one-way sensitivity analysis and a probabilistic sensitivity analysis were performed to verify the stability of model results.Results: The cumulative cost of screening for thyroid cancer was $18,819.24, with 18.74 quality-adjusted life years (QALYs), whereas the cumulative cost of non-screening was $15,864.28, with 18.71 QALYs. The incremental cost-effectiveness ratio of $106,947.50/QALY greatly exceeded the threshold of $50,000. The result of the one-way sensitivity analysis showed that the utility values of benign nodules and utility of health after thyroid cancer surgery would affect the results.Conclusions: Ultrasound screening for thyroid cancer has no obvious advantage in terms of cost-effectiveness compared with non-screening. The optimized thyroid screening strategy for a specific population is essential.

How do flexible sigmoidoscopy and fecal occult blood tests compare with each other and no screening for detecting colorectal cancer in asymptomatic adults?

How do flexible sigmoidoscopy and fecal occult blood tests compare with each other and no screening for detecting colorectal cancer in asymptomatic adults?

Check-up examination: recommendations in adults.

Check-up examinations, or periodic health examinations (PHEs), have gained in importance during the last decades and are nowadays among the most common reasons for consultations in primary care settings. The aim of PHEs is to identify risk factors and early signs of disease, but also to prevent future illness by early intervention. Therefore, each PHE should include counselling, immunisation and physical examination according to the patient's age and gender. However, deciding whether to screen a patient and choosing the most appropriate screening method can be challenging for general practitioners. The U.S. Preventive Service Task Force (USPSTF) provides updated recommendations on different existing preventive care measures based on relevant literature review. The aim of this review is to provide an updated statement of recommendations regarding preventive care measures based mostly on the guidelines derived from the USPSTF and the Swiss Medical Board. Among the major updates, there is no recommendation anymore to routinely screen for breast cancer and prostate cancer in asymptomatic adults. Since 2013, however, the USPSTF recommends annual screening for lung cancer with low-dose CT in patients aged 55 to 80 years with a smoking history of ≥30 pack years. During PHEs, the physician should be alert to the patients' hidden agendas, which are the reason for one third of all consultations in primary care.

The Korean guideline for colorectal cancer screening

Colorectal cancer is the third most common cancer in Korea; it is the second most common cancer in men and the third most common in women. The incidence rate in Korea has continuously increased since 1999 when the National Cancer Registry statistics began. Currently; there are several screening modalities; that have been recommended by expert societies, including fecal occult blood test, colonoscopy, computed tomographic colonography The annual fecal immunochemical test (FIT) has been used in adults aged 50 and older as part of the National Cancer Screening Program in Korea since 2004. Although several study results from regional or national colorectal cancer screening programs in other countries have been reported, the National Cancer Screening Program in Korea has not yet been evaluated with evidence-based methods. Herein report the consensus statements on the National Screening Guideline for colorectal cancer developed by a multi-society expert committee in Korea, as follows: 1) We recommend annual or biennial FIT for screening for colorectal cancer in asymptomatic adults, beginning at 45 years of age and continuing until 80 years (recommendation B). 2) There is no evidence for the risks or benefits of FIT in adults older than 80 years (recommendation I). 3) Selective use of colonoscopy for colorectal cancer screening is recommended, taking into consideration individual preference and the risk of colorectal cancer (recommendation C). 4) There is no evidence for the risks or benefits of double-contrast barium enema for colorectal cancer screening in asymptomatic adults (recommendation I). 5) There is no evidence for the risks or benefits of computed tomographic colonography for colorectal cancer screening in asymptomatic adults (recommendation I).

Eradicating Helicobacter pylori Lowers Risk for Gastric Cancer in Asymptomatic Adults

People who are positive for Helicobacter pylori are more likely to develop gastric cancer than are people without the infection. In this systematic review and meta-analysis of six randomized trials (duration range, 4–15 years; 5 conducted in Asia), investigators determined whether screening for and eradicating H. pylori in healthy asymptomatic adults (age, >16) lowers risk …

Screening for Oral Cancer: U.S. Preventive Services Task Force Recommendation Statement

Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for oral cancer. The USPSTF reviewed the evidence on whether screening for oral cancer reduces morbidity or mortality and on the accuracy of the oral screening examination for identifying oral cancer or potentially malignant disorders that have a high likelihood of progression to oral cancer. This recommendation applies to asymptomatic adults aged 18 years or older who are seen by primary care providers. This recommendation focuses on screening of the oral cavity performed by primary care providers and not dental providers or otolaryngologists. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral cancer in asymptomatic adults.

Oral cancer screening for asymptomatic adults: do the United States Preventive Services Task Force draft guidelines miss the proverbial forest for the trees?

general population 1 . For black men, the results are more discouraging, with a 5 year relative survival of just under 40%. Looking at lifetime risk, a child born today has an estimated 1.1% likelihood of developing oral cavity or pharyngeal cancer at some point during their life 3 . The stage at which the cancer is diagnosed has a significant effect on overall survival. Localized disease, representing disease confined to the primary site, is associated with an 83% 5year survival rate. With spread to the regional lymph nodes, the 5-year survival drops to just under 60%. The statistics are even grimmer in the presence of distant metastasis, with the 5-year survival dropping to 36%. With that backdrop in mind, the United States Preventive Services Task Force (USPSTF) recently released a draft Recommendation Statement which concluded that for adults age 18 years or older seen in the primary care setting, the “current evidence is insufficient to assess the balance of benefits and harms of screening for oral cancer in asymptomatic adults. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.” Rather than representing a paradigm shift, this statement is simply an update of the 2004 USPSTF recommendations, which similarly concluded “there was insufficient evidence to recommend for or against routine screening for oral cancer in adults 4 .” Other expert groups have reached comparable conclusions.

대장내시경 수검자에서 관찰된 대장용종의 유병률 및 위험인자

본 연구는 검진센터에서 대장내시경을 실시한 무증상 성인들을 중심으로 대장암의 전구병변인 대장용종의 유병률 및 위험인자를 알아보고 무증상의 건강한 성인들에게 대장암 관리를 위한 기초자료를 제공하고자 시행하였다. 2010년 1월부터 12월까지 일개 대학병원 검진센터에서 대장내시경검사를 받은 995명을 대상으로 자기기입식 설문지, 의료기록지, 임상검사 결과지들을 이용하여 후향적으로 시행하였으며, 자료의 분석은 SPSS18.0을 이용하였다. 무증상 성인들의 대장용종 유병률은 남성에서 높았고, 연령대가 높을수록 증가하였다. 남성, 고령, 운동을 하지 않은 경우 독립적인 위험인자로서 대장용종과 밀접한 관련이 있는 것으로 나타났다. 따라서 40대 이상 성인에서는 대장내시경 검사를 통한 대장용종의 조기 발견이 중요하며, 대장암 전구병변인 대장용종의 일차 예방을 위한 지속적인 생활습관 교정 및 운동프로그램 개발이 필요하다. This study was performed to evaluate the prevalence and risk factors of colonic polyps which is an established premalignant lesion and to provide basic data for the management of colon cancer in asymptomatic adults. The subjects of this study were 995 persons who underwent screening colonoscopy between January to December 2010 in health promotion center of an University Hospital located in Busan, and structured questionnaire, medical questionnaire, medical records were reviewed retrospectively. The data were analyzed by SPSS 18.0 program. Colonic polyps were found in 63.2% of the subjects. The prevalence rate of colonic polyps was significantly higher in males and it increased with age. Age, sex and exercise were found to be related independently to colonic polyps. Early detection of colonic polyps by colonoscopy is important for adults over 40 years, and it is necessary to advise such subjects to correct a wrong life-style in order to primarily prevent the development of colonic polyps.

Oral cancer screening for asymptomatic adults: do the United States Preventive Services Task Force draft guidelines miss the proverbial forest for the trees?

general population 1 . For black men, the results are more discouraging, with a 5 year relative survival of just under 40%. Looking at lifetime risk, a child born today has an estimated 1.1% likelihood of developing oral cavity or pharyngeal cancer at some point during their life 3 . The stage at which the cancer is diagnosed has a significant effect on overall survival. Localized disease, representing disease confined to the primary site, is associated with an 83% 5year survival rate. With spread to the regional lymph nodes, the 5-year survival drops to just under 60%. The statistics are even grimmer in the presence of distant metastasis, with the 5-year survival dropping to 36%. With that backdrop in mind, the United States Preventive Services Task Force (USPSTF) recently released a draft Recommendation Statement which concluded that for adults age 18 years or older seen in the primary care setting, the “current evidence is insufficient to assess the balance of benefits and harms of screening for oral cancer in asymptomatic adults. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.” Rather than representing a paradigm shift, this statement is simply an update of the 2004 USPSTF recommendations, which similarly concluded “there was insufficient evidence to recommend for or against routine screening for oral cancer in adults 4 .” Other expert groups have reached comparable conclusions.

Screening for Bladder Cancer: U.S. Preventive Services Task Force Recommendation Statement

Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for bladder cancer. The USPSTF performed a targeted literature search for new evidence on the benefits and harms of screening, the accuracy of primary care-feasible screening tests, and the benefits and harms of treatment. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for bladder cancer in asymptomatic adults (I statement).

Methods and rationale for the early detection of pancreatic cancer. Highlights from the "2010 ASCO Gastrointestinal Cancers Symposium". Orlando, FL, USA. January 22-24, 2010.

Pancreatic cancer often presents at an advanced stage that result in a very dismal five-year survival rates. Novel methods to detect tumors as early as possible are desperately needed. The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening for pancreatic cancer in asymptomatic adults using abdominal palpation, ultrasonography, or serologic markers. The evidence for diet-based prevention of pancreatic cancer is limited and conflicting. Recommendations about lifestyle changes, such as stopping the use of tobacco products, moderating alcohol intake, and eating a balanced diet with sufficient fruit and vegetables is generally made. However, screening for persons with hereditary predisposition to develop pancreatic cancer has not been included in this review. Biomarkers represent one tool for the early detection of small, surgically resectable cancers in both the general and high risk populations. Some of the currently utilized biomarkers including carcinoembryonic antigen (CEA), CA 19-9, SPan-1, and DUPAN-2 unfortunately have yet to show the sensitivity and specificity needed to be used for screening asymptomatic patients in the general population for pancreatic cancer. Herein, the authors report some updated information from the 2010 ASCO Gastrointestinal Cancers Symposium in detecting early stage pancreatic cancer.

CT colonography had 90% sensitivity and 86% specificity for diagnosing large adenomas and cancer in asymptomatic adults

Source Citation Johnson CD, Chen MH, Toledano AY, et al. Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 2008;359:1207-17. 18799557

Immunochemical fecal occult blood test for detection of rectosigmoid cancer in asymptomatic adults

Immunochemical fecal occult blood test for detection of rectosigmoid cancer in asymptomatic adults

Screening for colorectal cancer in a Hungarian county.

An initial screening for colorectal cancer in asymptomatic adults was performed with Haemoccult in 26,357 persons, rigid rectoscopy in 10,673 and flexible sigmoidoscopy in 3,963 persons. The rate of cancer detection was 4.4% in screenees with a positive Haemoccult test, 0.08% using rigid rectoscopy and 0.28% using flexible sigmoidoscopy. The respective frequency of patients discovered to have polyps was 16.2%, 1.32% and 8.49%. 77% of the 36 colorectal cancers detected due to the Haemoccult test program were either Dukes A or B. A comparison of these screening results indicates that Haemoccult screening markedly increases the yield of colorectal neoplasms when asymptomatic persons are examined. This screening should be repeated annually to reduce the morbidity and mortality of colorectal cancer.