Early Detection Rate Research Articles

Role of biochemical markers and autoantibodies in diagnosis of early-stage primary biliary cholangitis.

Primary biliary cholangitis (PBC) is a chronic progressive autoimmune cholestatic disease. The main target organ of PBC is the liver, and nonsuppurative inflammation of the small intrahepatic bile ducts may eventually develop into cirrhosis or liver fibrosis. To explore the clinical characteristics of early-stage PBC, identify PBC in the early clinical stage, and promptly treat and monitor PBC. The data of 82 patients with PBC confirmed by pathology at Tianjin Second People's Hospital from January 2013 to November 2021 were collected, and the patients were divided into stage I, stage II, stage III, and stage IV according to the pathological stage. The general data, serum biochemistry, immunoglobulins, and autoimmune antibodies of patients in each stage were retrospectively analyzed. In early-stage (stages I + II) PBC patients, 50.0% of patients had normal alanine aminotransferase (ALT) levels, and 37.5% had normal aspartate aminotransferase (AST) levels. For the remaining patients, the ALT and AST levels were mildly elevated; all of these patients had levels of < 3 times the upper limit of normal values. The AST levels were significantly different among the three groups (stages I + II vs stage III vs stage IV, P < 0.05). In the early stage, 29.2% of patients had normal alkaline phosphatase (ALP) levels. The remaining patients had different degrees of ALP elevation; 6.3% had ALP levels > 5 times the upper limit of normal value. Moreover, γ-glutamyl transferase (GGT) was more robustly elevated, as 29.2% of patients had GGT levels of > 10 times the upper limit of normal value. The ALP values among the three groups were significantly different (P < 0.05). In early stage, the jaundice index did not increase significantly, but it gradually increased with disease progression. However, the above indicators were significantly different (P < 0.05) between the early-stage group and the stage IV group. With the progression of the disease, the levels of albumin and albumin/globulin ratio tended to decrease, and the difference among the three groups was statistically significant (P < 0.05). In early-stage patients, IgM and IgG levels as well as cholesterol levels were mildly elevated, but there were no significant differences among the three groups. Triglyceride levels were normal in the early-stage group, and the differences among the three groups were statistically significant (P < 0.05). The early detection rates of anti-mitochondria antibody (AMA) and AMA-M2 were 66.7% and 45.8%, respectively. The positive rate of anti-sp100 antibodies was significantly higher in patients with stage IV PBC. When AMA and AMA-M2 were negative, in the early stage, the highest autoantibody was anti-nuclear antibody (ANA) (92.3%), and in all ANA patterns, the highest was ANA centromere (38.5%). In early-stage PBC patients, ALT and AST levels are normal or mildly elevated, GGT and ALP levels are not elevated in parallel, GGT levels are more robustly elevated, and ALP levels are normal in some patients. When AMA and AMA-M2 are negative, ANA especially ANA centromere positivity suggests the possibility of early PBC. Therefore, in the clinic, significantly elevated GGT levels with or without normal ALP levels and with ANA (particularly ANA centromere) positivity (when AMA and AMA-M2 are negative) may indicate the possibility of early PBC.

Perspectives on prostate cancer: advances and pending challenges for a multidisciplinary oncological approach in South America.

Prostate cancer is one of the tumors with the highest incidence and mortality among men worldwide, and this situation is no different in South America. However, epidemiological data are highly variable for each country and even more so than in North America. These data may be influenced by the very low rate of early detection of disease, availability of diagnostic methods, proper data collection, and limited access to specialized multidisciplinary treatment. For many South American countries, academic referral centers can only offer state-of-the-art diagnostics and multidisciplinary cancer treatment for patients who live in or can travel to large cities, so most patients are cared for by non-expert urologists with limited resources, which can have a negative impact on their prognosis and worsen oncologic outcomes. We aimed to show the clinical management of prostate cancer patients, the current advances in management, limitations present in South America, and how a multidisciplinary approach in referral cancer centers conformed of specialized urologists, medical oncologists, and mental health professionals can maximize patient outcomes.

FTP7.5 Accuracy of the END-PAC model in predicting the risk of developing pancreatic cancer in patients with new-onset diabetes: a systematic review and meta-analysis

Abstract Objectives to evaluate the accuracy of END-PAC model in predicting the risk of pancreatic cancer in patients with new-onset diabetes (NOD). Methods A systematic review in accordance with PRISMA statement standards was conducted to identify all studies evaluating the accuracy of END-PAC model in predicting the risk of pancreatic cancer in patients with NOD. The number of true positives, false negatives, true negatives, and false positives were used to construct two-by-two tables, coupled forest plots and the summary receiver operating characteristic plots. We estimated summary sensitivity and specificity points using diagnostic random effects model. Results We analysed 26752 patients from four studies. The pooled risk of pancreatic cancer was 0.8% (95% CI 0.6%-1.0%) with median follow-up of 3 years. END-PAC score ≥3 [sensitivity: 55.8% (43.9%-67%); specificity: 82.0% (76.4%-86.5%)] which classifies the patients as high risk was associated with better predictive performance than END-PAC score 1–2 [sensitivity: 22.2% (16.6%-29.2%); specificity: 69.9% (67.3%-72.4%)] and END-PAC score &amp;lt;1 [sensitivity: 18.0% (12.8%-24.6%); specificity: 50.9% (48.6%-53.2%)] which classify the patients as intermediate and low risks, respectively. The quality of the available evidence was moderate to high. Conclusions END-PAC model is promising in predicting the risk of pancreatic cancer in patients with new-onset diabetes. END-PAC score ≥3, which classifies the patients as high risk, has the best predictive performance and should be considered as optimum cut-off value. Future comparative studies are required to evaluate whether application of END-PAC model could improve pancreatic cancer early detection rate, pancreatic cancer resection rate, and pancreatic cancer treatment outcomes.

Breast Magnetic Resonance Imaging for Preoperative Evaluation of Breast Cancer: A Systematic Review and Meta-Analysis.

Purpose: Preoperative breast magnetic resonance imaging (MRI) is known to detect additional cancers that are occult on mammography and ultrasound. There is debate as to whether these additional lesions affect clinical outcomes. The objective of this systematic review was to summarize the evidence on whether additional information on disease extent obtained with preoperative breast MRI in patients with newly diagnosed breast cancer affects surgical management, rates of recurrence, survival, re-excision, and early detection of bilateral cancer. Methods: Embase, MEDLINE, and Cochrane Central Register of Controlled Trials were searched until January 2021 (partial update July 2022) for studies comparing outcomes with versus without pre-operative MRI. Included were both randomized controlled trials and other comparative studies provided MRI and control groups had equivalent disease and patient characteristics or methods such as multivariable analysis or propensity score matching were used to control potential confounders. Results: The search resulted in 26,399 citations, of which 8 randomized control trials, 1 prospective cohort study, and 42 retrospective studies met the inclusion criteria. Use of MRI resulted in decreased rates of reoperations (OR = 0.73, 95% CI = 0.63 to 0.85), re-excisions (OR = 0.63, 95% CI = 0.45 to 0.89), and recurrence (HR = 0.77, 95% CI = 0.65 to 0.90). Increased detection of synchronous contralateral breast cancers led to a reduction in metachronous contralateral breast cancer (HR = 0.71, 95% CI = 0.59 to 0.85). Hazard ratios for recurrence-free and overall survival were 0.77 (95% CI = 0.53 to 1.12) and 0.89 (95% CI = 0.74 to 1.07). Conclusion: This systematic review indicates substantial benefits of pre-operative breast MRI in decreasing reoperations and recurrence.

Implementation of artificial intelligence for the detection of cutaneous melanoma within a primary care setting: prevalence and types of skin cancer in outdoor enthusiasts.

There is enthusiasm for implementing artificial intelligence (AI) to assist clinicians detect skin cancer. Performance metrics of AI from dermoscopic images have been promising, with studies documenting sensitivity and specificity values equal to or superior to specialists for the detection of malignant melanomas (MM). Early detection rates would particularly benefit Australia, which has the worlds highest incidence of MM per capita. The detection of skin cancer may be delayed due to late screening or the inherent difficulty in diagnosing early skin cancers which often have a paucity of clinical features and may blend into sun damaged skin. Individuals who participate in outdoor sports and recreation experience high levels of intermittent ultraviolet radiation (UVR), which is associated with the development of skin cancer, including MM. This research aimed to assess the prevalence of skin cancer in individuals who regularly participate in activities outdoors and to report the performance parameters of a commercially available AI-powered software to assess the predictive risk of MM development. Cross-sectional study design incorporating a survey, total body skin cancer screening and AI-embedded software capable of predictive scoring of queried MM. A total of 423 participants consisting of surfers (n = 108), swimmers (n = 60) and walkers/runners (n = 255) participated. Point prevalence for MM was highest for surfers (6.48%), followed by walkers/runners (4.3%) and swimmers (3.33%) respectively. When compared to the general Australian population, surfers had the highest odds ratio (OR) for MM (OR 119.8), followed by walkers/runners (OR 79.74), and swimmers (OR 61.61) rounded out the populations. Surfers and swimmers reported comparatively lower lifetime hours of sun exposure (5,594 and 5,686, respectively) but more significant amounts of activity within peak ultraviolet index compared with walkers/runners (9,554 h). A total of 48 suspicious pigmented lesions made up of histopathology-confirmed MM (n = 15) and benign lesions (n = 33) were identified. The performance of the AI from this clinical population was found to have a sensitivity of 53.33%, specificity of 54.44% and accuracy of 54.17%. Rates of both keratinocyte carcinomas and MM were notably higher in aquatic and land-based enthusiasts compared to the general Australian population. These findings further highlight the clinical importance of sun-safe protection measures and regular skin screening in individuals who spend significant time outdoors. The use of AI in the early identification of MM is promising. However, the lower-than-expected performance metrics of the AI software used in this study indicated reservations should be held before recommending this particular version of this AI software as a reliable adjunct for clinicians in skin imaging diagnostics in patients with potentially sun damaged skin.

Impact of Physical Activity on Prostate Cancer Incidence

Prostate cancer is a leading cancer in men, with its incidence varying among different countries and ethnic groups. The introduction of serum prostate-specific antigen (PSA) testing has led to increased early detection rates, particularly in high Human Development Index (HDI) countries. Several extrinsic or modifiable factors have been implicated in the development of prostate cancer. Diet, including high meat and dairy consumption, alcohol intake, and dietary supplements, has shown inconsistent associations. Obesity has emerged as a significant risk factor for prostate cancer and can worsen prognosis and treatment outcomes. Conversely, consumption of fish and fish oil has been associated with a lower incidence and mortality rate of prostate cancer.&#x0D; The relationship between physical activity and prostate cancer risk has been extensively studied, yielding mixed results. While physical activity has consistently shown protective effects against other cancers, its association with prostate cancer risk is less clear. Some studies suggest a potential benefit, particularly with vigorous physical activity, while others find no significant association. However, physical activity has demonstrated positive effects on survival rates and disease progression among men already diagnosed with prostate cancer.

Regional Differences in Clinical Presentation and Prognosis of Patients With Post–Sustained Virologic Response Hepatocellular Carcinoma

Widespread use of direct-acting antivirals for hepatitis C virus infection has been paralleled with increased numbers of patients with hepatocellular carcinoma (HCC) after achieving sustained virologic response (post-SVR HCC) worldwide. Few data compare regional differences in the presentation and prognosis of patients with post-SVR HCC. We identified patients with advanced fibrosis (F3/F4) who developed incident post-SVR HCC between March 2015 and October 2021 from 30 sites in Europe, North America, South America, the Middle East, South Asia, East Asia, and Southeast Asia. We compared patient demographics, liver dysfunction, and tumor burden by region. We compared overall survival by region using Kaplan-Meier analysis and identified factors associated with survival using multivariable Cox regression analysis. Among 8796 patients with advanced fibrosis or cirrhosis who achieved SVR, 583 (6.6%) developed incident HCC. There was marked regional variation in the proportion of patients detected by surveillance (range: 59.5%-100%), median maximum tumor diameter (range, 1.8-5.0 cm), and the proportion with multinodular HCC (range, 15.4%-60.8%). The prognosis of patients highly varied by region (hazard ratio range, 1.82-9.92), with the highest survival rates in East Asia, North America, and South America, and the lowest survival rates in the Middle East and South Asia. After adjusting for geographic region, HCC surveillance was associated with early stage detection (Barcelona Clinic Liver Cancer stage 0/A, 71.0% vs 21.3%; P < .0001) and lower mortality rates (adjusted hazard ratio, 0.29; 95% CI, 0.18-0.46). Clinical characteristics, including early stage detection, and prognosis of post-SVR HCC differed significantly across geographic regions. Surveillance utilization appears to be a high-yield intervention target to improve prognosis among patients with post-SVR HCC globally.

Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists

ObjectiveThe documented variation in gastric cancer (GC) detection among endoscopists has often been dismissed as a coincidental artefact of the low incidence of gastric neoplasms; it is not considered associated...

Obstrucción congénita de la unión ureteropiélica. Estudio de casos en un centro de segundo nivel

Objective: To evaluate the incidence, clinical characteristics, diagnosis, and treatment of congenital ureteropelvic junction obstruction in pediatric patients (CUPBO) at the Hospital Infantil de Morelia. Material and methods: This was a retrospective, observational, descriptive, and cross-sectional study of pediatric patients diagnosed with CUPBO and treated in the urology service of a second-level care medical center from January 2018 to December 2021. Results: We reviewed 53 patients with prenatal hydronephrosis who underwent postnatal follow-up, of whom only 6 patients diagnosed with congenital ureteropelvic junction obstruction (CUPBO) were identified prenatally. Seven patients were diagnosed with hydronephrosis postnatally and subsequently diagnosed with CUPBO, resulting in a total sample of 13 diagnosed patients. The incidence of CUPBO was 3.4 patients per 100 first visits to the Pediatric Urology Service. Of the cases, 92.31% were male, and the most frequent clinical manifestations were skin infections and localized pain. Surgery was performed in all cases, with Anderson-Hynes pyeloplasty being the most frequent procedure. Complications included urinary tract infections, wound infections, and fistula, but most patients had satisfactory results with a reduction of hydronephrosis after surgery. Findings or conclusions: Our study found a low rate of early detection of CUPBO in patients with prenatal hydronephrosis follow-up. We recommend an intentional search for urologic alterations in structural ultrasound scans of prenatal control. We emphasize the importance of an accurate diagnosis and timely treatment of CUPBO to prevent renal complications.

Analyzing molecular typing and clinical application of immunogenic cell death-related genes in hepatocellular carcinoma

BackgroundHepatocellular carcinoma (HCC) is considered one of the most common cancers, characterized by low early detection and high mortality rates, and is a global health challenge. Immunogenic cell death (ICD) is defined as a specific type of regulated cell death (RCD) capable of reshaping the tumor immune microenvironment by releasing danger signals that trigger immune responses, which would contribute to immunotherapy.MethodsThe ICD gene sets were collected from the literature. We collected expression data and clinical information from public databases for the HCC samples in our study. Data processing and mapping were performed using R software to analyze the differences in biological characteristics between different subgroups. The expression of the ICD representative gene in clinical specimens was assessed by immunohistochemistry, and the role of the representative gene in HCC was evaluated by various in vitro assays, including qRT-PCR, colony formation, and CCK8 assay. Lasso-Cox regression was used to screen prognosis-related genes, and an ICD-related risk model (ICDRM) was constructed. To improve the clinical value of ICDRM, Nomograms and calibration curves were created to predict survival probabilities. Finally, the critical gene of ICDRM was further investigated through pan-cancer analysis and single-cell analysis.ResultsWe identified two ICD clusters that differed significantly in terms of survival, biological function, and immune infiltration. As well as assessing the immune microenvironment of tumors in HCC patients, we demonstrate that ICDRM can differentiate ICD clusters and predict the prognosis and effectiveness of therapy. High-risk subpopulations are characterized by high TMB, suppressed immunity, and poor survival and response to immunotherapy, whereas the opposite is true for low-risk subpopulations.ConclusionsThis study reveals the potential impact of ICDRM on the tumor microenvironment (TME), immune infiltration, and prognosis of HCC patients, but also a potential tool for predicting prognosis.

Profiles and Findings of Population-Based Esophageal Cancer Screening With Endoscopy in China: Systematic Review and Meta-analysis.

Population-based esophageal cancer (EC) screening trials and programs have been conducted in China for decades; however, screening strategies have been adopted in different regions and screening profiles are unclear. We performed a meta-analysis to profile EC screening in China by positivity rate, compliance rate, and endoscopy findings, aiming to provide explicit evidence and recommendations for EC screening programs. English (PubMed, Embase) and Chinese (China National Knowledge Infrastructure, Wanfang) language databases were systematically searched for population-based EC screening studies in the Chinese population until December 31, 2022. A meta-analysis was performed by standard methodology using a random-effects model. Pooled prevalence rates were calculated for three groups: high-risk areas with a universal endoscopy strategy, rural China with a risk-stratified endoscopic screening (RSES) strategy, and urban China with an RSES strategy. Positive cases included lesions of severe dysplasia, carcinoma in situ, intramucosal carcinoma, submucosal carcinoma, and invasive carcinoma. The pooled positivity rate of the high-risk population was higher in rural China (44.12%) than in urban China (23.11%). The compliance rate of endoscopic examinations was the highest in rural China (52.40%), followed by high-risk areas (50.11%), and was the lowest in urban China (23.67%). The pooled detection rate of positive cases decreased from 1.03% (95% CI 0.82%-1.30%) in high-risk areas to 0.48% (95% CI 0.25%-0.93%) in rural China and 0.12% (95% CI 0.07%-0.21%) in urban China. The pooled detection rate of low-grade intraepithelial neoplasia (LGIN) was also in the same order, being the highest in high-risk areas (3.99%, 95% CI 2.78%-5.69%), followed by rural China (2.55%, 95% CI 1.03%-6.19%) and urban China (0.34%, 95% CI 0.14%-0.81%). Higher detection rates of positive cases and LGIN were observed among males than among females and at older ages. The pooled early detection rate was 81.90% (95% CI 75.58%-86.88%), which was similar to the rates in high-risk areas (82.09%), in rural China (80.76%), and in urban China (80.08%). Under the current screening framework, a higher screening benefit was observed in high-risk areas than in other regions. To promote EC screening and reduce the current inequality of screening in China, more focus should be given to optimizing strategies of high-risk individual assessment and surveillance management to improve compliance with endoscopic examination. PROSPERO CRD42022375720; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=375720.

Evaluating a Comprehensive and Cost-Effective Accelerated Breast Health Curriculum in Guyana for Healthcare Providers

The incidence and mortality rate of breast cancer continues to rise in Guyana. One key factor contributing to this issue is that Guyana does not have a national breast cancer screening program nor the resources or infrastructure to support one. As a result, it is important to consider cost-effective solutions that can promote the early detection of breast cancer. The literature suggests a promising intervention could address gaps in frontline healthcare providers' knowledge and understanding of breast health. Providers who receive dedicated curricular training in breast health in conjunction with learning the clinical breast exam (CBE) and ultrasound tend to show an increase in their early detection rates. With this in mind, we sought to evaluate an existing breast health curriculum in Georgetown, Guyana, by measuring provider fund of knowledge before and after the intervention. Over 1 week, sixty-two participants, mostly nursing students, were divided into two groups. Each group participated in the two-and-a-half-day course. Participants were given a pretest assessment and then went through an intensive 8-module course complete with CBE training and ultrasound demonstration before taking a posttest. We found that while only one of the sixty-two participants passed the initial pretest assessment, forty of the sixty-two participants passed the posttest. Statistical analysis showed that the difference in test scores between the pretest and the posttest was statistically significant. While more studies are needed, these findings suggest that focusing on the breast health knowledge of providers in Guyana and other similar countries may be a highly effective yet cost-friendly intervention that could significantly improve early detection rates and ease the breast cancer disease burden.

Breast Self-Examination Among Female Adolescents in Nigeria: An Integrative Review

Earlier research on breast self-examination among female adolescents has formed different results. This integrative review aimed to summarize the evidence and to compare all existing evidence on the knowledge, attitude, perception, and practices of breast self-examination among female adolescents in the six geopolitical zones of Nigeria, comprising 36 states. A total of 10 articles were included in the final analysis. The article included in the review was limited to articles published in English between 2017 and 2022. The majority of the respondents in this review had a low knowledge level of breast self-examination for both the cross-sectional studies and the baseline (pre-intervention) assessment for intervention studies, had a poor attitude/perception towards BSE, and also had a poor practice of BSE. The major source of information for female adolescents about BSE is the internet, while pamphlets, and face-to-face interaction greatly improved knowledge for intervention studies. The studies further revealed that hearing about BSE does not translate into knowledge and practice. Intervention programs aimed at improving knowledge and practice of BSE among female adolescents are highly advocated as this would enhance their screening practices, improve early detection rates and sustain changes in behaviour towards BSE. Also, the review further identified peer education as a strategy that can be used to improve BSE knowledge and practices in female adolescents.

Low Rates of Early Detection Drive Excess Breast Cancer Mortality

Low Rates of Early Detection Drive Excess Breast Cancer Mortality

Improved Models for Diabetes Prediction by Integrating PCA Technique

Diabetes is an incurable, chronic disease indicated by hyperglycemia. It may lead to severe complications and is consequently one of the top ten causes of mortality in recent years. Fortunately, early detection can significantly aid in disease management. Based on their regular medical checkup results, people can make a preliminary evaluation of their risk of having the condition with the help of machine learning techniques. In this study, diabetes is predicted using Extreme Gradient Boosting (XGB), Support Vector Machine (SVM), Random Forest (RF), Logistic Regression (LR), Decision Tree (DT), and K-Nearest Neighbor Algorithm (KNN), ranked in descending order of accuracy. XGB comes out on top with an accuracy of 87.29%. The dimensionality reduction approach Principal Component Analysis (PCA) is conducted, resulting in a maximum accuracy gain of 1.27%. The study's enhanced diabetes prediction models allow people to more accurately gauge their risk of developing the condition. More potential patients would be notified to get checked, enhancing the disease's early detection rate.

A Case-Control Study by ddPCR of ALU 260/111 and LINE-1 266/97 Copy Number Ratio in Circulating Cell-Free DNA in Plasma Revealed LINE-1 266/97 as a Potential Biomarker for Early Breast Cancer Detection.

In Western countries, breast cancer (BC) is the most common cancer in women. Early detection has a positive impact on survival, quality of life, and public health costs. Mammography screening programs have increased early detection rates, but new approaches to more personalized surveillance could further improve diagnosis. Circulating cell-free DNA (cfDNA) in blood could provide a potential tool for early diagnosis by analyzing cfDNA quantity, circulating tumor DNA mutations, or cfDNA integrity (cfDI). Plasma was obtained from the blood of 106 breast cancer patients (cases) and 103 healthy women (controls). Digital droplet PCR was used for the determination of ALU 260/111 bp and LINE-1 266/97 bp copy number ratio and cfDI. cfDNA abundance was calculated using copies of the EEF1A2 gene. The accuracy of biomarker discrimination was analyzed with receiver operating characteristic curve (ROC). Sensitivity analyses were performed to account for age as a potential confounder. Cases had significantly lower ALU 260/111 or LINE-1 266/97 copy number ratios (median; ALU 260/111 = 0.08, LINE-1 266/97 = 0.20), compared with control (median; ALU 260/111 = 0.10, LINE-1 266/97 = 0.28) (p < 0.001). ROC analysis showed that copy number ratio discriminated cases from controls (area under the curve, AUC = 0.69, 95% CI: 0.62-0.76 for ALU and 0.80, 95% CI: 0.73-0.86 for LINE-1). ROC from cfDI confirmed the better diagnostic performance of LINE-1 compared with ALU. Analysis of LINE-1 266/97 copy number ratio or cfDI by ddPCR appears to be a useful noninvasive test that could aid in early BC detection. Further studies in a large cohort are needed to validate the biomarker.

Methylated SDC2 testing in stool DNA for early screening of colorectal cancer in Shipai Town, Dongguan City

Objective: To explore the utility of stool-based DNA test of methylated SDC2 (mSDC2) for colorectal cancer (CRC) screening in residents of Shipai Town, Dongguan City. Methods: This was a cross-sectional study. Using a cluster sampling method, residents of 18 villages in Shipai Town, Dongguan City were screened for CRC from May 2021 to February 2022. In this study, mSDC2 testing was employed as a preliminary screening method. Colonoscopy examination was recommended for individuals identified as high-risk based on the positive mSDC2 tests. The final screening results, including the rate of positive mSDC2 tests, the rate of colonoscopy compliance, the rate of lesions detection, and the cost-effectiveness of screening, were analyzed to explore the benefits of this screening strategy. Results: A total of 10 708 residents were enrolled and completed mSDC2 testing, giving a participation rate of 54.99% (10 708/19 474) and a pass rate of 97.87% (10 708/10 941). These individuals included 4 713 men (44.01%) and 5 995 women (55.99%) with a mean age of (54.52±9.64) years. The participants were allocated to four age groups (40-49, 50-59, 60-69, and 70-74 years), comprising 35.21%(3770/10 708), 36.25% (3882/10 708), 18.84% (2017/10 708), and 9.70% (1039/10 708) of all participants, respectively. mSDC2 testing was positive in 821/10 708 (7.67%) participants, 521 of whom underwent colonoscopy, resulting in a compliance rate of 63.46% (521/821). After eliminating of 8 individuals without pathology results, data from 513 individuals were finally analyzed. Colonoscopy detection rate differed significantly between age groups (χ2=23.155, P<0.001),ranging from a low of 60.74% in the 40-49 year age group to a high of 86.11% in the 70-74 year age group. Colonoscopies resulted in the diagnosis of 25 (4.87%) CRCs, 192 (37.43%) advanced adenomas, 67 (13.06%) early adenomas, 15 (2.92%) serrated polyps, and 86 (16.76%) non- adenomatous polyps. The 25 CRCs were Stage 0 in 14 (56.0%) individuals, stage I in 4 (16.0%), and Stage II in 7(28.0%). Thus, 18 of the detected CRCs were at an early stage. The early detection rate of CRCs and advanced adenomas was 96.77% (210/217). The rate of mSDC2 testing for all intestinal lesions was 75.05% (385/513). In particular, the financial benefit of this screening was 32.64 million yuan, and the benefit-cost ratio was 6.0. Conclusion: Screening for CRCs using stool-based mSDC2 testing combined with colonoscopy has a high lesion detection rate and a high cost-effectiveness ratio. This is a CRC screening strategy that deserves to be promoted in China.

Analysis of differential gene immune infiltration and clinical characteristics of skin cutaneous melanoma based on systems biology and drug repositioning methods to identify drug candidates for skin cutaneous melanoma.

Skin cutaneous melanoma (SKCM) has a low early detection rate and a high mortality rate. There are many problems such as side effects and drug resistance in existing therapeutic drugs. Current studies have confirmed that SKCM pathogenesis-related genes promote the invasion and metastasis of cutaneous melanoma, but their roles in the tumor microenvironment (TME) remain unclear. Network pharmacology provides new opportunities for drug repurposing and repositioning, and is a fast, safe, and inexpensive drug discovery method to find new drugs for the treatment of SKCM. In this study, based on 3 databases (KEGG, OMIM, and Genotype) to obtain SKCM-related genes, and TCGA SKCM dataset, SKCM differential genes in GSE3189 and GSE46517 were intersected to identify SKCM pathogenesis-related differential genes, and the differential genes were immune infiltration and analysis, For survival analysis, a prognostic nomogram risk model was constructed based on the results of multivariate Cox regression analysis for risk stratification and prognosis prediction, then focused on the differential expression of ZC3H12A and its effect on TME. Finally, the protein interaction network method was used to quantify the similarity between 684 drug targets and skin melanoma, and to screen out drugs similar to skin melanoma. Based on 3 databases of KEGG, OMIM, and Genotype, 294 SKCM-related genes and 18 SKCM pathogenesis-related differential genes were obtained, and 18 SKCM pathogenesis-related differential genes were significantly correlated with TME. The constructed prognostic nomogram risk model predicted performance better and provided valuable information for immunotherapy. Multivariate Cox regression analysis and K-M analysis showed that ZC3H12A was a differentially expressed gene affecting the prognosis of SKCM and promoted the infiltration of anti-tumor immune cells CD8 + T cells, B cells, and DC cells. Based on the analysis of the protein interaction network method, 43 drugs were found to have high potential in the treatment of SKCM, and the literature search of these 43 drugs was carried out, and 21 drugs were found to have experimental verification for the treatment of SKCM. Taken together, the differential genes associated with the pathogenesis of SKCM have important roles in the tumor immune microenvironment, clinicopathological features, and prognosis, especially ZC3H12A has a potential role in identifying early SKCM patients. At the same time, it provides a new strategy for the drug development of SKCM and provides a basis for the reuse of SKCM drugs.

HPV-related oropharyngeal cancer early detection in gay and bisexual men is an "orphan" practice: A qualitative analysis among healthcare providers.

Among US men, oropharyngeal cancer (cancer of the back of the mouth and throat) is the 8th most common cancer. If detected early, human papillomavirus (HPV)-16-associated oropharyngeal cancer has a high 5-year survival rate. Risk factors such as high numbers of oral sex partners, disparities in smoking and drinking, and low rates of HPV vaccination may put gay and bisexual men at even higher risk for oropharyngeal cancer. We recruited 21 healthcare providers in Minneapolis-St. Paul, Minnesota and Houston, Texas to participate in semi-structured interviews. Nurses, physician assistants, dental hygienists, and dentists were asked about their clinical experiences serving gay and bisexual men and opinions on potential interventions for the early detection of oropharyngeal cancer. Providers typically did not tailor health screenings and examinations for gay and bisexual men. Participants lacked confidence in their ability to effectively implement routine screening for oropharyngeal cancer. The extent to which oropharyngeal cancer screening was incorporated into clinical practice varied by specialty, and practices necessary to detect it were scattered across clinical environments. HIV- and LGBTQ-focused healthcare providers were more aware of HPV-associated oropharyngeal cancer in gay and bisexual men, and appeared readier to act and lead on this issue. Further studies should (1) evaluate protocols for oropharyngeal cancer detection; (2) identify and assess the acceptability of screening in the community; and (3) study how to best close gaps in health services for gay and bisexual men which might contribute to low early detection rates of oropharyngeal cancer.

Development of a Novel Circulating Autoantibody Biomarker Panel for the Identification of Patients with 'Actionable' Pulmonary Nodules.

Due to poor compliance and uptake of LDCT screening among high-risk populations, lung cancer is often diagnosed in advanced stages where treatment is rarely curative. Based upon the American College of Radiology's Lung Imaging and Reporting Data System (Lung-RADS) 80-90% of patients screened will have clinically "non-actionable" nodules (Lung-RADS 1 or 2), and those harboring larger, clinically "actionable" nodules (Lung-RADS 3 or 4) have a significantly greater risk of lung cancer. The development of a companion diagnostic method capable of identifying patients likely to have a clinically actionable nodule identified during LDCT is anticipated to improve accessibility and uptake of the paradigm and improve early detection rates. Using protein microarrays, we identified 501 circulating targets with differential immunoreactivities against cohorts characterized as possessing either actionable (n = 42) or non-actionable (n = 20) solid pulmonary nodules, per Lung-RADS guidelines. Quantitative assays were assembled on the Luminex platform for the 26 most promising targets. These assays were used to measure serum autoantibody levels in 841 patients, consisting of benign (BN; n = 101), early-stage non-small cell lung cancer (NSCLC; n = 245), other early-stage malignancies within the lung (n = 29), and individuals meeting United States Preventative Screening Task Force (USPSTF) screening inclusion criteria with both actionable (n = 87) and non-actionable radiologic findings (n = 379). These 841 patients were randomly split into three cohorts: Training, Validation 1, and Validation 2. Of the 26 candidate biomarkers tested, 17 differentiated patients with actionable nodules from those with non-actionable nodules. A random forest model consisting of six autoantibody (Annexin 2, DCD, MID1IP1, PNMA1, TAF10, ZNF696) biomarkers was developed to optimize our classification performance; it possessed a positive predictive value (PPV) of 61.4%/61.0% and negative predictive value (NPV) of 95.7%/83.9% against Validation cohorts 1 and 2, respectively. This panel may improve patient selection methods for lung cancer screening, serving to greatly reduce the futile screening rate while also improving accessibility to the paradigm for underserved populations.