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mass screening of prostate cancer in a Chinese population:the relationship between pathological features of prostate cancer and serum prostate specific antigen

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Asian Journal of Andrology 2005年第2期7卷 159-163页

作者： Hong-WenGao Yu-LinLi ShanWu Yi-ShuWang Hai-FengZhang Yu-ZhuoPan LingZhang HirooTateno IkuroSato MasaakiKuwahara Xue-JianZhao DepartmentofPathology JilinUniversitySecondHospitalChangchun130041China／／ProstateDiseasesPreventionandTreatmentResearchCenterJilinUniversityChangchun130021China DepartmentofPathology BasicMedicalCollegeJilinUniversityChangchun130021China ProstateDiseasesPreventionandTreatmentResearchCenter JilinUniversityChangchun130021China DepartmentofPathology MiyagiCancerCenterMiyagiPrefectureJapan DepartmentofUrology MiyagiCancerCenterMiyagiPrefectureJapan

Aim:To investigate the pathological features of the prostate biopsy through mass screening for prostate cancer in a Chinese cohort and their association with serum prostate specific antigen (PSA).Methods:A total of 12 027 Chinese men in Changchun were screened for prostate cancer by means of the serum total prostate specific antigen (tPSA) test (by Elisa assay).Transrectal ultrasound-guided systematic six-sextant biopsies were performed on those whose serum tPSA value was >4.0 ng/mL and those who had obstructive symptoms (despite their tPSA value) and were subject to subse- quent pathological analysis with the aid of the statistic software SPSS 10.0 (SPSS.Inc.,Chicago.USA).Results:Of the 12 027 cases,158 (including 137 patients whose serum tPSA values were >4.0 ng/mL and 21 patients [serum tPSA mass screening for prostate cancer by testing for serum tPSA values and the first to investigate the pathological features of prostate cancer in a cohort of Chinese men.Our results reveal that the moderately differentiated carcinoma is the most common type of prostate cancer.This study also has shown that the serum tPSA value in prostate cancer is associated with the Gleason score and the size of tumor.

关键词： prostate cancer mass screening prostate specific antigen pathomorphology

Age-specific effectiveness of primary human papillomavirus screening versus cytology in a cervical cancer screening program: a nationwide cross-sectional study

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Cancer Communications 2022年第3期42卷 191-204页

作者： Heling Bao Lan Ma Yanxia Zhao Bo Song Jiangli Di Linhong Wang Yanqiu Gao Wenhui Ren Shi Wang Jiuling Wu Hai-Jun Wang Department of Maternal and Child Health School of Public HealthPeking UniversityBeijing 100191P.R.China National Center for Women and Children’s Health Chinese Center for Disease Control and PreventionBeijing 100081P.R.China National Center for Chronic and Non-communicable Disease Control and Prevention Chinese Center for Disease Control and PreventionBeijing 100050P.R.China

Background:Primary human papillomavirus(HPV)screening is recommended for the detection of cervical intraepithelial neoplasia(CIN)in the general pop-ulation;however,the triage for HPV-positive women remains a challenge.This study aimed to evaluate the age-specific effectiveness of primary HPV screening versus primary cytology screening for identifying optimal strategies for women of different ages.Methods:The dataset of the prevalence round screening was derived from the National Cervical Cancer screening Program in China.Primary cervical screen-ing protocols included cytology only,HPV testing with cytology triage,and HPV testing with HPV-16/18 genotyping plus cytology triage.The primary outcomes were age-specific detection rate,colposcopy referral rate and positive predictive value(PPV)for CIN2+.Multivariate Poisson regression was used to evaluate the relativeeffectivenessofHPVtestingandcytologyaccordingtoagegroups.TheI 2 statisticwitharandom-effectmodelwasusedtotesttheheterogeneityinrelative effectiveness of HPV testing versus cytology between age groups.Results:This study included 1,160,981 women.HPV testing with HPV-16/18 genotyping plus cytology triage significantly increased the CIN2+detection by 36%(rate ratio[RR]:1.36,95%confidential interval[CI]1.21–1.54)for women aged 35-44 years and by 34%(RR:1.34,95%CI 1.20-1.51)for women aged 45-54 years compared with cytology only.HPV testing with cytology triage had simi-lar CIN2+detection rate compared with cytology only.The PPVs were substan-tially increased for both HPV testing groups.Among women aged 55-64 years old,HPV testing with HPV-16/18 genotyping plus cytology triage increased the colposcopyreferralrateby19%(RR1.19,95%CI1.10-1.29)comparedwithcytology only,butdidnotincreasetheCIN2+detection(1.09,0.91–1.30).Theeffectiveness ofHPVtestingwithcytologytriagedidnotchangeinolderwomen.Thebetween-age-group heterogeneity in the effectiveness was statistically significant for HPV testing with HPV-16/18 genotyping plus cytology triage versus cytology only.Conclusions:

关键词： age groups cervical intraepithelial neoplasia cytology early detection of cancer human papil-lomavirus test mass screening triage uterine cervical neoplasms

Breast cancer: Epidemiology, risk factors and screening

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Chinese Journal of Cancer Research 2023年第6期35卷 565-583页

作者： Hangcheng Xu Binghe Xu Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

Breast cancer is a global health concern with a significant impact on the well-being of women. Worldwide, the past several decades have witnessed changes in the incidence and mortality of breast cancer. Additionally,epidemiological data reveal distinct geographic and demographic disparities globally. A range of modifiable and non-modifiable risk factors are established as being associated with an increased risk of developing breast cancer.This review discusses genetic, hormonal, behavioral, environmental, and breast-related risk factors. screening plays a critical role in the effective management of breast cancer. Various screening modalities, including mammography,ultrasound, magnetic resonance imaging(MRI), and physical examination, have different applications, and a combination of these modalities is applied in practice. Current screening recommendations are based on factors including age and risk, with a significant emphasis on minimizing potential harms to achieve an optimal benefits-to-harms ratio. This review provides a comprehensive insight into the epidemiology, risk factors, and screening of breast cancer. Understanding these elements is crucial for improving breast cancer management and reducing its burden on affected individuals and healthcare systems.

关键词： Breast neoplasms epidemiology mass screening risk factors

Comparing upper gastrointestinal X-ray and endoscopy for gastric cancer diagnosis in Korea

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World Journal of Gastroenterology 2010年第2期16卷 245-250页

作者： Hoo-Yeon Lee Eun-Cheol Park Jae Kwan Jun Kui Son Choi Myung-Il Hahm National Cancer Control Research Institute National Cancer Center111 Jungbalsan-roIlsandong-guGoyang-si Gyeonggi-do 410-769South Korea Department of U-Healthcare Management College of Medical ScienceSoonChunHyang University646 Eupnae-riShinchang-myeonAsan-siChungnam 336-745 South Korea

AIM:To compare the cost and accuracy of upper gastrointestinal(GI)X-ray and upper endoscopy for diagnosis of gastric cancer using data from the 2002-2004 Korean National Cancer screening Program(NCSP). METHODS:The study population included 1 503 646 participants in the 2002-2004 stomach cancer screening program who underwent upper GI X-ray or endoscopy.The accuracy of screening was defined as the probability of detecting gastric cancer.We calculated the probability by merging data from the NCSP and the Korea Central Cancer Registry.We estimated the direct costs of the medical examination and the tests for up- per GI X-ray,upper endoscopy,and biopsy. RESULTS:The probability of detecting gastric cancervia upper endoscopy was 2.9-fold higher than via upper GI X-ray.The unit costs of screening using upper GI X-ray and upper endoscopy were$32.67 and$34.89, respectively.In 2008,the estimated cost of identifying one case of gastric cancer was$53094.64 using upper GI X-ray and$16 900.43 using upper endoscopy.The cost to detect one case of gastric cancer was the same for upper GI X-ray and upper endoscopy at a cost ratio of 1:3.7. CONCLUSION:Upper endoscopy is slightly more costly to perform,but the cost to detect one case of gastric cancer is lower.

关键词： Gastric cancer mass screening Endoscopy Early diagnosis X-ray diagnosis

Acceptance on colorectal cancer screening upper age limit in South Korea

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World Journal of Gastroenterology 2020年第27期26卷 3963-3974页

作者： Xuan Quy Luu Kyeongmin Lee Yun Yeong Lee Mina Suh Yeol Kim Kui Son Choi Graduate School of Cancer Science and Policy National Cancer CenterGoyang-si 10408South Korea National Cancer Control Institute National Cancer CenterGoyang-si 10408South Korea

BACKGROUND The Korea National Cancer screening Program currently provides screening for colorectal cancer(CRC)for adults older than 50 years with no upper age limit.In general,people are likely to only pay attention to the benefits of cancer screening and to neglect its risks.Most consider the benefits of cancer screening as being far greater than the risks and are unaware that any potential benefits and harms can vary with age.AIM To report acceptance of an upper age limit for CRC screening and factors associated therewith among cancer-free individuals in Korea.METHODS The present study analyzed data from the Korea National Cancer screening Survey 2017,a nationally representative random sample of 4500 Korean individuals targeted for screening for the five most common types of cancer.A total of 1922 participants were included in the final analysis.The baseline characteristics of the study population are presented as unweighted numbers and weighted proportions.Both univariate and multivariate logistic regression models were developed to examine factors related with acceptance of an upper age limit for CRC screening;subgroup analysis was also applied.RESULTS About 80%(1554/1922)of the respondents agreed that CRC screening should not be offered for individuals older than 80 years.Specifically,those who had never been screened for CRC had the highest acceptance rate(91%).Overall,screening history for CRC[screened by both fecal occult blood test and colonoscopy,adjusted odds ratio(aOR)=0.33,95%CI:0.22-0.50]and other cancers(aOR=0.55,95%CI:0.34-0.87),as well as a family history of cancer(aOR=0.66,95%CI:0.50-0.87),were negatively associated with acceptance of an upper age limit for CRC screening.In contrast,metropolitan residents(aOR=1.86,95%CI:1.29-2.68)and people who exercised regularly(aOR=1.42,95%CI:1.07-1.89)were more likely to accept an upper age limit.After subgrouping,we found gender,marital status,and lifetime smoking history among never-screened individuals and residential region,family history of cancer,and p

关键词： Colorectal cancer Cancer early detection mass screening Patient participation Elderly Patients dropouts

Colorectal cancer screening in the COVID-19 era

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World Journal of Gastrointestinal Oncology 2021年第4期13卷 238-251页

作者： Anusri Kadakuntla Tiffany Wang Karen Medgyesy Enxhi Rrapi James Litynski Gillian Adynski Micheal Tadros Albany Medical College Albany Medical CollegeAlbanyNY 12208United States Division of Gastroenterology Albany Medical CenterAlbanyNY 12208United States National Clinician Scholars Program Duke University School of NursingDurhamNC 27710United States

Colorectal cancer(CRC)is the third most diagnosed form of cancer and second most deadly cancer worldwide.Introduction of better screening has improved both incidence and mortality.However,as the coronavirus disease 2019(COVID-19)pandemic began,healthcare resources were shunted away from cancer screening services resulting in a sharp decrease in CRC screening and a backlog of patients awaiting screening tests.This may have significant effects on CRC cancer mortality,as delayed screening may lead to advanced cancer at diagnosis.Strategies to overcome COVID-19 related disruption include utilizing stool-based cancer tests,developing screening protocols based on individual risk factors,expanding telehealth,and increasing open access colonoscopies.In this review,we will summarize the effects of COVID-19 on CRC screening,the potential longoutcomes,and ways to adapt CRC screening during this global pandemic.

关键词： Colorectal cancer COVID-19 Colonoscopy Early detection of cancer Diagnostic screening programs mass screening

Use of prostate-specific antigen testing in Medicare beneficiaries:Association with previous evaluation

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Family Medicine and Community Health 2017年第2期5卷 109-118页

作者： Gregory S.Cooper Tzuyung Doug Kou Mark D.Schluchter Avi Dor Siran M.Koroukian Simon P.Kim Division of Gastroenterology University Hospitals Cleveland Medical Center11100 Euclid Ave.ClevelandOH 44106USA Department of Urology University Hospitals Cleveland Medical Center11100 Euclid Ave.ClevelandOH 44106USA Case Comprehensive Cancer Center Wearn BuildingCase Western Reserve University11100 Euclid Ave.ClevelandOH 44106USA Department of Epidemiology and Biostatistics School of MedicineWood BuildingCase Western Reserve University10900 Euclid Ave.ClevelandOH 44106USA Department of Health Policy and Management Milken Institute School of Public HealthGeorge Washington University950 New Hampshire Ave.NWWashingtonDC 20052USA

Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims.We measured the annualized frequency of PSA screening among men due for PSA testing,stratified by PSA testing use in the previous 2 years,and clustered by ordering provider.Results:Throughout the study period,PSA testing use was consistently higher for men with previous screening than for men without previous screening.For men without previous screening,there was a decline in testing that was most pronounced in 2012.Compared with 2009,the cor-responding odds ratios were 0.98[95%confidence interval(CI)(0.96-1.00)]in 2010,0.94[95%CI(0.92-0.95)]in 2011,and 0.66[95%CI(0.65-0.68)]in 2012.In contrast,for men with previous screening,PSA testing frequency was stable from 2009 to 2011,and declined to a lesser extent in 2012[odds ratio 0.80,95%CI(0.79-0.81)].Conclusion:Receipt of PSA testing is highly dependent on whether an individual was tested in the recent past.In previously unscreened men,the largest decrease occurred in 2012,which may reflect in part the publication of US Preventive Services Task Force guidelines,but there was much less impact among men already being screened.

关键词： Prostate-specific antigen Medicare mass screening clinical practice patterns