Research Progress and Prevention Strategies of Interval Breast Cancer / 肿瘤防治研究

Breast cancer screening can significantly reduce the death rate of patients. Although the domestic screening programs have certain health economic value, the high-cost ones need to be weighed. The incidence rate of interval breast cancer is one of important indicators to measure the sensitivity of breast cancer screening program. This paper reviews the epidemiology, clinical features, pathological features and prognosis of interval breast cancer patients, with emphasis on the risk factors and prevention strategies of interval breast cancer.

Advances in Studies on Surveillance after Resection of Colorectal Adenoma and Interval Cancer / 胃肠病学

Colorectal polyps are eminence lesions that protruded from mucosa into lumen,including adenomatous polyps and non-adenomatous polyps. Early detection and resection of adenoma has significance in prevention of colorectal cancer,and the surveillance afterwards is also crucial. Interval cancer is the colorectal cancer that develops between initial negative colonoscopy or all the polyps having cleared and the next colonoscopy. It is an important duty for endoscopists to reduce the incidence of interval cancer. This article reviewed the advances in studies on surveillance after resection of colorectal adenoma and the development of interval cancer.

Colonoscopy Quality is the Answer for the Emerging Issue of Interval Cancer

Colonoscopy is currently regarded as the gold standard and preferred screening method for colorectal cancer (CRC). Recently, however, a limitation of colonoscopy in the prevention of CRCs has been identified, particularly in the right-sided colon, and the problem of so-called interval cancers has emerged. The prevalence of interval cancer is estimated to be between 4% and 8% of CRCs detected. Although the exact etiology of interval cancer remains unknown, factors implicated in the development of interval cancers include missed lesions at the time of colonoscopy, incomplete resection of previous neoplastic lesions, different tumor biology, and serrated pathway of carcinogenesis. However, recent evidence suggests that interval cancers are related to the training of the endoscopist and quality of the colonoscopy rather than tumor biology. Therefore, the importance of adequate training and continuous monitoring of the colonoscopy quality, which are amenable to improvement, cannot be overstated in order to prevent the risk of interval cancers. In this study, the current literature regarding the prevalence and potential factors related to interval cancers and colonoscopy quality-related issues are reviewed.

Prevalence, Clinicopathologic Characteristics, and Predictors of Interval Colorectal Cancers in Korean Population

BACKGROUND/AIMS: A subset of patients may develop colorectal cancer after a colonoscopy that was negative for carcinoma. These missed or de novo developed lesions were termed as interval cancers. Many studies regarding interval cancer have been conducted in Western countries, whereas very limited data are available in Asian populations. Therefore, the purpose of this study was to investigate prevalence, clinicopathologic features, and predictors of interval colorectal cancers in the Korean population. METHODS: Interval cancer was defined as a cancer that is diagnosed within 5 years of a negative colonoscopy result. Among the patients who were diagnosed colorectal cancers at Kangbuk Samsung Hospital from January 2007 to April 2012, clinicopathologic characteristics of interval cancers were compared with those of sporadic cancers. RESULTS: Among the 785 patients, 482 responded to telephone calls. Of these, 30 (6.2%) developed interval cancers. Finally, 28 patients who had interval cancers were compared with 415 patients who had sporadic cancers. Interval cancer group was significantly younger and more frequent in the right side colon than sporadic cancer group. There was no differences in sex, tumor size, differentiation, and staging between two groups. In multivariate analysis, young age and right side colon cancer were independent factors associated with an interval cancer. CONCLUSIONS: A significant proportion of Korean patients developed interval colorectal cancer, especially at the young age and in the proximal colon.

Interval cancer in mammogram screening: Incidence and diagnostic value of additional ultrasonography in Thai women.

Objective: The purpose of this study was to characterize the mammographic and ultrasonographic ( US) findings in interval cancer and to evaluate incidence and additional diagnostic value of US in interval breast cancer. Methods: A retrospective study involved three women who had negative results in both screening mammogram and US within 18 months before a diagnosis of breast cancer. The mammographic and US findings were classified according to Breast Imaging Reporting and Data System, categories 0-5. The method of detection, tumor histologic grade, axillary node status and tumor size were analyzed. Results: The interval cancer incidence in our institute was 3.14 per 10,000 screens. Three interval cancers were found. All patients had heterogenous dense breasts. Two of the three interval cancers could only be identified by US. All of them were invasive cancer with a high-to-intermediate grade (grade 2-3). Conclusions: Adjunctive US is noninvasive and valuable a modality for detection and characterization of interval cancer.