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1.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 31-43, Marzo 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1551189

ABSTRACT

Introducción: El cáncer de pulmón (CP) es una enfermedad con gran impacto a nivel mundial en el número de muertes y en costos en salud. La alta incidencia y mortalidad de esta enfermedad asociada al diagnóstico tardío, y la mejoría del pronóstico ante una detección temprana, determinan que sea una patología pasible de beneficiarse mediante detección temprana. La tomografía de baja dosis de radiación (TCBD) demostró ser un método que se pue- de realizar periódicamente a un grupo de personas con alto riesgo de desarrollar CP y así reducir la mortalidad por esta enfermedad. Sin embargo, este beneficio es tal cuan- do se encuentra desarrollado bajo un programa organizado y con participación multi- disciplinaria especializada en cáncer de pulmón. Métodos: Se plantea determinar lineamientos básicos para el desarrollo de la detección temprana de cáncer de pulmón en América Latina para que pueda ser realizada en forma uniforme, con el menor riesgo y el máximo beneficio esperado. Se analizaron las principales publicaciones referidas a este tema, contemplando la diversidad de atención y acceso de América Latina. Resultado: Se desarrollan requerimientos mínimos para la implementación de un pro- grama. Discusión: El número de programas en la región es escaso y depende más de esfuerzos individuales que de políticas generales de salud. Consideramos que estos lineamien- tos pueden servir de apoyo para el desarrollo de más programas en la región y de for- ma más homogénea.


Introduction: Lung cancer (LC) is a disease with a great impact worldwide in the number of deaths and health costs. The high incidence and mortality of this disease associated with late diagnosis and the improved prognosis with early detection determine that it is a pathology that can benefit from early detection. Low radiation dose tomography (LDCT) demonstrated a method that can be performed periodically to a group of people at high risk of developing CP and thus reduce mortality from this disease. However, this benefit is such when it is developed under an organized program with multidisciplinary participation specialized in lung cancer. Methods: It is proposed to determine basic guidelines for the development of early de- tection of lung cancer in Latin America so that it can be carried out uniformly, with the lowest risk and the maximum expected benefit. The main publications referring to this topic were analyzed, considering the diversity of care and access in Latin America. Result: Minimum requirements are developed for the implementation of a program. Discussion: The number of programs in the region is small and depends more on individual efforts than on general health policies. We consider that these guidelines can serve as support for the development of more programs in the region and in a more ho- mogeneous way.


Subject(s)
Humans , Health Programs and Plans , Early Detection of Cancer , Lung Neoplasms/diagnosis , Patient Care Team/organization & administration , Preventive Health Services/organization & administration , Tomography/methods , Incidence , Mortality , Education, Professional , Health Policy , Latin America
2.
Rev. Bras. Cancerol. (Online) ; 70(1)Jan-Mar. 2024.
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1537398

ABSTRACT

As alterações orais potencialmente malignas e o câncer oral, quando diagnosticados precocemente, possuem um bom prognóstico. No entanto, a imprecisão nos atendimentos odontológicos dificulta a detecção precoce, fazendo com que o câncer bucal permaneça como um problema de saúde pública atualmente. Objetivo: Avaliar o conhecimento de graduandos em odontologia sobre lesões orais de câncer e alterações orais potencialmente malignas. Método: Os dados foram coletados por meio de um questionário virtual, enviado para graduandos de odontologia de algumas universidades/faculdades localizadas no Estado da Bahia, entre os meses de junho e outubro de 2022. Posteriormente, os dados foram analisados estatisticamente e quatro conceitos foram estabelecidos: A (ótimo nível de informação); B (bom nível de informação); C (nível insatisfatório de informação); e D (péssimo nível de informação). Resultados: A amostra foi composta por 161 estudantes, a maioria entre 20 e 29 anos e do sexo feminino (78,3%). Não houve uma diferença estatística significativa entre os estudantes com até um ano de aprovação em componentes curriculares de estomatologia, patologia ou correlatos, com discentes com mais de um ano de aprovação (p = 0,126). A leucoplasia foi a alteração mais relacionada ao câncer (77%) para os entrevistados, e apenas 23% dos graduandos obtiveram o conceito A; no entanto, 96,9% dos entrevistados possuem interesse em assistir ao curso de educação contínua sobre o assunto. Conclusão: A maioria dos acadêmicos avaliados apresentou um bom nível de informação, entretanto, observou-se que os fatores de risco e a localização das lesões malignas geraram grandes dúvidas nos participantes deste estudo.


Potentially malignant oral disorders and oral cancer in early stages, when diagnosed early, have good prognosis. However, oral cancer is a public health problem today due to imprecision of dental care which makes early detection difficult. Objective: To evaluate the knowledge of dental students about oral cancer lesions and potentially malignant oral disorders. Method: Data were collected through a virtual questionnaire sent to undergraduate dentistry students from some universities/colleges located in the state of Bahia, between June and October 2022. Subsequently, the data were statically analyzed and four concepts were established: A (excellent level of information); B (good level of information); C (unsatisfactory level of information) and D (very poor level of information). Results: The sample consisted of 161 female students (78.3%) mostly between 20 and 29 years old. There was no statistically significant difference between students with up to one year of approval in stomatology, pathology or related disciplines, an students with more than one year of approval (p = 0.126). Leukoplakia was the disorder most related to cancer (77%) and only 23% of undergraduates obtained grade A, however, 96.9% of the respondents are interested in attending a continuing education course on the subject. Conclusion: The majority of the students evaluated had good level of information, nevertheless, the study participants had great doubts about the risk factors and the location of malignant lesions.


Los trastornos orales potencialmente malignos y el cáncer oral en estadios tempranos, cuando se diagnostican a tiempo, tienen un buen pronóstico. Sin embargo, la imprecisión en los tratamientos dentales dificulta la detección previa, por lo que el cáncer bucal sigue siendo un problema de salud pública en la actualidad. Objetivo: Evaluar el conocimiento de los estudiantes de odontología sobre las lesiones orales cancerosas y los trastornos orales potencialmente malignos. Método: Los datos fueron recolectados a través de un cuestionario virtual, enviado a estudiantes de grado en odontología de algunas universidades/facultades ubicadas en el estado de Bahía, entre junio y octubre de 2022. Posteriormente, los datos fueron analizados estadisticamente y se establecieron cuatro conceptos: A (nivel excelente de información); B (buen nivel de información); C (nivel de información insatisfactorio) y D (nivel de información muy bajo). Resultados: La muestra estuvo conformada por 161 estudiantes, la mayoría entre 20 y 29 años y de sexo femenino (78,3%). No hubo diferencia estadísticamente significativa entre estudiantes con hasta un año de aprobación en estomatología, patología o disciplinas afines, con estudiantes con más de un año de aprobación (p=0,126). La leucoplasia fue el trastorno que más se relacionó con el cáncer (77%) y solo el 23% de los estudiantes de pregrado obtuvo la calificación A, sin embargo, el 96,9% de los encuestados está interesado en asistir a un curso de educación continua sobre el tema. Conclusión: La mayoría de los estudiantes evaluados presentaron un buen nivel de información, sin embargo, se observó que los factores de riesgo y la localización de las lesiones malignas generaron grandes dudas entre los participantes de este estudio


Subject(s)
Mouth Neoplasms , Evaluation Study , Early Detection of Cancer
3.
Femina ; 51(9): 538-542, 20230930.
Article in Portuguese | LILACS | ID: biblio-1532483

ABSTRACT

A mamografia é o método de eleição para o rastreamento do câncer de mama, sendo o único que demonstra redução de mortalidade na população de risco habitual. A periodicidade de realização e a idade de início do rastreamento mamográfico são um tema controverso na literatura. Entretanto, dados no nosso país apontam para uma porção significativa de neoplasia de mamas em mulheres abaixo dos 50 anos. A Federação Brasileira das Associações de Ginecologia e Obstetrícia (Febrasgo), a Sociedade Brasileira de Mastologia (SBM) e o Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR) concordam que o rastreamento mamográfico deveria ser realizado, anualmente, por todas as mulheres a partir de 40 anos de idade. No Brasil, há uma distribuição desigual de mamógrafos nas várias regiões. As políticas de rastreamento devem considerar essa desigualdade. A grande maioria dos serviços no Brasil realiza rastreamento oportunístico para o câncer de mama. A implantação de rastreamento organizado por faixa etária e estratificação de risco pode otimizar os custos do sistema público de saúde. Pacientes de alto risco precisam ser rastreadas de forma diferente das pacientes de risco habitual. Essas pacientes precisam ter acesso à ressonância magnética das mamas e também iniciar seu rastreamento em idade mais precoce. O protocolo abreviado da ressonância magnética para rastreamento de pacientes de alto risco para câncer de mama pode melhorar a adesão e o acesso dessas pacientes ao programa de rastreamento. A ultrassonografia das mamas não é método de rastreamento isoladamente. Entretanto, ela tem seu papel como método complementar à mamografia e à ressonância magnética em cenários específicos, bem como em substituição à ressonância magnética em pacientes com contraindicação ao uso desse método. As mamas densas possuem baixa sensibilidade para o rastreamento por mamografia


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Breast Neoplasms/prevention & control , Mammography/methods , Mass Screening , Magnetic Resonance Spectroscopy/methods , Women's Health , Ultrasonography/methods , Early Detection of Cancer/methods
4.
RFO UPF ; 28(1): 115-131, 20230808.
Article in Portuguese | LILACS, BBO | ID: biblio-1509418

ABSTRACT

Objetivos: Instruir e orientar ao cirurgião dentista e demais profissionais de saúde a importância da detecção e rastreio precoce de lesões pré-malignas. Revisão de Literatura: O Líquen Plano Oral é uma condição dermatológica crônica, de origem auto-imune, relativamente comum na população, que atinge o epitélio de mucosa e pele, sendo considerada, pela Organização Mundial de Saúde (OMS), uma desordem potencialmente maligna quando associado a áreas de ulceração. A revisão de literatura foi realizada nas bases de dados PubMed e Lilacs. Buscamos investigar o potencial de malignização do Líquen Plano Oral associado a condições erosivas, analisando o processo de carcinogênese no processo inflamatório. Conclusão: Conclui-se que o objeto de estudo ainda é um assunto pouco explorado pela literatura, porém há indícios etiopatológicos que enfatizam o processo de malignização oriundo de uma lesão pré-maligna como o Líquen Plano Oral. Além disso, enfatizamos a importância do diagnóstico precoce das lesões estomatognáticas, para que assim possamos aumentar as chances de cura do paciente.(AU)


Objectives: To instruct and guide dentists and other health professionals on the importance of early detection and screening of pre-malignant lesions. Literature Review: Oral Lichen Planus is a chronic dermatological condition, of autoimmune origin, relatively common in the population, which affects the epithelium of the mucosa and skin, being considered, by the World Health Organization (WHO), a potentially fatal disorder. malignant when associated with areas of ulceration. A literature review was performed on the PubMed and Lilacs databases. We sought to investigate the potential for malignancy of Oral Lichen Planus associated with erosive conditions, analyzing the process of carcinogenesis in the inflammatory process. Conclusion: It is concluded that the object of study is still a subject little explored in the literature, but there are etiopathological accusations that emphasize the process of malignancy arising from a pre-malignant lesion such as Oral Lichen Planus. In addition, we emphasize the importance of early diagnosis of stomatognathic lesions, so that we can increase the patient's chances of cure.(AU)


Subject(s)
Humans , Mouth Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Cell Transformation, Neoplastic/pathology , Lichen Planus, Oral/pathology , Mouth Neoplasms/diagnosis , Carcinoma, Squamous Cell/diagnosis , Lichen Planus, Oral/diagnosis , Early Detection of Cancer
5.
Medisan ; 27(3)jun. 2023. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1514552

ABSTRACT

Introducción: La creciente aparición del cáncer bucal en etapas avanzadas revela la necesidad de egresar profesionales preparados que contribuyan a su prevención y diagnóstico precoz. Objetivo: Evaluar un sistema de tareas docentes para el desarrollo de la habilidad en el diagnóstico precoz del cáncer bucal. Métodos: Se realizó un preexperimento en 32 estudiantes y 10 profesores vinculados al proceso de enseñanza-aprendizaje de la asignatura Atención Integral a la Población de la carrera de Estomatología en la Universidad de Ciencias Médicas de Guantánamo, en el curso escolar 2022-2023. A tal efecto, se determinó la variable el desarrollo de la habilidad para el diagnóstico precoz del cáncer bucal, con sus dimensiones e indicadores, y se comprobó la significación de un sistema de tareas docentes para este fin a través de la prueba de Wilcoxon. Resultados: De acuerdo con los rangos de Wilcoxon, el sistema de tareas docentes resultó confiable para contribuir al desarrollo de la habilidad objeto de estudio (p<0,05). Los estudiantes consideraron que dicho sistema constituye la vía idónea para su preparación en el tema; de igual forma, todos los profesores coincidieron en cuanto a su pertinencia, factibilidad, efectividad, utilidad práctica y relevancia. Conclusiones: El sistema de tareas docentes aplicado durante la práctica preprofesional de los estudiantes de estomatología demostró ser factible para el desarrollo de la habilidad en el diagnóstico precoz del cáncer bucal.


Introduction: The increasing appearance of advanced oral cancer reveals the need of graduating professionals, prepared to contribute to its prevention and early diagnosis. Objective: To evaluate a system of teaching tasks for the development of competence in oral cancer early diagnosis. Methods: A pre-experiment was carried out with 32 students and 10 professors, who were involved in the teaching-learning process of the subject Comprehensive Dental Care for the Population of Dentistry degree in the University of Medical Sciences from Guantánamo, in the 2022-2023 academic year. For this purpose, the development of competence in oral cancer early diagnosis was determined as the variable, with its dimensions and indicators, and the significance of a system of teaching tasks for this objective was verified through the Wilcoxon test. Results: According to the Wilcoxon ranks, the teaching task system was reliable in contributing to the development of the competence under study (p<0.05). The students considered that this system is the ideal way for their training on the subject; in the same way, all teachers agreed regarding the relevance, feasibility, effectiveness, and practical utility of the teaching task system. Conclusions: The teaching task system applied during pre-professional practice of dentistry students proved to be feasible for the development of competence in oral cancer early diagnosis.


Subject(s)
Mouth Neoplasms , Early Detection of Cancer
6.
Rev. bras. ginecol. obstet ; 45(5): 235-241, May 2023. tab, graf
Article in English | LILACS | ID: biblio-1449738

ABSTRACT

Abstract Objective To evaluate the accuracy and patient acceptability toward self-sampling using a new device - SelfCervix® - for detecting HPV-DNA. Methods A total of 73 women aged 25-65 who underwent regular cervical cancer screening from March to October 2016 were included. Women performed self-sampling followed by a physician-sampling, and the samples were analyzed for HPV-DNA. After that, patients were surveyed about their acceptability of self-sampling. Results HPV-DNA detection rate of self-sampling presented high accuracy and was similar to physician-collection. Sixty-four (87.7%) patients answered the acceptability survey. Most patients (89%) considered the self-sampling comfortable, and 82.5% preferred self-sampling to physician-sampling. The reasons cited were time-saving and convenience. Fifty-one (79.7%) reported that they would recommend self-sampling. Conclusion Self-sampling using the new Brazilian device SelfCervix® is not inferior in HPV-DNA detection rate compared with physician-collection, and patients are supportive of the method. Therefore, it might be an option to reach under-screened populations in Brazil.


Resumo Objetivo Avaliar a acurácia e aceitabilidade da auto-coleta utilizando um novo coletor - SelfCervix® - para a detecção de DNA de HPV. Métodos Foram incluídas no estudo 73 mulheres com idade entre 25-65 anos que realizaram seu rastreamento regular do câncer de colo do útero entre Março e Outubro de 2016. Estas mulheres realizaram a auto-coleta, seguida de coleta profissional e as amostras foram analisadas paraa presença de DNA de HPV. Após, elas responderam um questionário sobre a experiência da auto-coleta. Resultados As taxas de detecção de DNA de HPV por auto-coleta foram altas e similares as da coleta profissional. Sessenta e quatro (87,7%) pacientes responderam o questionário de experiência. A maioria (89%) considerou a auto-coleta confortável, e 82,5% preferiram o método comparado a coleta profissional. As razões citadas foram economia de tempo e conveniência. Cinquenta e uma (79,7%) mulheres confirmaram que recomendariam a auto-coleta. Conclusão Auto-coleta utilizando o novo coletor desenvolvido no Brasil não é inferior na detecção de DNA de HPV quando comparada a coleta profissional, e apresenta uma boa aceitabilidade pelas mulheres. Desta maneira, pode ser uma opção para alcançar populações que não realizam o rastreamento padrão.


Subject(s)
Humans , Female , Adult , Middle Aged , Uterine Cervical Dysplasia , Mass Screening , Early Detection of Cancer , Papillomaviridae
7.
Article in English | LILACS | ID: biblio-1429004

ABSTRACT

Cervical cancer is still one of the leading causes of cancer and mortality in women, especially in low- and middle-income countries. Normally, the prevention of its occurrence is done through efficient screening and treatment programs for high-grade epithelial lesions, which are pre-malignant lesions. Cheaper diagnostic techniques ensure greater access to women, which can prevent a large number of cancer cases worldwide. Objective: The aim of the study was to evaluate the accuracy of visual inspection either with acetic acid or with Lugol's iodine, cervical cytology and colposcopy in the diagnosis of cervical intraepithelial neoplasia 2 and 3. Methods: This is a study of diagnostic accuracy. We evaluated 115 women with high-grade squamous intraepithelial lesion confirmed by biopsy, 54 with cervical intraepithelial neoplasia 2 and 61 with cervical intraepithelial neoplasia 3, from January 2016 to December 2018 at the Lower Genital Tract Pathology and Colposcopy Service of the Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. A comparative analysis of the visual inspection, Pap smear and colposcopy diagnostic methods was performed. Results: The average age was 33.1 years (standard deviation=9.83) for cervical intraepithelial neoplasia 2 cases and 35.2 years (standard deviation=7.97) for cervical intraepithelial neoplasia 3. In the cervical intraepithelial neoplasia 2 group, visual inspection tests were positive for high-grade squamous intraepithelial lesion in 98.1% of the cases with acetic acid and 94.4% with Lugol's iodine. Colposcopy identified a probable high-grade squamous intraepithelial lesion in 94.4% of the cases, while cytology only in 42.6%. In the cervical intraepithelial neoplasia 3 group, the visual inspection tests were positive for high-grade squamous intraepithelial lesion in 91.8% of the cases with acetic acid and 95.1% with Lugol's iodine. Colposcopy identified a probable high-grade squamous intraepithelial lesion in 93.5% of the cases, while cytology in 65.6%. Conclusion: Visual inspection with acetic acid and Lugol's iodine, and colposcopy test were more accurate for the diagnosis of cervical intraepithelial neoplasia 2 and 3 than through cytopathology. (AU)


Introdução: O câncer do colo de útero ainda é uma das principais causas de câncer e mortalidade em mulheres, especialmente em países de baixa e média renda. Normalmente, a prevenção de sua ocorrência é feita por meio de programas eficientes de triagem e tratamento de lesões epiteliais de alto grau, que são as lesões pré-malignas. Técnicas diagnósticas mais baratas garantem maior acesso às mulheres, podendo evitar um grande número de casos de câncer no mundo inteiro. Objetivo: O objetivo deste estudo foi avaliar a acurácia da inspeção visual (com ácido acético e com solução de lugol), da citologia cervical e da colposcopia no diagnóstico de neoplasias intraepiteliais cervicais 2/3. Métodos: Trata-se de um estudo de acurácia diagnóstica. Foram avaliadas 115 mulheres com lesão intraepitelial escamosa de alto grau confirmada por biópsia, 54 com neoplasias intraepiteliais cervicais 2 e 61 com neoplasias intraepiteliais cervicais 3, no período de janeiro de 2016 a dezembro de 2018 no Serviço de Patologia e Colposcopia do Trato Genital Inferior do Hospital de Clínicas de Porto Alegre, em Porto Alegre, Brasil. Foi realizada análise comparativa dos métodos de diagnóstico Inspeção visual com ácido acético, Inspeção visual com Solução de Lugol, colpocitologia oncótica e colposcopia. Resultados: A média de idade foi de 33,11 anos (DP 9,83) para os casos de neoplasias intraepiteliais cervicais 2 e de 35,28 anos (DP 7,97) para neoplasias intraepiteliais cervicais 3. No grupo de neoplasias intraepiteliais cervicais 2, os testes de inspeção visual foram positivos para tratamento de lesões epiteliais de alto grau em 98,1% dos casos com Inspeção visual com ácido acético e em 94,4% daqueles com Inspeção visual com Solução de Lugol. A colposcopia identificou provável tratamento de lesões epiteliais de alto grau em 94,4% dos casos, enquanto a citologia apenas 42,6%. No grupo neoplasias intraepiteliais cervicais 3, os testes de inspeção visual foram positivos para tratamento de lesões epiteliais de alto grau em 91,8% dos casos com Inspeção visual com ácido acético e em 95,1% daqueles com Inspeção visual com Solução de Lugol. A colposcopia identificou provável tratamento de lesões epiteliais de alto grau em 93,5% dos casos, enquanto a citologia em 65,6%. Conclusão: A inspeção visual (com ácido acético e com Solução de Lugol) e a colposcopia foram mais precisas para o diagnóstico de neoplasias intraepiteliais cervicais 2/3 do que a citopatologia. (AU)


Subject(s)
Humans , Female , Adult , Young Adult , Uterine Cervical Dysplasia/diagnosis , Colposcopy , Papanicolaou Test , Reproducibility of Results , Sensitivity and Specificity , Early Detection of Cancer
8.
Pan Afr. med. j ; 44(NA)2023. tables
Article in English | AIM | ID: biblio-1425224

ABSTRACT

Introduction: there is a great diversity in the profile of cancers in the world. This study set out to analyze the profile of gynecological cancer in Federal University Teaching Hospital, Owerri, [FUTHO] (former Federal Medical Centre, Owerri, Imo state, Nigeria). Methods: this was a retrospective cross sectional descriptive study of the records of women admitted in the gynecological ward in FUTHO from January 2020 to November 2022. It was analyzed using SPSS version 23.0 and reported in simple percentages for categorical variables and measures of central tendency for quantitative variables. Results: a total of 1,378 gynecological patients were admitted into the Gynaecological ward of the hospital, out of which 242 (17.6%) were cancer cases. The most common cancer over the three years in review, was ovarian, 81(33.5%), followed by cervical, 66 (27.3 %), endometrial, 65 (26.8 %), choriocarcinoma, 22 (9.1%), vulvar, 6 (2.5%) and vagina, 2(0.8%). The most common gynecological cancers in this study is very different from previous reports from Nigeria and other African countries. The pattern looks like that seen in the developed countries where endometrial and ovarian cancers top the list. Conclusion: this report shows a possible change in lifestyle and improved access to cervical cancer prevention strategies. It is also assumed that all the facilities who have recorded cervical cancer as the most common cancer can actually have a similar result as ours if a more current review is done.


Subject(s)
Humans , Female , Uterine Neoplasms , Vulvar Neoplasms , Choriocarcinoma , Uterine Cervical Neoplasms , Endometrial Neoplasms , Early Detection of Cancer , Tertiary Care Centers , Epidemiology , Disease Prevention
9.
Chinese Journal of Lung Cancer ; (12): 1-9, 2023.
Article in Chinese | WPRIM | ID: wpr-971172

ABSTRACT

Lung cancer is the leading cause of cancer-related death in China. The effectiveness of low-dose computed tomography (LDCT) screening has been further validated in recent years, and significant progress has been made in research on identifying high-risk individuals, personalizing screening interval, and management of screen-detected findings. The aim of this study is to revise China national lung cancer screening guideline with LDCT (2018 version). The China Lung Cancer Early Detection and Treatment Expert Group (CLCEDTEG) designated by the China's National Health Commission, and China Lung Oncolgy Group experts, jointly participated in the revision of Chinese lung cancer screening guideline (2023 version). This revision is based on the recent advances in LDCT lung cancer screening at home and abroad, and the epidemiology of lung cancer in China. The following aspects of the guideline were revised: (1) lung cancer risk factors besides smoking were considered for the identification of high risk population; (2) LDCT scan parameters were further classified; (3) longer screening interval is recommended for individuals who had negative LDCT screening results for two consecutive rounds; (4) the follow-up interval for positive nodules was extended from 3 months to 6 months; (5) the role of multi-disciplinary treatment (MDT) in the management of positive nodules, diagnosis and treatment of lung cancer were emphasized. This revision clarifies the screening, intervention and treatment pathways, making the LDCT screening guideline more appropriate for China. Future researches based on emerging technologies, including biomarkers and artificial intelligence, are needed to optimize LDCT screening in China in the future.
.


Subject(s)
Humans , Lung Neoplasms/epidemiology , Early Detection of Cancer/methods , Artificial Intelligence , Mass Screening/methods , Tomography, X-Ray Computed/methods , China/epidemiology
10.
Chinese Medical Journal ; (24): 159-166, 2023.
Article in English | WPRIM | ID: wpr-970030

ABSTRACT

BACKGROUND@#Colorectal cancer (CRC) screening is effective in reducing CRC incidence and mortality. The aim of this study was to retrospectively determine and compare the detection rate of adenomas, advanced adenomas (AAs) and CRCs, and the number needed to screen (NNS) of individuals in an average-risk Chinese population of different ages and genders.@*METHODS@#This was a retrospective study performed at the Institute of Health Management, Chinese People's Liberation Army General Hospital. Colonoscopy results were analyzed for 53,152 individuals finally enrolled from January 2013 to December 2019. The detection rate of adenomas, AAs, or CRCs was computed and the characteristics between men and women were compared using chi-squared test.@*RESULTS@#The average age was 48.8 years (standard deviation [SD], 8.5 years) for men and 50.0 years (SD, 9.0 years) for women, and the gender rate was 66.27% (35,226) vs . 33.73% (17,926). The detection rates of adenomas, AAs, serrated adenomas, and CRCs were 14.58% (7750), 3.09% (1641), 1.23% (653), and 0.59% (313), respectively. Men were statistically significantly associated with higher detection rates than women in adenomas (17.20% [6058/35,226], 95% confidence interval [CI] 16.74-17.53% vs . 9.44% [1692/17,926], 95% CI 8.94-9.79%, P  < 0.001), AAs (3.72% [1309], 95% CI 3.47-3.87% vs . 1.85% [332], 95% CI 1.61-2.00%, P  < 0.001), and serrated adenomas (1.56% [548], 95% CI 1.43-1.69% vs . 0.59% [105], 95% CI 0.47-0.70%, P  < 0.001). The detection rate of AAs in individuals aged 45 to 49 years was 3.17% (270/8510, 95% CI 2.80-3.55%) in men and 1.69% (69/4091, 95% CI 1.12-1.86%) in women, and their NNS was 31.55 (95% CI 28.17-35.71) in men and 67.11 (95% CI 53.76-89.29) in women. The NNS for AAs in men aged 45 to 49 years was close to that in women aged 65 to 69 years (29.07 [95% CI 21.05-46.73]).@*CONCLUSIONS@#The detection rates of adenomas, AAs, and serrated adenomas are high in the asymptomatic population undergoing a physical examination and are associated with gender and age. Our findings will provide important references for effective population-based CRC screening strategies in the future.


Subject(s)
Humans , Male , Female , Middle Aged , Retrospective Studies , Early Detection of Cancer , Colonoscopy/methods , Adenoma/epidemiology , Colorectal Neoplasms/epidemiology
11.
Chinese Journal of Gastrointestinal Surgery ; (12): 372-379, 2023.
Article in Chinese | WPRIM | ID: wpr-986800

ABSTRACT

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.


Subject(s)
Male , Humans , Female , Adult , Middle Aged , Cross-Sectional Studies , Early Detection of Cancer/methods , Colorectal Neoplasms/pathology , Colonoscopy/methods , Mass Screening/methods , Adenoma/diagnosis , DNA , Syndecan-2/genetics
12.
Chinese Journal of Epidemiology ; (12): 999-1005, 2023.
Article in Chinese | WPRIM | ID: wpr-985625

ABSTRACT

Objective: To evaluate the effectiveness of a risk-adapted colorectal cancer screening strategy constructed utilizing genetic and environmental risk score (ERS). Methods: A polygenic risk score (PRS) was constructed based on 20 previously published single nucleotide polymorphisms for colorectal cancer in East Asian populations, using 2 160 samples with MassARRAY test results from a multicenter randomized controlled trial of colorectal cancer screening in China. The ERS was calculated using the Asia-Pacific Colorectal Screening Score system. Logistic regression was used to analyze the association between PRS alone and PRS combined with ERS and colorectal neoplasms risk, respectively. We also designed a risk-adapted screening strategy based on PRS and ERS (high-risk participants undergo a single colonoscopy, low-risk participants undergo an annual fecal immunochemical test, and those with positive results undergo further diagnostic colonoscopy) and compared its effectiveness with the all-acceptance colonoscopy strategy. Results: The high PRS group had a 26% increased risk of colorectal neoplasms compared with the low PRS group (OR=1.26, 95%CI: 1.03-1.54, P=0.026). Participants with the highest PRS and ERS were 3.03 times more likely to develop advanced colorectal neoplasms than those with the lowest score (95%CI: 1.87-4.90, P<0.001). As the risk-adapted screening simulation reached the third round, the detection rate of the PRS combined with ERS strategy was not statistically different from the all-acceptance colonoscopy strategy (8.79% vs. 10.46%, P=0.075) and had a higher positive predictive value (14.11% vs. 10.46%, P<0.001) and lower number of colonoscopies per advanced neoplasms detected (7.1 vs. 9.6, P<0.001). Conclusion: The risk-adapted screening strategy combining PRS and ERS helps achieve population risk stratification and better effectiveness than the traditional colonoscopy-based screening strategy.


Subject(s)
Humans , Early Detection of Cancer , Risk Factors , Colorectal Neoplasms/genetics , Asia , China/epidemiology
13.
Chinese Journal of Lung Cancer ; (12): 274-280, 2023.
Article in Chinese | WPRIM | ID: wpr-982157

ABSTRACT

BACKGROUND@#With the aging of the population and the increased importance of lung cancer screening, the number of early-stage lung cancer patients has been on the rise in recent years, which can be classified into operable early-stage lung cancer and inoperable early-stage lung cancer. The most common pathological type is non-small cell lung cancer (NSCLC). Stereotactic body radiation therapy (SBRT) is the optimal treatment for inoperable early-stage NSCLC. The aim of this study was to investigate the prognosis of early-stage NSCLC patients treated with SBRT and its influencing factors in order to reduce the side effects of radiotherapy and improve the survival and quality of life.@*METHODS@#Clinical data and follow-up outcomes of early-stage NSCLC patients treated with SBRT in our hospital from August 2010 to August 2020 were collected. Kaplan-Meier method was used to assess the prognosis, and the Cox proportional risk model was used for multivariate prognostic analysis.@*RESULTS@#A total of 165 patients were included with a median follow-up time of 43.2 (range: 4.8-132.1) mon. The local control (LC) rates at 1-yr, 2-yr and 5-yr were 98.1%, 94.8% and 86.5% respectively. Karnofsky performance status (KPS) score greater than 80 was an independent prognostic factor for LC (P=0.02). The overall survival (OS) rates at 1-yr, 2-yr and 5-yr were 97.6%, 93.0% and 68.9% respectively. A biological equivalent dose when α/β=10 (BED10) greater than 132 Gy was an independent prognostic factor for OS (P=0.04). Progression-free survival (PFS) rates at 1-yr, 2-yr and 5-yr were 93.3%, 79.5% and 55.3% respectively. The distance metastasis free survival (DMFS) rates at 1-yr, 2-yr and 5-yr were 94.5%, 83.2% and 58.4% respectively. BED10 greater than 150 Gy was an independent prognostic factor for DMFS (P=0.02). The regional control (RC) rates at 1-yr, 2-yr and 5-yr were 98.8%, 95.4% and 87.9% respectively.@*CONCLUSIONS@#SBRT is effective in treating early-stage NSCLC. KPS greater than 80 is an independent prognostic factor for LC; BED10 greater than 132 Gy is an independent prognostic factor for OS; BED10 greater than 150 Gy is an independent prognostic factor for DMFS.


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Radiosurgery/methods , Early Detection of Cancer , Quality of Life , Prognosis , Small Cell Lung Carcinoma , Retrospective Studies , Treatment Outcome
14.
Chinese Journal of Biotechnology ; (12): 1425-1444, 2023.
Article in Chinese | WPRIM | ID: wpr-981147

ABSTRACT

The estimated new cases of breast cancer (BC) patients were 2.26 million in 2020, which accounted for 11.7% of all cancer patients, making it the most prevalent cancer worldwide. Early detection, diagnosis and treatment are crucial to reduce the mortality, and improve the prognosis of BC patients. Despite the widespread use of mammography screening as a tool for BC screening, the false positive, radiation, and overdiagnosis are still pressing issues that need to be addressed. Therefore, it is urgent to develop accessible, stable, and reliable biomarkers for non-invasive screening and diagnosis of BC. Recent studies indicated that the circulating tumor cell DNA (ctDNA), carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3), extracellular vesicles (EV), circulating miRNAs and BRCA gene from blood, and the phospholipid, miRNAs, hypnone and hexadecane from urine, nipple aspirate fluid (NAF) and volatile organic compounds (VOCs) in exhaled gas were closely related to the early screening and diagnosis of BC. This review summarizes the advances of the above biomarkers in the early screening and diagnosis of BC.


Subject(s)
Humans , Female , Biomarkers, Tumor , Early Detection of Cancer , Breast Neoplasms/diagnosis , Prognosis , MicroRNAs/genetics
15.
Chinese Medical Journal ; (24): 1047-1056, 2023.
Article in English | WPRIM | ID: wpr-980911

ABSTRACT

BACKGROUND@#Screening using low-dose computed tomography (LDCT) is a more effective approach and has the potential to detect lung cancer more accurately. We aimed to conduct a meta-analysis to estimate the accuracy of population-based screening studies primarily assessing baseline LDCT screening for lung cancer.@*METHODS@#MEDLINE, Excerpta Medica Database, and Web of Science were searched for articles published up to April 10, 2022. According to the inclusion and exclusion criteria, the data of true positives, false-positives, false negatives, and true negatives in the screening test were extracted. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the literature. A bivariate random effects model was used to estimate pooled sensitivity and specificity. The area under the curve (AUC) was calculated by using hierarchical summary receiver-operating characteristics analysis. Heterogeneity between studies was measured using the Higgins I2 statistic, and publication bias was evaluated using a Deeks' funnel plot and linear regression test.@*RESULTS@#A total of 49 studies with 157,762 individuals were identified for the final qualitative synthesis; most of them were from Europe and America (38 studies), ten were from Asia, and one was from Oceania. The recruitment period was 1992 to 2018, and most of the subjects were 40 to 75 years old. The analysis showed that the AUC of lung cancer screening by LDCT was 0.98 (95% CI: 0.96-0.99), and the overall sensitivity and specificity were 0.97 (95% CI: 0.94-0.98) and 0.87 (95% CI: 0.82-0.91), respectively. The funnel plot and test results showed that there was no significant publication bias among the included studies.@*CONCLUSIONS@#Baseline LDCT has high sensitivity and specificity as a screening technique for lung cancer. However, long-term follow-up of the whole study population (including those with a negative baseline screening result) should be performed to enhance the accuracy of LDCT screening.


Subject(s)
Humans , Adult , Middle Aged , Aged , Lung Neoplasms/diagnostic imaging , Early Detection of Cancer , Sensitivity and Specificity , Mass Screening , Tomography, X-Ray Computed
19.
Article in Portuguese | LILACS, CONASS, ColecionaSUS, SES-GO | ID: biblio-1532024

ABSTRACT

A mastectomia preventiva relacionada às neoplasias de mama precoces é um tema de grande importância na área da oncologia, especialmente para mulheres com alto risco genético de desenvolver câncer de mama. Objetivo: Descrever como a mastectomia relaciona-se com a prevenção de neoplasias de mama precoces. Métodos: Trata-se de uma revisão integrativa da literatura. Para construção da pesquisa, a coleta e análise de dados foi realizada através do Portal da Biblioteca Virtual da Saúde e da base de dados Medical Literature Analysis and Retrievel System Online via PubMed, através dos Descritores em Ciências da Saúde (DeCS): "Mastectomia Profilática", "Neoplasias da Mama" e "Fatores de Risco" combinados entre si pelo operador booleano AND. Como critérios de inclusão: estudos relacionados à temática excluindo-se as revisões de literatura, com delimitação temporal dos últimos cinco anos, nos idiomas inglês, português e espanhol. A questão norteadora foi construída com base na estratégia PICo de acordo com a descrição (População, Interesse e Contexto). Resultados: Foram encontrados 76 artigos, destes 64 foram excluídos devido aos filtros utilizados e a leitura dos resumos e na íntegra, restando apenas 12 estudos para compor a amostra final. Em suma, os estudos demonstram que a mastectomia preventiva pode oferecer às mulheres com alto risco genético uma opção para reduzir suas chances de desenvolver câncer de mama. Conclusão: A mastectomia preventiva relacionada às neoplasias de mama precoces é uma opção terapêutica complexa e individualizada, que busca reduzir o risco de desenvolvimento ou recorrência do câncer de mama em mulheres de alto risco


: Preventive mastectomy related to early breast neoplasms is a topic of great concern in the field of oncology, especially for women with a high genetic risk of developing breast cancer. Objective: To describe how mastectomy is related to the prevention of early breast cancer. Methods: This is an integrative literature review. For the construction of the research, data collection and analysis was carried out through the Virtual Health Library Portal and the Medical Literature Analysis and Retrievel System Online database via PubMed, through the Health Sciences Descriptors (DeCS): "Prophylactic Mastectomy","Breast Neoplasms" and "Risk Factors" combined with the Boolean AND operator. As inclusion criteria: studies related to the theme excluding literature reviews,with publication time delimitation of the last five years, in English, Portuguese and Spanish. The research question was structured based on the PICo strategy according to the description (Population, Interest and Context). Results: 76 articles were found, of which 64 were excluded after the filters application. We performed the reading of abstracts and full text, and 12 studies were selected to compose the final sample. In summary, studies demonstrate that preventive mastectomy can offer women at high genetic risk an option to reduce their chances of developing breast cancer. Conclusion: Preventive mastectomy related to early breast neoplasms is a complex and individualized therapeutic option that seeks to reduce the risk of breast cancer development or recurrence in high-risk women


Subject(s)
Humans , Female , Breast Neoplasms , Early Detection of Cancer , Risk Factors , Prophylactic Mastectomy/psychology
20.
Rev. Bras. Cancerol. (Online) ; 69(1)jan.-mar. 2023.
Article in English, Spanish, Portuguese | LILACS, SES-SP | ID: biblio-1512241

ABSTRACT

Communication with the population is strategic for cancer control since the creation of a public health policy in Brazil in the first decades of the 20th century1 . Communication actions which expand the society's knowledge on how to prevent and early detect cancer and deconstruct stigmas that delay the treatment continue to be critical to deal with this raising public health problem. The actions are interconnected according to the National Policy of Cancer Prevention and Control2 and every managerial level of the National Health System (SUS) is assigned the role of creating strategies to widen the population knowledge about cancer and its risk factors, forms of prevention and control. The criticism of the prevailing communication model centered in the transmission of information and behavioral recommendations draw attention to its boundaries. Grounded on technical expertise, the actions of this model are vertical and did not consider the influence of the economic, sociocultural and symbolic context, nor the other as producer of knowledge and subject of the communication. The production of statements and their formats seem to be the major focus, but few problematize its reach and the possibility of being understood and mean something to the other3 . The necessity to include the "voice of the other" in the production, circulation and evaluation of practices is a perspective aligned to the idea of participation, an invaluable notion to SUS and structuring the concept of empowerment, which is one of the objectives of the National Policy of Health Promotion4 , that attempts to increase the capacity and autonomy of the subjects and collectivities to advocate health and life, with the support of "several formal and popular communication expressions and listen to what the different groups involved wish to verbalize" The National Policy of Popular Education in Health also addresses dialogic communication5 , a shared knowledge construction principle which proposes decentralized communication processes considering the context of the subjects and translated into practices identified with the popular reality, language and culture"5 . Regardless of its relevance and necessity of innovative routes able to recognize the complexity involved in the communication and encourage reflection and dialogue, the institutional health practice follows the model of campaigns with barely known results. The pursue of better forms of establishing communicative processes with the population remains challenging. The present article presents issues that permeate the communication on prevention and early detection of cancer based in the experience the author has on the interface of education with health communication, in public institutions, and in the dialogue with critical texts on the theme in Brazil and updates some principles that should be applied in practice. It is expected to help health professionals and managers, mostly those working in primary and secondary care, to recognize the relevance of the critical, reflexive and creative investment in health communication with the population.


Subject(s)
Early Detection of Cancer
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