[Conquering intestinal cancer by early detection--the Felix Burda Foundation and the Network for Early Intestinal Cancer Detection].
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Colorectal Neoplasms↗
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An expert system for the early detection of melanoma using knowledge-based image analysis.
Melanoma is the most lethal skin cancer; however, nearly all patients can be saved and cured by early detection and prompt surgical treatment. It has been demonstrated that the major diagnostic and prognostic parameters of melanoma are the vertical thickness, three-dimensional (3D) size and shape, and color of the lesion. The other characteristic features of early melanoma are irregularities in the boundary of the lesion and the appearance of nonuniform pigmentation (with a variety of color). During early stages of development of the melanoma, the changes in these parameters are very difficult to assess since no good tool exists for measuring them in situ and analyzing them for malignancy. A novel optical instrument called the "Nevoscope" has been developed to obtain multiple views of the transilluminated skin lesion from several angles. These views have been used to measure the thickness and 3D size of the skin lesion without excision. A knowledge-based image analysis and interpretation system is being developed to analyze images of the skin lesion for a set of diagnostic and prognostic features: thickness, 3D size, color and margin, boundary and surface characteristics. This analysis combined with the patient's history, such as occurrence of melanoma or dysplastic nevi in the family, life style, skin type, etc., is used by the knowledge-based expert system to detect early or potentially malignant lesions. The diagnostic and prognostic knowledge bases for the early detection of melanoma are being developed with the help of expert dermatologists and published case studies.
Algorithms↗
Predictors of the performance of breast and cervical cancer early detection by public health nurses.
INTRODUCTION: Public health nurses (PHNs) often serve as primary care providers, yet few studies have examined their practice patterns in the early detection of breast and cervical cancer. METHODS: We conducted a cross-sectional survey of all PHNs (N = 1,894) employed by the county health departments of North Carolina in July 1993 to describe the predictors of their performance of breast and cervical cancer early detection. The main outcome measures were self-report of cancer prevention and screening services provided for their adult clients, nursing self-confidence for counseling clients about cancer prevention, and training experience. Self-confidence for counseling clients about cancer prevention was measured by asking whether a nurse had sufficient knowledge to educate clients about cancer prevention as well as by obtaining nursing perception of the quality of their clinical skills. RESULTS: The response rate was 78%. Final sample consisted of 1,369 PHNs, after exclusion of 101 nurse practitioners. Nurses reported high performance rates of cancer screening, although self-rating of the quality of their clinical skills was often low. However, nurses who reported having higher quality clinical skills or who reported having sufficient knowledge to educate clients were significantly more likely to report a greater frequency of performing cancer screening and counseling. This self-confidence and performance association was independent of nursing certification to perform screening, job classification, education, knowledge, or continuing education coursework. CONCLUSIONS: Self-confidence is a significant predictor of PHNs' reported performance of cancer screening and counseling. Further studies to verify whether self-report predicts actual performance of cancer early detection are needed.
Adult↗
Ovarian cancer screening. The role of ultrasound in early detection.
BACKGROUND: Because of the urgent need for effective techniques with which to detect organ-confined curable ovarian cancers, efforts have been focused on early detection. Current ovarian cancer screening trials have been hampered by deficiencies in our knowledge of the molecular and biologic events leading to ovarian tumorigenesis. The lack of early ovarian cancer symptoms and the intraperitoneal location of the ovaries contribute to the dilemma of early diagnosis. METHODS: Real-time ultrasound screening is aimed at detecting the earliest possible architectural alterations in the ovary indicative of neoplastic growth. Color Doppler imaging detects early alterations in ovarian blood flow that accompany tumorigenesis. RESULTS: To be effective, these modalities must diagnose asymptomatic curable Stage I ovarian cancers and improve ovarian disease-specific survival. Because of the relatively low prevalence of ovarian cancer in the general population, investigators have targeted women at increased risk of ovarian cancer either based on their increasing age or their family histories of cancer. Some of these studies have been underway since the late 1980s and have already demonstrated the potential usefulness and limitations of current sonographic techniques used for screening. CONCLUSIONS: Ultrasound screening for ovarian cancer has not demonstrated adequate sensitivity and specificity, thus it is not used widely outside of the clinical trial setting. Current clinical guidelines for ovarian cancer screening as well as exploratory methods for use in early ovarian cancer detection are presented.
Female↗
Early detection of spoilage moulds in bread using volatile production patterns and quantitative enzyme assays.
AIMS: Early detection of spoilage fungi (two Eurotium spp., a Penicillium chrysogenum species) in bread analogues over periods of 72 h at 25 degrees C and 0.95 water activity was evaluated using volatile production patterns, hydrolytic enzyme production, and changes in fungal populations. METHODS AND RESULTS: Using an electronic nose system it was possible to differentiate between uninoculated controls and samples contaminated with P. chrysogenum within 28 h. After 40-48 h it was possible to differentiate between the Eurotium spp., P. chrysogenum and the control using Principal Component Analysis (PCA). Cluster analyses could differentiate between the control, P. chrysogenum and the Eurotium spp. after 40 h. Of seven hydrolytic enzymes examined after 48 h, the specific activities of three were significantly different from uninoculated control bread. There were also differences between the mould species in production of three enzymes. Penicillium chrysogenum populations increased fastest, from about 10(3) cfu g(-1) to 10(6)-10(7) cfu g(-1) after 72 h. For the Eurotium spp. this increase was slower. CONCLUSIONS: Overall, this study suggests, for the first time, that an electronic nose system using a surface polymer sensor array is able to detect qualitative changes in volatile production patterns for the early detection of the activity of spoilage moulds in bakery products. SIGNIFICANCE AND IMPACT OF THE STUDY: Potential exists for application of such systems for microbial quality assurance in intermediate moisture food products.
Ascomycota↗
American Cancer Society guidelines for the early detection of cancer.
This issue of CA inaugurates a yearly report on American Cancer Society guidelines for early detection of cancer in asymptomatic individuals. The current recommendations, which reflect almost 20 years of updates, cover screening recommendations for breast, colorectal, prostate, and cervical cancers, as well as for other cancers, depending on patient age, history, environmental and/or occupational exposures, etc. A key concept for both the general public and health providers is the distinction between public health recommendations regarding screening and decisions about early detection tests that might be undertaken on an individual basis. Although it is likely that current screening protocols will be supplanted by newer technologies, such as genetic and molecular markers of risk and disease, greater utilization of the technologies at hand will improve efforts toward establishing an organized and systematic approach to early cancer detection.
Adolescent↗
Early detection and intervention with schizophrenia: rationale.
This article explores the rationale for early detection and intervention in schizophrenia. The most compelling reason is the disorder's severity and chronicity and our knowledge that, while many treatments for schizophrenia are effective, they are also limited and palliative. This state of affairs suggests that researchers pay closer attention to schizophrenia's premorbid and onset phases, when the vulnerability to psychosis becomes expressed and the neurobiological deficit processes driving symptom formation appear to be the most active. We review the evidence that brain plasticity can be retained or reversed despite deficit processes. This evidence includes the putative attenuation of the severity of schizophrenia throughout the 20th century, retrospective and prospective linkage of earlier neuroleptic treatment and better long-term outcome, and data from a program designed to intervene in the prodromal phase of disorder. While the evidence to date does not demonstrate that early intervention with known treatments can change the natural history of schizophrenia, it is suggestive enough (for both biological and psychosocial treatment) to support further investigation. Focusing on the early course of schizophrenia also offers the possibility of identifying potential patients long before onset using vulnerability markers and of making more feasible primary prevention efforts. Finally, studies of untreated psychosis in first-episode cases have revealed that patients are often actively psychotic for a very long time before they get help. Bringing treatment more rapidly to a person who has been psychotic is in itself enough to justify early detection efforts.
Adolescent↗
Ex vivo evaluation of a novel polyiodinated compound for early detection of atherosclerosis.
Atherosclerosis is a primary cause of heart disease and stroke; it is the underlying cause of about 50% of all deaths in Western countries. It is known that early detection of atherosclerotic lesions would significantly reduce the risk of mortality. The objective of this study was to develop a radioimaging method for early detection of atherosclerotic plaques. A novel polyiodinated cholesterol analog, cholesteryl 1,3-diiopanoate glyceryl ether (C2I, patent pending), was synthesized and radiolabeled with 125I. 125I-C2I was incorporated into acetylated low-density lipoprotein (AcLDL), which is considered to be an atherosclerotic plaque-seeking carrier. 125I-C2I was also prepared as a chylomicron-like emulsion. Transgenic mice deficient in apoE and low-density lipoprotein receptors (LDLR), known as apoE/LDLR double knockout, were used as an animal model of early atherosclerosis. 125I-C2I/AcLDL or 125I-C2I emulsion was injected into the apoE/LDLR knockout mice via the tail vein, and the mice were killed humanely 24 h after injection. Various tissues including aorta were removed and radioactivity was determined. The aorta samples were also imaged to determine the accumulation of radioactivity from C2I. The images were compared to the atherosclerotic lesions revealed by histological studies. It was found that both 125I-C2I/AcLDL and 125I-C2I emulsion resulted in accumulation of radioactivity at the site of early atherosclerotic lesions, and they therefore may be useful for early detection of atherosclerosis.
Animals↗
Early detection of human immunodeficiency virus infection using third- and fourth-generation screening assays.
Early detection of infection with human immunodeficiency virus (HIV) is critical for clinical diagnosis and treatment of patients, as well as for ensuring the safety of blood transfusion products. Recently, a number of fourth-generation HIV screening assays have been developed that offer increased sensitivity over earlier tests by combining detection of anti-HIV antibodies with detection of the p24 viral antigen. Previously, six different HIV assays were compared against a broad range of 30 seroconversion panels. In the present study, three of the newer fourth-generation assays were tested together with three of the third-generation HIV antibody-only assays. This extensive analysis highlights (i) the importance of p24 antigen detection for early diagnosis, (ii) the improved sensitivity of fourth-generation assays over antibody-only tests, and (iii) the superior performance of the Vidas Duo assay, which allows reduction of the diagnostic window by up to 2 weeks. Finally, the results emphasize the detection limitations of the different assays and suggest improvements for future HIV screening assays.
HIV Antibodies↗
Skin cancer prevention, early detection, and management: current beliefs and practices of Australian family physicians.
The primary aim of this study was to examine Australian family physicians' beliefs and practices in relation to skin cancer prevention, early detection, and management. These factors were assessed by a mail-out survey, which was completed by 97 family physicians (69% return rate) randomly selected from the telephone book. Family physicians perceived that issues relating to the prevention and early detection of melanoma and other skin cancers were part of the role of family physicians. Furthermore, family physicians were rated as the most appropriate group for screening (100%; N = 94) and providing skin cancer education to the general public (96%; N = 93). Factors that discouraged family physicians from screening their patients included lack of time (32%; N = 31), forgetting (26%, N = 25), lack of financial incentive (20%; N = 19), and not being familiar with the patient's screening history (14%; N = 14). The family physicians sampled felt least confident in deciding whether changes are malignant (45%; N = 44), in diagnosing a melanoma (39%; N = 38), and in diagnosing a dysplastic nevus (33%; N = 32). While two-thirds of family physicians believed they currently detected 90 to 100% of their patients with melanoma, 93% felt that they should detect this proportion under ideal conditions, and 75% indicated that they should detect this proportion even given the existing constraints of their practice. The results indicate the need for formal training for family physicians in skin cancer prevention, early detection, and management issues, in order to bridge the gap between what family physicians believe they should be doing and their current practice.
Adult↗
Medullary carcinoma in children. Results of early detection and surgery.
Early diagnosis and surgical treatment of medullary carcinoma of the thyroid (MCT) in children is essential to decrease the likelihood of metastatic spread. To determine the optimal timing of screening and surgery, we reviewed all children younger than 16 years old who were undergoing surgical treatment. From 1970 to 1988, 33 children 6 months old to 15.9 years old (mean, 9 years old) with MCT or C-cell hyperplasia or both underwent total thyroidectomy. Follow-up was 4 months to 15 years after surgery (mean, 9 years). Six of 31 patients presented with a neck mass. Basal immunoreactive calcitonin level was increased in 3 of 7 patients with C-cell hyperplasia alone, in 10 of 18 patients with nonmetastatic MCT, and in all 5 patients with metastatic MCT. At the time of surgery, 7 patients had C-cell hyperplasia, 19 patients had MCT without metastasis, and 7 patients had MCT with metastases. All children with metastasis were more than 12 years old. Medullary carcinoma of the thyroid was seen as early as age 6 months in a child with multiple endocrine neoplasia type IIb (MEN-IIb) and age 3 years in a child with MEN-IIa. At follow-up, 25 patients were free of disease and 8 had had recurrent disease. Two of the 8 patients with MEN-IIb had died. All 6 children with a neck mass at presentation had recurrent disease. Of 27 patients diagnosed by screening, 25 had no evident disease and 2 had persistent disease. Thus, in children with MEN-II syndromes, screening studies are highly effective in detecting MCT. All children with MEN-IIb should be studied shortly after birth, and those with MEN-IIa should be studied by 1 year old.
Adolescent↗
Early detection of prostate cancer. Results of a prostate specific antigen-based detection program in Japan.
BACKGROUND: Prostate cancer increasingly is becoming a medical problem in Japan. To maximize the chance for cure, extensive effort is being made to detect prostate cancer while confined to the gland. METHODS: Determination was made of serum prostate specific antigen (PSA) in the early detection of prostate cancer in an Asian male population aged 55 years or older. Recommendation for biopsy was based solely on this parameter when its value exceeded 2.0 ng/ml in IMx immunoenzymetric assay. RESULTS: Of 1189 men, 150 (12.6%) had elevated values. The proportion of males with serum PSA greater than 4.0 ng/ml was only 3.4%. Of the 99 males who underwent ultrasound-guided biopsies, 16 cancers were detected, a cancer detection rate of 1.3%. Most of these (81.3%) were clinically localized cancers. Seven patients with cancer had serum PSA levels below 4.0 ng/ml including 5 less than 3.0 ng/ml. These tumors would have been overlooked if the conventional cutoff levels of 4.0 ng/ml had been applied. Radical prostatectomy was conducted on 13 patients. All had histologic features of clinically significant cancer and 69.2% were pathologically confined within the gland. CONCLUSIONS: Elderly Asian males appear to have lower serum PSA than their Western counterparts. The optimal cutoff of serum PSA for early detection should be examined further in Asian male populations. Differences in the incidence of prostate cancer between ethnic groups may have been overestimated in previous studies owing in part to unawareness by the physician and general public. Though the frequent use of more sophisticated diagnostic modalities will likely disclose greater numbers of prostate cancers in Japan, whether early detection reduces mortality by minimizing risk of death from cancer remains a point to be determined.
Aged↗
The value of ultrasonography in early detection of renal cell carcinoma.
Renal cell carcinoma is the third most frequent cause of urological cancer death in Japan. The first is bladder cancer and the second is prostatic cancer. However, there has been no clinical trial of mass screening for early detection of renal cell carcinoma. With a view to discovering a method of early detection for renal cell carcinoma, we analyzed the procedures for discovering renal cell carcinoma in 33 patients who were treated at our hospital. In 10 patients, carcinoma had been discovered accidentally without gross hematuria, abdominal mass or flank pain. Seven of these patients were first suspected of having renal cell carcinoma by ultrasonography, two by intravenous pyelography (IVP) and one by computed tomography. Seven out of nine patients operated on were surgically diagnosed as having stage I and two as having stage II. Ultrasonography is far better than IVP from the points of view of noninvasiveness, ease of performance and accuracy. In our study, ultrasonography was the most useful method for early detection of renal cell carcinoma. However, for the mass screening of renal cell cancer by ultrasonography, it is necessary to make its specificity and sensitivity clear and to debate its cost effectiveness.
Adult↗
The TE4D-Cog: a new test for detecting early dementia in English-speaking populations.
BACKGROUND: The screening test usually used to detect dementia (Mini Mental State Examination, MMSE) is limited by a ceiling effect and high false positive rates, as are other similar instruments. There is therefore a need for a more sensitive and specific screening tool to aid early detection and diagnosis of dementia. OBJECTIVE: The hypothesis of the study was that the TE4D-Cog would be more sensitive and specific than the MMSE in detecting mild cognitive impairment in patients with AD. METHOD: The TE4D (Test for the Early Detection of Dementia from Depression) was adapted from its original German version for English-speaking populations. This new scale (the TE4D-Cog) was then administered together with the MMSE and the cognitive subscale of the Alzheimer's disease Assessment Scale (ADAS-Cog) to 178 people with a diagnosis of Alzheimer's disease and 25 cognitively intact comparators. The sensitivity and specificity in detecting dementia of the TE4D-Cog and the MMSE were compared in those with mild dementia and those without dementia. RESULTS: The TE4D-cog had high sensitivity with an acceptable specificity and low false positive rate. It also had good concurrent validity, high inter-rater reliability, good internal consistency and strong predictive validity. CONCLUSIONS: The TE4D-Cog is easy to administer, short and acceptable. Results are independent of age, gender and level of education. The TE4D-Cog may therefore be a useful alternative to the MMSE as a dementia screening instrument.
Aged↗
Early detection of malignant process in benign lesions of breast tumor by measurements of changes in structuredness of cytoplasmic matrix in circulating lymphocytes (SCM test) reinduced in vitro by specific tumor antigen.
Early detection is crucial for successful treatment of all types of cancer. The specificity and sensitivity of the current methods vary from 50% to 80%. The use of specific tumor antigens and cytometric technology has resulted in the development of a new procedure for the early detection of breast tumors. This new method is reported. The test utilizes static cytometry, which records polarization and intensity changes in fluorescent light emitted from each individual lymphocyte obtained from tumor-bearing patients stimulated by the relevant specific tumor antigen. Using MUC-1/SEC as the specific antigen, we detected breast tumors with 85% specificity and 81% sensitivity in 137 breast tumor-bearing women. A significant linear correlation was found between the SCM test and the conventional classification of relative risk for breast cancer in benign lesions, suggesting that this is a precise method that could be used in mass screening for early detection of breast cancer.
Journal Article↗
[Experimental study on early detection of alloxan-induced pulmonary injury by magnetic resonance imaging].
We studied the early detection of alloxan-induced pulmonary injury by magnetic resonance imaging in vivo. Permeability edema was induced in ten rats by intravenous injection of alloxan at 100 mg/kg. T1-and T2-weighted images were acquired in five rats every 30 min for 120 min after alloxan injection. Five rats served as controls. The rats were sacrificed immediately after imaging and examined microscopically. CT images were also acquired in five rats every 30 min for 120 min after alloxan injection. Five rats served as controls. The rats were sacrificed immediately after imaging, and the wet-to-dry ratio of the lung was measured. In T1-weighted images, relative signal intensity from the lung with permeability edema rose from 30 min to 120 min, and was greater than that from normal lung every time. In T2-weighted images, there was no statistically significant difference in relative signal intensity of the lung between permeability edema and the control during 120 min. In CT images, there was also no statistically significant difference in lung density between permeability edema and the control during 120 min. There was no statistically significant difference in the wet-to-dry lung ratio between edematous lung and normal lung. In histological study, mild congestion and interstitial edema were observed in edematous lung. These results suggest the potential capability of MR imaging in detecting the early phase of permeability pulmonary edema.
Alloxan↗
Early detection and treatment of melanoma: update 2000.
Risk factors for the development of melanoma, early detection, biopsy technique, and treatment recommendations are discussed. Survival depends upon the stage at the time of diagnosis; thus, early detection of thin melanoma limited to the skin's surface enhances survival.
Clinical Trials as Topic↗
Development of a mathematical model of the cervical spinal canal and its use in detecting early pathologic changes.
Detection of subtle osseous changes on plain film roentgenograms of the cervical spine is essential in expediting the evaluation of suspected intraspinal tumors. It is our experience that the earliest osseous changes in such cases involve thinning or erosion of the adjacent pedicles and/or lamina and a subsequent increase in the oblique diameter of the cervical spinal canal. A statistical model is established which accurately describes the normal cervical vertebral column in terms of its spinal canal size (sagittal and oblique diameters) as well as pedicle and lamina thickness. Data was obtained from a series of 86 normal exams. Six surgically proven cases of cervical intraspinal tumors were analyzed using this model. Variations from expected normal values reveal statistically significant osseous changes involving thinning of the lamina and increased oblique diameter of the spinal canal, while the sagittal diameter of the canal remains normal. Because of these findings we feel that oblique cervical spine films should be included in the initial evaluation of neural canal tumors.
Adult↗