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PubMed2006

Comparison of observed and expected numbers of detected cancers in the research center for cancer prevention and screening program.

BACKGROUND: The Research Center for Cancer Prevention and Screening program is a one-arm prospective study designed to evaluate the effect of multiple modalities for cancer screening. Basic programs consist of screening tests for cancer of the lung, esophagus, stomach, colon, rectum, liver, gall bladder, pancreas and kidneys, in addition to prostate cancer screening for males and breast, cervical, endometrial and ovarian cancer screenings for females. OBJECTIVE: To investigate the possibility of overdiagnosis, we compared the observed numbers with expected numbers based on the model. METHODS: We calculated the expected number of cancers on the basis of negative or positive history of screening tests within the previous year, based on assumed sensitivity and sojourn time. Observed numbers of screen-detected cases for stomach, colorectal, lung, prostate and breast cancer were compared with expected numbers. RESULTS: From February 2004 to January 2005, 3786 participants were enrolled in our study. The overall cancer detection rate was 5.8% (119/2061) for males and 4.1% (71/1725) for females. No statistically significant difference was found between observed and expected cases for colorectal cancer screening, gastric cancer screening for females and lung cancer screening for males. Observed numbers of breast, prostate and lung cancer for females exceeded those expected (P < 0.05). CONCLUSIONS: Although cancer screening programs in the present study increased the detection of potentially curable cancers, these modalities, particularly lung, breast and prostate screening, might detect cancers which would not necessarily be clinically significant. We should therefore weigh up benefit and harm for such cancer screening programs.

Adult↗
PubMed1994

Prevalence in a volunteer population of pelvic cancer detected with transvaginal ultrasound and color flow Doppler.

Our objective was to find the prevalence of non-symptomatic endometrial and ovarian neoplasms in a volunteer population of women, aged 40 and over. We offered a free volunteer screening program to asymptomatic women for a study using transvaginal ultrasound and color flow Doppler for the detection of pelvic cancer. In the first 2 years, 2117 women were examined, 51.3% post-menopausal. An ovarian cyst was defined as having a maximum diameter of more than 2.4 cm. Color flow was used to identify blood vessels feeding pelvic organs and adnexal enlargements. An abnormal Doppler flow velocity for the ovary was defined as a resistance index of less than 0.41. Ovarian cysts of less than 5 cm with normal Doppler indices were followed up in 6 months to 1 year. An adnexal morphology score was created to quantify the usefulness of this parameter, particularly in postmenopausal women. Indications for surgery were pre-defined as a persistent ovarian cyst of more than 5 cm, a persistent suspicious Doppler and a total endometrial thickness of greater than 0.59 cm in postmenopausal women not taking hormones.A total of 202 women (9.5%) had ovarian cysts. Fourteen women were operated upon because of size criteria, one because of family history and three for persistent abnormal flow. By Doppler study, 15 cysts were predicted to be benign and histology was confirmatory. There were two false positives and one true positive, a stage Ib ovarian cancer. There were no false negatives, although a stage I endometrioid cancer of the ovary was detected 8 months after a negative scan. In those cases in which follow-up data were available, 56% of the cysts regressed in premenopausal women. In postmenopausal women, 28% regressed. Twenty of 1086 postmenopausal women had endometrial biopsies. Three had endometrial cancer, two stage I and one stage IIA. Five had atypical or adenomatous hyperplasia, and seven had benign polyps. So many women have small asymptomatic cysts of the ovary that a major reorientation of physicians' attitudes towards the ovary will have to be introduced to adapt to this new information. In this population, the prevalence of benign epithelial ovarian neoplasms was 7/1000, and of malignancy was 05/1000. In postmenopausal women, the prevalence rate for endometrial cancer was 5/1000, with 5/1000 hyperplasias and 7/1000 benign polyps. When endometrial and ovarian cancer screening are combined, the yield is comparable to that seen in breast and cervical cancer screening.

Journal Article↗
PubMed1996

[Investigation of gastric cancers detected at a medical check-up center].

Most of the gastric cancers investigated in this study were detected during mass screening at a Medical Check-up Center. The research period was 5 years, from 1990 to 1994. The total number of patients undergoing initial gastric examinations was 300,658. Four point eight percent of these needed detailed examinations, and 77.2% actually underwent detailed examinations. Over the 5 years, the number of gastric cancers detected was 253. The rate of detection of these cancers was almost unchanged every year, with the average rate of change being 0.11%. The rate of detected gastric cancers was investigated according to age and sex. No cancers were found below age 29, and the rate gradually rose over age 30. Over age 50, the rate in males was twice that in females. The rate of early gastric cancers was 66.4% of all reported cancers. As regards location of 253 cases, 16.5% were in the C-area, 45.8% in the M-area, 36.2% in the A-area; 19.2% were in the greater curvature, 33.9% were in the lesser curvature, 17.3% in the anterior wall, and 26.1% in the posterior wall. The sizes of the lesions were as follows: 11.5% were below 1.0 cm, 29.6% were from 1.1 cm to 2.0 cm, 46.6% were from 2.1 cm to 5.0 cm, and 12.3% were over 5.1 cm. It was considered that indirect X-rays were slightly inferior to direct X-rays in detecting early gastric cancer. The X-ray positionings in which cancers were detected were: 75.7% by supine double contrast and 48.6% by compression in 144 cases of early cancer. On the other hand, the rate were 75.6% by supine double contrast, and 51.2% by compression in 82 cases of advanced cancer. A similar tendency was found in one-shot X-ray positioning which revealed cancers. The rate of gastric cancer notdetected by X-ray pictures was 5.9% of the 253 cases. The size of the cancers notdetected by X-ray was within 2.0 cm in all cases. 58.7% of the 155 early cancer patients and 48.2% of the 83 advanced cancer patients had examinations the previous year. Therefore, it is clear that some cases of advanced cancer were not detected in the mass gastric screenings. Endoscopically, 7 cases of gastric cancer were diagnosed correctly by means of repeated biopsies which were needed 3 or 4 times over 3 to 18 months owing to pseudonegative findings on the first bioptic examination. Consequently, it is necessary to make naked eye diagnosis by endoscopic examination. Six cases of death from gastric cancer were certified within one year after normal diagnosis during the mass screening. Three cases were Borr. 4, 2 cases Borr. 3, and 1 case was Borr 2. A retrospective investigation of X-ray pictures showed that it would have been difficult to identify the lesions in these cases. The above results show that the accuracy of examinations and diagnosis must be raised in mass gastric screenings, but it is doubtful whether relying on the present methods of screening will lead to a marked improvement. For the purpose of increasing the effectiveness of mass gastric screening, we would emphasize the necessity of the following new tests; serum pepsinogen measurement, reinvestigation of patient's ages, shortening the intervals between examinations in high risk groups, using direct X-rays rather than indirect X-rays, and intermitted endoscopic examinations.

Adult↗
PubMed1996

Cancer detection activities coordinated by nursing students in community health.

This article describes ongoing cancer screening in a low-income and ethnically diverse community (primarily Southeast Asian and Hispanic). These services are part of the comprehensive care provided in a district nursing community health clinical. Screening services occur within the refugee community and include mammograms, individualized breast self-exam (BSE) teaching, home follow-up on the BSE teaching, and assistance obtaining any additional screening or treatment, if necessary. Except for technician activities, students plan, implement, and evaluate all services. The first event was in spring 1995, the second in summer 1995, and the third in fall 1995. Thus far, 85 women have received services. Cambodian and Laotian women show the lowest level of knowledge and experience related to breast cancer detection. This article provides some of the first data on cancer screening for low-income Cambodian and Laotian women in the United States. The article also shows how ongoing cancer screening and prevention services can be provided to populations that have not been successfully reached through usual means, e.g., referral by nurse practitioner, physician, and electronic or print media. Specific means of overcoming barriers to screening, prevention, and learning are described in detail.

Breast Neoplasms↗
PubMed2004

Radical retropubic prostatectomy in men younger than 45 years diagnosed during early prostate cancer detection program.

OBJECTIVES: To evaluate the incidence and outcome of prostate cancer in men younger than 45 years of age treated with radical retropubic prostatectomy after screening in an early prostate cancer detection program. METHODS: Our study group comprised 19,302 men younger than 45 years old who participated in this program. The indications for prostate biopsy were a prostate-specific antigen (PSA) level of 1.25 ng/mL or greater and a percent-free PSA value of 18% or less. Patients with prostate cancer underwent nerve-sparing radical retropubic prostatectomy. Intraoperative and early postoperative complications, clinical and pathologic stage, Gleason score, and surgical margins were reviewed retrospectively. In addition, potency, continence, and biochemical recurrence were assessed at the last follow-up visit. RESULTS: Of the study population eligible for prostate biopsy (1027 patients), only 175 (17%) consented to undergo the procedure (mean PSA 3.8 ng/mL). Twenty-eight men were diagnosed with prostate cancer, corresponding to 0.14% of the screened population and 16% of the biopsied patients. Twenty-six patients agreed to undergo radical retropubic prostatectomy. Pathologic examination revealed organ-confined disease in 22 (84.6%) and extraprostatic extension in 4 (15.4%). Positive surgical margins were seen in 2 patients (7.7%). The Gleason score was 7 or greater in 11 (42.3%) and 6 or less in 15 patients (57.7%). During a mean follow-up period of 15.8 months (range 3 to 36), all patients were continent, and 13 of the 16 patients with a follow-up of 12 months or longer were potent. CONCLUSIONS: In a large screening population younger than 45 years old, 16% of biopsied patients were positive for prostate cancer. These tumors were clinically significant but of a low stage and therefore potentially curable by surgery.

Adenocarcinoma↗
PubMed2005

Still a place for the classical systematic sextant technique? Cancer detection rates and complications in 1025 consecutive prostatic biopsies.

OBJECTIVES: To verify if there might still be an indication to the sextant biopsy technique we reviewed the cancer detection rate obtained and the complications encountered during a five years interval, at our hospital. METHODS: From January 1997 to December 2002 we have submitted to prostatic biopsy a total of 1025 consecutive patients with a clinical suspect of prostate cancer. A total of six cores were obtained in all the patients with an additional core at suspect lesions. RESULTS: Overall, prostate cancer was present in the biopsies of 444 of 1025 patients giving a detection rate of 43.3%. In patients with serum PSA levels between 4.1 and 10 ng/ml., 169 of 466 biopsies were positive, for a detection rate of 36.3%. An increase in percentage of positivity was observed with increasing decades of age. Overall complication rate was 1.4%. CONCLUSIONS: In patients older than 70 years, and with PSA levels higher than 10 ng/ml, the sextant technique may offer cancer detection rates comparable with techniques using an increased number of cores, and with lower complication rates.

Aged↗
PubMed2004

Salivary transcriptome diagnostics for oral cancer detection.

PURPOSE: Oral fluid (saliva) meets the demand for noninvasive, accessible, and highly efficient diagnostic medium. Recent discovery that a large panel of human RNA can be reliably detected in saliva gives rise to a novel clinical approach, salivary transcriptome diagnostics. The purpose of this study is to evaluate the diagnostic value of this new approach by using oral squamous cell carcinoma (OSCC) as the proof-of-principle disease. EXPERIMENTAL DESIGN: Unstimulated saliva was collected from patients (n = 32) with primary T1/T2 OSCC and normal subjects (n = 32) with matched age, gender, and smoking history. RNA isolation was done from the saliva supernatant, followed by two-round linear amplification with T7 RNA polymerase. Human Genome U133A microarrays were applied for profiling human salivary transcriptome. The different gene expression patterns were analyzed by combining a t test comparison and a fold-change analysis on 10 matched cancer patients and controls. Quantitative polymerase chain reaction (qPCR) was used to validate the selected genes that showed significant difference (P < 0.01) by microarray. The predictive power of these salivary mRNA biomarkers was analyzed by receiver operating characteristic curve and classification models. RESULTS: Microarray analysis showed there are 1,679 genes exhibited significantly different expression level in saliva between cancer patients and controls (P < 0.05). Seven cancer-related mRNA biomarkers that exhibited at least a 3.5-fold elevation in OSCC saliva (P < 0.01) were consistently validated by qPCR on saliva samples from OSCC patients (n = 32) and controls (n = 32). These potential salivary RNA biomarkers are transcripts of IL8, IL1B, DUSP1, HA3, OAZ1, S100P, and SAT. The combinations of these biomarkers yielded sensitivity (91%) and specificity (91%) in distinguishing OSCC from the controls. CONCLUSIONS: The utility of salivary transcriptome diagnostics is successfully demonstrated in this study for oral cancer detection. This novel clinical approach could be exploited to a robust, high-throughput, and reproducible tool for early cancer detection. Salivary transcriptome profiling can be applied to evaluate its usefulness for other major disease applications as well as for normal health surveillance.

Biomarkers, Tumor↗
PubMed1992

Clinicopathological features of advanced gastric cancer detected by periodic mass screening.

We have attempted to clarify the clinicopathologic features of advanced gastric cancers that were detected in periodic mass screening by comparing them with those of cancers detected by an initial mass screening. The macroscopic type of the cancers detected by periodic mass screening included Borrmann's type 3 in 47% of cases but was an unclassifiable type because of its resemblance to early cancer in gross appearance in another 47% of cases. The predominant histologic type of the cancers was found to be poorly differentiated adenocarcinoma with scirrhous growth. From these results, advanced gastric cancers that resemble early cancers of the depressed type, in gross morphology, and which are histologically diagnosed as poorly differentiated scirrhous carcinoma, are assumed to be rapidly growing tumors. Therefore, some of the cases that have these characteristics may, in fact, represent early-phase scirrhous carcinoma, diffuse carcinoma classified as Borrmann's type 4, of the stomach.

Adenocarcinoma↗
PubMed2006

Comparison between endoscopic brush cytology performed before and after biliary stricture dilation for cancer detection.

BACKGROUND: Confirmation of malignancy within biliary strictures is endoscopically challenging. Dilation of strictures has been reported to enhance cytological diagnosis. AIM: To compare brush cytology results before and after biliary stricture dilation. PATIENTS AND METHODS: Patients with extra-hepatic biliary stricture at endoscopic retrograde cholangiopancreatography were included in the study. Brushing was performed before and immediately after dilation using a 10 Fr dilating catheter. Cytology samples were classified as: negative for malignancy, presence of atypical cells, insufficient material, suspicious for malignancy or positive for malignancy. Final diagnosis was established by surgery, biopsy or follow-up. RESULTS: Biliary brush cytology was performed in 50 patients, with an overall sensitivity of 40% and 27.5%, before and after dilation, respectively. The combination of results increased cancer detection rate to 45%. There were 5/50 (10%) minor complications and one death related to the procedure. CONCLUSIONS: Brush cytology performed before biliary stricture dilation has a similar cancer detection rate to that following dilation, although the combination of results enhances sensitivity.

Adult↗
PubMed2000

Chest wall recurrence of breast cancer detected by scintimammography.

A case of chest wall recurrence of breast cancer detected by scintimammography is presented. A 63-year-old woman who had a right mastectomy for breast carcinoma 24 years earlier was evaluated for left axillary adenopathy. Although it was suspected that a second primary malignancy had developed in the left breast, results of mammography and magnetic resonance imaging of that breast were negative. Scintimammography performed with Tc-99m sestamibi confirmed a normal left breast but revealed a lesion in the right chest wall at the site of the previous mastectomy. This was surgically confirmed as recurrent breast carcinoma, which subsequently altered patient management.

Breast Neoplasms↗
PubMed1994

The nature of prostate cancer detected through prostate specific antigen based screening.

Prostate specific antigen (PSA) based screening nearly doubles the detection rate of early prostate cancer. However, it is unknown whether the additional tumors detected are medically important. Traditional clinical and pathological features associated with medically important cancer include a palpable tumor, multifocal or diffuse involvement and moderately or poorly differentiated histology. In contrast, microfocal, well differentiated tumors are considered to be possibly medically unimportant. We sought to examine the clinical and pathological tumor stage and tumor grade in 1,169 consecutive men whose prostate cancer was detected during serial PSA based screening protocols involving 24,346 men screened at 6-month intervals. Of the patients 97% had clinically localized (clinical stage T1 or T2) tumors, of which 39% were not palpable (stage T1). Of the men whose cancer was detected through initial screening who underwent surgical staging 69% had pathologically organ confined (pathological stage whose cancer was detected through initial screening pT1 or pT2) disease compared to 74% whose cancer was detected through serial screening (after an initially negative screening). Impalpable, clinically focal, well differentiated minimal tumors were noted in 16% of the men. However, only 3% of the men who underwent surgical staging had impalpable, pathologically microfocal, well differentiated minimal tumors. We conclude that the majority of tumors detected through PSA based screening have the clinical and pathological features associated with medically important prostate cancer.

Aged↗
PubMed1994

Prostate cancer screening. Appropriate choices? Investigators of the American Cancer Society National Prostate Cancer Detection Project.

Early detection of prostate cancer has produced distinct stage migration of prostate cancer to earlier, more curable disease through optimized combined use of digital rectal exam (DRE), transrectal ultrasound, and prostate specific antigen (PSA). Currently available and emerging data can be assessed according to the World Health Organization's established criteria. As a significant public health problem, prostate cancer meets almost all the criteria for screening. While concerns about incomplete natural history, progression rates, and the need for better prognostic factors are valid, important social and public health issues also need to be considered. If future expenditures for terminal cancer care are minimized via reductions in therapy choices or coverage, no economic benefit for prostate cancer screening should exist. Narrow-focused attempts at cost reduction could inappropriately discourage high risk groups from participating in early detection programs, thereby eliminating the greatest potential benefit. Conversely, the greatest immediate cost-control issue for prostate cancer care in the United States could be the marked increased detection in men older than 75 years of age. Current cost savings are possible with improved public health education about the appropriateness of early detection in the oldest age groups or those with significant preexisting medical conditions. Prostate cancer control perhaps requires a tailored approach of screening in high risk groups and more appropriate "case finding" in the lower risk, general population. The initial combination of PSA and DRE can result in early detection, which is both ethical and economic, for individual patients consulting with informed physicians.

Aged↗
PubMed2001

Cervical cancer detection by hybrid capture and evaluation of local risk factors.

UNLABELLED: The city of Recife, northeastern Brazil, is reported to have the highest incidence of cervical cancer worldwide (83.2/100000 women). OBJECTIVE: To evaluate the efficacy of Hybrid Capture I (HC I) in cervical cancer detection and some risk factors in Recife. METHOD: Cervical scrapes for HC I analysis followed by colposcopy were collected from 140 women (70 with cervical cancer and 70 with normal cervix) from three screening services in Recife. RESULT: HC I sensitivity and specificity were 82.9 and 41.4%, respectively. The odds ratios for cervical cancer when Gesta > or = 5 and vaginal parity > or = 4 were, respectively, 5.30 and 4.27. CONCLUSION: HC I is a moderately sensitive method to detect cervical cancer, but it does not seem to be useful as a primary screening tool for it's low specificity. Early pregnancy, high Gesta/Para and living in rural areas were important local risk factors.

Adult↗
PubMed2005

Impact of multiple biopsy cores on predicting final tumor volume in prostate cancer detected by a single microscopic focus of cancer on biopsy.

OBJECTIVES: To compare the impact that the number of biopsy cores have on final pathologic findings when minimal disease is detected at biopsy. Discordance has been noted between transrectal ultrasound-guided biopsy results and tumor volume even when minimal amounts of tumor are found on biopsy. METHODS: We identified patients who had undergone radical retropubic prostatectomy for a single microscopic focus of adenocarcinoma from a prospectively maintained surgical database. Patients were stratified into two groups: those with six biopsies or less and those with seven or more. The Gleason score, margin status, presence of extracapsular extension, and percentage of tumor volume were compared. RESULTS: A total of 102 patients in our database had a single microscopic focus of adenocarcinoma detected by needle biopsy. Of these patients, 65 underwent six or fewer biopsies and 37 underwent seven or more at transrectal ultrasonography. Of the 37 patients in group 2, 27 (73%) had a final tumor volume of less than 5% compared with 24 (37%) of 65 patients in group 1 (P = 0.002). Of the group 2 patients, 15 (75%) with Stage T1c had an estimated tumor volume of less than 5% compared with only 11 (34%) in group 1 (P = 0.01). No statistically significant difference was noted between the two groups for margin status, presence of extracapsular extension, or Gleason score. CONCLUSIONS: A single microscopic focus of cancer obtained after multiple cores predicts for a significantly lower tumor volume on final pathologic examination across clinical stages. In the context of greater tissue sampling, the minimal disease designation may carry more predictive value and be a useful parameter in stratifying patients with Stage T1c and other good-risk factors with regard to surgical outcome.

Adenocarcinoma↗
PubMed1988

[Comparison of the clinical features of uterine cervical cancers detected by mass screening and voluntary visit].

In order to identify the characteristics of uterine cervical cancers detected by mass screenings (mass group), these cancers were compared to cancers diagnosed in patients voluntarily visiting medical institutions (voluntary group), and the following results were obtained. 1. The mass group tended to show a higher incidence of cervical cancer, and the voluntary group had a higher incidence of endometrial cancer. 2. In the mass group having cervical cancer, the age was younger than that in the voluntary group. Also the incidence of cancer among relatives within the third generation and the frequency of previous participating in a mass screening were both significantly greater (p less than 0.01), compared to the voluntary group. 3. As compared to the voluntary group, many patients in the mass group having cervical cancer were asymptomatic and were diagnosed at an early stage, and even if symptomatic, there still were more early cancers in the mass group than in the voluntary group (p less than 0.01). 4. The incidence of lymph node metastases in advanced cervical cancer, that is beyond stage I b, was lower in the mass group than in voluntary group (p less than 0.01). 5. Cervical cancers in the mass group were surgically treated in 94.2% of cases, and the rate was higher than that in the voluntary group. In the surgical treatment, 77.4% of cases in the mass group underwent a simple hysterectomy and a semi-radical hysterectomy, and the frequency of surgical treatment was higher than that in the voluntary group (p less than 0.01). There also was a tendency toward a shorter time of operative procedures, less bleeding during operation, and fewer postoperative complications. 6. In the mass group having cervical cancers, the prognosis was favorable (p less than 0.01). By the clinical stage, in early cancers including stage 0 and stage I a, there was no significant difference in the prognosis between the mass group and voluntary group, and in the advanced cancer, the prognosis was more favorable in the mass group compared to the voluntary group (p less than 0.01). Asymptomatic patients had a better prognosis than symptomatic patients, and there was no difference between the two groups, but among symptomatic patients the prognosis was more favorable in the mass group than in the voluntary group.

Adult↗
PubMedDate not supplied

The role of Compton background and breast compression on cancer detection in scintimammography.

99mTc MIBI scintimammography is a promising diagnostic technique for cancer detection. Using a dedicated Small Field Of View Gamma Camera (SFOVGC) with the high spatial resolution recently developed, it is possible to improve the sensitivity and to achieve images in projections similar to mammography with the breast under moderate compression. This new technique is called Single Photon Emission Mammography (SPEM). Several factors affect the imaging of small cancers; breast thickness, tumor-collimator distance and body activity. A phantom study was performed to assess the role of breast compression in scintimammography. In this work we analyze the intensity and the energy distribution of Compton scattering affecting the breast scintigraphy, by a Germanium detector and by SFOVCG. Five patients with 7 to 18 mm sized cancer were studied. The intensity of Compton scattering resulted from 4 to 10 times greater than true events. The fundamental role played by breast compression to improve the scintimammographic sensitivity is discussed.

Breast↗
PubMedDate not supplied

Development of high-sensitivity near-infrared fluorescence imaging device for early cancer detection.

We have developed a high-sensitivity near-infrared (NIR) optical imaging system for noninvasive cancer detection based on the molecular-labeled fluorescent contrast agents. Recent developments in molecular beacons offer a way to selectively tag various precancer and cancer signatures and provide high tumor-to-background contrast. Near-infrared imaging can deeply probe tissue up to a couple of centimeters; thus, it possesses the potential for noninvasive detection of breast or lymph node cancer. A phase cancellation (in- and antiphase) device is used to increase the sensitivity in detecting fluorescent photons and the accuracy of tumor localization. The optoelectronic system consists of the laser diode sources, fiber optics, interference filter (to select the fluorescent photons), and the high-sensitivity photon detector (photomultiplier tube). The source-detector pair scans the tissue surface in multiple directions, and the localization image can be obtained by angular back-projection reconstruction. Simulations and experimental data demonstrated the feasibility of detection and localization offluorescent object embedded inside the highly scattering media. Tumor-bearing mouse model with injection of fluorescent contrast agents is used to simulate the human breast tumor labeled with molecular beacons. The system can detect fluorescent contrast agents as small as one nanomole at the depth of three centimeters, with a three-millimeter localization error. This instrument has the potential for tumor diagnosis and imaging, and the accuracy of the localization suggests that this system could help guide the clinical fine-needle biopsy. Also, this portable device would be complementary to x-ray mammography and provide add-on information on early diagnosis and localization of breast tumor.

Animals↗
PubMed2004

Lower body mass index is associated with a higher prostate cancer detection rate and less favorable pathological features in a biopsy population.

PURPOSE: Body mass index (BMI), calculated as weight in kg divided by the square of height in m, is used as an indicator of obesity. We assessed the relationship between BMI, and prostate cancer detection rates and biopsy features in a referral based biopsy population. MATERIALS AND METHODS: A total of 787 consecutive patients referred for abnormal digital rectal examination and/or prostate specific antigen (PSA) greater than 4 ng/ml underwent systematic prostate biopsy. Three standard categories of BMI were considered, namely normal-less than 25, overweight-25 to 29.9 and obese-30 or greater kg/m. The presence or absence of cancer, percent of core involvement and tumor grade were correlated with BMI. Additional analyses controlled for patient age, PSA and prostate volume. RESULTS: For the entire population detection rates were highest in the normal BMI group compared to the overweight or obese group (52% vs 37% vs 42%, p = 0.0026). When stratified by age, this observation was true for men younger than 70 years (49% vs 32% vs 37%, p = 0.0042) but not for men 70 years or older. When only patients with PSA 10 ng/ml or less were considered, detection rates were highest in the normal BMI group (44% vs 28% vs 36%, p = 0.0061). This observation also persisted in patients younger than 70 years with PSA 10 ng/ml or less, or when only patients younger than 70 years with a total prostate volume of less than 50 cc were included. Of patients with cancer those with a normal BMI had a greater length of needle core involvement on biopsy. CONCLUSIONS: Normal BMI correlates with a higher cancer detection rate and larger cancers in men undergoing prostate biopsy.

Aged↗