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At least 451 records · Page 25Linked to original sources
PubMed2000

Clinical breast examination for screening of asymptomatic women: the importance of clinical breast examination for breast cancer detection.

Of 489 asymptomatic women who were referred to our institute from other screening clinics, 46 were eventually proven to be breast cancer patients, and this number equated to 8.1% of the 565 breast cancer patients treated in our institute during the period of January 1997 to December 1998. Among the 46 cancer patients of the initial 489 asymptomatic women, twenty-five (54.35%) were detected by mammogram alone, six (13.04%) by clinical breast examination (CBE) alone, and the remaining 15 (32.61%) by both mammogram and CBE. In context with age, the mammographic sensitivity for cancer detection was 100% for women aged over 60, 91% for 50s, 78.9% for 40s, and 75% for 30s, and inversely correlated with the patient's age. Among the 25 cancers detected by mammogram alone, 18 (72%) belonged to DCIS or stage I. In contrast, four (66.7%) of six cancers detected by CBE alone and nine (60%) of 15 cancers by both CBE and mammography were included in stage IIa or IIb. However, the total incidence of early cancers (stages 0 and I) was significantly higher in the screening group than in the symptomatic group (p < 0.01). These results suggest that the role of mammography is important in the detection of cancers in their earlier stage and CBE is helpful in reducing false negative results in breast cancer screening. In conclusion, film mammography is the best tool for the detection of microcalcification and is useful for the detection of earlier lesions, but is not perfect for the detection of breast cancer particularly in young women. A careful CBE is an essential part of breast screening in order to reduce false-negative results.

Adult↗
PubMed1999

Total and transition zone prostate volume and age: how do they affect the utility of PSA-based diagnostic parameters for early prostate cancer detection?

OBJECTIVES: To define the role of total prostate (TP) volume, transition zone (TZ) volume, and age as determinants of the utility of prostate-specific antigen (PSA)-based diagnostic parameters for early detection of prostate cancer (PCa) in a prospective multicenter study. METHODS: The study participants were 974 consecutive men with serum total PSA (tPSA) levels of 4 to 10 ng/mL who were referred for early PCa detection or lower urinary tract symptoms. All patients underwent prostate ultrasound examination and sextant biopsy with two additional TZ biopsies. In patients with negative initial biopsies, repeated biopsies were performed at 6 weeks. tPSA, the free/total PSA ratio (f/t PSA), PSA density of the TZ (PSA-TZ), PSA density (PSAD), and PSA velocity (PSAV) were determined and compared across TP volume strata of 30 cm3 or less and greater than 30 cm3, TZ volume strata of 20 cm3 or less and greater than 20 cm3, and various age groups to evaluate the need for volume and/or age-specific reference ranges. RESULTS: PCa was found in 345 (35.4%) of 974 patients and benign prostatic tissue was found in 629 (64.6%) of 947 patients. Across TP volume strata, significantly higher values of tPSA (P <0.01), PSA-TZ, PSAD (P <0.001), and PSAV (P <0.05) and lower values of f/t PSA (P <0.001) were observed in patients with PCa than in those without PCa. Similar results were obtained with respect to TZ volume strata, except in the case of PSAV (P <0.05). tPSA, PSA-TZ, and PSAD were significantly higher (P <0.05) in patients with PCa than in those without PCa for all corresponding age ranges. In patients with PCa, f/t PSA was significantly lower (P <0.001) within the same age ranges. Within each group (PCa or benign), f/t PSA, PSAD, PSA-TZ, and PSAV values were unaffected by age strata. However, PSA parameters dependent on prostate volume (PSAD, PSA-TZ) were statistically lower (P <0.001) in prostates with a higher TP volume (greater than 30 cm3) and TZ volume (greater than 20 cm3); f/t PSA values were unaffected by TP and TZ volumes. CONCLUSIONS: f/t PSA and PSA-TZ were the most powerful parameters to differentiate between benign prostatic tissue and PCa. f/t PSA was the sole parameter unaffected by age and prostate volume. We believe new volume-specific cutpoints, as presented in the current study, should be employed when using PSAD and PSA-TZ for the early detection of PCa.

Adult↗
PubMed1983

Therapy for cervical cancer detected by mass screening.

Over a 19 year period since 1962, 972 cases of cervical cancer have been detected by mass screening in Miyagi Prefecture, a detection rate of 0.11%. Among these cases, 551 (56.7%) were cases of carcinoma in situ. In contrast, cervical cancers detected by means of private screening gave a detection rate of 0.39% (889 cases), among which there were 611 cases of invasive carcinoma (68.7%). Among the 421 cases of invasive carcinoma detected by mass screening, 352 were Stage I, 52 were Stage II, 14 were Stage III and 1 was Stage IV. Moreover, 178 of the 352 Stage I cases were Stage Ia. The 5 year survival rate for the cervical cancer patients detected by mass screening was 97.8% for Stage 0, 92.9% for Stage I, 75% for Stage II, 45.5% for Stage III and 0% for Stage IV. The 5-year survival rate for invasive carcinoma was 88.7%. Twenty-five deaths due to recurrence of the cancer were found, but all such cases were invasive carcinomas. There were no mortalities due to recurrence of carcinoma in situ among such cases detected by mass screening.

Carcinoma↗
PubMed1989

The Papanicolaou test for cervical cancer detection. A triumph and a tragedy.

The complex detection system leading to the discovery and treatment of precancerous lesions and early cancer of the uterine cervix is described in detail and discussed. By far the most difficult and underestimated component of this system is the screening and interpretation of cervical (Papanicolaou) smears. Cytologic case finding may fail because of inadequate samples, insufficient time devoted to screening, or human fatigue. Other weak points of the system, such as an inadequate clinical component, inadequate patient compliance, poor reproducibility of diagnoses, and ineffective aftercare, are also described. For example, obtaining a second smear to confirm or refute a diagnosis of cellular atypia is often a misleading practice. Although this cancer detection system has been shown to be effective in reducing the rate of morbidity and mortality from invasive cervical cancer in appropriately screened populations, there is no evidence that the Papanicolaou test has succeeded anywhere in complete eradication of this theoretically preventable disease. It is important to inform the public about the potential failures of the system and the reasons for them.

Carcinoma↗
PubMedDate not supplied

Use of neostigmine to increase the rate of lung cancer detection by sputum cytology.

Neostigmine induction was investigated as a method for increasing the rate of detection of lung cancer in respiratory cytology samples. Eleven patients with dry and essentially nonproductive cough were given neostigmine, 15 mg by mouth or 0.5 mg by hypodermic injection. The quality of sputum produced was increased in all cases; the sputum was also more easily expectorated. Eight patients suspected of having lung cancer had previously negative cytologic examinations of sputum obtained by conventional methods. Following the administration of neostigmine, malignant cells indicating squamous-cell carcinoma were found in the sputum samples of three of these patients while dysplastic cells were detected in the samples from two patients. It is postulated that neostigmine intake may increase the excretion of mucous glands in the bronchial submucosa as well as the bronchial epithelium itself.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Portable near-infrared diffusive light imager for breast cancer detection.

We present a frequency-domain near-infrared optical tomography system designed for breast cancer detection, in conjunction with conventional ultrasound. It features fast optical switching, three-wavelength excitations, and avalanche photodiode as detectors. Laser diodes at 660, 780, and 830 nm are used as light sources and their outputs are distributed sequentially to one of nine source fibers. An equivalent 130-dB isolation between electrical signals from different source channels is achieved with the optical switches of very low crosstalk. Ten detection channels, each of which includes a silicon avalanche photodiode, detect diffusive photon density waves simultaneously. The dynamic range of an avalanche photodiode is about 20 to 30 dB higher than that of a photomultiplier tube, thus eliminating the need for multistep system gain control. The entire system is compact in size (<0.051 m(3)) and fast in data acquisition (less than 2 sec for a complete scan). Calibration and the clinical experiment results are presented in the paper.

Algorithms↗
PubMed2004

Reproducibility of a multitarget stool-based DNA assay for colorectal cancer detection.

OBJECTIVES: Recent studies have demonstrated good sensitivity and specificity for the detection of colorectal cancer (CRC) utilizing a multitarget DNA assay panel (MTAP) on a single stool specimen. The aim of this study was to determine if analyzing three stool specimens obtained on three different days with the MTAP was superior to a single specimen for the detection of CRC. A secondary aim was to confirm the sensitivity of this MTAP reported in earlier studies. METHODS: Sixteen patients with newly diagnosed CRC underwent stool collection on three different days prior to surgical resection. Each specimen was analyzed using a MTAP that included 21 specific mutations of p53, K-ras and APC, and a microsatellite instability marker (BAT-26). RESULTS: Eleven of the sixteen patients (69%) had at least one mutation detected in their first stool specimen. Identical mutations were found in 18 of 21 (86%) subsequent stool specimens from patients initially positive. No new mutations were detected in these 21 specimens or 9 subsequent specimens from 5 patients initially negative. Overall, there was a 93% concordance between initial results and subsequent stools analyzed. CONCLUSION: There did not appear to be any additional benefit from performing the MTAP on more than one specimen per patient. This MTAP was reproducible with the same mutation detected in serial samples from each patient. The sensitivity detected in this study was comparable to earlier reports. Studies in an asymptomatic average-risk population are required to determine the role of the MTAP in CRC screening.

Adult↗
PubMed1996

Prospective study of relative weight and risk of breast cancer: the Breast Cancer Detection Demonstration Project follow-up study, 1979 to 1987-1989.

Despite extensive research on obesity and breast cancer in recent decades, inconsistencies in the literature exist. The authors examined prospectively the relation between adult relative weight (weight (kg)/height (m)1.5) and breast cancer risk in a cohort of 54,896 women aged 31-89 years who had previously participated in the Breast Cancer Detection Demonstration Project. During a mean follow-up period of 7 years, 226 of the premenopausal women and 1,198 of the postmenopausal women developed breast cancer. Analysis was performed using Cox proportional hazards regression methods with age as the underlying time variable and adjusted for the effects of potential confounders. Among postmenopausal women, the risk of breast cancer increased with increasing relative weight (p < 0.05 for trend); relative risk for the highest compared with the lowest quintile for relative weight was 1.3 (95% confidence interval (CI) 1.1-1.6). This association was modified by age at diagnosis, with relative risks of 1.1 (95% CI 0.8-1.4), 1.2 (95% CI 0.8-1.7), and 1.8 (95% CI 1.3-2.5), respectively, for women aged < 60, 60-64, and > or = 65 years. The higher risk of breast cancer among the older and overweight women was largely confined to women whose weights were measured during the postmenopausal but not the premenopausal period. This risk pattern was observed among the naturally menopausal women, but was also apparent in the smaller group of women with bilateral oophorectomy or hysterectomy with one ovary retained. Among premenopausal women, adult relative weight was not associated with breast cancer risk. These findings suggest that the inconsistencies in the literature on obesity and breast cancer may be due in part to the differing age distributions of the populations studied. The authors conclude that prevention of obesity throughout adulthood, particularly after menopause, may help reduce breast cancer among older women.

Adult↗
PubMedDate not supplied

Costs and benefits of prostate cancer screening. Investigators of the American Cancer Society--National Prostate Cancer Detection Project.

Optimal combinations of digital rectal examination (DRE), transrectal ultrasound (TRUS) and prostate specific antigen (PSA) may better detect patients at high risks, as well as those in whom continued screening may not be cost effective. Our recent cost analysis of prostate cancer early detection used current data from three consecutive years of the American Cancer Society's National Prostate Cancer Detection Project. Marginal cost analysis showed marked increased costs for the DRE by year three due to significantly reduced sensitivity for incident cancers. The benefit-cost equation acknowledges that many parameters of both cost and probability are not definitive at this time, yet illustrated major points for discussion. The cost parameters most sensitive to incremental change in decreasing order are: the specificity of the screening test > benefits obtained from early therapy > prevalence of the disease. Benefit-cost calculations demonstrated that DRE, when performed by highly skilled examiners, had the lowest cost. However, DRE became one of the most costly detection scenarios when a minor decrease in DRE performance was assumed for more general examiners. If slightly more specific PSA usage (or assay) is developed, the higher prevalence of clinically detectable prostate cancer could make screening less costly than breast cancer screening. If we assume minimized future expenditures for terminal cancer care via reductions in therapy choices or coverage, no economic benefit for screening exists. If we also assume that potential costs to society are not roughly approximated by any benefits, we may engender inappropriate attempts at cost reduction by effectively discouraging screening in the highest risk groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMed1997

Receiver operating characteristic (ROC) curve analysis of transrectal ultrasonographic prostate cancer detection.

PURPOSE: To provide an overview of receiver operating characteristics (ROC) curve theory and create an ROC curve describing transrectal ultrasound (TRUS) detection of prostate cancer (PCa). METHODS: One hundred thirty-two patients with either an abnormal digital rectal exam (DRE) or a prostate-specific antigen (PSA) above 4 ng/ml or both underwent TRUS and biopsy of the peripheral zone (PZ) of each quadrant. ROC software was used to create an ROC curve. RESULTS: One hundred seventy-nine of 528 quadrants (34%) harbored PCa. The performance of TRUS in detection of PCa as defined by the area below the ROC is 0,809. CONCLUSIONS: Future investigators are encouraged to employ ROC analysis of TRUS to permit more meaningful comparisons of performance.

Journal Article↗
PubMedDate not supplied

Using a population-based cancer reporting system to evaluate a breast cancer detection and awareness program.

During May 1987, a total of 10,207 Wisconsin women were screened as part of a statewide Breast Cancer Detection and Awareness program sponsored by the Wisconsin Division of the American Cancer Society. Data from a population-based cancer reporting system were used to predict the number of expected breast cancer cases for that year. After controlling for secular and seasonal trends, we found that, compared with the number of cases that would have been expected, 51 more cases of localized breast cancer were diagnosed in the state during the time of the program. This study demonstrates the public health impact of a statewide screening program and the usefulness of a cancer reporting system in program evaluation.

Adult↗
PubMed2004

Prostate cancer: detection of extracapsular extension by genitourinary and general body radiologists at MR imaging.

PURPOSE: To determine whether predictive value of endorectal magnetic resonance (MR) imaging findings in detection of prostate cancer extracapsular extension (ECE) is significantly affected by the reader's subspecialty experience. MATERIALS AND METHODS: In this cohort study, 344 consecutive patients with biopsy-proved prostate cancer underwent endorectal MR imaging followed by surgery. Likelihood of ECE described in MR imaging reports was compared with clinical predictor variables. ECE was determined from the final pathologic report on specimens resected at surgery. Readers of MR images were classified into genitourinary MR imaging radiologists (n = 4) and general body MR imaging radiologists (n = 6). For data analysis, Wilcoxon rank sum and chi(2) tests, as well as receiver operating characteristic (ROC) curves and univariate and multivariate logistic regression analyses, were used. A difference with P <.05 was considered significant. RESULTS: Univariate analysis results demonstrated that all predictors except clinical stage were significantly associated with detection of ECE in both groups of readers (P <.05). In the genitourinary MR imaging radiologist group of patients, area under the ROC curve for endorectal MR imaging findings (0.833) was larger than areas under the curves for all other predictors (0.566-0.701). In the general body MR imaging radiologist group of patients, area under the ROC curve for endorectal MR imaging findings (0.646) was not larger than areas under the curves for all other predictors (0.582-0.793). Results of multivariate analysis of two models, one with all predictors and another with all predictors except endorectal MR imaging findings, demonstrated a significant increase in area under the ROC curve with endorectal MR images interpreted by genitourinary MR imaging radiologists (P =.019 and.31, respectively). CONCLUSION: Endorectal MR imaging findings are significant predictors for detection of ECE when MR images are interpreted by genitourinary radiologists experienced with MR imaging of the prostate.

Adult↗
PubMed1993

Pancreatic cancer detected by positron emission tomography with 18F-labelled deoxyglucose: method and first results.

In order to evaluate the utility of positron emission tomography (PET) with 18F-labelled deoxyglucose (FDG) for detection of pancreatic cancer 15 patients with pancreatic masses shown by computed tomography were investigated. Static PET scans covering an axial field of view of 15 cm were obtained 45 min after intravenous injection of 150-300 MBq FDG. Focally increased FDG accumulation was present in 12 out of 13 patients with histologically proven adenocarcinoma, in particular in eight of nine lymph node and four of five liver metastases. Scans of two patients with chronic pancreatitis confirmed by surgery revealed a normal FDG distribution. Contrast between tumour and normal tissue depended the metabolic situation prior to FDG injection. High ratios were found in fasting patients whereas no elevated FDG uptake was measured in an insulin-dependent diabetic suffering from carcinoma of the pancreatic head. We conclude that FDG PET might have the potential for detection and even differentiation of pancreatic carcinoma from chronic pancreatitis. Further studies are necessary to substantiate these preliminary findings and to optimize results in diabetic patients.

Adenocarcinoma↗
PubMed1990

Screening and early cancer detection.

NCI is the primary research institution that has funded most of the research to establish evidence of benefit from mass cancer screening. A study of prostate, lung, and colorectal cancer is presently being planned. These trials are large, expensive, and require 10 to 15 years or longer to complete. RCST trials are only feasible in the three or four most common sites. While developing better evidence, NCI suggests the Working Guidelines for the Early Detection of Cancer in seven sites where direct and/or indirect evidence suggests benefit. The potential for early cancer detection to contribute to a decrease in cancer mortality is great. However, unless early detection is applied by the public and by physicians, it is useless. It is hoped that this chapter has been helpful to physicians and oncologists in judging these matters and applying the benefits to patients.

Adult↗
PubMed1992

[A comparative analysis of interval breast cancer with breast cancer detected by mass screening or in outpatient clinics].

To investigate the characteristics and the prognosis of interval breast cancer, 21 interval cases were reviewed and compared with a total of 87 patients with breast cancer detected by mass screening and 266 found in outpatient clinics on the basis of the clinicopathological features. The postoperative cumulative 7-year disease-free rates were 61.1%, 81.4% and 69.0% in the interval cases, mass screening cases and outpatient clinic cases, respectively. The percentage of cases showing frequent mitoses in cancer cells was statistically higher for interval cancer than for the other breast cancers. The average tumor size of the interval cases calculated from the speculated tumor doubling times, was 1.51 cm. It is surmised that interval breast cancer is characterized by a marked proliferation of tumor cells and has a poorer prognosis than the other breast cancers. This might be due to the marked proliferation of interval breast cancer rather than under-counting because there were no malignant findings at the time of the last screening.

Adult↗
PubMed1990

Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen.

The prostate cancer detection rate from screening by digital rectal examination and tactilely guided prostate biopsy is approximately 1.7%. Among 1,807 men a detection rate of 14.6% was achieved in a clinical urological practice by physician-conducted prostate ultrasonography, digital rectal examination and determination of serum prostate specific antigen. Results are presented in 5-year increments as well as for the group as a whole. The possible benefit to be derived from an improved detection rate is undetermined. Recommendations are made regarding the clinical use of these diagnostic modalities.

Aged↗