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At least 145 records · Page 8Linked to original sources
PubMed2003

Best approach for prostate cancer detection: a prospective study on transperineal versus transrectal six-core prostate biopsy.

OBJECTIVES: To compare the efficacy of transperineal versus transrectal six-core prostate biopsy. Transrectal sextant biopsy is the most common method for prostate cancer detection. However, the cancer detection rate with this technique is increasingly considered inadequate. Different prostate biopsy procedures, mainly based on addition of additional transrectal cores to traditional sextant biopsy, have been proposed to increase the cancer diagnosis rate. The efficacy of the transperineal approach has not yet been fully established. METHODS: In a prospective study, 107 patients with elevated prostate-specific antigen levels (greater than 4.0 ng/mL) underwent prostate biopsy with six transperineal cores, using a "fan" scheme, plus six transrectal cores, according to the sextant technique. The median prostate-specific antigen level was 8.2 ng/mL (range 4.1 to 240). RESULTS: The overall cancer detection rate was 40% (43 of 107); prostate cancer was found in 38% (41 of 107) of patients with the transperineal approach and in 32% (34 of 107) of patients with the transrectal approach. Of 43 diagnosed cancers, 41 (95%) were found with the transperineal approach and 34 (79%) with the transrectal approach (P = 0.012). No patient had low-grade cancer (Gleason score 2 to 4), 25 patients had intermediate-grade cancer (Gleason score 5 to 6), and 18 patients had high-grade cancer (Gleason score 7 to 10). CONCLUSIONS: This is the first report comparing in vivo two different approaches to prostate biopsy. Transperineal biopsy seems superior to transrectal biopsy to detect prostate cancer. Both the transperineal and the transrectal approach should be familiar to the urologist who needs to obtain an adequate cancer detection rate. Transrectal sextant biopsy cannot be considered the standard technique for prostate cancer detection.

Aged↗
PubMed2000

Survival of patients with colorectal cancer detected by a community screening program.

OBJECTIVE: To determine survival rates for people with colorectal cancer detected through Bowelscan, a community screening program. DESIGN: Survey of data from local medical practitioners, and comparison with data from State cancer registries. SUBJECTS AND SETTING: 249 people with colorectal cancer detected after faecal occult blood screening in north-eastern New South Wales, 1987-1996. Follow-up was in 1998-1999. MAIN OUTCOME MEASURES: Five-year survival rates and relative survival ratios. RESULTS: Five-year survival rates for the screen-detected cancer patients were 90% for those with Dukes' stage A cancers, 75% for Dukes' B, 52% for Dukes' C and 0 for Dukes' D (although one person with Dukes' D cancer was living at four-year follow-up at the end of the study). Because of the higher percentage of Dukes' A cases in the population whose cancer was detected through screening, the resulting five-year relative survival ratio was significantly better than for those recorded by New South Wales, South Australian and Queensland cancer registries: 0.82 (95% confidence interval, 0.74-0.90) compared to 0.59 (P < or = 0.001). CONCLUSIONS: The study supports the findings of three overseas randomised trials that screening reduces mortality from colorectal cancer. We estimate that screening 200,000 people would detect about 250 colorectal cancers and prevent as many as 55 deaths.

Adult↗
PubMed2003

Evidence of increased prostate cancer detection in men aged 50 to 59: a review of 324,684 biopsies performed between 1995 and 2002.

OBJECTIVES: To analyze the age-specific detection rate of prostate cancer diagnosed from 324,684 biopsies submitted to a single laboratory and to assess the degree of prostate cancer in younger men. The advent of prostate-specific antigen (PSA) testing and increased prostate cancer screening has led to increased evaluations for prostate cancer. The initial stage and age at presentation in prostate cancer has shifted. METHODS: From 1995 through 2001, all prostate biopsies submitted to the laboratory were reviewed and analyzed for the diagnosis of prostate cancer, cancer detection rate, and age at diagnosis. RESULTS: The overall detection rate of prostate cancer increased by 15% from 29% to 34% for all biopsies submitted during the study period. For the age group 50 to 59 years, a 45% increase occurred in the detection of prostate cancer from a baseline of approximately 11% in 1995 to greater than 16% in 2001. For the age group 70 to 79 years, the detection of prostate cancer decreased from a baseline of 41% in 1995 to 36% in 2001. CONCLUSIONS: The increase in prostate cancer diagnosis among younger men in the United States has been significant. The increase is likely multifactorial and may be attributable to the impact of PSA and prostate cancer screening efforts. This has led to a greater number of younger men undergoing evaluation for prostate cancer. Thus, a heightened awareness regarding the diagnosis of prostate cancer among younger men is needed.

Adenocarcinoma↗
PubMed2003

Breast cancer detection by mapping hemoglobin concentration and oxygen saturation.

Near-infrared (NIR) spectroscopic imaging technology provides a new modality for measuring changes in total hemoglobin concentration (HbT) and blood oxygen saturation (SO2) in human tissue. The technology can be used to detect breast cancer because cancers may cause greater vascularization and greater oxygen consumption than in normal tissue. Based on the NIR technology, ViOptix, Inc., has developed an optical device that provides two-dimensional mapping of HbT and SO2 in human tissue. As an adjunctive tool to mammography, the device was preliminarily tested in a clinical trial with 50 mammogram-positive patients at the Massachusetts General Hospital. The results of the clinical trial demonstrate that the device can reach as much as 92% diagnostic sensitivity and 67% specificity in detecting ductal carcinoma. These results may indicate that the NIR technology can potentially be used as an adjunct to mammography for breast cancer detection to reduce the number of biopsies performed.

Adult↗
PubMedDate not supplied

Impact of prior biopsy scheme on pathologic features of cancers detected on repeat biopsies.

The object of our study was to characterize the biopsy features of cancers detected in a repeat biopsy population stratified on the basis of the type of prior negative biopsy. We studied 218 patients with a prior negative biopsy who underwent a 10-core extended systematic biopsy scheme, and a subset (n = 139) underwent additional 6 anteriorly directed biopsies. Clinicopathologic features of patients with cancer on the biopsy were compared as a function of type of prior negative biopsy. Overall and unique cancer detection rates were calculated for each of the biopsy sites. Cancer detection rates tended to be higher in patients who had undergone a prior sextant biopsy compared to a prior extended biopsy scheme (39% vs. 28%). Trends towards more positive cores and greater total core length of cancer involvement were seen in patients who had undergone a prior negative sextant biopsy. Apical and laterally directed biopsies had higher overall and unique cancer detection rates in patients who had undergone a prior negative sextant biopsy. Anteriorly directed biopsies had a low unique cancer detection rate in all patients. We conclude that in patients undergoing repeat biopsy, the detection rate is affected by the extent of the prior biopsy. Clinicopathologic features of cancers detected on repeat biopsy tend to be worse in patients who have undergone a prior negative sextant biopsy compared to a negative prior extended biopsy.

Aged↗
PubMed2004

Monofocal and plurifocal high-grade prostatic intraepithelial neoplasia on extended prostate biopsies: factors predicting cancer detection on extended repeat biopsy.

OBJECTIVES: To evaluate factors predicting cancer detection by extended repeat prostate biopsies in patients with an initial, isolated, monofocal or plurifocal, high-grade prostatic intraepithelial neoplasia (HGPIN) diagnosis. METHODS: From 1995 to 2002, after a first set of 10 to 12 systematic biopsy cores, 47 patients with an initial HGPIN diagnosis underwent repeat biopsy using the same technique (mean repeat biopsy cores 11.5) after a median follow-up of 11.4 months (range 3 to 24). RESULTS: Cancer was detected at the second biopsy in 21 patients (44.6%). Cancer detection was significantly greater in patients with plurifocal HGPIN than in those with monofocal HGPIN (70% vs. 10%, respectively; P <0.005) and in patients who underwent repeat biopsy more than 6 months after the first biopsy set (65%) compared with patients who underwent repeat biopsy within 6 months (25%; P <0.01; mean follow-up 15.5 and 3.8 months, respectively). Multivariate analysis showed that prostate-specific antigen, prostate-specific antigen density, digital rectal examination, and transrectal ultrasound findings were not statistically significant predictors of prostate cancer, and HGPIN multifocality and interval between biopsies (more than a 6-month follow-up interval) were independent prognostic factors (odds ratio 4.65 and 2.65, respectively). After radical prostatectomy (14 patients), no statistically significant differences were found in the pathologic stage between patient groups stratified by repeat biopsy interval (within or after 6 months). CONCLUSIONS: After a 10 to 12-core biopsy, patients with initial, isolated monofocal or plurifocal HGPIN diagnoses had an overall cancer detection rate of 45% on repeat extended biopsies. Plurifocal HGPIN on the first biopsy set was the strongest independent predictive factor in cancer detection. A 12 to 18-month interval before repeat biopsy could permit a significantly greater cancer detection rate, with no apparent likelihood of clinical cancer progression.

Aged↗
PubMed2005

Comparison of the incidence of latent prostate cancer detected at autopsy before and after the prostate specific antigen era.

PURPOSE: Most data regarding the prevalence of latent prostate cancer found only at autopsy are from old reports. To determine if significant differences exist in the prevalence of latent prostate cancer between periods before and after the advent of screening for prostate cancer, we compared 2 groups of men undergoing autopsy during the 2 periods. MATERIALS AND METHODS: Our institutional autopsy record database was searched to identify all men found to have prostate cancer before or after death between 1955 and 1960 (total 3,307 men and 1,578 men older than 40 years), and between 1991 and 2001 (total 2,938 men, 1,380 men older than 40 years). We calculated the age based incidence of latent prostate cancer detected only at autopsy in an at risk population of men (older than 40 years). We also compared Gleason grade distribution and proportion of stage cT3 or greater cancers between the 2 periods. RESULTS: Between 1955 and 1960 the prevalence of latent prostate cancer detected only at autopsy in men older than 40 years was 4.8% compared to 1.2% (p < 0.0001) between 1991 and 2001. A significant decrease in the prevalence of latent, autopsy detected cancers was observed in men 70 to 89 years old at death. Autopsy detected cancers were found to be grossly invading adjacent structures (stage cT3 or greater) in 17 of 76 (22%) cancers discovered between 1955 and 1960, while none of the latent prostate cancers found in the 1991 to 2001 period were found to extend grossly beyond the prostate. CONCLUSIONS: Autopsy rates are decreasing at our institution. With the more widespread use of screening, the prevalence of latent prostate cancer has decreased 3-fold. The decrease in the prevalence of latent prostate cancer is especially dramatic in men older than 70 years. Further study will determine the significance of many of the tumors currently detected clinically, which may have been latent and found at autopsy if not for screening.

Adult↗
PubMed1992

The relationship of prostate-specific antigen to digital rectal examination and transrectal ultrasonography. Findings of the American Cancer Society National Prostate Cancer Detection Project.

The participating institutions of the American Cancer Society National Prostate Cancer Detection Project did 520 biopsies on 2425 men over a 3.5-year period. A total of 88 cancers were confirmed pathologically, 93% of which clinically were organ confined. In 324 men (62.3%), a recommendation for biopsy was made based solely on the results of transrectal ultrasonography (TRUS); in 69 patients (13.3%), solely on the digital rectal examination (DRE); in 116 patients (22.3%), on abnormal DRE and TRUS examinations; and in 11 patients (2.1%), in whom DRE and TRUS were normal, on elevated prostate-specific antigen (PSA) levels. The TRUS was abnormal in 80.6% of men found to have cancer, and the PSA level and DRE were abnormal for 67% and 50% of cancers, respectively. The influence of PSA level on cancer detection increased as the serum level increased above 4 ng/ml. The positive predictive values of both the DRE and TRUS were influenced significantly by the presence of an elevated PSA level (P = 0.044 and P less than 0.001, respectively). The results of this ongoing multicenter study support the following statements: (1) the prostate cancer detection rate is influenced by this diagnostic triad and (2) the detection rate of organ-confined disease can be improved substantially by early detection programs.

Aged↗
PubMedDate not supplied

Improved prostate cancer detection with anterior apical prostate biopsies.

PURPOSE: Research to improve prostate cancer detection with transrectal ultrasound-guided prostate biopsies has focused on increasing the number of cores and the directing of biopsies laterally. In this study, we describe our experience with the addition of anterior apical biopsies. MATERIALS AND METHODS: A total of 164 consecutive patients with an increased or increasing prostate-specific antigen and/or abnormal digital rectal examination underwent transrectal ultrasound and systematic biopsy. We performed our standard laterally directed sextant biopsies plus additional mid parasagittal plane biopsies at the base and mid-gland, and an anteriorly directed biopsy at the apex. Site-specific detection and tumor characteristics are reported. RESULTS: Prostate cancer was detected in 71 patients (43.3%). The most commonly unique site was the anterior apex. Excluding these biopsies would have missed 17% of the cancers detected. The cancers limited to the anterior apex had tumor characteristics similar to all other cancers detected. CONCLUSION: In our experience, the anterior apical biopsies increase the detection of prostate cancer on transrectal ultrasound-guided biopsies. Further study on incorporating this site into the biopsy scheme is indicated.

Adenocarcinoma↗
PubMed2005

Association between body mass index and prostate cancer detection rates in Japanese urologic patients.

OBJECTIVES: To examine whether an association exists between body mass index (BMI) and prostate cancer detection rates or pathologic features of cancer in Japanese urologic patients. METHODS: We studied the age, BMI, and biopsy results of 481 patients who underwent transrectal prostate biopsy. They were stratified by BMI into three groups according to the cutoffs recommended for Asian populations: normal, BMI less than 23.0 (n = 248); overweight, BMI 23.0 to 25.0 (n = 116); and obese, BMI greater than 25.0 (n = 117). We then compared the cancer detection rates and pathologic features among the three groups. Multivariate logistic regression analysis was also performed. RESULTS: No significant differences in the cancer detection rate were found among the three groups (40.2% to 43.1%, P = 0.87) on univariate analysis. Multivariate logistic regression analyses revealed significant associations between the BMI and cancer detection (P = 0.029, 95% confidence interval [CI] 0.85 to 0.99), but no significant associations were observed between BMI and the presence of Gleason components 4 or 5 (P = 0.061, 95% CI 0.79 to 1.01), poor cell differentiation (P = 0.174, 95% CI 0.96 to 1.24), or clinically organ-confined disease (P = 0.45, 95% CI 0.84 to 1.08). CONCLUSIONS: BMI seems to have a significant impact on prostate cancer detection rates, although it seems difficult to apply the BMI directly to the management of patients at risk of prostate cancer in urologic clinics.

Adult↗
PubMed2003

Advances in breast cancer detection and management.

Breast cancer detection and management have undergone dramatic changes over the past three decades. Women are increasingly diagnosed with early stage disease, and leaving them with breast conserving options versus mastectomy. Furthermore, advances in the chemoprevention arena offer the promise of reduced overall breast cancer burden in the future.

Activities of Daily Living↗
PubMed2004

Soluble tumor-associated antigens in cancer detection, prevention and therapy.

Soluble tumor-associated antigens (sTAA) with molecular mass of 66 and 51 kDa isolated from the serum of cancer patients was shown can be used for cancer detection, prevention and therapy. CANCER DETECTION: Cancer progression is reflected in the relationship between p66 and p51 compared to healthy people or to patients with non-cancer diseases. The method was shown to be highly sensitive (92 to 96%) and moderate specific (42 to 65%) for the detection of different types of cancer, such as of the colon, uterus, ovary, and breast, as well as melanoma. CANCER PREVENTION AND THERAPY: sTAA have both tumor-preventive and tumor-suppressive effects on chemically induced cancers of the colon, skin and mammary glands in rats and mice. sTAA promote suppression of rat mammary tumors by different anticancer drugs, such as cyclophosphamide, tamoxifen and 5-fluorouracil, and decrease the drug's toxic side-effects. This effect was shown to be connected with activation of the host's immune system, especially those which is responsible for activity of T and B lymphocytes. CONCLUSIONS: We propose the follow-up after cancer patients in order to verify earlier as soon as possible recurrent cancer and perform preventive therapy of cancer suspect patients with their own sTAA as a kind of autoimmunotherapy. Moreover, in combination with anticancer drugs, sTAA may serve as a new tool in prevention of toxic side-effects of chemotherapy.

Animals↗
PubMed2005

Early breast cancer detection practices, health beliefs, and cancer worries in Jewish and Arab women.

BACKGROUND: Breast examinations (BE) for the early detection of breast cancer are the principal way of increasing survival rates in breast cancer. To date, BE practices among Jewish as compared with Arab women, and the factors associated with them have not been examined in Israel. OBJECTIVES: (1) To study differences in BE practices among Arab and Jewish women. (2) To characterize demographic, cognitive, and emotional factors related to Arab and Jewish women's BE practices. METHOD: In 2004, 489 Jewish women and 440 Arab women, ages 20-60, and randomly sampled from the female population of Israel, answered a telephone questionnaire related to BE practices, health beliefs, and breast cancer worries.

Adult↗