Cancer Screening in the United States, 2011 A Review of Current American Cancer Society Guidelines and Issues in Cancer Screening

Director of Cancer Screening, Cancer Control Science Department, American Cancer Society, Atlanta, GA, USA.
CA A Cancer Journal for Clinicians (Impact Factor: 115.84). 01/2014; 61(1):8-30. DOI: 10.3322/caac.20096
Source: PubMed


Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. This article summarizes the current ACS guidelines, describes the anticipated impact of new health care reform legislation on cancer screening, and discusses recent public debates over the comparative effectiveness of different colorectal cancer screening tests. The latest data on the utilization of cancer screening from the National Health Interview Survey is described, as well as several recent reports on the role of health care professionals in adult utilization of cancer screening.

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Article: Cancer Screening in the United States, 2011 A Review of Current American Cancer Society Guidelines and Issues in Cancer Screening

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    • "Since breast cancer is a very heterogeneous disease and most of the cancers are detected among women without currently known risk factors, a uniform and population-based mammography screening protocol is recommended for all women who are older than the qualifying age. Scientific evidence has shown that early detection of breast cancer combined with improved treatment strategies has incrementally and significantly reduced patients' mortality and morbidity rates over the past four decades (Tabar et al., 2001; Smith et al., 2011). However, the task of visually interpreting mammograms and detecting cancer is difficult due to the high variability of breast abnormalities and overlapping dense fibroglandular tissue (FGT). "
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    ABSTRACT: The high false-positive recall rate is one of the major dilemmas that significantly reduce the efficacy of screening mammography, which harms a large fraction of women and increases healthcare cost. This study aims to investigate the feasibility of helping reduce false-positive recalls by developing a new computer-aided diagnosis (CAD) scheme based on the analysis of global mammographic texture and density features computed from four-view images. Our database includes full-field digital mammography (FFDM) images acquired from 1052 recalled women (669 positive for cancer and 383 benign). Each case has four images: two craniocaudal (CC) and two mediolateral oblique (MLO) views. Our CAD scheme first computed global texture features related to the mammographic density distribution on the segmented breast regions of four images. Second, the computed features were given to two artificial neural network (ANN) classifiers that were separately trained and tested in a ten-fold cross-validation scheme on CC and MLO view images, respectively. Finally, two ANN classification scores were combined using a new adaptive scoring fusion method that automatically determined the optimal weights to assign to both views. CAD performance was tested using the area under a receiver operating characteristic curve (AUC). The AUC = 0.793 ± 0.026 was obtained for this four-view CAD scheme, which was significantly higher at the 5% significance level than the AUCs achieved when using only CC (p = 0.025) or MLO (p = 0.0004) view images, respectively. This study demonstrates that a quantitative assessment of global mammographic image texture and density features could provide useful and/or supplementary information to classify between malignant and benign cases among the recalled cases, which may eventually help reduce the false-positive recall rate in screening mammography.
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    • "More than 60% of patients with CRC are either locally or distantly invasive at diagnosis, restricting treatment options and reducing survival rates, whereas the 5-year survival rate is extremely favorable if detected at an early stage and treated early, while the tumors were still localized [2-5]. However, the early diagnosis rate is still comparatively low as the current clinical procedures utilized for CRC diagnosis are either invasive, unpleasant, inconvenient or low sensitivity [6,7]. Hence, the need for simple blood tests that could be used for the early detection, which emerging with potential to improve screening effectiveness and userfriendliness, is crucial for its ultimate control and prevention. "
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    ABSTRACT: Colorectal cancer (CRC) remains a major worldwide cause of cancer-related morbidity and mortality largely due to the insidious onset of the disease. The current clinical procedures utilized for disease diagnosis are invasive, unpleasant, and inconvenient. Hence, the need for simple blood tests that could be used for the early detection is crucial for its ultimate control and prevention. The present work is a case-control study focused on proteomic analysis of serum of healthy volunteers and CRC patients by the ClinProt profiling technology based on mass spectrometry. This approach allowed to identifying a pattern of proteins/peptides able to differentiate the studied populations. Moreover, some of peptides differentially expressed in the serum of patients as compared to healthy volunteers were identified by LTQ Orbitrap XL. A Quick Classifier Algorithm was used to construct the peptidome patterns (m/z 1208, 1467, 1505, 1618, 1656 and 4215) for the identification of CRC from healthy volunteers with accuracy close to 100% (>CEA, P < 0.05). Peaks at m/z 1505 and 1618 were identified as alpha-2-HS-glycoprotein precursor and tubulin beta chain, respectively. Alpha-2-HS-glycoprotein precursor and tubulin beta chain could be involved in the pathogenesis of CRC and perform as potential serology diagnosis biomarker.Virtual slides: The virtual slide(s) for this article can be found here:
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    • "e l s e v i e r . c o m / l o c a t e / y p m e d Puliti and Zappa, 2012; Smith et al., 2011). Despite controversies around the benefit and harm of MS (Gotzsche and Jorgensen, 2013; Independent UK Panel on Breast Cancer Screening, 2012; Jorgensen and Gotzsche, 2009; Jorgensen et al., 2009), organised mammography screening programmes (SP) have been implemented in many countries. "
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    ABSTRACT: We investigated factors explaining low breast cancer screening programme (BCSP) attendance taking into account a European transnational ecological Deprivation Index. Patients and Methods Data of 13,565 women aged 51-74years old invited to attend an organised mammography screening session between 2010 and 2011 in thirteen French departments were randomly selected. Information on the women's participation in BCSP, their individual characteristics and the characteristics of their area of residence were recorded and analysed in a multilevel model. Between 2010 and 2012, 7,121 (52.5%) women of the studied population had their mammography examination after they received the invitation. Women living in the most deprived neighbourhood were less likely than those living in the most affluent neighbourhood to participate in BCSP (OR 95%CI=0.84[0.78-0.92]) as were those living in rural areas compared with those living in urban areas (OR 95%CI=0.87[0.80-0.95]). Being self-employed (p<0.0001) or living more than 15minutes away from an accredited screening centre (p=0.02) were also barriers to participation in BCSP. Despite the classless delivery of BCSP, inequalities in uptake remain. To take advantage of prevention and to avoid exacerbating disparities in cancer mortality, BCSP should be adapted to women's personal and contextual characteristics.
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