Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H...Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.展开更多
Cancer screening is a strategy focused on highrisk populations rather than universal populationwide screening, based on a comprehensive evaluation of epidemiological principles and practical feasibility. The effective...Cancer screening is a strategy focused on highrisk populations rather than universal populationwide screening, based on a comprehensive evaluation of epidemiological principles and practical feasibility. The effectiveness of screening depends on factors such as disease prevalence, as well as the sensitivity and specificity of the screening technology employed.展开更多
Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified...Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.展开更多
Objective:To describe temporal changes associated with deployment of an optical character recognition(OCR)-enabled OneIdentity(One-ID)digital platform for rural cervical cancer screening,focusing on over-screening rat...Objective:To describe temporal changes associated with deployment of an optical character recognition(OCR)-enabled OneIdentity(One-ID)digital platform for rural cervical cancer screening,focusing on over-screening rates,CIN2+detection,colposcopy follow-up,and CIN2+management.Methods:A multi-county pre-post observational study was conducted in six rural counties in Shanxi,Yunnan,and Sichuan Provinces(2021±2024),encompassing 153,978 encounters.The digital platform integrates OCR identity capture,deterministic One-ID linkage,and real-time duplicate alerts.Over-screening proportions before and after digital deployment were compared,changes in CIN2+detection rate were evaluated,and colposcopy follow-up and CIN2+management were assessed.Differences were tested withχ2 or Fisher's exact tests.Results:Among 153,978 encounters,the proportion of over-screening decreased from 12.64%in 2023 to 0.17%in 2024 with an absolute reduction of 12.17%(95%CI:11.94±12.40;P<0.001).The share of women receiving a first screening within the preceding 3 y increased from 78.3%to 88.2%(P<0.001).Colposcopy completion improved from 64.1%to 84.9%.The CIN2+detection rate rose from 0.35%(2021±2023 pooled)to 0.67%in 2024(P<0.001)and CIN2+management completion increased from 56.0%to 76.2%(95%CI:13.3±27.2;P<0.001).These improvements were consistent across age groups,counties,and screening strategies.Conclusions:The OCR-enabled One-ID platform substantially reduced over-screening,increased CIN2+detection rate,and strengthened case follow-up/management,particularly where baseline tracking was weak,supporting scalable digital reinforcement of rural screening programmes.展开更多
BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated wit...BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.展开更多
Colorectal cancer is a major cause of cancer-related mortality worldwide,under-scoring the importance of early and effective colorectal cancer screening to im-prove survival rates.Traditional colorectal cancer screeni...Colorectal cancer is a major cause of cancer-related mortality worldwide,under-scoring the importance of early and effective colorectal cancer screening to im-prove survival rates.Traditional colorectal cancer screening methods include non-invasive tests,such as the fecal immunochemical test(FIT),as well as diagnostic procedures like colonoscopy.Colonoscopy remains the gold standard for detec-ting and treating precancerous polyps and early-stage cancer,regardless of whe-ther it is used as the first screening test or the second test following a positive FIT.However,its effectiveness can be affected by factors such as operator skill,patient variability,and limited lesion visibility,resulting in a significant rate of missed lesion rates and highlighting the need for more efficient and accurate screening techniques.This review is aimed to assess the current challenges of traditional screening methods with the impact of artificial intelligence(AI)in the diagnostic flow.The literature on AI-powered tools for colorectal cancer screening,including novel applications,emerging programs,and recent guidelines,has been reviewed to highlight both the advantages and limitations of implementing this technology in healthcare.Recent advances in AI have introduced soft AI colonoscopy,with the purpose of improving lesion recognition(computer-aided detection)and/or improving optical diagnosis(computer-aided diagnosis).AI-powered colono-scopy systems employ deep learning algorithms to analyze real-time endoscopic images,enhancing detection rates for adenomas,serrated lesions and cancer by reducing human error.AI-assisted colonoscopy enhances adenoma detection,enabling earlier intervention and improved patient outcomes.The benefits are particularly pronounced for less-experienced practitioners,as the detection rates for AI-assisted colonoscopy are similar to experts.AI integration also helps in the teaching process,in developing standardized procedures,and improving screening procedure accuracy and efficiency across different healthcare providers.However,there are challenges and limitations,such as the cost of AI implementation,data privacy concerns,and the need for extensive clinical validation.As AI technology continues to evolve,its transformation of the colorectal cancer screening system could revolutionize the field,making early detection more accessible and reducing mortality,on the condition that the above issues are addressed before widespread use.展开更多
Objective:National Health Commission of the People's Republic of China collaborated with many ministries and commissions government and initiated a population-based cancer screening program in high-risk area of ru...Objective:National Health Commission of the People's Republic of China collaborated with many ministries and commissions government and initiated a population-based cancer screening program in high-risk area of rural China,targeting three types of cancer that are most prevalent in these areas,including esophageal,stomach and liver cancer.This study protocol was reported to show the design and evaluate the effectiveness of cancer screening and appropriate screening strategies of three cancers in rural China.Methods and analysis:A two-step design with cancer risk assessment based on questionnaire interview,Hepatitis B surface antigen(HBsAg)test strip and subsequent clinical intervention for high-risk populations was adopted&ee of charge at the local hospitals designated in the program.Ethic and dissemination:This study was approved by the Institutional Review Board of Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College.The results will evaluate the effectiveness of cancer screening and appropriate screening strategies in rural China.展开更多
AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in China.METHODS:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) an...AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in China.METHODS:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) and other high risk factors questionnaire in a population sample of 13 214 community residents who completed both the iFOBT and questionnaire investigation.Patients with either a positive iFOBT and/or questionnaire were regarded as a high risk population and those eligible were asked to undergo colonoscopy.RESULTS:The iFOBT had the highest positive predictive value and negative predictive value in screening for advanced neoplasia.The iFOBT had the highest sensitivity,lowest number of extra false positive results associated with the detection of one extra abnormality for screening advanced neoplasias and adenomas.A history of chronic cholecystitis or cholecystectomy,chronic appendicitis or appendectomy,and chronic diarrhea also had a higher sensitivity than a history of adenomatous polyps in screening for advanced neoplasias and adenomas.The sensitivity of a history of chronic cholecystitis or cholecystectomy was highest among the 10 high risk factors in screening for nonadenomatous polyps.A history of chronic appendicitis or appendectomy,chronic constipation,chronic diarrhea,mucous and bloody stool,CRC in first degree relatives,malignant tumor and a positive iFOBT also had higher sensitivities than a history of adenomas polyps in screening for non-adenomatous polyps.Except for a history of malignant tumor in screening for non-adenomatous polyps,the gain in sensitivity was associated with an increase in extra false positive results associated with the detection of one extra abnormality.CONCLUSION:The iFOBT may be the best marker for screening for advanced neoplasias and adenomas.Some unique high risk factors may play an important role in CRC screening in China.展开更多
Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The eff...Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and “screen and treat” method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening.展开更多
AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： St...AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： Stool DNA was isolated from 45 subjects including 25 CRC patients and 20 healthy individuals using a new, fast and easy extraction method. Long DNA associated with tumor was detected using polymerase chain reaction method. Microsatellite studies were performed utilizing denaturating polyacrylamide gel to determine the instability of BAT-26. Methylation status of p16 promoter was analyzed using methylation-specific PCR （MSP）. RESULTS： The results showed a significant difference in existence of long DNA （16 in patients vs 1 in controls, P 〈 0.001） and p16 （5 in patients vs none in controls, P = 0.043） in the stool samples of two groups. Long DNA was detected in 64% of CRC patients; whereas just one of the healthy individuals was positive for Long DNA. p16 methylation was found in 20% of patients and in none of healthy individuals. Instability of BATo26 was not detected in any of stool samples. CONCLUSION： We could detect colorectal cancer related genetic alterations by analyzing stool DNA with a sensitivity of 64% and 20% and a specificity of 95% and 100% for Long DNA and p16 respectively. A non- invasive molecular stool-based DNA testing can provide a screening strategy in high-risk individuals. However, additional testing on more samples is necessary from Iranian subjects to determine the exact specificity and sensitivity of these markers.展开更多
AIM: To evaluate the utility of the innovative fecal tumor M2-Pyruvate kinase (M2-PK) test in our daily clinical routine, as a marker for the pre-selection of patients who should subsequently undergo colonoscopy for t...AIM: To evaluate the utility of the innovative fecal tumor M2-Pyruvate kinase (M2-PK) test in our daily clinical routine, as a marker for the pre-selection of patients who should subsequently undergo colonoscopy for the diagnosis or exclusion of colorectal cancer. METHODS: Fecal tumor M2-PK was measured in stool samples of 96 study participants (33 patients with colorectal cancer, 21 patients with rectal carcinoma and 42 controls) who all underwent total colonoscopy. RESULTS: In 39 of 42 individuals in the control group, fecal tumor M2-PK was below 4.0 kU/L (93% specificity). Colorectal tumors were accompanied by a highly significant increase (P < 0.001) in fecal tumor M2- PK levels (median: colon carcinoma, 23.1 kU/L; rectal carcinoma, 6.9 kU/L; colorectal carcinoma, 14.7 kU/L), which correlated with Duke’s staging and T-classification. The overall sensitivity was 78% for colorectal cancer, increasing from 60% for stage T1 to 100% for stage T4 and from 60% for Duke’s A to 90% for Duke’s D tumors. CONCLUSION: Fecal tumor M2-PK is an appropriately sensitive tool to pre-select those patients requiring colonoscopy for the further diagnostic confirmation or exclusion of colorectal cancer.展开更多
AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected f...AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.展开更多
Objective:We aimed to evaluate the effectiveness of different triage strategies for high-risk human papillomavirus(hrHPV)-positive women in primary healthcare settings in China.Methods:This study was undertaken in 11 ...Objective:We aimed to evaluate the effectiveness of different triage strategies for high-risk human papillomavirus(hrHPV)-positive women in primary healthcare settings in China.Methods:This study was undertaken in 11 rural and 9 urban sites.Women aged 35-64 years old were enrolled.HrHPV-positive women were randomly allocated to liquid-based cytology(LBC),visual inspection with acetic acid and Lugol’s iodine(VIA/VILI)(rural only)triage,or directly referred to colposcopy(direct COLP).At 24 months,hrHPV testing,LBC and VIA/VILI were conducted for combined screening.Results:In rural sites,1,949 hrHPV-positive women were analyzed.A total of 852,218 and 480 women were randomly assigned to direct COLP,LBC and VIA/VILI.At baseline,colposcopy referral rates of LBC or VIA/VILI triage could be reduced by 70%-80%.LBC(n=3 and n=7)or VIA/VILI(n=8 and n=26)could significantly decrease the number of colposcopies needed to detect one cervical intraepithelial neoplasia(CIN)2 or worse and CIN3+compared with direct COLP(n=14 and n=23).For the 24-month cumulative detection rate of CIN2+,VIA/VILI triage was 0.50-fold compared with LBC triage and 0.46-fold with the direct COLP.When stratified by age,baseline LBC triage+performed best(P<0.001),peaking among women aged 35-44 years(Ptrend=0.002).In urban sites,1,728 women were hrHPV genotyping test positive.A total of 408,571 and 568women were randomly assigned to direct COLP for HPV16/18+,direct COLP for other hrHPV subtypes+,and LBC triage for other hrHPV subtypes+.LBC(n=12 and n=31)significantly decreased the number of colposcopies needed to detect one CIN2+and CIN3+compared with direct COLP(n=14 and n=44).HPV16/18+increased the 24-month cumulative detection rate of CIN2+(17.89%,P<0.001).Conclusions:LBC triage for hrHPV-positive women in rural settings and direct COLP for HPV16/18+women and LBC triage for other hrHPV subtype+women in urban settings might be feasible strategies.展开更多
Cancer stands as a prominent public health concern in China, with elusive intervention targets due to unidentified high-risk causal factors for most cancers. Consequently, emphasis has shifted towards screening, diagn...Cancer stands as a prominent public health concern in China, with elusive intervention targets due to unidentified high-risk causal factors for most cancers. Consequently, emphasis has shifted towards screening, diagnosing, and treating early cancer cases within the general population. However, China faces considerable obstacles in its cancer prevention and control efforts, attributing to the complexity and heterogeneity of the occurrence, progression, and prognosis of malignant tumors across populations, time, and regions. Taking esophageal cancer screening practices as an example, this review outlines the importance and assessment of cancer screening, delineating major challenges in China's cancer prevention and control: 1) limited comprehension of cancer's natural history;2) lack of “China Evidence” supporting screening effectiveness and value;3) compromised efficiency and accuracy in current screening modality;and 4) insufficient sustainability of the current screening practices and translation of relevant scientific research achievements. To address these challenges, we propose potential coping strategies: 1)establishing tailored technologies and pathways for cancer prevention and control based on population-based and clinical epidemiological studies using high-quality designs;2) breaking conventional constraints to establish a novel cancer screening strategy aligned with real-world needs;and 3) establishing enhanced communication platforms among scientific research teams, policymakers, and industrial institutions to foster collaboration and innovation.展开更多
This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Sample...This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.展开更多
Computed tomography colonography(CTC) in colorectal cancer(CRC) screening has two roles:one present and the other potential.The present role is,without any further discussion,the integration into established screening...Computed tomography colonography(CTC) in colorectal cancer(CRC) screening has two roles:one present and the other potential.The present role is,without any further discussion,the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy.The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test,sigmoidoscopy and colonoscopy.However,despite the fact that CTC has been officially endorsed for CRC screening of average-risk individuals by different scientif ic societies including the American Cancer Society,the American College of Radiology,and the US Multisociety Task Force on Colorectal Cancer,other entities,such as the US Preventive Services Task Force,have considered the evidence insuff icient to justify its use as a mass screening method.Medicare has also recently denied reimbursement for CTC as a screening test.Nevertheless,multiple advantages exist for using CTC as a CRC screening test:high accuracy,full evaluation of the colon in virtually all patients,non-invasiveness,safety,patient comfort,detection of extracolonic findings and cost-effectiveness.The main potential drawback of a CTC screening is the exposure to ionizing radiation.However,this is not a major issue,since low-dose protocols are now routinely implemented,delivering a dose comparable or slightly superior to the annual radiation exposure of any individual.Indirect evidence exists that such a radiation exposure does not induce additional cancers.展开更多
Cervical cancer is a severe threat to women’s health.The majority of cervical cancer cases occur in developing countries.The WHO has proposed screening 70%of women with high-performance tests between 35 and 45 years ...Cervical cancer is a severe threat to women’s health.The majority of cervical cancer cases occur in developing countries.The WHO has proposed screening 70%of women with high-performance tests between 35 and 45 years of age by 2030 to accelerate the elimination of cervical cancer.Due to an inadequate health infrastructure and organized screening strategy,most low-and middle-income countries are still far from achieving this goal.As part of the efforts to increase performance of cervical cancer screening,it is necessary to investigate the most accurate,efficient,and effective methods and strategies.Artificial intelligence(AI)is rapidly expanding its application in cancer screening and diagnosis and deep learning algorithms have offered human-like interpretation capabilities on various medical images.AI will soon have a more significant role in improving the implementation of cervical cancer screening,management,and follow-up.This review aims to report the state of AI with respect to cervical cancer screening.We discuss the primary AI applications and development of AI technology for image recognition applied to detection of abnormal cytology and cervical neoplastic diseases,as well as the challenges that we anticipate in the future.展开更多
AIM:To investigate gastric cancer screening and preventive behaviors among the relatives of patients with gastric cancer[i.e.,gastric cancer relatives(GCRs)].METHODS:We examined the Korean National Health and Nutritio...AIM:To investigate gastric cancer screening and preventive behaviors among the relatives of patients with gastric cancer[i.e.,gastric cancer relatives(GCRs)].METHODS:We examined the Korean National Health and Nutrition Examination Survey 2005(KNHANESⅢ) database and compared the gastric cancer screening and preventive behaviors of GCRs(n=261)with those of non-GCRs(n=454)and controls without a family history of cancer(n=2842).RESULTS:The GCRs were more likely to undergo gastric cancer screening compared with the control group(39.2%vs 32.3%,adjusted odds ratio:1.43,CI:1.05-1.95),although the absolute screening rate was low.Dietary patterns and smoking rates did not differ significantly between the groups,and a high proportion of GCRs reported inappropriate dietary habits(i.e.,approximately 95%consumed excessive sodium,30% were deficient in vitamin C,and 85%were deficient in dietary fiber).CONCLUSION:The gastric cancer screening and preventive behaviors of GCRs have yet to be improved.To increase awareness among GCRs,systematic family education programs should be implemented.展开更多
AIM To evaluate the performance of 18-fluoro-2-deoxyglucose positron emission tomography(FDG-PET) for esophageal cancer(EC) screening.METHODS We retrospectively analyzed the data of consecutive asymptomatic individual...AIM To evaluate the performance of 18-fluoro-2-deoxyglucose positron emission tomography(FDG-PET) for esophageal cancer(EC) screening.METHODS We retrospectively analyzed the data of consecutive asymptomatic individuals who underwent FDG-PET and esophagogastroduodenoscopy(EGD) simultaneously for cancer screening at our institution from February 2004 to March 2013. In total, 14790 FDG-PET and EGD procedures performed for 8468 individuals were included in this study, and the performance of FDGPET for EC screening was assessed by comparing the results of FDG-PET and EGD, considering the latter as the reference.RESULTS Thirty-two EC lesions were detected in 28 individuals(31 squamous cell carcinomas and 1 adenocarcinoma). The median tumor size was 12.5 mm, and the depths of the lesions were as follows: Tis(n = 12), T1a(n = 15), and T1b(n = 5). Among the 14790 FDG-PET procedures, 51 examinations(0.3%) showed positive findings in the esophagus; only 1 was a true-positive finding. The screen sensitivity, specificity, positive predictive value, and negative predictive value of FDGPET for ECs were 3.6%(95%CI: 0.1-18.3), 99.7%(95%CI: 99.6-99.7), 2.0%(95%CI: 0.0-10.4), and 99.8%(95%CI: 99.7-99.9), respectively. Of the 50 FDG-PET false-positive cases, 31 were observed in the lower esophagus, and gastroesophageal reflux disease was observed in 17 of these 31 cases.CONCLUSION This study is the first to clarify the FDG-PET performance for EC screening. Based on the low screen sensitivity, FDG-PET is considered to be difficult to use as a screening modality for ECs.展开更多
文摘Helicobacter pylori(H.pylori)infection induces pathological changes via chronic inflammation and virulence factors,thereby increasing the risk of gastric cancer development.Compared with invasive examination methods,H.pylori-related serum indicators are cost-effective and valuable for the early detection of gastric cancer(GC);however,large-scale clinical validation and sufficient understanding of the specific molecular mechanisms involved are lacking.Therefore,a comprehensive review and analysis of recent advances in this field is necessary.In this review,we systematically analyze the relationship between H.pylori and GC and discuss the application of new molecular biomarkers in GC screening.We also summarize the screening potential and application of anti-H.pylori immunoglobulin G and virulence factor-related serum antibodies for identifying GC risk.These indicators provide early warning of infection and enhance screening accuracy.Additionally,we discuss the potential combination of multiple screening indicators for the comprehensive analysis and development of emerging testing methods to improve the accuracy and efficiency of GC screening.Although this review may lack sufficient evidence due to limitations in existing studies,including small sample sizes,regional variations,and inconsistent testing methods,it contributes to advancing personalized precision medicine in high-risk populations and developing GC screening strategies.
文摘Cancer screening is a strategy focused on highrisk populations rather than universal populationwide screening, based on a comprehensive evaluation of epidemiological principles and practical feasibility. The effectiveness of screening depends on factors such as disease prevalence, as well as the sensitivity and specificity of the screening technology employed.
基金supported by the National R&D Program for Cancer Control through the National Cancer Center funded by the Ministry of Health & Welfare, Republic of Korea (No. HA21C0225)。
文摘Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.
基金supported by the Chongqing Tencent Sustainable Development Foundation through the project"Comprehensive Prevention and Control Demonstration Project for Eliminating Cervical Cancer and Breast Cancer in Low Health Resource Areas of China"(Project No.SD20240904145730)by the Tencent Sustainable Social Value(SSV)Inclusive Health Lab(Project No.SSVPJ202307060001)。
文摘Objective:To describe temporal changes associated with deployment of an optical character recognition(OCR)-enabled OneIdentity(One-ID)digital platform for rural cervical cancer screening,focusing on over-screening rates,CIN2+detection,colposcopy follow-up,and CIN2+management.Methods:A multi-county pre-post observational study was conducted in six rural counties in Shanxi,Yunnan,and Sichuan Provinces(2021±2024),encompassing 153,978 encounters.The digital platform integrates OCR identity capture,deterministic One-ID linkage,and real-time duplicate alerts.Over-screening proportions before and after digital deployment were compared,changes in CIN2+detection rate were evaluated,and colposcopy follow-up and CIN2+management were assessed.Differences were tested withχ2 or Fisher's exact tests.Results:Among 153,978 encounters,the proportion of over-screening decreased from 12.64%in 2023 to 0.17%in 2024 with an absolute reduction of 12.17%(95%CI:11.94±12.40;P<0.001).The share of women receiving a first screening within the preceding 3 y increased from 78.3%to 88.2%(P<0.001).Colposcopy completion improved from 64.1%to 84.9%.The CIN2+detection rate rose from 0.35%(2021±2023 pooled)to 0.67%in 2024(P<0.001)and CIN2+management completion increased from 56.0%to 76.2%(95%CI:13.3±27.2;P<0.001).These improvements were consistent across age groups,counties,and screening strategies.Conclusions:The OCR-enabled One-ID platform substantially reduced over-screening,increased CIN2+detection rate,and strengthened case follow-up/management,particularly where baseline tracking was weak,supporting scalable digital reinforcement of rural screening programmes.
基金Supported by Natural Science Foundation of Tianjin,No.21JCZDJC00060 and No.21JCYBJC00180Tianjin Health and Medical Science and Technology Project,No.TJWJ2023QN040National Key Research and Development Program,No.2017YFC1700606 and No.2017YFC1700604.
文摘BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.
文摘Colorectal cancer is a major cause of cancer-related mortality worldwide,under-scoring the importance of early and effective colorectal cancer screening to im-prove survival rates.Traditional colorectal cancer screening methods include non-invasive tests,such as the fecal immunochemical test(FIT),as well as diagnostic procedures like colonoscopy.Colonoscopy remains the gold standard for detec-ting and treating precancerous polyps and early-stage cancer,regardless of whe-ther it is used as the first screening test or the second test following a positive FIT.However,its effectiveness can be affected by factors such as operator skill,patient variability,and limited lesion visibility,resulting in a significant rate of missed lesion rates and highlighting the need for more efficient and accurate screening techniques.This review is aimed to assess the current challenges of traditional screening methods with the impact of artificial intelligence(AI)in the diagnostic flow.The literature on AI-powered tools for colorectal cancer screening,including novel applications,emerging programs,and recent guidelines,has been reviewed to highlight both the advantages and limitations of implementing this technology in healthcare.Recent advances in AI have introduced soft AI colonoscopy,with the purpose of improving lesion recognition(computer-aided detection)and/or improving optical diagnosis(computer-aided diagnosis).AI-powered colono-scopy systems employ deep learning algorithms to analyze real-time endoscopic images,enhancing detection rates for adenomas,serrated lesions and cancer by reducing human error.AI-assisted colonoscopy enhances adenoma detection,enabling earlier intervention and improved patient outcomes.The benefits are particularly pronounced for less-experienced practitioners,as the detection rates for AI-assisted colonoscopy are similar to experts.AI integration also helps in the teaching process,in developing standardized procedures,and improving screening procedure accuracy and efficiency across different healthcare providers.However,there are challenges and limitations,such as the cost of AI implementation,data privacy concerns,and the need for extensive clinical validation.As AI technology continues to evolve,its transformation of the colorectal cancer screening system could revolutionize the field,making early detection more accessible and reducing mortality,on the condition that the above issues are addressed before widespread use.
基金This study was sponsored by National Key R&D Program of China(No.2O18YFC13131OO)Sanming Project of Medicine in Shenzhen(No.SZSM201911015)CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2019-I2M-2-004).
文摘Objective:National Health Commission of the People's Republic of China collaborated with many ministries and commissions government and initiated a population-based cancer screening program in high-risk area of rural China,targeting three types of cancer that are most prevalent in these areas,including esophageal,stomach and liver cancer.This study protocol was reported to show the design and evaluate the effectiveness of cancer screening and appropriate screening strategies of three cancers in rural China.Methods and analysis:A two-step design with cancer risk assessment based on questionnaire interview,Hepatitis B surface antigen(HBsAg)test strip and subsequent clinical intervention for high-risk populations was adopted&ee of charge at the local hospitals designated in the program.Ethic and dissemination:This study was approved by the Institutional Review Board of Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College.The results will evaluate the effectiveness of cancer screening and appropriate screening strategies in rural China.
基金Supported by 11th 5-Year Key Programs for Science and Technology Development of China,No.2006BAI02A08
文摘AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in China.METHODS:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) and other high risk factors questionnaire in a population sample of 13 214 community residents who completed both the iFOBT and questionnaire investigation.Patients with either a positive iFOBT and/or questionnaire were regarded as a high risk population and those eligible were asked to undergo colonoscopy.RESULTS:The iFOBT had the highest positive predictive value and negative predictive value in screening for advanced neoplasia.The iFOBT had the highest sensitivity,lowest number of extra false positive results associated with the detection of one extra abnormality for screening advanced neoplasias and adenomas.A history of chronic cholecystitis or cholecystectomy,chronic appendicitis or appendectomy,and chronic diarrhea also had a higher sensitivity than a history of adenomatous polyps in screening for advanced neoplasias and adenomas.The sensitivity of a history of chronic cholecystitis or cholecystectomy was highest among the 10 high risk factors in screening for nonadenomatous polyps.A history of chronic appendicitis or appendectomy,chronic constipation,chronic diarrhea,mucous and bloody stool,CRC in first degree relatives,malignant tumor and a positive iFOBT also had higher sensitivities than a history of adenomas polyps in screening for non-adenomatous polyps.Except for a history of malignant tumor in screening for non-adenomatous polyps,the gain in sensitivity was associated with an increase in extra false positive results associated with the detection of one extra abnormality.CONCLUSION:The iFOBT may be the best marker for screening for advanced neoplasias and adenomas.Some unique high risk factors may play an important role in CRC screening in China.
基金Supported by Grant-in-Aid for H22-Third Term Comprehensive Control Research for Cancer 022 from the Japanese Ministry of Health,Labour and Welfare
文摘Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and “screen and treat” method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening.
基金Supported by a grant from the vice chancellor for research at Mashhad University of Medical Sciences,NO. 84082
文摘AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： Stool DNA was isolated from 45 subjects including 25 CRC patients and 20 healthy individuals using a new, fast and easy extraction method. Long DNA associated with tumor was detected using polymerase chain reaction method. Microsatellite studies were performed utilizing denaturating polyacrylamide gel to determine the instability of BAT-26. Methylation status of p16 promoter was analyzed using methylation-specific PCR （MSP）. RESULTS： The results showed a significant difference in existence of long DNA （16 in patients vs 1 in controls, P 〈 0.001） and p16 （5 in patients vs none in controls, P = 0.043） in the stool samples of two groups. Long DNA was detected in 64% of CRC patients; whereas just one of the healthy individuals was positive for Long DNA. p16 methylation was found in 20% of patients and in none of healthy individuals. Instability of BATo26 was not detected in any of stool samples. CONCLUSION： We could detect colorectal cancer related genetic alterations by analyzing stool DNA with a sensitivity of 64% and 20% and a specificity of 95% and 100% for Long DNA and p16 respectively. A non- invasive molecular stool-based DNA testing can provide a screening strategy in high-risk individuals. However, additional testing on more samples is necessary from Iranian subjects to determine the exact specificity and sensitivity of these markers.
文摘AIM: To evaluate the utility of the innovative fecal tumor M2-Pyruvate kinase (M2-PK) test in our daily clinical routine, as a marker for the pre-selection of patients who should subsequently undergo colonoscopy for the diagnosis or exclusion of colorectal cancer. METHODS: Fecal tumor M2-PK was measured in stool samples of 96 study participants (33 patients with colorectal cancer, 21 patients with rectal carcinoma and 42 controls) who all underwent total colonoscopy. RESULTS: In 39 of 42 individuals in the control group, fecal tumor M2-PK was below 4.0 kU/L (93% specificity). Colorectal tumors were accompanied by a highly significant increase (P < 0.001) in fecal tumor M2- PK levels (median: colon carcinoma, 23.1 kU/L; rectal carcinoma, 6.9 kU/L; colorectal carcinoma, 14.7 kU/L), which correlated with Duke’s staging and T-classification. The overall sensitivity was 78% for colorectal cancer, increasing from 60% for stage T1 to 100% for stage T4 and from 60% for Duke’s A to 90% for Duke’s D tumors. CONCLUSION: Fecal tumor M2-PK is an appropriately sensitive tool to pre-select those patients requiring colonoscopy for the further diagnostic confirmation or exclusion of colorectal cancer.
基金Supported by The National Scientific and Technological Program in the 11th "Five-Year Plan", the Grant number is 2006BAI02A08
文摘AIM:To investigate barriers to colorectal cancer(CRC) screening in a community population.METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire.Cases were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in 2004.Control groups were matched by gender, age group and community.Control 1 included those having a positive FOBT but refusing a colonoscopy.Control 2 included those who refused both an FOBT and colonoscopy.RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2.Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate.Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test.Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid.Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy.CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.
基金National Health Commission(formerly Health and Family Planning Commission)of China(No.201502004)CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2021-I2M-1-004)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019PT320010 and No.2018PT32025)。
文摘Objective:We aimed to evaluate the effectiveness of different triage strategies for high-risk human papillomavirus(hrHPV)-positive women in primary healthcare settings in China.Methods:This study was undertaken in 11 rural and 9 urban sites.Women aged 35-64 years old were enrolled.HrHPV-positive women were randomly allocated to liquid-based cytology(LBC),visual inspection with acetic acid and Lugol’s iodine(VIA/VILI)(rural only)triage,or directly referred to colposcopy(direct COLP).At 24 months,hrHPV testing,LBC and VIA/VILI were conducted for combined screening.Results:In rural sites,1,949 hrHPV-positive women were analyzed.A total of 852,218 and 480 women were randomly assigned to direct COLP,LBC and VIA/VILI.At baseline,colposcopy referral rates of LBC or VIA/VILI triage could be reduced by 70%-80%.LBC(n=3 and n=7)or VIA/VILI(n=8 and n=26)could significantly decrease the number of colposcopies needed to detect one cervical intraepithelial neoplasia(CIN)2 or worse and CIN3+compared with direct COLP(n=14 and n=23).For the 24-month cumulative detection rate of CIN2+,VIA/VILI triage was 0.50-fold compared with LBC triage and 0.46-fold with the direct COLP.When stratified by age,baseline LBC triage+performed best(P<0.001),peaking among women aged 35-44 years(Ptrend=0.002).In urban sites,1,728 women were hrHPV genotyping test positive.A total of 408,571 and 568women were randomly assigned to direct COLP for HPV16/18+,direct COLP for other hrHPV subtypes+,and LBC triage for other hrHPV subtypes+.LBC(n=12 and n=31)significantly decreased the number of colposcopies needed to detect one CIN2+and CIN3+compared with direct COLP(n=14 and n=44).HPV16/18+increased the 24-month cumulative detection rate of CIN2+(17.89%,P<0.001).Conclusions:LBC triage for hrHPV-positive women in rural settings and direct COLP for HPV16/18+women and LBC triage for other hrHPV subtype+women in urban settings might be feasible strategies.
基金supported by the National Key R&D Program of China (No. 2021YFC2500405)。
文摘Cancer stands as a prominent public health concern in China, with elusive intervention targets due to unidentified high-risk causal factors for most cancers. Consequently, emphasis has shifted towards screening, diagnosing, and treating early cancer cases within the general population. However, China faces considerable obstacles in its cancer prevention and control efforts, attributing to the complexity and heterogeneity of the occurrence, progression, and prognosis of malignant tumors across populations, time, and regions. Taking esophageal cancer screening practices as an example, this review outlines the importance and assessment of cancer screening, delineating major challenges in China's cancer prevention and control: 1) limited comprehension of cancer's natural history;2) lack of “China Evidence” supporting screening effectiveness and value;3) compromised efficiency and accuracy in current screening modality;and 4) insufficient sustainability of the current screening practices and translation of relevant scientific research achievements. To address these challenges, we propose potential coping strategies: 1)establishing tailored technologies and pathways for cancer prevention and control based on population-based and clinical epidemiological studies using high-quality designs;2) breaking conventional constraints to establish a novel cancer screening strategy aligned with real-world needs;and 3) establishing enhanced communication platforms among scientific research teams, policymakers, and industrial institutions to foster collaboration and innovation.
基金funded by Beijing Municipal Science & Technology Commission(No.Y0905001000091)
文摘This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.
文摘Computed tomography colonography(CTC) in colorectal cancer(CRC) screening has two roles:one present and the other potential.The present role is,without any further discussion,the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy.The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test,sigmoidoscopy and colonoscopy.However,despite the fact that CTC has been officially endorsed for CRC screening of average-risk individuals by different scientif ic societies including the American Cancer Society,the American College of Radiology,and the US Multisociety Task Force on Colorectal Cancer,other entities,such as the US Preventive Services Task Force,have considered the evidence insuff icient to justify its use as a mass screening method.Medicare has also recently denied reimbursement for CTC as a screening test.Nevertheless,multiple advantages exist for using CTC as a CRC screening test:high accuracy,full evaluation of the colon in virtually all patients,non-invasiveness,safety,patient comfort,detection of extracolonic findings and cost-effectiveness.The main potential drawback of a CTC screening is the exposure to ionizing radiation.However,this is not a major issue,since low-dose protocols are now routinely implemented,delivering a dose comparable or slightly superior to the annual radiation exposure of any individual.Indirect evidence exists that such a radiation exposure does not induce additional cancers.
基金supported by grants from CAMS Innovation Fund for Medical Sciences(Grant No.CAMS 2021-I2M-1-004)from the Bill&Melinda Gates Foundation(Grant No.INV-031449).
文摘Cervical cancer is a severe threat to women’s health.The majority of cervical cancer cases occur in developing countries.The WHO has proposed screening 70%of women with high-performance tests between 35 and 45 years of age by 2030 to accelerate the elimination of cervical cancer.Due to an inadequate health infrastructure and organized screening strategy,most low-and middle-income countries are still far from achieving this goal.As part of the efforts to increase performance of cervical cancer screening,it is necessary to investigate the most accurate,efficient,and effective methods and strategies.Artificial intelligence(AI)is rapidly expanding its application in cancer screening and diagnosis and deep learning algorithms have offered human-like interpretation capabilities on various medical images.AI will soon have a more significant role in improving the implementation of cervical cancer screening,management,and follow-up.This review aims to report the state of AI with respect to cervical cancer screening.We discuss the primary AI applications and development of AI technology for image recognition applied to detection of abnormal cytology and cervical neoplastic diseases,as well as the challenges that we anticipate in the future.
文摘AIM:To investigate gastric cancer screening and preventive behaviors among the relatives of patients with gastric cancer[i.e.,gastric cancer relatives(GCRs)].METHODS:We examined the Korean National Health and Nutrition Examination Survey 2005(KNHANESⅢ) database and compared the gastric cancer screening and preventive behaviors of GCRs(n=261)with those of non-GCRs(n=454)and controls without a family history of cancer(n=2842).RESULTS:The GCRs were more likely to undergo gastric cancer screening compared with the control group(39.2%vs 32.3%,adjusted odds ratio:1.43,CI:1.05-1.95),although the absolute screening rate was low.Dietary patterns and smoking rates did not differ significantly between the groups,and a high proportion of GCRs reported inappropriate dietary habits(i.e.,approximately 95%consumed excessive sodium,30% were deficient in vitamin C,and 85%were deficient in dietary fiber).CONCLUSION:The gastric cancer screening and preventive behaviors of GCRs have yet to be improved.To increase awareness among GCRs,systematic family education programs should be implemented.
基金Supported by (in part) the National Cancer Center Research and Development Fund,No.27-A-5
文摘AIM To evaluate the performance of 18-fluoro-2-deoxyglucose positron emission tomography(FDG-PET) for esophageal cancer(EC) screening.METHODS We retrospectively analyzed the data of consecutive asymptomatic individuals who underwent FDG-PET and esophagogastroduodenoscopy(EGD) simultaneously for cancer screening at our institution from February 2004 to March 2013. In total, 14790 FDG-PET and EGD procedures performed for 8468 individuals were included in this study, and the performance of FDGPET for EC screening was assessed by comparing the results of FDG-PET and EGD, considering the latter as the reference.RESULTS Thirty-two EC lesions were detected in 28 individuals(31 squamous cell carcinomas and 1 adenocarcinoma). The median tumor size was 12.5 mm, and the depths of the lesions were as follows: Tis(n = 12), T1a(n = 15), and T1b(n = 5). Among the 14790 FDG-PET procedures, 51 examinations(0.3%) showed positive findings in the esophagus; only 1 was a true-positive finding. The screen sensitivity, specificity, positive predictive value, and negative predictive value of FDGPET for ECs were 3.6%(95%CI: 0.1-18.3), 99.7%(95%CI: 99.6-99.7), 2.0%(95%CI: 0.0-10.4), and 99.8%(95%CI: 99.7-99.9), respectively. Of the 50 FDG-PET false-positive cases, 31 were observed in the lower esophagus, and gastroesophageal reflux disease was observed in 17 of these 31 cases.CONCLUSION This study is the first to clarify the FDG-PET performance for EC screening. Based on the low screen sensitivity, FDG-PET is considered to be difficult to use as a screening modality for ECs.
