Ten year experience of an integrated cancer prevention center screening for multiple cancer types

Autor: Shiran Shapira, Nadir Arber, Ido Wolf, Miri Sror, Eliezer Liberman, Amira Harlap-Gat, Eyal Gur, Ravit Geva, Moran Steiner, Arye Blachar, Orit Golan, Galit Av, Maayan Jean, Lior Galazan, Hanoch Elran, Ari Leshno, Ada Kessler
Rok vydání: 2017
Předmět:
Zdroj: Journal of Clinical Oncology. 35:1549-1549
ISSN: 1527-7755
0732-183X
Popis: 1549 Background: Cancer is the leading cause of mortality worldwide. Prevention and early detection are pivotal tools for reducing cancer burden. Methods: We describe the 10 year experience (2006-2016) of an integrated cancer prevention center that provides screening for prevention and early detection of 11 most common cancer types. Healthy individuals (20-80 yr) were included. Extensive clinical and epidemiological data was obtained. DNA was extracted from all participants and genotyped for APC I1307K and E1317Q. Patients were examined by specialists in internal medicine, surgery, plastic surgery, OBGYN, urology, oncology, oral surgery, gastroenterology, and others. Women underwent vaginal US and pap smear and (40yr) mammography and US/MRI with a clinical indication. PSA and free PSA for Men ( > 40yr). LDCT for heavy smokers. Colonoscopy was recommended to all subjects ( > 40yr). Results: A total of 6258 (49%) men and 6461 (51%) women mean age 47.0±11.5 year were screened. New malignant lesions were detected in 389 (1.75%) of screeners. The most common cancers were of skin (74, 0.6%), prostate (62, 0.5%), thyroid (51, 0.4%), breast (36, 0.3%), colorectal (22, 0.2%), ovarian (19, 0.1%), uterus (14, 0.1%), testis (12, 0.09%) urinary (9, 0.07%) and lung (10, 0.08%). In 28 patients (0.22%) more than one cancer was detected. Twenty eight of the cancer patients (7.2%) died after 32.4±28.1 months at a mean age of 69.4±14.2 years. Significantly, better than the expected cancer mortality. The APC I1307K and E1317Q variants were detected in 572 (4.8%) and 182 (1.5%) subjects respectively. First degree family member with cancer (OR = 2.02), I1307K carrier ship (OR = 1.53), female gender (OR = 1.23) and advanced age (OR = 1.06) were all associated with statistically significant (P < 0.05) increased cancer risk. Advanced age and first degree family history were also associated with detection of more than one cancer types. Conclusions: One stop shop screening, in the setting of a multidisciplinary outpatient clinic, is feasible and can prevent and detect cancer at an early stage. It significantly improve morbidity and mortality. Impressively the APC I1307K carries an overall increase cancer risk.
Databáze: OpenAIRE
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