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Horakova L, Kriemler S, Študent V, Pichler Hefti J, Hillebrandt D, Jean D, Mateikaitė-Pipirienė K, Paal P, Rosier A, Andjelkovic M, Beidlemann B, Derstine M, Keyes LE. Hormonal Contraception and Menstrual Cycle Control at High Altitude: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2024. [PMID: 38607652 DOI: 10.1089/ham.2024.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Horakova, Lenka , Susi Kriemler, Vladimír Študent, Jacqueline Pichler Hefti, David Hillebrandt, Dominique Jean, Kastė Mateikaitė-Pipirienė, Peter Paal, Alison Rosier, Marija Andjelkovic, Beth Beidlemann, Mia Derstine, and Linda E. Keyes. Hormonal contraception and menstrual cycle control at high altitude: a scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 00:00-00, 2024. Background: Women who use hormonal contraception (HC) may have questions about their use during travel to high altitude. This scoping review summarizes current evidence on the efficacy and safety of HC and cycle control during high-altitude travel. Methods: We performed a scoping review for the International Climbing and Mountaineering Federation (UIAA) Medical Commission series on Women's Health in the Mountains. Pertinent literature from PubMed and Cochrane was identified by keyword search combinations (including contraception) with additional publications found by hand search. Results: We identified 17 studies from 7,165 potentially eligible articles. No articles assessed the efficacy of contraception during a short-term high-altitude sojourn. Current data show no advantage or disadvantage in HC users for acclimatization or acute mountain sickness (AMS). Use of HC during high-altitude travel is common and safe for menses suppression. A potential concern of estrogen-containing HC is the increased thrombotic risk, which theoretically could be compounded in hypobaric hypoxia. Conclusions: Evidence is limited for the interaction of HC and high altitude on performance, thrombosis, and contraceptive efficacy. HC does not affect the risk of AMS. The most efficacious and safest method at high altitude is generally the one women are most familiar with and already using.
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Affiliation(s)
- Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University Prague, Kladno, Czech Republic
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Vladimír Študent
- Department of Gynecology and Obstetrics, Prachatice Hospital, Prachatice, Czech Republic
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsorthy, United Kingdom
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pediatrics, Infectious Diseases and Altitude Medicine, Grenoble, France
| | - Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Dialysis Clinic, Elektrėnai, Lithuania
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Alison Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth Beidlemann
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
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2
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Kuo HC, Lee WY, Hsu HC, Creedy DK, Tsao Y. Effectiveness of a Digital Decision Aid for Nutrition Support in Women with Gynaecological Cancer: A Comparative Study. Nutr Cancer 2024; 76:325-334. [PMID: 38327136 DOI: 10.1080/01635581.2024.2307649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024]
Abstract
This study aimed to examine the effects of an animated Patient Decision Aid (PtDA) about dietary choices on decisional conflict and decision regret. A prospective, observational, two-group comparative effectiveness study was conducted with patients (n = 90) from a southern Taiwan oncology inpatient unit. Data included the Malnutrition Universal Screening Tool (MUST), laboratory results, 16-item Decisional Conflict Scale (sf-DCS), and 5-item Decision Regret Scale (DRSc). Data were collected at admission (T0), after the first-cycle of chemotherapy but before discharge (T1), and after the six-cycle chemotherapy protocol (T2) (around 3 months). Group A received standardized nutrition education and a printed brochure, while Group B watched a 10-minute information video during a one-on-one inpatient consultation and engaged in a values clarification exercise between T0 and T1. The percentage of women with a MUST score ≧1 in Group A sharply increased over time, but not in Group B. Decision aid usage significantly increased patients' hemoglobin and lymphocyte values over time (p < 0.05). The digital PtDA contributed to less decisional conflict and decision regret in at-risk patients and improved their nutritional well-being. Decision-aids help patients make healthcare decisions in line with their values, and are sustainable for use by busy clinicians.
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Affiliation(s)
- Hoi-Chen Kuo
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen-Ying Lee
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hui-Chun Hsu
- Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Debra K Creedy
- School of Nursing & Midwifery, Griffith University, Nathan, Australia
| | - Ying Tsao
- Department of Nursing, Tzu-Chi University, Hualien, Taiwan
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3
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Solati A, Thvimi S, Khatami SH, Shabaninejad Z, Malekzadegan Y, Alizadeh M, Mousavi P, Taheri-Anganeh M, Razmjoue D, Bahmyari S, Ghasemnejad-Berenji H, Vafadar A, Soltani Fard E, Ghasemi H, Movahedpour A. Non-coding RNAs in gynecologic cancer. Clin Chim Acta 2023; 551:117618. [PMID: 38375624 DOI: 10.1016/j.cca.2023.117618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 02/21/2024]
Abstract
The term "gynecologic cancer" pertains to neoplasms impacting the reproductive tissues and organs of women encompassing the endometrium, vagina, cervix, uterus, vulva, and ovaries. The progression of gynecologic cancer is linked to various molecular mechanisms. Historically, cancer research primarily focused on protein-coding genes. However, recent years have unveiled the involvement of non-coding RNAs (ncRNAs), including microRNAs, long non-coding RNAs (LncRNAs), and circular RNAs, in modulating cellular functions within gynecological cancer. Substantial evidence suggests that ncRNAs may wield a dual role in gynecological cancer, acting as either oncogenic or tumor-suppressive agents. Numerous clinical trials are presently investigating the roles of ncRNAs as biomarkers and therapeutic agents. These endeavors may introduce a fresh perspective on the diagnosis and treatment of gynecological cancer. In this overview, we highlight some of the ncRNAs associated with gynecological cancers.
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Affiliation(s)
- Arezoo Solati
- Department of Reproductive Biology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Thvimi
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Seyyed Hossein Khatami
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Shabaninejad
- Department of Nanobiotechnology, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Mehdi Alizadeh
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Pegah Mousavi
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mortaza Taheri-Anganeh
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Damoun Razmjoue
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran; Department of Pharmacognosy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sedigheh Bahmyari
- Department of Reproductive Biology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hojat Ghasemnejad-Berenji
- Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Asma Vafadar
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elahe Soltani Fard
- Department of Molecular Medicine, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
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4
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Moss CL, Guerrero-Urbano T, White I, Taylor B, Kristeleit R, Montes A, Fox L, Beyer K, Sztankay M, Ratti MM, Sisca ES, Derevianko A, MacLennan S, Wood N, Wintner LM, Van Hemelrijck M. Assessing the quality of patient-reported outcome measurements for gynecological cancers: a systematic review. Future Oncol 2023; 19:663-678. [PMID: 37128990 DOI: 10.2217/fon-2022-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
Purpose: To provide perspective on patient-reported outcome measurement (PROM) instruments to adopt in patients diagnosed with gynecological cancers. Methods: A systematic search was conducted to identify PROMs developed for or applied in gynecological cancer populations. PROMs identified in more than one study subsequently underwent assessment according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. Results: Overall, 55 PROMs were identified within the gynecological cancer setting, and 20 were assessed according to COSMIN guidelines. Most PROMs had limited information reported, but a best fit approach was adopted to recommend a number of instruments for use in patients with gynecological cancer. Conclusion: Further study to assess the methodological quality of each PROM utilized in gynecological cancers is warranted to endorse the recommendations of this review.
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Affiliation(s)
- Charlotte L Moss
- Translational & Oncology Research (TOUR), King's College London, Faculty of Life Sciences & Medicine, London, UK
| | - Teresa Guerrero-Urbano
- Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK
| | - Ingrid White
- Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK
| | - Benjamin Taylor
- Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK
| | - Rebecca Kristeleit
- Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK
| | - Ana Montes
- Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK
| | - Louis Fox
- Translational & Oncology Research (TOUR), King's College London, Faculty of Life Sciences & Medicine, London, UK
| | - Katharina Beyer
- Translational & Oncology Research (TOUR), King's College London, Faculty of Life Sciences & Medicine, London, UK
| | - Monika Sztankay
- Department of Psychiatry, Psychotherapy & Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Maria M Ratti
- Clinical & Health Psychology, IRCCS San Raffaele Hospital, Olgettina Street, 60 - 20132, Milan, Italy
| | - Elena S Sisca
- Clinical & Health Psychology, IRCCS San Raffaele Hospital, Olgettina Street, 60 - 20132, Milan, Italy
| | - Alexandra Derevianko
- Clinical & Health Psychology, IRCCS San Raffaele Hospital, Olgettina Street, 60 - 20132, Milan, Italy
| | - Steven MacLennan
- Academic Urology Unit, Health Services Research Unit, University of Aberdeen, AB24 3FX, Aberdeen, UK
| | - Nicholas Wood
- Department of Obstetrics & Gynaecology, Lancashire Teaching Hospitals NHS Foundation Trust, PR2 9HT, Lancashire, UK
| | - Lisa M Wintner
- Department of Psychiatry, Psychotherapy & Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - Mieke Van Hemelrijck
- Translational & Oncology Research (TOUR), King's College London, Faculty of Life Sciences & Medicine, London, UK
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Holtedahl K, Borgquist L, Donker GA, Buntinx F, Weller D, Campbell C, Månsson J, Hammersley V, Braaten T, Parajuli R. Symptoms and signs of urogenital cancer in primary care. BMC PRIMARY CARE 2023; 24:107. [PMID: 37101110 PMCID: PMC10131418 DOI: 10.1186/s12875-023-02063-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 04/14/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Urogenital cancers are common, accounting for approximately 20% of cancer incidence globally. Cancers belonging to the same organ system often present with similar symptoms, making initial management challenging. In this study, 511 cases of cancer were recorded after the date of consultation among 61,802 randomly selected patients presenting in primary care in six European countries: a subgroup analysis of urogenital cancers was carried out in order to study variation in symptom presentation. METHODS Initial data capture was by completion of standardised forms containing closed questions about symptoms recorded during the consultation. The general practitioner (GP) provided follow-up data after diagnosis, based on medical record data made after the consultation. GPs also provided free text comments about the diagnostic procedure for individual patients. RESULTS The most common symptoms were mainly associated with one or two specific types of cancer: 'Macroscopic haematuria' with bladder or renal cancer (combined sensitivity 28.3%), 'Increased urinary frequency' with bladder (sensitivity 13.3%) or prostatic (sensitivity 32.1%) cancer, or to uterine body (sensitivity 14.3%) cancer, 'Unexpected genital bleeding' with uterine cancer (cervix, sensitivity 20.0%, uterine body, sensitivity 71.4%). 'Distended abdomen, bloating' had sensitivity 62.5% (based on eight cases of ovarian cancer). In ovarian cancer, increased abdominal circumference and a palpable tumour also were important diagnostic elements. Specificity for 'Macroscopic haematuria' was 99.8% (99.7-99.8). PPV > 3% was noted for 'Macroscopic haematuria' and bladder or renal cancer combined, for bladder cancer in male patients. In males aged 55-74, PPV = 7.1% for 'Macroscopic haematuria' and bladder cancer. Abdominal pain was an infrequent symptom in urogenital cancers. CONCLUSIONS Most types of urogenital cancer present with rather specific symptoms. If the GP considers ovarian cancer, increased abdominal circumference should be actively determined. Several cases were clarified through the GP's clinical examination, or laboratory investigations.
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Affiliation(s)
- Knut Holtedahl
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Lars Borgquist
- Department of Health, Medicine and Caring Sciences, Linköping University, 58183, Linköping, Sweden
| | - Gé A Donker
- Primary Care Database, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513, The Netherlands
| | - Frank Buntinx
- Department of General Practice, KU Leuven, Oude Markt 13, 3000, Leuven, Belgium
- Maastricht University, P.O. Box 616, Maastricht, 6200, The Netherlands
| | - David Weller
- Usher Institute of Population Health Sciences and Medical Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Christine Campbell
- Usher Institute of Population Health Sciences and Medical Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Jörgen Månsson
- Department of Public Health and Community Medicine/Primary Health Care, University of Gothenburg, Box 100, 40530, Gothenburgh, Sweden
| | - Victoria Hammersley
- Usher Institute of Population Health Sciences and Medical Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Tonje Braaten
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.
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Lin W, Huang W, Mei C, Liu P, Wang H, Yuan S, Zhao X, Wang Y. Associations between the signing status of family doctor contract services and cervical cancer screening behaviors: a cross-sectional study in Shenzhen, China. BMC Public Health 2023; 23:573. [PMID: 36973711 PMCID: PMC10045612 DOI: 10.1186/s12889-023-15462-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND As a core part of the primary healthcare system, family doctor contract services (FDCS) may help healthcare providers promote cervical cancer screening to the female population. However, evidence from population-based studies remains scant. This study aimed to investigate the potential associations between the signing status of FDCS and cervical cancer screening practices in Shenzhen, China. METHODS A cross-sectional survey among female residents was conducted between July to December 2020 in Shenzhen, China. A multistage sampling method was applied to recruit women seeking health services in community health service centers. Binary logistic regression models were established to assess the associations between the signing status of FDCS and cervical cancer screening behaviors. RESULTS Overall, 4389 women were recruited (mean age: 34.28, standard deviation: 7.61). More than half (54.3%) of the participants had signed up with family doctors. Women who had signed up for FDCS performed better in HPV-related knowledge (high-level rate: 49.0% vs. 35.6%, P<0.001), past screening participation (48.4% vs. 38.8%, P<0.001), and future screening willingness (95.9% vs. 90.8%, P<0.001) than non-signing women. Signing up with family doctors was marginally associated with past screening participation (OR: 1.13, 95%CI: 0.99-1.28), which tended to be robust among women with health insurance, being older than 25 years old at sexual debut, using condom consistently during sexual intercourse, and with a low level of HPV related knowledge. Similarly, signing up with family doctors was positively associated with future screening willingness (OR: 1.68, 95%CI: 1.29-2.20), which was more pronounced among women who got married and had health insurance. CONCLUSIONS This study suggests that signing up with family doctors has positive associations with cervical cancer screening behaviors among Chinese women. Expanding public awareness of cervical cancer prevention and FDCS may be a feasible way to achieve the goal of cervical cancer screening coverage.
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Affiliation(s)
- Wei Lin
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518048, China
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Weikang Huang
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Chaofan Mei
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Peiyi Liu
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
- Research Institute of Maternity and Child Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - He Wang
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
- Research Institute of Maternity and Child Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Shixin Yuan
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
- Research Institute of Maternity and Child Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Xiaoshan Zhao
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518048, China
| | - Yueyun Wang
- Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518048, China.
- Research Team of Cervical Cancer Prevention Project in Shenzhen, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China.
- Research Institute of Maternity and Child Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China.
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7
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Georgiou D, Monje-Garcia L, Miles T, Monahan K, Ryan NAJ. A Focused Clinical Review of Lynch Syndrome. Cancer Manag Res 2023; 15:67-85. [PMID: 36699114 PMCID: PMC9868283 DOI: 10.2147/cmar.s283668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/23/2022] [Indexed: 01/19/2023] Open
Abstract
Lynch syndrome (LS) is an autosomal dominant condition that increases an individual's risk of a constellation of cancers. LS is defined when an individual has inherited pathogenic variants in the mismatch repair genes. Currently, most people with LS are undiagnosed. Early detection of LS is vital as those with LS can be enrolled in cancer reduction strategies through chemoprophylaxis, risk reducing surgery and cancer surveillance. However, these interventions are often invasive and require refinement. Furthermore, not all LS associated cancers are currently amenable to surveillance. Historically only those with a strong family history suggestive of LS were offered testing; this has proved far too restrictive. New criteria for testing have recently been introduced including the universal screening for LS in associated cancers. This has increased the number of people being diagnosed with LS but has also brought about unique challenges such as when to consent for germline testing and questions over how and who should carry out the consent. The results of germline testing for LS can be complicated and the diagnostic pathway is not always clear. Furthermore, by testing only those with cancer for LS we fail to identify these individuals before they develop potentially fatal pathology. This review will outline these challenges and explore solutions. Furthermore, we consider the potential future of LS care and the related treatments and interventions which are the current focus of research.
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Affiliation(s)
- Demetra Georgiou
- Genomics and Personalised Medicine Service, Charing Cross Hospital, London, UK
| | - Laura Monje-Garcia
- The St Mark's Centre for Familial Intestinal Cancer Polyposis, St Mark's Hospital, London, UK.,School of Public Health, Imperial College, London, UK
| | - Tracie Miles
- South West Genomics Medicine Service Alliance, Bristol, UK
| | - Kevin Monahan
- The St Mark's Centre for Familial Intestinal Cancer Polyposis, St Mark's Hospital, London, UK.,Department of Gastroenterology, Imperial College, London, UK
| | - Neil A J Ryan
- Department of Gynaecological Oncology, Royal Infirmary of Edinburgh, Edinburgh, UK.,The College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
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8
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Chen Y, Yao Q, Zeng X, Hao C, Li X, Zhang L, Zeng P. Determination of monosaccharide composition in human serum by an improved HPLC method and its application as candidate biomarkers for endometrial cancer. Front Oncol 2022; 12:1014159. [PMID: 36408150 PMCID: PMC9671074 DOI: 10.3389/fonc.2022.1014159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Altered glycan levels in serum have been associated with increased risk of cancer. In this study, we have developed and validated a HPLC-based method to analyze monosaccharide composition (D-mannose, Glucosamine, Galactosamine, Glucuronic acid, D-glucose, D-galactose, D-xylose, L-fucose) in human serum, with L-rhamnose, being used as internal standard. Monosaccharides obtained from hydrolyzed serum samples were derivatized by 1-Phenyl-3-methyl-5-pyrazolone. A ZORBAX XDB-C18 column(150×4.6mm) was used for chromatographic separation with 100 mM ammonium acetate buffer (NH4Ac-HAc, PH=5.5, solvent A), acetonitrile (ACN, solvent B) as a mobile phase. The calibration standard curves for the eight monosaccharides showed good linearity over the range of 2.5-500μg/mL with R2 > 0.995. The relative standard deviation values for intra-day and inter-day precision were ≤ 5.49%. Recovery was 69.01-108.96%. We observed that this column exhibited high specificity and selectivity to separate monosaccharides from serum. This method was then applied to quantitatively analyze the serum monosaccharide levels in 30 patients with endometrial cancer and 30 matched healthy controls. Statistical analysis indicated that the serum monosaccharide levels were significantly higher in patients compared with healthy controls (P value< 0.0001). Overall, we report here a simple, reliable, low-cost, and reproducible HPLC method for the separation and quantification monosaccharides in the human serum, which has potential value to serve as a screening marker for endometrial cancer.
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Affiliation(s)
- Yulong Chen
- Department of Gynaecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Qin Yao
- Department of Gynaecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xuan Zeng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cui Hao
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiulian Li
- School of Pharmacy, Binzhou Medical University, Yantai, China
| | - Lijuan Zhang
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- *Correspondence: Pengjiao Zeng, ; Lijuan Zhang,
| | - Pengjiao Zeng
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- *Correspondence: Pengjiao Zeng, ; Lijuan Zhang,
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9
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Petrova D, Špacírová Z, Fernández-Martínez NF, Ching-López A, Garrido D, Rodríguez-Barranco M, Pollán M, Redondo-Sánchez D, Espina C, Higueras-Callejón C, Sánchez MJ. The patient, diagnostic, and treatment intervals in adult patients with cancer from high- and lower-income countries: A systematic review and meta-analysis. PLoS Med 2022; 19:e1004110. [PMID: 36264841 PMCID: PMC9584443 DOI: 10.1371/journal.pmed.1004110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Longer time intervals to diagnosis and treatment are associated with worse survival for various types of cancer. The patient, diagnostic, and treatment intervals are considered core indicators for early diagnosis and treatment. This review estimated the median duration of these intervals for various types of cancer and compared it across high- and lower-income countries. METHODS AND FINDINGS We conducted a systematic review with meta-analysis (prospectively registered protocol CRD42020200752). Three databases (MEDLINE, Embase, and Web of Science) and information sources including grey literature (Google Scholar, OpenGrey, EThOS, ProQuest Dissertations & Theses) were searched. Eligible articles were published during 2009 to 2022 and reported the duration of the following intervals in adult patients diagnosed with primary symptomatic cancer: patient interval (from the onset of symptoms to first presentation to a healthcare professional), diagnostic interval (from first presentation to diagnosis), and treatment interval (from diagnosis to treatment start). Interval duration was recorded in days and study medians were combined in a pooled estimate with 95% confidence intervals (CIs). The methodological quality of studies was assessed using the Aarhus checklist. A total of 410 articles representing 68 countries and reporting on 5,537,594 patients were included. The majority of articles reported data from high-income countries (n = 294, 72%), with 116 (28%) reporting data from lower-income countries. Pooled meta-analytic estimates were possible for 38 types of cancer. The majority of studies were conducted on patients with breast, lung, colorectal, and head and neck cancer. In studies from high-income countries, pooled median patient intervals generally did not exceed a month for most cancers. However, in studies from lower-income countries, patient intervals were consistently 1.5 to 4 times longer for almost all cancer sites. The majority of data on the diagnostic and treatment intervals came from high-income countries. Across both high- and lower-income countries, the longest diagnostic intervals were observed for hematological (71 days [95% CI 52 to 85], e.g., myelomas (83 days [47 to 145])), genitourinary (58 days [50 to 77], e.g., prostate (85 days [57 to 112])), and digestive/gastrointestinal (57 days [45 to 67], e.g., colorectal (63 days [48 to 78])) cancers. Similarly, the longest treatment intervals were observed for genitourinary (57 days [45 to 66], e.g., prostate (75 days [61 to 87])) and gynecological (46 days [38 to 54], e.g., cervical (69 days [45 to 108]) cancers. In studies from high-income countries, the implementation of cancer-directed policies was associated with shorter patient and diagnostic intervals for several cancers. This review included a large number of studies conducted worldwide but is limited by survivor bias and the inherent complexity and many possible biases in the measurement of time points and intervals in the cancer treatment pathway. In addition, the subintervals that compose the diagnostic interval (e.g., primary care interval, referral to diagnosis interval) were not considered. CONCLUSIONS These results identify the cancers where diagnosis and treatment initiation may take the longest and reveal the extent of global disparities in early diagnosis and treatment. Efforts should be made to reduce help-seeking times for cancer symptoms in lower-income countries. Estimates for the diagnostic and treatment intervals came mostly from high-income countries that have powerful health information systems in place to record such information.
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Affiliation(s)
- Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Zuzana Špacírová
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Nicolás Francisco Fernández-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Interlevel Clinical Management Unit for Prevention, Promotion and Health Surveillance, Reina Sofía University Hospital, Córdoba, Spain
| | - Ana Ching-López
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dunia Garrido
- Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marina Pollán
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- National Center for Epidemiology, Health Institute Carlos III, Madrid, Spain
| | - Daniel Redondo-Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | - Maria José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Cook CJ, Miller AE, Barker TH, Di Y, Fogg KC. Characterizing the extracellular matrix transcriptome of cervical, endometrial, and uterine cancers. Matrix Biol Plus 2022; 15:100117. [PMID: 35898192 PMCID: PMC9309672 DOI: 10.1016/j.mbplus.2022.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/09/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
The matrisome plays a critical role in the progression of cancer, but the matrisomes of gynecological cancers have not been well characterized. We built an in silico analysis pipeline to analyze publicly available bulk RNA-seq datasets of cervical, endometrial, and uterine cancers. Using a machine learning approach, we identified genes and gene networks that held inferential significance for cancer stage and patient survival. Cervical, endometrial, and uterine cancers are highly distinct from one another and should be analyzed separately.
Increasingly, the matrisome, a set of proteins that form the core of the extracellular matrix (ECM) or are closely associated with it, has been demonstrated to play a key role in tumor progression. However, in the context of gynecological cancers, the matrisome has not been well characterized. A holistic, yet targeted, exploration of the tumor microenvironment is critical for better understanding the progression of gynecological cancers, identifying key biomarkers for cancer progression, establishing the role of gene expression in patient survival, and for assisting in the development of new targeted therapies. In this work, we explored the matrisome gene expression profiles of cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC), uterine corpus endometrial carcinoma (UCEC), and uterine carcinosarcoma (UCS) using publicly available RNA-seq data from The Cancer Genome Atlas (TCGA) and The Genotype-Tissue Expression (GTEx) portal. We hypothesized that the matrisomal expression patterns of CESC, UCEC, and UCS would be highly distinct with respect to genes which are differentially expressed and hold inferential significance with respect to tumor progression, patient survival, or both. Through a combination of statistical and machine learning analysis techniques, we identified sets of genes and gene networks which characterized each of the gynecological cancer cohorts. Our findings demonstrate that the matrisome is critical for characterizing gynecological cancers and transcriptomic mechanisms of cancer progression and outcome. Furthermore, while the goal of pan-cancer transcriptional analyses is often to highlight the shared attributes of these cancer types, we demonstrate that they are highly distinct diseases which require separate analysis, modeling, and treatment approaches. In future studies, matrisome genes and gene ontology terms that were identified as holding inferential significance for cancer stage and patient survival can be evaluated as potential drug targets and incorporated into in vitro models of disease.
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Affiliation(s)
- Carson J Cook
- Department of Bioengineering, Oregon State University, Corvallis, OR 97331, USA
| | - Andrew E Miller
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA
| | - Thomas H Barker
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22904, USA
| | - Yanming Di
- Department of Statistics, Oregon State University, Corvallis, OR 97331, USA
| | - Kaitlin C Fogg
- Department of Bioengineering, Oregon State University, Corvallis, OR 97331, USA.,Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR 97201, USA
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11
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Dhanis J, Keidan N, Blake D, Rundle S, Strijker D, van Ham M, Pijnenborg JMA, Smits A. Prehabilitation to Improve Outcomes of Patients with Gynaecological Cancer: A New Window of Opportunity? Cancers (Basel) 2022; 14:cancers14143448. [PMID: 35884512 PMCID: PMC9351657 DOI: 10.3390/cancers14143448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Surgery is an important mainstay in the treatment of gynaecological cancers but is associated with operative complications, especially for those with poor physical and mental health. Prehabilitation is a new and upcoming strategy to optimise patients’ functional capacity, nutritional status and psychosocial wellbeing in order to reduce complications and enhance recovery. In this review, we assessed the evidence on prehabilitation programmes for patients with gynaecological cancer. The limited evidence shows that prehabilitation may reduce length of hospital stay for ovarian cancer patients, and may result in significant weight loss in patients with endometrial and cervical cancer. Comparative prospective studies are required to determine the effectiveness of prehabilitation on reducing operative complications and improving quality of life, and to further specify the content of such a programme for patients with gynaecological cancer. Abstract The literature evaluating the effect of prehabilitation programmes on postoperative outcomes and quality of life of patients with gynaecological cancer undergoing surgery was reviewed. Databases including Pubmed, Medline, EMBASE (Ovid) and PsycINFO were systematically searched to identify studies evaluating the effect of prehabilitation programmes on patients with gynaecological cancer. Both unimodal and multimodal prehabilitation programmes were included encompassing physical exercise and nutritional and psychological support. Primary outcomes were surgical complications and quality of life. Secondary outcomes were anthropometric changes and adherence to the prehabilitation programme. Seven studies fulfilled the inclusion criteria, comprising 580 patients. Included studies were nonrandomised prospective studies (n = 4), retrospective studies (n = 2) and one case report. Unimodal programmes and multimodal programmes were included. In patients with ovarian cancer, multimodal prehabilitation resulted in significantly reduced hospital stay and time to chemotherapy. In patients with endometrial and cervical cancer, prehabilitation was associated with significant weight loss, but had no significant effects on surgical complications or mortality. No adverse events of the programmes were reported. Evidence on the effect of prehabilitation for patients with gynaecological cancer is limited. Future studies are needed to determine the effects on postoperative complications and quality of life.
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Affiliation(s)
- Joëlle Dhanis
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
- Faculty of Medical Sciences, Radboud University, 6526 GA Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-644404756
| | - Nathaniel Keidan
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
| | - Dominic Blake
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
| | - Stuart Rundle
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
| | - Dieuwke Strijker
- Department of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands;
| | - Maaike van Ham
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
| | - Johanna M. A. Pijnenborg
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
| | - Anke Smits
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (M.v.H.); (J.M.A.P.); (A.S.)
- Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; (N.K.); (D.B.); (S.R.)
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12
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Urine CA125 and HE4 for the Triage of Symptomatic Women with Suspected Endometrial Cancer. Cancers (Basel) 2022; 14:cancers14143306. [PMID: 35884367 PMCID: PMC9313438 DOI: 10.3390/cancers14143306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/21/2022] [Accepted: 07/05/2022] [Indexed: 12/15/2022] Open
Abstract
A simple, noninvasive and accurate detection tool that can triage women with suspected endometrial cancer for definitive testing will transform patient care. The aim of this study was to evaluate urine CA125 and HE4 levels for the detection of endometrial cancer in symptomatic women. This was a cross-sectional diagnostic accuracy study of 153 symptomatic women who underwent urgent diagnostic investigations for suspected endometrial cancer at a large gynecological cancer center. Urine samples were collected prior to routine clinical procedures. Urine CA125 and HE4 levels were determined using automated chemiluminescent enzyme immunoassays. Univariate and multivariable receiver operating characteristic (ROC) curve analyses were performed. Urine CA125 and HE4 were discovered to be significantly elevated in women with endometrial cancer, compared to controls (p < 0.001 and p = 0.01, respectively). Urine CA125 and HE4 detected endometrial cancer with an area under the ROC curve (AUC) of 0.89 (0.81, 0.98) and 0.69 (0.55, 0.83), respectively. CA125 exhibited good discriminatory potential for Type I and early-stage tumors (AUC 0.93 and 0.90, respectively). A diagnostic model that combined urine CA125 and transvaginal ultrasound-measured endometrial thickness predicted endometrial cancer with an AUC of 0.96 (0.91, 1.00). Urine CA125 displays potential as a diagnostic tool for symptomatic women with suspected endometrial cancer. When combined with transvaginal ultrasound-measured endometrial thickness, this patient-friendly, urine-based test could help triage women for invasive diagnostics or safe reassurance, reducing costs and improving patient experience.
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13
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Crosbie EJ, Kitson SJ, McAlpine JN, Mukhopadhyay A, Powell ME, Singh N. Endometrial cancer. Lancet 2022; 399:1412-1428. [PMID: 35397864 DOI: 10.1016/s0140-6736(22)00323-3] [Citation(s) in RCA: 307] [Impact Index Per Article: 153.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/26/2022] [Accepted: 02/03/2022] [Indexed: 12/21/2022]
Abstract
Endometrial cancer is the most common gynaecological cancer in high income countries and its incidence is rising globally. Although an ageing population and fewer benign hysterectomies have contributed to this trend, the growing prevalence of obesity is the major underlying cause. Obesity poses challenges for diagnosis and treatment and more research is needed to offer primary prevention to high-risk women and to optimise endometrial cancer survivorship. Early presentation with postmenopausal bleeding ensures most endometrial cancers are cured by hysterectomy but those with advanced disease have a poor prognosis. Minimally invasive surgical staging and sentinel-lymph-node biopsy provides a low morbidity alternative to historical surgical management without compromising oncological outcomes. Adjuvant radiotherapy reduces loco-regional recurrence in intermediate-risk and high-risk cases. Advances in our understanding of the molecular biology of endometrial cancer have paved the way for targeted chemotherapeutic strategies, and clinical trials will establish their benefit in adjuvant, advanced, and recurrent disease settings in the coming years.
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Affiliation(s)
- Emma J Crosbie
- Gynaecological Oncology Research Group, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK; Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
| | - Sarah J Kitson
- Gynaecological Oncology Research Group, Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
| | - Jessica N McAlpine
- Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University of British Columbia and BC Cancer, Vancouver, BC, Canada
| | - Asima Mukhopadhyay
- Kolkata Gynecological Oncology Trials and Translational Research Group, Chittaranjan National Cancer Institute, Kolkata, India; Department of Gynaecological Oncology, James Cook University Hospital, Middlesbrough, UK; Department of Gynaecological Oncology, Newcastle University, Newcastle upon Tyne, UK
| | - Melanie E Powell
- Department of Clinical Oncology, Barts and The London NHS Trust, London, UK
| | - Naveena Singh
- Department of Anatomic Pathology, Vancouver General Hospital, Vancouver, BC, Canada
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14
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Morrison J, Balega J, Buckley L, Clamp A, Crosbie E, Drew Y, Durrant L, Forrest J, Fotopoulou C, Gajjar K, Ganesan R, Gupta J, Hughes J, Miles T, Moss E, Nanthakumar M, Newton C, Ryan N, Walther A, Taylor A. British Gynaecological Cancer Society (BGCS) uterine cancer guidelines: Recommendations for practice. Eur J Obstet Gynecol Reprod Biol 2022; 270:50-89. [DOI: 10.1016/j.ejogrb.2021.11.423] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/19/2021] [Indexed: 12/24/2022]
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15
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Ryan N, Snowsill T, McKenzie E, Monahan KJ, Nebgen D. Should women with Lynch syndrome be offered gynaecological cancer surveillance? BMJ 2021; 374:n2020. [PMID: 34475027 DOI: 10.1136/bmj.n2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Naj Ryan
- The Academic Women's Health Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Obstetrics and Gynaecology, St Michael's Hospital, Bristol, UK
| | - T Snowsill
- Health Economics Group, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK
| | | | - K J Monahan
- The Lynch Syndrome and Family Cancer Clinic, St Mark's Hospital and Academic Institute, Harrow, London, UK Imperial College London, London, UK
| | - D Nebgen
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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16
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Karasiewicz M, Chawłowska E, Lipiak A, Więckowska B. A Step towards Understanding and Tackling Health Inequalities: The Use of Secondary Prevention Services and the Need for Health Promotion in a Rural Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168492. [PMID: 34444237 PMCID: PMC8394776 DOI: 10.3390/ijerph18168492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/01/2023]
Abstract
Poland has recently intensified its health promotion in an effort to extend healthy life expectancy and reduce health inequalities. Our aim was to reach a deprived rural population, increase its health literacy, and explore its use of and barriers to cancer screening and public health care. A CBPR study was conducted in one of the poorest districts in Wielkopolska region, Poland, among 122 beneficiaries of health education workshops. A self-developed questionnaire was used. The reported barriers to participation in cancer screening included: lack of time, lack of need, or feeling healthy (32.8%); long waiting times (17.2%); fear of costs (9%). Physicians seldom recommended screening to their patients. Only 7.4% of respondents had ever received dermatoscopy. Among women, 18.2% did not perform any breast exams and 25% had never had smear tests. Diagnostics was often financed out of pocket (thyroid ultrasound = 58.1%; smear test = 48.5%; breast ultrasound = 36.8%). The health system needs mentioned by participants included better access to physicians (65.6%), promotion of free screening tests (54.9%), and access to public health programmes (22.1%). There is an urgent need to translate national strategies into action. Health promotion and better access to care must become priorities in deprived areas, while primary care providers should become key figures in delivering these services.
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Affiliation(s)
- Monika Karasiewicz
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (E.C.); (A.L.)
- Correspondence:
| | - Ewelina Chawłowska
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (E.C.); (A.L.)
| | - Agnieszka Lipiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (E.C.); (A.L.)
| | - Barbara Więckowska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
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17
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Comprehensive Library Generation for Identification and Quantification of Endometrial Cancer Protein Biomarkers in Cervico-Vaginal Fluid. Cancers (Basel) 2021; 13:cancers13153804. [PMID: 34359700 PMCID: PMC8345211 DOI: 10.3390/cancers13153804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 01/08/2023] Open
Abstract
Simple Summary Endometrial cancer is the most common cancer of the female reproductive tract, and its incidence is rising. Early diagnosis has the potential to improve survival as women can receive care at the earliest possible stage when curative treatment is likely. Current tests for endometrial cancer diagnosis are sequentially invasive with low patient acceptability. A detection tool based on minimally invasive samples such as cervico-vaginal fluid would be a major advance in the field. This study focuses on the potential of detecting endometrial cancer based on the proteins and peptides expressed in cervico-vaginal fluid. Using Sequential window acquisition of all theoretical mass spectra (SWATH-MS), we present a spectral library of thousands of proteins in the cervico-vaginal fluid of women with or at risk of endometrial cancer. This important resource will enable the identification of endometrial cancer biomarkers in cervico-vaginal fluid and advances our knowledge of the role of proteomics in endometrial cancer detection. Abstract Endometrial cancer is the most common gynaecological malignancy in high-income countries and its incidence is rising. Early detection, aided by highly sensitive and specific biomarkers, has the potential to improve outcomes as treatment can be provided when it is most likely to effect a cure. Sequential window acquisition of all theoretical mass spectra (SWATH-MS), an accurate and reproducible platform for analysing biological samples, offers a technological advance for biomarker discovery due to its reproducibility, sensitivity and potential for data re-interrogation. SWATH-MS requires a spectral library in order to identify and quantify peptides from multiplexed mass spectrometry data. Here we present a bespoke spectral library of 154,206 transitions identifying 19,394 peptides and 2425 proteins in the cervico-vaginal fluid of postmenopausal women with, or at risk of, endometrial cancer. We have combined these data with a library of over 6000 proteins generated based on mass spectrometric analysis of two endometrial cancer cell lines. This unique resource enables the study of protein biomarkers for endometrial cancer detection in cervico-vaginal fluid. Data are available via ProteomeXchange with unique identifier PXD025925.
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18
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Jones ER, Carter S, O'Flynn H, Njoku K, Barr CE, Narine N, Shelton D, Rana D, Crosbie EJ. DEveloping Tests for Endometrial Cancer deTection (DETECT): protocol for a diagnostic accuracy study of urine and vaginal samples for the detection of endometrial cancer by cytology in women with postmenopausal bleeding. BMJ Open 2021; 11:e050755. [PMID: 34321307 PMCID: PMC8320249 DOI: 10.1136/bmjopen-2021-050755] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Postmenopausal bleeding (PMB), the red flag symptom for endometrial cancer, triggers urgent investigation by transvaginal ultrasound scan, hysteroscopy and/or endometrial biopsy. These investigations are costly, invasive and often painful or distressing for women. In a pilot study, we found that voided urine and non-invasive vaginal samples from women with endometrial cancer contain malignant cells that can be identified by cytology. The aim of the DEveloping Tests for Endometrial Cancer deTection (DETECT) Study is to determine the diagnostic test accuracy of urine and vaginal cytology for endometrial cancer detection in women with PMB. METHODS AND ANALYSIS This is a multicentre diagnostic accuracy study of women referred to secondary care with PMB. Eligible women will be asked to provide a self-collected voided urine sample and a vaginal sample collected with a Delphi screener before routine clinical procedures. Pairs of specialist cytologists, blinded to participant cancer status, will assess and classify samples independently, with differences settled by consensus review or involving a third cytologist. Results will be compared with clinical outcomes from standard diagnostic tests. A sample size of 2000 women will have 80% power to establish a sensitivity of vaginal samples for endometrial cancer detection by cytology of ≥85%±7%, assuming 5% endometrial cancer prevalence. The primary objective is to determine the diagnostic accuracy of urogenital samples for endometrial cancer detection by cytology. Secondary objectives include the acceptability of urine and vaginal sampling to women. ETHICS AND DISSEMINATION This study has been approved by the North West-Greater Manchester West Research Ethics Committee (16/NW/0660) and the Health Research Authority. Results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and via charity websites. TRIAL REGISTRATION NUMBER ISRCTN58863784.
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Affiliation(s)
- Eleanor R Jones
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Suzanne Carter
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - Helena O'Flynn
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - Kelechi Njoku
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | - Chloe E Barr
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Nadira Narine
- Manchester Cytology Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - David Shelton
- Manchester Cytology Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Durgesh Rana
- Manchester Cytology Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma J Crosbie
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
- Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester, UK
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Funston G, Mounce LT, Price S, Rous B, Crosbie EJ, Hamilton W, Walter FM. CA125 test result, test-to-diagnosis interval, and stage in ovarian cancer at diagnosis: a retrospective cohort study using electronic health records. Br J Gen Pract 2021; 71:e465-e472. [PMID: 33875416 PMCID: PMC8074643 DOI: 10.3399/bjgp.2020.0859] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/02/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In the UK, the cancer antigen 125 (CA125) test is recommended as a first-line investigation in women with symptoms of possible ovarian cancer. AIM To compare time between initial primary care CA125 test and diagnosis, tumour morphology, and stage in women with normal (<35 U/ml) and abnormal (≥35 U/ml) CA125 levels prior to ovarian cancer diagnosis. DESIGN AND SETTING Retrospective cohort study using English primary care and cancer registry data. METHOD Associations between CA125 test results and test-to-diagnosis interval, stage, and ovarian cancer morphology were examined. RESULTS In total, 456 women were diagnosed with ovarian cancer in the 12 months after having a CA125 test. Of these, 351 (77%) had an abnormal, and 105 (23%) had a normal, CA125 test result. The median test-to-diagnosis interval was 35 days (interquartile range [IQR] 21-53) for those with abnormal CA125 levels, and 64 days (IQR 42-127) for normal CA125 levels. Tumour morphology differed by CA125 result: indolent borderline tumours were less common in those with abnormal CA125 levels (n = 47, 13%) than those with normal CA125 levels (n = 51, 49%) (P<0.001). Staging data were available for 304 women with abnormal, and 77 with normal, CA125 levels. Of those with abnormal CA125 levels, 35% (n = 106) were diagnosed at an early stage, compared to 86% (n = 66) of women with normal levels. The odds of being diagnosed with early-stage disease were higher in women with normal as opposed to abnormal CA125 levels (odds ratio 12.2, 95% confidence interval = 5.8 to 25.1, P<0.001). CONCLUSION Despite longer intervals between testing and diagnosis, women with normal, compared with abnormal, CA125 levels more frequently had indolent tumours and were more commonly diagnosed at an early stage in the course of the disease. Although testing approaches that have greater sensitivity might expedite diagnosis for some women, it is not known if this would translate to earlier-stage diagnosis.
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Affiliation(s)
- Garth Funston
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge
| | - Luke Ta Mounce
- University of Exeter Medical School, University of Exeter, Exeter
| | - Sarah Price
- University of Exeter Medical School, University of Exeter, Exeter
| | - Brian Rous
- National Cancer Registration and Analysis Service, Public Health England, Cambridge
| | - Emma J Crosbie
- Gynaecological Oncology Research Group, University of Manchester; consultant in gynaecological oncology, Manchester University NHS Foundation Trust, Manchester
| | - Willie Hamilton
- University of Exeter Medical School, University of Exeter, Exeter
| | - Fiona M Walter
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge
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Njoku K, Barr CE, Hotchkies L, Quille N, Wan YL, Crosbie EJ. Impact of socio-economic deprivation on endometrial cancer survival in the North West of England: a prospective database analysis. BJOG 2021; 128:1215-1224. [PMID: 33289967 PMCID: PMC8248174 DOI: 10.1111/1471-0528.16618] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the impact of socio-economic deprivation on endometrial cancer survival. DESIGN Single-centre prospective database study. SETTING North West England. POPULATION Women with endometrial cancer treated between 2010 and 2015. METHODS Areal-level socio-economic status, using the English indices of multiple deprivation from residential postcodes, was analysed in relation to survival using Kaplan-Meier estimation and multivariable Cox regression. MAIN OUTCOME MEASURES Overall survival, cancer-specific survival and patterns and rates of recurrence. RESULTS A total of 539 women, with a median age of 66 years (interquartile range, IQR 56-73 years) and a body mass index (BMI) of 32 kg/m2 (IQR 26-39 kg/m2 ), were included in the analysis. Women in the most deprived social group were younger (median 64 years, IQR 55-72 years) and more obese (median 34 kg/m2 , IQR 28-42 kg/m2 ) than women in the least deprived group (median age 68 years, IQR 60-74 years; BMI 29 kg/m2 , IQR 25-36 kg/m2 ; P = 0.002 and <0.001, respectively). There were no differences in endometrial cancer type, stage or grade between social groups. There was no difference in recurrence rates, however, women in the middle and most deprived social groups were more likely to present with distant/metastatic recurrence (80.6 and 79.2%, respectively) than women in the least deprived group (43.5%, P < 0.001). Women in the middle and most deprived groups had a two-fold (adjusted hazard ratio, HR = 2.00, 95% CI 1.07-3.73, P = 0.030) and 53% (adjusted HR = 1.53, 95% CI 0.77-3.04, P = 0.221) increase in cancer-specific mortality compared with women in the least deprived group. There were no differences in overall survival. CONCLUSIONS We found that socio-economically deprived women with endometrial cancer were more likely to develop fatal recurrence. Larger studies are needed to confirm these findings and to identify modifiable contributing factors. TWEETABLE ABSTRACT Socio-economic deprivation is linked to an increased risk of death from endometrial cancer in the North West of England.
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Affiliation(s)
- K Njoku
- Division of Cancer SciencesSchool of Medical SciencesFaculty of Biology, Medicine and HealthSt Mary’s HospitalUniversity of ManchesterManchesterUK
- Division of Cancer SciencesFaculty of Biology, Medicine and HealthStoller Biomarker Discovery CentreUniversity of ManchesterManchesterUK
- Department of Obstetrics and GynaecologyManchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
| | - CE Barr
- Division of Cancer SciencesSchool of Medical SciencesFaculty of Biology, Medicine and HealthSt Mary’s HospitalUniversity of ManchesterManchesterUK
- Department of Obstetrics and GynaecologyManchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
| | - L Hotchkies
- Division of Cancer SciencesSchool of Medical SciencesFaculty of Biology, Medicine and HealthSt Mary’s HospitalUniversity of ManchesterManchesterUK
| | - N Quille
- Division of Cancer SciencesSchool of Medical SciencesFaculty of Biology, Medicine and HealthSt Mary’s HospitalUniversity of ManchesterManchesterUK
| | - YL Wan
- Division of Cancer SciencesSchool of Medical SciencesFaculty of Biology, Medicine and HealthSt Mary’s HospitalUniversity of ManchesterManchesterUK
- Department of Obstetrics and GynaecologyManchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
| | - EJ Crosbie
- Division of Cancer SciencesSchool of Medical SciencesFaculty of Biology, Medicine and HealthSt Mary’s HospitalUniversity of ManchesterManchesterUK
- Department of Obstetrics and GynaecologyManchester University NHS Foundation TrustManchester Academic Health Science CentreManchesterUK
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21
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Seppälä TT, Dominguez-Valentin M, Crosbie EJ, Engel C, Aretz S, Macrae F, Winship I, Capella G, Thomas H, Hovig E, Nielsen M, Sijmons RH, Bertario L, Bonanni B, Tibiletti MG, Cavestro GM, Mints M, Gluck N, Katz L, Heinimann K, Vaccaro CA, Green K, Lalloo F, Hill J, Schmiegel W, Vangala D, Perne C, Strauß HG, Tecklenburg J, Holinski-Feder E, Steinke-Lange V, Mecklin JP, Plazzer JP, Pineda M, Navarro M, Vida JB, Kariv R, Rosner G, Piñero TA, Pavicic W, Kalfayan P, Ten Broeke SW, Jenkins MA, Sunde L, Bernstein I, Burn J, Greenblatt M, de Vos Tot Nederveen Cappel WH, Della Valle A, Lopez-Koestner F, Alvarez K, Büttner R, Görgens H, Morak M, Holzapfel S, Hüneburg R, von Knebel Doeberitz M, Loeffler M, Redler S, Weitz J, Pylvänäinen K, Renkonen-Sinisalo L, Lepistö A, Hopper JL, Win AK, Lindor NM, Gallinger S, Le Marchand L, Newcomb PA, Figueiredo JC, Thibodeau SN, Therkildsen C, Wadt KAW, Mourits MJE, Ketabi Z, Denton OG, Rødland EA, Vasen H, Neffa F, Esperon P, Tjandra D, Möslein G, Rokkones E, Sampson JR, Evans DG, Møller P. Uptake of hysterectomy and bilateral salpingo-oophorectomy in carriers of pathogenic mismatch repair variants: a Prospective Lynch Syndrome Database report. Eur J Cancer 2021; 148:124-133. [PMID: 33743481 PMCID: PMC8916840 DOI: 10.1016/j.ejca.2021.02.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 12/14/2022]
Abstract
Purpose: This study aimed to report the uptake of hysterectomy and/or bilateral salpingo-oophorectomy (BSO) to prevent gynaecological cancers (risk-reducing surgery [RRS]) in carriers of pathogenic MMR (path_MMR) variants. Methods: The Prospective Lynch Syndrome Database (PLSD) was used to investigate RRS by a cross-sectional study in 2292 female path_MMR carriers aged 30–69 years. Results: Overall, 144, 79, and 517 carriers underwent risk-reducing hysterectomy, BSO, or both combined, respectively. Two-thirds of procedures before 50 years of age were combined hysterectomy and BSO, and 81% of all procedures included BSO. Risk-reducing hysterectomy was performed before age 50 years in 28%, 25%, 15%, and 9%, and BSO in 26%, 25%, 14% and 13% of path_MLH1, path_MSH2, path_MSH6, and path_PMS2 carriers, respectively. Before 50 years of age, 107 of 188 (57%) BSO and 126 of 204 (62%) hysterectomies were performed in women without any prior cancer, and only 5% (20/392) were performed simultaneously with colorectal cancer (CRC) surgery. Conclusion: Uptake of RRS before 50 years of age was low, and RRS was rarely undertaken in association with surgical treatment of CRC. Uptake of RRS aligned poorly with gene- and age-associated risk estimates for endometrial or ovarian cancer that were published recently from PLSD and did not correspond well with current clinical guidelines. The reasons should be clarified. Decision-making on opting for or against RRS and its timing should be better aligned with predicted risk and mortality for endometrial and ovarian cancer in Lynch syndrome to improve outcomes.
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Affiliation(s)
- Toni T Seppälä
- Department of Gastrointestinal Surgery, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland; Department of Surgical Oncology, Johns Hopkins Hospital, Baltimore, MD, USA; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom.
| | - Mev Dominguez-Valentin
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo, Norway; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - Emma J Crosbie
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester and St Mary's Hospital, Manchester, UK; Directorate of Gynaecology, Manchester University, NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK
| | - Stefan Aretz
- Institute of Human Genetics, Medical Faculty, University of Bonn, Bonn, Germany; National Center for Hereditary Tumor Syndromes, University Hospital Bonn, Germany
| | - Finlay Macrae
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, Melbourne University, Melbourne, Australia; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK
| | - Ingrid Winship
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, Melbourne University, Melbourne, Australia
| | - Gabriel Capella
- Hereditary Cancer Program, Institut Catal. D'Oncologia-IDIBELL Institut D'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - Huw Thomas
- St Mark's Hospital, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Eivind Hovig
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo, Norway; Department of Informatics, University of Oslo, Oslo, Norway
| | - Maartje Nielsen
- Department of Clinical Genetics, Leids Universitair Medisch Centrum, Leiden, Netherlands
| | - Rolf H Sijmons
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - Lucio Bertario
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy; Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria G Tibiletti
- Ospedale di Circolo ASST Settelaghi, Centro di Ricerca Tumori Eredo-familiari, Università Dell'Insubria, Varese, Italy
| | - Giulia M Cavestro
- Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy
| | - Miriam Mints
- Department of Women's and Children's Health, Division of Obstetrics and Gyneacology, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Nathan Gluck
- Tel-Aviv Sourasky Medical Center, Research Center for Digestive Disorders and Liver Diseases; Department of Gastroenterology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Lior Katz
- High Risk and GI Cancer Prevention Clinic, Gatro-Oncology Unit, The Department of Gastroenterology, Sheba Medical Center, Israel
| | - Karl Heinimann
- Medical Genetics, Institute for Medical Genetics and Pathology, University Hospital Basel, Switzerland
| | - Carlos A Vaccaro
- Hereditary Cancer Program (PROCANHE) Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Instituto de Medicina Traslacional e Ingenieria Biomedica (IMTIB), Argentina
| | - Kate Green
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - James Hill
- Department of Surgery, Manchester University Hospitals NHS Foundation Trust and University of Manchester, Manchester, UK
| | - Wolff Schmiegel
- Department of Medicine, Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany
| | - Deepak Vangala
- Department of Medicine, Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany
| | - Claudia Perne
- Institute of Human Genetics, Medical Faculty, University of Bonn, Bonn, Germany; National Center for Hereditary Tumor Syndromes, University Hospital Bonn, Germany
| | - Hans-Georg Strauß
- Department of Gynaecology, University Clinics, Martin-Luther University, Halle-Wittenberg, Germany
| | | | - Elke Holinski-Feder
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, Munich, Germany; MGZ- Medical Genetics Center, Munich, Germany; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - Verena Steinke-Lange
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, Munich, Germany; MGZ- Medical Genetics Center, Munich, Germany
| | - Jukka-Pekka Mecklin
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland & Department of Surgery, Central Finland Health Care District, Jyväskylä, Finland; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - John-Paul Plazzer
- The Royal Melbourne Hospital, Melbourne, Australia; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK
| | - Marta Pineda
- Hereditary Cancer Program, Institut Català D'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Matilde Navarro
- Hereditary Cancer Program, Institut Català D'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan B Vida
- Hereditary Cancer Program, Institut Català D'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Revital Kariv
- Department of Gastroenterology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Guy Rosner
- Department of Gastroenterology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Tamara A Piñero
- Instituto de Medicina Traslacional e Ingenieria Biomedica (IMTIB), Argentina
| | - Walter Pavicic
- Instituto de Medicina Traslacional e Ingenieria Biomedica (IMTIB), Argentina
| | - Pablo Kalfayan
- Instituto de Medicina Traslacional e Ingenieria Biomedica (IMTIB), Argentina
| | - Sanne W Ten Broeke
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Lone Sunde
- Department of Clinical Genetics, Aalborg University Hospital, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Inge Bernstein
- Department of Surgical Gastroenterology, Aalborg University Hospital, Aalborg, Denmark; Faculty of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - John Burn
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - Marc Greenblatt
- University of Vermont, Larner College of Medicine, Burlington, VT 05405, USA
| | | | - Adriana Della Valle
- Grupo Colaborativo Uruguayo, Investigación de Afecciones Oncológicas Hereditarias (GCU), Hospital Fuerzas Armadas, Montevideo, Uruguay
| | - Francisco Lopez-Koestner
- Lab. Oncología y Genética Molecular, Unidad de Coloproctología Clínica Las Condes, Santiago, Chile
| | - Karin Alvarez
- Lab. Oncología y Genética Molecular, Unidad de Coloproctología Clínica Las Condes, Santiago, Chile
| | | | - Heike Görgens
- Department of Surgery, Technische Universität Dresden, Dresden, Germany
| | - Monika Morak
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, Munich, Germany; MGZ- Medical Genetics Center, Munich, Germany
| | | | - Robert Hüneburg
- Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany
| | - Magnus von Knebel Doeberitz
- Department of Applied Tumour Biology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany; Cooperation Unit Applied Tumour Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Silke Redler
- Heinrich-Heine-University, Medical Faculty, Institute of Human Genetics, Düsseldorf, Germany
| | - Jürgen Weitz
- Department of Surgery, Technische Universität Dresden, Dresden, Germany
| | - Kirsi Pylvänäinen
- Department of Education and Science, Central Finland Health Care District, Jyväskylä, Finland
| | - Laura Renkonen-Sinisalo
- Department of Gastrointestinal Surgery, Helsinki University Central Hospital, Applied Tumour Genomics Research Program, University of Helsinki, Helsinki, Finland
| | - Anna Lepistö
- Department of Gastrointestinal Surgery, Helsinki University Central Hospital, Applied Tumour Genomics Research Program, University of Helsinki, Helsinki, Finland
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Aung K Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia; University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne, VIC, 3010, Australia; Genetic Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
| | | | - Steven Gallinger
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto
| | | | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109-1024, USA
| | - Jane C Figueiredo
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109-1024, USA
| | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Christina Therkildsen
- The Danish HNPCC Register, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - Karin A W Wadt
- Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Marian J E Mourits
- Department of Gynaecologic Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Zohreh Ketabi
- Dept. of Obstetrics and Gynaecology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Oliver G Denton
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, UK
| | - Einar A Rødland
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo, Norway
| | - Hans Vasen
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Florencia Neffa
- Lab. Oncología y Genética Molecular, Unidad de Coloproctología Clínica Las Condes, Santiago, Chile
| | - Patricia Esperon
- Lab. Oncología y Genética Molecular, Unidad de Coloproctología Clínica Las Condes, Santiago, Chile
| | - Douglas Tjandra
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Australia
| | - Gabriela Möslein
- Department of Surgery, Ev. Krankenhaus Bethesda Hospital, Duisburg, Germany; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - Erik Rokkones
- Department of Gynaecological Oncology, Division of Cancer Medicine, The Norwegian Radium Hospital, Oslo, Norway
| | - Julian R Sampson
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, UK; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
| | - D G Evans
- Division of Evolution and Genomic Medicine, University of Manchester, Manchester, UK; Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Pål Møller
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo, Norway; The International Society for Gastrointestinal Hereditary Tumours (InSiGHT), The Polyposis Registry, St Mark's Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK; European Hereditary Tumour Group (EHTG), C/o Lindsays, Caledonian Exchange, 19A Canning Street, Edinburgh, EH3 8HE, United Kingdom
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Njoku K, Chiasserini D, Jones ER, Barr CE, O’Flynn H, Whetton AD, Crosbie EJ. Urinary Biomarkers and Their Potential for the Non-Invasive Detection of Endometrial Cancer. Front Oncol 2020; 10:559016. [PMID: 33224875 PMCID: PMC7670058 DOI: 10.3389/fonc.2020.559016] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/12/2020] [Indexed: 12/24/2022] Open
Abstract
Endometrial cancer is the most common malignancy of the female genital tract and its incidence is rising in parallel with the mounting prevalence of obesity. Early diagnosis has great potential to improve outcomes as treatment can be curative, especially for early stage disease. Current tests and procedures for diagnosis are limited by insufficient accuracy in some and unacceptable levels of invasiveness and discomfort in others. There has, therefore, been a growing interest in the search for sensitive and specific biomarkers for endometrial cancer detection based on non-invasive sampling methodologies. Urine, the prototype non-invasive sample, is attractive for biomarker discovery as it is easily accessible and can be collected repeatedly and in quantity. Identification of urinary biomarkers for endometrial cancer detection relies on the excretion of systemic biomarkers by the kidneys or urinary contamination by biomarkers shed from the uterus. In this review, we present the current standing of the search for endometrial cancer urinary biomarkers based on cytology, genomic, transcriptomic, proteomic, and metabolomic platforms. We summarize the biomarker candidates and highlight the challenges inherent in urinary biomarker discovery. We review the various technologies with promise for biomarker detection and assess these novel approaches for endometrial cancer biomarker research.
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Affiliation(s)
- Kelechi Njoku
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, St. Mary’s Hospital, Manchester, United Kingdom
- Stoller Biomarker Discovery Centre, Faculty of Biology, Medicine and Health, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Davide Chiasserini
- Stoller Biomarker Discovery Centre, Faculty of Biology, Medicine and Health, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Section of Physiology and Biochemistry, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Eleanor R. Jones
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, St. Mary’s Hospital, Manchester, United Kingdom
- Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Chloe E. Barr
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, St. Mary’s Hospital, Manchester, United Kingdom
- Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Helena O’Flynn
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, St. Mary’s Hospital, Manchester, United Kingdom
- Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Anthony D. Whetton
- Stoller Biomarker Discovery Centre, Faculty of Biology, Medicine and Health, Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Emma J. Crosbie
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, St. Mary’s Hospital, Manchester, United Kingdom
- Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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An Update on Screening and Prevention for Breast and Gynecological Cancers in Average and High Risk Individuals. Am J Med Sci 2020; 360:489-510. [DOI: 10.1016/j.amjms.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 05/22/2020] [Accepted: 06/03/2020] [Indexed: 11/21/2022]
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Dominguez-Valentin M, Seppälä TT, Engel C, Aretz S, Macrae F, Winship I, Capella G, Thomas H, Hovig E, Nielsen M, Sijmons RH, Bertario L, Bonanni B, Tibiletti MG, Cavestro GM, Mints M, Gluck N, Katz L, Heinimann K, Vaccaro CA, Green K, Lalloo F, Hill J, Schmiegel W, Vangala D, Perne C, Strauß HG, Tecklenburg J, Holinski-Feder E, Steinke-Lange V, Mecklin JP, Plazzer JP, Pineda M, Navarro M, Vidal JB, Kariv R, Rosner G, Piñero TA, Gonzalez ML, Kalfayan P, Sampson JR, Ryan NAJ, Evans DG, Møller P, Crosbie EJ. Risk-Reducing Gynecological Surgery in Lynch Syndrome: Results of an International Survey from the Prospective Lynch Syndrome Database. J Clin Med 2020; 9:jcm9072290. [PMID: 32708519 PMCID: PMC7408942 DOI: 10.3390/jcm9072290] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose: To survey risk-reducing hysterectomy and bilateral salpingo-oophorectomy (BSO) practice and advice regarding hormone replacement therapy (HRT) in women with Lynch syndrome. Methods: We conducted a survey in 31 contributing centers from the Prospective Lynch Syndrome Database (PLSD), which incorporates 18 countries worldwide. The survey covered local policies for risk-reducing hysterectomy and BSO in Lynch syndrome, the timing when these measures are offered, the involvement of stakeholders and advice regarding HRT. Results: Risk-reducing hysterectomy and BSO are offered to path_MLH1 and path_MSH2 carriers in 20/21 (95%) contributing centers, to path_MSH6 carriers in 19/21 (91%) and to path_PMS2 carriers in 14/21 (67%). Regarding the involvement of stakeholders, there is global agreement (~90%) that risk-reducing surgery should be offered to women, and that this discussion may involve gynecologists, genetic counselors and/or medical geneticists. Prescription of estrogen-only HRT is offered by 15/21 (71%) centers to women of variable age range (35–55 years). Conclusions: Most centers offer risk-reducing gynecological surgery to carriers of path_MLH1, path_MSH2 and path_MSH6 variants but less so for path_PMS2 carriers. There is wide variation in how, when and to whom this is offered. The Manchester International Consensus Group developed recommendations to harmonize clinical practice across centers, but there is a clear need for more research.
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Affiliation(s)
- Mev Dominguez-Valentin
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Part of Oslo University Hospital, 0379 Oslo, Norway; (E.H.); (P.M.)
- Correspondence: (M.D.-V.); (E.J.C)
| | - Toni T. Seppälä
- Department of Abdominal Surgery, Helsinki University Central Hospital, 00029 Helsinki, Finland;
- Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107 Leipzig, Germany;
| | - Stefan Aretz
- Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany; (S.A.); (C.P.)
- Center for Hereditary Tumor Syndromes, University Hospital Bonn, 53127 Bonn, Germany
| | - Finlay Macrae
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, 3052 Melbourne, Australia; (F.M.); (I.W.); (J.-P.P.)
- Department of Medicine, University of Melbourne, 3052 Melbourne, Australia
| | - Ingrid Winship
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, 3052 Melbourne, Australia; (F.M.); (I.W.); (J.-P.P.)
- Department of Medicine, University of Melbourne, 3052 Melbourne, Australia
| | - Gabriel Capella
- Hereditary Cancer Program, Catalan Institute of Oncology, Insititut d’Investigació Biomèdica de Bellvitge (IDIBELL), ONCOBELL Program, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (G.C.); (M.P.); (M.N.); (J.B.V.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Huw Thomas
- Department of Surgery and Cancer, St Mark’s Hospital, Imperial College London, London HA1 3UJ, UK;
| | - Eivind Hovig
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Part of Oslo University Hospital, 0379 Oslo, Norway; (E.H.); (P.M.)
- Center for Bioinformatics, Department of Informatics, University of Oslo, 0316 Oslo, Norway
| | - Maartje Nielsen
- Leids Universitair Medisch Centrum, Department of Clinical Genetics, 2300RC Leiden, The Netherlands;
| | - Rolf H Sijmons
- Department of Genetics, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands;
| | - Lucio Bertario
- Scientific Consultant of the Division of Prevention and Genetic Oncology, European Institute of Oncology, Fondazione IRCCS Isrtituto nazionale dei Tumori, 20141 Milan, Italy;
| | - Bernardo Bonanni
- Division of Prevention and Genetic Oncology, European Institute of Oncology, 20141 Milan, Italy;
| | - Maria Grazia Tibiletti
- Ospedale di Circolo ASST Settelaghi, Centro di Ricerca Tumori Eredo-Familiari, Università dell’Insubria, 21100 Varese, Italy;
| | - Giulia Martina Cavestro
- Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Miriam Mints
- Karolinska Institutet, 171 76 Stockholm, Sweden;
| | - Nathan Gluck
- Department of Gastroenterology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, 64239 Tel Aviv, Israel; (N.G.); (R.K.); (G.R.)
| | - Lior Katz
- Department of Gastroenterology and Hepatology, Hadassah Medical Center, 91120 Jerusalem, Israel;
| | - Karl Heinimann
- Medical Genetics, Institute for Medical Genetics and Pathology, University Hospital Basel, 4031 Basel, Switzerland;
| | - Carlos A. Vaccaro
- Hereditary Cancer Program (PROCANHE) Hospital Italiano de Buenos Aires, C1199ABB Ciudad Autónoma de Buenos Aires, Argentina; (C.A.V.); (T.A.P.); (M.L.G.); (P.K.)
| | - Kate Green
- University of Manchester & Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (K.G.); (F.L.); (N.A.J.R.); (D.G.E.)
| | - Fiona Lalloo
- University of Manchester & Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (K.G.); (F.L.); (N.A.J.R.); (D.G.E.)
| | - James Hill
- Department of Surgery, Manchester University NHS Foundation Trust and University of Manchester, Manchester M13 9WL, UK;
| | - Wolff Schmiegel
- Department of Medicine, Knappschaftskrankenhaus, Ruhr-University Bochum, 44801 Bochum, Germany;
| | - Deepak Vangala
- Department of Medicine, Knappschaftskrankenhaus, Ruhr-University Bochum, 44892 Bochum, Germany;
| | - Claudia Perne
- Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany; (S.A.); (C.P.)
- Center for Hereditary Tumor Syndromes, University Hospital Bonn, 53127 Bonn, Germany
| | - Hans-Georg Strauß
- Department of Gynecology, University Clinics, Martin-Luther University, D-06097 Halle (Saale), Germany;
| | - Johanna Tecklenburg
- Institute of Human Genetics, Hannover Medical School, 30625 Hannover, Germany;
| | - Elke Holinski-Feder
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, 80336 Munich, Germany; (E.H.-F.); (V.S.-L.)
- MGZ-Medical Genetics Center, 80335 Munich, Germany
| | - Verena Steinke-Lange
- Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, 80336 Munich, Germany; (E.H.-F.); (V.S.-L.)
- MGZ-Medical Genetics Center, 80335 Munich, Germany
| | - Jukka-Pekka Mecklin
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland;
- Department of Surgery, Central Finland Health Care District, 40620 Jyväskylä, Finland
| | - John-Paul Plazzer
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, 3052 Melbourne, Australia; (F.M.); (I.W.); (J.-P.P.)
| | - Marta Pineda
- Hereditary Cancer Program, Catalan Institute of Oncology, Insititut d’Investigació Biomèdica de Bellvitge (IDIBELL), ONCOBELL Program, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (G.C.); (M.P.); (M.N.); (J.B.V.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Matilde Navarro
- Hereditary Cancer Program, Catalan Institute of Oncology, Insititut d’Investigació Biomèdica de Bellvitge (IDIBELL), ONCOBELL Program, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (G.C.); (M.P.); (M.N.); (J.B.V.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Joan Brunet Vidal
- Hereditary Cancer Program, Catalan Institute of Oncology, Insititut d’Investigació Biomèdica de Bellvitge (IDIBELL), ONCOBELL Program, L’Hospitalet de Llobregat, 08908 Barcelona, Spain; (G.C.); (M.P.); (M.N.); (J.B.V.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain
| | - Revital Kariv
- Department of Gastroenterology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, 64239 Tel Aviv, Israel; (N.G.); (R.K.); (G.R.)
| | - Guy Rosner
- Department of Gastroenterology, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, 64239 Tel Aviv, Israel; (N.G.); (R.K.); (G.R.)
| | - Tamara Alejandra Piñero
- Hereditary Cancer Program (PROCANHE) Hospital Italiano de Buenos Aires, C1199ABB Ciudad Autónoma de Buenos Aires, Argentina; (C.A.V.); (T.A.P.); (M.L.G.); (P.K.)
| | - María Laura Gonzalez
- Hereditary Cancer Program (PROCANHE) Hospital Italiano de Buenos Aires, C1199ABB Ciudad Autónoma de Buenos Aires, Argentina; (C.A.V.); (T.A.P.); (M.L.G.); (P.K.)
| | - Pablo Kalfayan
- Hereditary Cancer Program (PROCANHE) Hospital Italiano de Buenos Aires, C1199ABB Ciudad Autónoma de Buenos Aires, Argentina; (C.A.V.); (T.A.P.); (M.L.G.); (P.K.)
| | - Julian R. Sampson
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff CF14 4XN, UK;
| | - Neil A. J. Ryan
- University of Manchester & Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (K.G.); (F.L.); (N.A.J.R.); (D.G.E.)
| | - D. Gareth Evans
- University of Manchester & Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (K.G.); (F.L.); (N.A.J.R.); (D.G.E.)
| | - Pål Møller
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Part of Oslo University Hospital, 0379 Oslo, Norway; (E.H.); (P.M.)
| | - Emma J. Crosbie
- University of Manchester & Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (K.G.); (F.L.); (N.A.J.R.); (D.G.E.)
- Correspondence: (M.D.-V.); (E.J.C)
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Chava S, Gupta R. Identification of the Mutational Landscape of Gynecological Malignancies. J Cancer 2020; 11:4870-4883. [PMID: 32626534 PMCID: PMC7330690 DOI: 10.7150/jca.46174] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/30/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Cancer is a complex disease that arises from the accumulation of multiple genetic and non-genetic changes. Advances in sequencing technologies have allowed unbiased and global analysis of patient-derived tumor samples and the discovery of genetic and transcriptional changes in key genes and oncogenic pathways. That in turn has facilitated a better understanding of the underlying causes of cancer initiation and progression, resulting in new therapeutic targets. Methods: In our study, we have analyzed the mutational landscape of gynecological malignancies using datasets from The Cancer Genome Atlas (TCGA). We have also analyzed Oncomine datasets to establish the impact of their alteration on disease recurrence and survival of patients. Results: In this study, we analyzed a series of different gynecological malignancies for commonly occurring genetic and non-genetic alterations. These studies show that white women have higher incidence of gynecological malignancies. Furthermore, our study identified 16 genes that are altered at a frequency >10% among all of the gynecological malignancies and tumor suppressor TP53 is the most altered gene in these malignancies (>50% of the cases). The top 16 genes fall into the categories of either tumor suppressor or oncogenes and a subset of these genes are associated with poor prognosis, some affecting recurrence and survival of ovarian cancer patients. Conclusion: In sum, our study identified 16 major genes that are broadly mutated in a large majority of gynecological malignancies and in some cases predict survival and recurrence in patients with gynecological malignancies. We predict that the functional studies will determine their relative role in the initiation and progression of gynecological malignancies and also establish if some of them represents drug targets for anti-cancer therapy.
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Affiliation(s)
| | - Romi Gupta
- Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
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La Rosa VL, Shah M, Kahramanoglu I, Cerentini TM, Ciebiera M, Lin LT, Dirnfeld M, Minona P, Tesarik J. Quality of life and fertility preservation counseling for women with gynecological cancer: an integrated psychological and clinical perspective. J Psychosom Obstet Gynaecol 2020; 41:86-92. [PMID: 31373525 DOI: 10.1080/0167482x.2019.1648424] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: Relational and sexual problems are frequent in patients with a diagnosis of gynecological cancer, because this disease has a strong negative impact on female identity and sexuality. Psychological and sexual functioning is affected by inauspicious diagnosis. Furthermore, therapies may compromise reproductive function. The aim of this study is to propose a general overview on the impact of gynecological cancer on quality of life and psychological and sexual functioning, as well as on the importance of adequate counseling related to fertility preservation techniques.Materials and methods: We provide a narrative overview of the recent literature about quality of life and fertility preservation counselling in women with gynecological cancer.Results and conclusions: According to recent studies, 75% of women between 18 and 45 years with a diagnosis of cancer wish to have children. When cancer affects the reproductive system, the psychological distress is even stronger because there is a loss of menstrual function and fertility. Currently, fertility preservation techniques in women with gynecological cancer are beneficial and lead to an improvement in the quality of life.
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Affiliation(s)
| | - Mohsin Shah
- Department of Physiology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Ilker Kahramanoglu
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Li-Te Lin
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Martha Dirnfeld
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology-IVF, Carmel Medical Center, Bruce & Ruth Rappaport Faculty of Medicine, Technion Haifa, Haifa, Israel
| | | | - Jan Tesarik
- Molecular Assisted Reproduction and Genetics, MARGen Clinic, Granada, Spain
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Ghunaim S, Ghazeeri G, Khalife D, Azim HA. Fertility preservation in patients with BRCA mutation. Ecancermedicalscience 2020; 14:1033. [PMID: 32419845 PMCID: PMC7221131 DOI: 10.3332/ecancer.2020.1033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Indexed: 12/27/2022] Open
Abstract
Evidence suggests a likely negative impact of deleterious BRCA mutations on female fertility. Hence, different studies have aimed to address the reproductive potential and performance of fertility preservation strategies in BRCA-mutated breast cancer patients with a prime focus on their safety and efficacy. However, several uncertainties exist in many domains of this field. The aim of the current paper is to overview the reproductive potential and fertility preservation options in breast and ovarian cancer patients harbouring a BRCA mutation. We also discuss pre-implantation genetic testing in an attempt to help physicians during oncofertility counselling of these patients.
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Affiliation(s)
- Suleiman Ghunaim
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Haifa Idriss-ART Unit, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Ghina Ghazeeri
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Haifa Idriss-ART Unit, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Dalia Khalife
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Haifa Idriss-ART Unit, American University of Beirut Medical Center, PO Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Hatem A Azim
- Breast Cancer Centre, Hospital Zambrano Hellion, Tecnologico de Monterrey, San Pedro Garza Garcia, Mexico
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Albertsdottir E, Juel J. Quadruple synchronous primary cancers in a single patient. BMJ Case Rep 2020; 13:13/4/e233326. [PMID: 32354761 DOI: 10.1136/bcr-2019-233326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Patients diagnosed with quadruple synchronous primary cancers are extremely rare and we present here, to the best of our knowledge, the first case report of this combination of primary cancers. A 70-year-old woman was diagnosed with cervical adenocarcinoma, melanoma on the right leg, invasive ductal cell carcinoma metastasis in the left axilla with no primary breast tumour detected and multiple basal cell carcinomas on the limbs, all within 2 months. The management was conducted in collaboration with six medical specialties. The cancers were surgically managed, with further adjuvant chemotherapy and ongoing hormone therapy for her breast cancer. Four years after the diagnosis, no signs of recurrence or further metastases from any of the cancers are present.
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Affiliation(s)
- Elin Albertsdottir
- Department of Plastic and Breast Surgery, Zealand University Hospital, Roskilde, Denmark
| | - Jacob Juel
- Department of Plastic Surgery, Aalborg University Hospital, Aalborg, Nordjylland, Denmark
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Evcili F, Bekar M. Prevention of gynecological cancers: the affecting factors and knowledge levels of Turkish women. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-07-2019-0171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PurposeGynecological cancers are preventable and treatable diseases in case of early diagnosis. However, lack of knowledge is one of the factors preventing women from benefiting from early diagnosis. Increasing women's knowledge of gynecological cancers contributes to improving the health of both women and the community. The purpose of this research study was to determine the affecting factors and knowledge level of Turkish women-related gynecological cancer prevention.Design/methodology/approachThis was a cross-sectional descriptive study and was carried out at a state hospital's outpatient clinic between May and June 2019. The sampling included 496 women who are not diagnosed with gynecological cancer in the individual or in the family. Data were collected using the personal information form and Gynecological Cancer Prevention Information Scale (GCPIS). Data were evaluated using the SPSS 22.0 software program. Frequencies, mean and standard deviation were used for the descriptive variables. For the data that met the parametric conditions, those with two groups were analyzed using independent samplest-tests and those with more than two groups were analyzed usingF-test.FindingsIn this study, the GCPIS total mean score of women was found 16.22 ± 8.21 (min: 0, max: 35). A statistically significant difference was found between the women's level of knowledge according to the age group of the participants, education level, economic status perception, regular pap-smear test, regular vulva examination and getting information about prevention from gynecologic cancers (p < 0.05).Research limitations/implicationsThis study was conducted on a group of Turkish women and cannot be generalized to other cultures.Practical implicationsThis study can be beneficial for determining the Turkish women's knowledge levels about gynecological cancers of women and for providing data for health education programs planning to be created.Social implicationsThe data of this study can be used to improve women's knowledge and examination skills of gynecological cancers. Thus, the quality of life of women can be improved.Originality/valueHealthcare professionals can play vital roles in presenting needed knowledge about gynecological cancers and raising awareness in women. It is extremely important for women to be informed about gynecological cancers for prevention of gynecological cancers and health improvement.
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Njoku K, Abiola J, Russell J, Crosbie EJ. Endometrial cancer prevention in high-risk women. Best Pract Res Clin Obstet Gynaecol 2019; 65:66-78. [PMID: 32107136 DOI: 10.1016/j.bpobgyn.2019.12.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/24/2022]
Abstract
Endometrial cancer (EC) is the most common gynaecological malignancy, and its incidence is rising alongside the growing prevalence of obesity. Effective risk-reducing interventions hijacking the key mechanisms driving endometrial carcinogenesis may affect EC diagnoses if aimed at those at greatest risk. An understanding of the key risk factors and their role in tumourigenesis is critical in developing such prevention strategies. In this review, we summarise the major risk factors for EC and the evidence for available risk-reducing interventions in high-risk women. We suggest potential prevention strategies and make a case for the need for risk prediction models that identify specific groups of women at a particularly high risk of EC for whom risk-reducing interventions are likely to have a significant impact.
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Affiliation(s)
- Kelechi Njoku
- Division of Cancer Sciences, University of Manchester, School of Medical Sciences, Faculty of Biology, Medicine and Health, 5th Floor Research, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
| | - Joanna Abiola
- Department of Obstetrics and Gynaecology, Tameside General Hospital, Fountain St, Ashton-under-Lyne, OL6 9RW, UK.
| | - Johanna Russell
- University of Manchester Medical School, Oxford Road, Manchester, M13 9PL, UK.
| | - Emma J Crosbie
- Division of Cancer Sciences, University of Manchester, School of Medical Sciences, Faculty of Biology, Medicine and Health, 5th Floor Research, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
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Crosbie EJ, Ryan NAJ, Arends MJ, Bosse T, Burn J, Cornes JM, Crawford R, Eccles D, Frayling IM, Ghaem-Maghami S, Hampel H, Kauff ND, Kitchener HC, Kitson SJ, Manchanda R, McMahon RFT, Monahan KJ, Menon U, Møller P, Möslein G, Rosenthal A, Sasieni P, Seif MW, Singh N, Skarrott P, Snowsill TM, Steele R, Tischkowitz M, Evans DG. The Manchester International Consensus Group recommendations for the management of gynecological cancers in Lynch syndrome. Genet Med 2019; 21:2390-2400. [PMID: 30918358 PMCID: PMC6774998 DOI: 10.1038/s41436-019-0489-y] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/06/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE There are no internationally agreed upon clinical guidelines as to which women with gynecological cancer would benefit from Lynch syndrome screening or how best to manage the risk of gynecological cancer in women with Lynch syndrome. The Manchester International Consensus Group was convened in April 2017 to address this unmet need. The aim of the Group was to develop clear and comprehensive clinical guidance regarding the management of the gynecological sequelae of Lynch syndrome based on existing evidence and expert opinion from medical professionals and patients. METHODS Stakeholders from Europe and North America worked together over a two-day workshop to achieve consensus on best practice. RESULTS Guidance was developed in four key areas: (1) whether women with gynecological cancer should be screened for Lynch syndrome and (2) how this should be done, (3) whether there was a role for gynecological surveillance in women at risk of Lynch syndrome, and (4) what preventive measures should be recommended for women with Lynch syndrome to reduce their risk of gynecological cancer. CONCLUSION This document provides comprehensive clinical guidance that can be referenced by both patients and clinicians so that women with Lynch syndrome can expect and receive appropriate standards of care.
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Affiliation(s)
- Emma J Crosbie
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK.
- Directorate of Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
- Prevention Early Detection Theme, NIHR Biomedical Research Centre, The Christie NHS Foundation Trust, Manchester, UK.
| | - Neil A J Ryan
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Medicine, University of Manchester, St Mary's Hospital, Manchester, UK
| | - Mark J Arends
- Division of Pathology & Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Tjalling Bosse
- Pathology Department, Leiden University Medical Center, Leiden, the Netherlands
| | - John Burn
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | - Robin Crawford
- Department of Gynaecological Oncology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Diana Eccles
- Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, UK
| | - Ian M Frayling
- Institute of Cancer and Genetics, Cardiff University, Cardiff, UK
| | | | - Heather Hampel
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Noah D Kauff
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Henry C Kitchener
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
| | - Sarah J Kitson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
| | - Ranjit Manchanda
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Raymond F T McMahon
- Department of Histopathology, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - Pål Møller
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, part of Oslo University Hospital, Oslo, Norway
- Research Group Inherited Cancer, Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- Center for Hereditary Tumors, Helios University Hospital Wuppertal, University of Witten-, Herdecke, Germany
| | - Gabriela Möslein
- Center for Hereditary Tumors, Helios University Hospital Wuppertal, University of Witten-, Herdecke, Germany
| | - Adam Rosenthal
- Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK
| | - Peter Sasieni
- School of Cancer and Pharmaceutical Sciences, Kings College London, London, UK
| | - Mourad W Seif
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
- Directorate of Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Naveena Singh
- Department of Cellular Pathology, Barts Health NHS Trust, London, UK
| | - Pauline Skarrott
- Lynch Syndrome UK, Linden House, 9/11 Main Street, Ingleton, Carnforth, UK
| | - Tristan M Snowsill
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK
- Health Economics Group, University of Exeter, Exeter, UK
| | - Robert Steele
- Division of Cancer, Medical Research Institute, Ninewells Hospital and Medical School, Dundee, UK
| | - Marc Tischkowitz
- Academic Laboratory of Medical Genetics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, UK
| | - D Gareth Evans
- Prevention Early Detection Theme, NIHR Biomedical Research Centre, The Christie NHS Foundation Trust, Manchester, UK
- Division of Evolution and Genomic Medicine, University of Manchester, St Mary's Hospital, Manchester, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Urkmez E, Andac-Jones E, Cibula D, Querleu D, Halaska MJ, Driak D, Sehouli J, Grabowski JP, Inci G, Zalewski K, Minig L, Zorrero C, Sancı M, Alan M, Ledermann JA, Fotopoulou C, Gultekin M. Perceptions, expectations, and experiences of gynecological cancer patients: a pan-European ESGO-ENGAGe survey. Int J Gynecol Cancer 2019; 29:1425-1430. [DOI: 10.1136/ijgc-2019-000567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 12/26/2022] Open
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Abstract
PURPOSE OF THE REVIEW To assess the most recent high-quality evidence for endometrial cancer prevention strategies. RECENT FINDINGS Obesity is an established risk factor for endometrial cancer. Weight cycling and weight gain in middle age are risk factors for endometrial cancer. Bariatric surgery reduces the risk of endometrial cancer by up to 81% in obese women who attain and maintain a normal weight. Combined oral contraceptives provide durable protection against endometrial cancer for 30 years or more. Ever use of the levonorgestrel intrauterine system (LNG-IUS) and inert intrauterine devices reduce endometrial cancer risk. The first oestrogen-based non-progestin HRT for non-hysterectomised women that contains estradiol and bazedoxifene has an effective protective effect on endometrium. Bisphosphonates reduce endometrial cancer risk. Weight loss and LNG-IUS would seem to be an effective strategy for preventing the development of obesity-driven endometrial cancer in the highest risk women. Future research may identify other safe and effective chemoprevention interventions, such as aspirin, bisphosphonates or metformin.
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Affiliation(s)
- Michelle L MacKintosh
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma J Crosbie
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK.
- Gynaecological Oncology Research Group, NIHR Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, 5th Floor Research, St Mary's Hospital, Oxford Road, Manchester, M13 9WL, UK.
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