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Wang R, Pan Y, Zhang L, Wang J, Ni J, Ding Y, Wang S, Yin J, Ding L, Ran X, Fan S, Sun Q, Tan SY, Koeffler HP, Li J, Mi Y, Chen YQ. Prebiotic stachyose inhibits PRDX5 activity and castration-resistant prostate cancer development. Int J Biol Macromol 2024; 278:134844. [PMID: 39168191 DOI: 10.1016/j.ijbiomac.2024.134844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 08/08/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024]
Abstract
Stachyose (STA) is a prebiotic with poor oral bioavailability. In this study, we developed stachyose caproate (C6-STA), as a novel STA derivative, to demonstrate its high adsorption rate via oral administration. Pharmacokinetic analysis reveals that after absorption, the STA derived from C6-STA reaches its highest peak in the blood, liver, and kidney at 20 min, 30 min, and 12-24 h, with approximate levels of 1200 μg/mL, 0.14 μg/mL, and 0.2-0.3 μg/mL, respectively. In addition, the accumulation of STA in prostate tissues of mice with castration-resistant prostate cancer (CRPC) (1.75 μg/mg) is 10-fold higher than that in normal prostate tissues (0.14 μg/mg). The analysis also reveals that C6-STA has t1/2 of 12.8 h and Tmax of 0.25 h, indicating that it has the potential to be used as a promising drug in clinical practice. The toxicological evaluation shows no obvious side effects of C6-STA in mice administered with a 0.2 g/kg intragastric dose. Pharmacodynamic analysis and mechanism investigation of C6-STA show its ability to inhibit peroxiredoxin 5 (PRDX5) enzyme activity, disrupt PRDX5-nuclear factor erythroid 2-related factor 2 (NRF2) interaction, and decrease NAD(P)H quinone dehydrogenase 1 (NQO1) levels. NQO1 decrease further causes the accumulation of quinone radicals, which ultimately leads to the apoptosis of LNCaP cell-derived drug-tolerant persister (DTP) cells and slows CRPC progression. Our study discovered the anti-tumor activity of stachyose and shows that prebiotics have biological functions in vivo besides in the gut. Further investigation of C6-STA, especially in CRPC patients, is warranted.
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Affiliation(s)
- Rong Wang
- MOE Medical Basic Research Innovation Center for Gut Microbiota and Chronic Diseases, Wuxi School of Medicine, Jiangnan University, Wuxi, China; School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Yu Pan
- MOE Medical Basic Research Innovation Center for Gut Microbiota and Chronic Diseases, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Lan Zhang
- MOE Medical Basic Research Innovation Center for Gut Microbiota and Chronic Diseases, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jun Wang
- First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China; Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, China
| | - Jiang Ni
- Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, China
| | - Yang Ding
- College of Pharmacy, Pharmaceutical Series, China Pharmaceutical University, Nanjing, China
| | - Shaopeng Wang
- Jiangnan University Medical Center, Jiangnan University, Wuxi, China
| | - Jian Yin
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology & School of Life Sciences and Health Engineering, Jiangnan University, Wuxi, China
| | - Lingwen Ding
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore; Nanomedicine Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xuebin Ran
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Shuangyi Fan
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qiaoyang Sun
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, Singapore
| | - Soo Yong Tan
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - H Phillip Koeffler
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore; Division of Hematology/Oncology, Cedars-Sinai Medical Center, UCLA School of Medicine, CA, Los Angeles, USA
| | - Jie Li
- First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
| | - Yuanyuan Mi
- Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, China.
| | - Yong Q Chen
- MOE Medical Basic Research Innovation Center for Gut Microbiota and Chronic Diseases, Wuxi School of Medicine, Jiangnan University, Wuxi, China; School of Food Science and Technology, Jiangnan University, Wuxi, China.
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Dou R, Liu R, Su P, Yu X, Xu Y. The GJB3 correlates with the prognosis, immune cell infiltration, and therapeutic responses in lung adenocarcinoma. Open Med (Wars) 2024; 19:20240974. [PMID: 39135979 PMCID: PMC11317640 DOI: 10.1515/med-2024-0974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 03/26/2024] [Accepted: 05/01/2024] [Indexed: 08/15/2024] Open
Abstract
Gap junction protein beta 3 (GJB3) has been reported as a tumor suppressor in most tumors. However, its role in lung adenocarcinoma (LUAD) remains unknown. The purpose of this study is to explore the role of GJB3 in the prognosis and tumor microenvironment of LUAD patients. The data used in this study were acquired from The Cancer Genome Atlas, Gene Expression Omnibus, and imvigor210 cohorts. We found that GJB3 expression was increased in LUAD patients and correlated with LUAD stages. LUAD patients with high GJB3 expression exhibited a worse prognosis. A total of 164 pathways were significantly activated in the GJB3 high group. GJB3 expression was positively associated with nine transcription factors and might be negatively regulated by hsa-miR-6511b-5p. Finally, we found that immune cell infiltration and immune checkpoint expression were different between the GJB3 high and GJB3 low groups. In summary. GJB3 demonstrated high expression levels in LUAD patients, and those with elevated GJB3 expression displayed unfavorable prognoses. Additionally, there was a correlation between GJB3 and immune cell infiltration, as well as immune checkpoint expression in LUAD patients.
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Affiliation(s)
- Ruigang Dou
- Department of Thoracic Surgery, The First Affiliated Hospital of Xingtai Medical College,
Xingtai054000, Hebei, P. R. China
| | - Rongfeng Liu
- Department of Oncology, Fourth Hospital of Hebei Medical University,
Shijiazhuang050011, Hebei, P. R. China
| | - Peng Su
- Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University,
Shijiazhuang050011, Hebei, P. R. China
| | - Xiaohui Yu
- Department of Computer Science and Technology, Tangshan Normal University,
Tangshan050011, Hebei, P. R. China
| | - Yanzhao Xu
- Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang050011, Hebei, P. R. China
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Osei EA. Innovations in healthcare delivery: Human papilloma virus self sampling diagnostics and participatory innovations for CCS. Cancer Med 2023; 12:15544-15551. [PMID: 37325887 PMCID: PMC10417092 DOI: 10.1002/cam4.6201] [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: 01/28/2023] [Revised: 04/21/2023] [Accepted: 05/23/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is a major contributor to the development of cervical cancer, resulting in over 500,000 cases and 266,000 deaths annually worldwide. Previous cervical cancer screening programs have been successful in reducing cervical cancer rates, but have faced challenges such as low acceptance and adherence rates. Innovations in screening technology, such as the HerSwab self-sampling test, have the potential to increase awareness, acceptance, and participation in cervical cancer screening programs. AIM This literature review examines the effectiveness of HerSwab and participatory innovations in increasing adherence to cervical cancer screening. METHOD This manuscript comprised a comprehensive narrative literature review encompassing the years 2006-2022. The review process adhered to the PRISMA diagram as a guiding framework. Among the search terms utilized, a total of 200 articles were initially retrieved. However, after applying the predefined inclusion criteria, only 57 articles were included. RESULTS The HerSwab self-sampling test is described, including how it is performed, challenges, and facilitators, and evaluation and assessment of its effectiveness. While the HerSwab diagnostic test is not currently widely available, studies should assess its feasibility in less developed countries where cervical cancer mortality rates are high. CONCLUSION By increasing awareness and availability of innovative screening techniques, such as HerSwab, we can work toward reducing the incidence of cervical cancer and improving outcomes for women worldwide.
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Uygun A, Caliskan ND, Tezcan S. Community Pharmacists' Knowledge on Cancer and Screening Methods. J Oncol Pharm Pract 2023; 29:386-392. [PMID: 35018843 DOI: 10.1177/10781552211073822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of the study is to evaluate the knowledge of community pharmacists on cancer and screening methods. SETTING AND METHOD This study was a descriptive cross-sectional study and was conducted between January-June 2020 in Istanbul/Turkey. a structured questionnaire was applied to pharmacists as online. The questionnaire was prepared by the researchers and consisted of 49 questions; basic information about cancer (15 items), signs and symptoms (11 items), causes and risk factors (14 items), cancer screening methods (9 items). RESULTS It was determined that the majority (>90%) of the pharmacists did not receive any education on cancer and/or cancer screening methods after graduation. The sufficient knowledge level of the pharmacists about cancer basics, signs and symptoms, and risk factors were found to be as 80%, 77%, and 67%, respectively. The internal consistency level of the questionnaire was calculated (Cronbach's alpha = 0.814). The item "Every woman should perform breast self-examination and notify a health professional when there is a change in breast appearance or feeling," was answered correctly by 98% of the pharmacists. It was determined that 71% of the pharmacists gave the correct answer to the item "Women aged 21-30 years should have a PAP smear every 3 years". CONCLUSION According to the results of the study, while the rate of sufficient knowledge level on cancer was found to be low, knowledge on cancer screening was found to be sufficient. We think that pharmacists should receive training on cancer and screening methods and to follow the guidelines closely.
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Affiliation(s)
- Aysen Uygun
- Marmara University Institute of Health Sciences, Istanbul, Turkey
| | | | - Songul Tezcan
- Marmara University Faculty of Pharmacy52982, Clinical Pharmacy Department, Istanbul, Turkey
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Ugai T, Sasamoto N, Lee HY, Ando M, Song M, Tamimi RM, Kawachi I, Campbell PT, Giovannucci EL, Weiderpass E, Rebbeck TR, Ogino S. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nat Rev Clin Oncol 2022; 19:656-673. [PMID: 36068272 PMCID: PMC9509459 DOI: 10.1038/s41571-022-00672-8] [Citation(s) in RCA: 151] [Impact Index Per Article: 75.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 02/07/2023]
Abstract
Over the past several decades, the incidence of early-onset cancers, often defined as cancers diagnosed in adults <50 years of age, in the breast, colorectum, endometrium, oesophagus, extrahepatic bile duct, gallbladder, head and neck, kidney, liver, bone marrow, pancreas, prostate, stomach and thyroid has increased in multiple countries. Increased use of screening programmes has contributed to this phenomenon to a certain extent, although a genuine increase in the incidence of early-onset forms of several cancer types also seems to have emerged. Evidence suggests an aetiological role of risk factor exposures in early life and young adulthood. Since the mid-20th century, substantial multigenerational changes in the exposome have occurred (including changes in diet, lifestyle, obesity, environment and the microbiome, all of which might interact with genomic and/or genetic susceptibilities). However, the effects of individual exposures remain largely unknown. To study early-life exposures and their implications for multiple cancer types will require prospective cohort studies with dedicated biobanking and data collection technologies. Raising awareness among both the public and health-care professionals will also be critical. In this Review, we describe changes in the incidence of early-onset cancers globally and suggest measures that are likely to reduce the burden of cancers and other chronic non-communicable diseases.
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Affiliation(s)
- Tomotaka Ugai
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Naoko Sasamoto
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Hwa-Young Lee
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute of Convergence Science, Convergence Science Academy, Yonsei University, Seoul, Republic of Korea
| | - Mariko Ando
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mingyang Song
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Peter T Campbell
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Timothy R Rebbeck
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
- Zhu Family Center for Global Cancer Prevention, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shuji Ogino
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Broad Institute of MIT and Harvard, Cambridge, MA, USA.
- Cancer Immunology and Cancer Epidemiology Programs, Dana-Farber Harvard Cancer Center, Boston, MA, USA.
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Wan Y, Tong Y, Liu Y, Huang Y, Yao G, Chen DQ, Liu B. Evaluation of the Combination of Artificial Intelligence and Radiologist Assessments to Interpret Malignant Architectural Distortion on Mammography. Front Oncol 2022; 12:880150. [PMID: 35515107 PMCID: PMC9067265 DOI: 10.3389/fonc.2022.880150] [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: 02/21/2022] [Accepted: 03/29/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare the mammographic malignant architectural distortion (AD) detection performance of radiologists who read mammographic examinations unaided versus those who read these examinations with the support of artificial intelligence (AI) systems. Material and Methods This retrospective case-control study was based on a double-reading of clinical mammograms between January 2011 and December 2016 at a large tertiary academic medical center. The study included 177 malignant and 90 benign architectural distortion (AD) patients. The model was built based on the ResNeXt-50 network. Algorithms used deep learning convolutional neural networks, feature classifiers, image analysis algorithms to depict AD and output a score that translated to malignant. The accuracy for malignant AD detection was evaluated using area under the curve (AUC). Results The overall AUC was 0.733 (95% CI, 0.673-0.792) for Reader First-1, 0.652 (95% CI, 0.586-0.717) for Reader First-2, and 0.655 (95% CI, 0.590-0.719) for Reader First-3. and the overall AUCs for Reader Second-1, 2, 3 were 0.875 (95% CI, 0.830-0.919), 0.882 (95% CI, 0.839-0.926), 0.884 (95% CI, 0.841-0.927),respectively. The AUCs for all the reader-second radiologists were significantly higher than those for all the reader-first radiologists (Reader First-1 vs. Reader Second-1, P= 0.004). The overall AUC was 0.792 (95% CI, 0.660-0.925) for AI algorithms. The combination assessment of AI algorithms and Reader First-1 achieved an AUC of 0.880 (95% CI, 0.793-0.968), increased than the Reader First-1 alone and AI algorithms alone. AI algorithms alone achieved a specificity of 61.1% and a sensitivity of 80.6%. The specificity for Reader First-1 was 55.5%, and the sensitivity was 86.1%. The results of the combined assessment of AI and Reader First-1 showed a specificity of 72.7% and sensitivity of 91.7%. The performance showed significant improvements compared with AI alone (p<0.001) as well as the reader first-1 alone (p=0.006). Conclusion While the single AI algorithm did not outperform radiologists, an ensemble of AI algorithms combined with junior radiologist assessments were found to improve the overall accuracy. This study underscores the potential of using machine learning methods to enhance mammography interpretation, especially in remote areas and primary hospitals.
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Affiliation(s)
- Yun Wan
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yunfei Tong
- AI Research Lab, Boston Meditech Group, Burlington, MA, United States.,AI Research Lab, Shanghai Yanghe Huajian Artificial Intelligence Technology Co., Ltd, Shanghai, China
| | - Yuanyuan Liu
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Huang
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guoyan Yao
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Daniel Q Chen
- AI Research Lab, Boston Meditech Group, Burlington, MA, United States
| | - Bo Liu
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Wanders AJT, Mees W, Bun PAM, Janssen N, Rodríguez-Ruiz A, Dalmış MU, Karssemeijer N, van Gils CH, Sechopoulos I, Mann RM, van Rooden CJ. Interval Cancer Detection Using a Neural Network and Breast Density in Women with Negative Screening Mammograms. Radiology 2022; 303:269-275. [PMID: 35133194 DOI: 10.1148/radiol.210832] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Inclusion of mammographic breast density (BD) in breast cancer risk models improves accuracy, but accuracy remains modest. Interval cancer (IC) risk prediction may be improved by combining assessments of BD and an artificial intelligence (AI) cancer detection system. Purpose To evaluate the performance of a neural network (NN)-based model that combines the assessments of BD and an AI system in the prediction of risk of developing IC among women with negative screening mammography results. Materials and Methods This retrospective nested case-control study performed with screening examinations included women who developed IC and women with normal follow-up findings (from January 2011 to January 2015). An AI cancer detection system analyzed all studies yielding a score of 1-10, representing increasing likelihood of malignancy. BD was automatically computed using publicly available software. An NN model was trained by combining the AI score and BD using 10-fold cross-validation. Bootstrap analysis was used to calculate the area under the receiver operating characteristic curve (AUC), sensitivity at 90% specificity, and 95% CIs of the AI, BD, and NN models. Results A total of 2222 women with IC and 4661 women in the control group were included (mean age, 61 years; age range, 49-76 years). AUC of the NN model was 0.79 (95% CI: 0.77,0.81), which was higher than AUC of the AI cancer detection system or BD alone (AUC, 0.73 [95% CI: 0.71, 0.76] and 0.69 [95% CI: 0.67, 0.71], respectively; P < .001 for both). At 90% specificity, the NN model had a sensitivity of 50.9% (339 of 666 women; 95% CI: 45.2, 56.3) for prediction of IC, which was higher than that of the AI system (37.5%; 250 of 666 women; 95% CI: 33.0, 43.7; P < .001) or BD percentage alone (22.4%; 149 of 666 women; 95% CI: 17.9, 28.5; P < .001). Conclusion The combined assessment of an artificial intelligence detection system and breast density measurements enabled identification of a larger proportion of women who would develop interval cancer compared with either method alone. Published under a CC BY 4.0 license.
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Affiliation(s)
- Alexander J T Wanders
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Willem Mees
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Petra A M Bun
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Natasja Janssen
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Alejandro Rodríguez-Ruiz
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Mehmet Ufuk Dalmış
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Nico Karssemeijer
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Carla H van Gils
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Ioannis Sechopoulos
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Ritse M Mann
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
| | - Cornelis Jan van Rooden
- From the Dutch Breast Cancer Screening Program, Region South-West, Laan 20, 2512 GB, The Hague, the Netherlands (A.J.T.W., W.M., P.A.M.B., C.J.v.R.); Screen-Point Medical, Nijmegen, the Netherlands (N.J., A.R., M.U.D., N.K.); Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands (N.K., I.S., R.M.M.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (C.H.v.G.); Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.); Department of Radiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands (R.M.M.); and Department of Radiology, Haga Teaching Hospital, The Hague, the Netherlands (C.J.v.R.)
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8
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Abuadas FH, Alsharari AF, Abuadas MH. Predictors of Colorectal Cancer Screening among Average and High-Risk Saudis Population. J Pers Med 2022; 12:662. [PMID: 35629085 PMCID: PMC9144519 DOI: 10.3390/jpm12050662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/02/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) screening intention is one of the most important elements influencing the longstanding effectiveness of community-based CRC screening programs. The primary purpose of this study is to generate and validate a predictive screening model that investigates the influence of Saudis’ demographics, CRC knowledge, and beliefs on intention to undergo CRC screening via fecal occult blood test (FOBT). Convenience sampling was used to recruit 600 average and high-risk participants from multiple primary health care centers in three major Saudi provinces. A valid and reliable self-administered online survey was used to collect data from March 2021 to October 2021. The final modified screening prediction model explained 57.35% of the variance in screening intention. Intention to screen was significantly influenced by seven factors in which the perceived barriers factor (β = −0.55, p < 0.001) was the strongest predictor. Those who had lower perceived barriers and greater levels of knowledge (β = 0.36, p < 0.001), health motivation (β = 0.35, p < 0.001), perceived benefits of screening (β = 0.35, p < 0.001), severity (β = 0.29, p < 0.001), and susceptibility (β = 0.28, p < 0.001) were more likely to become involved in screening practices. Health care practitioners and various media forms could benefit from the prediction model playing a significant role in raising awareness, reducing perceived barriers, and enhancing Saudi screening rates.
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Affiliation(s)
- Fuad H. Abuadas
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Abdalkarem F. Alsharari
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia;
- Medical Surgical Department, College of Nursing, Jouf University, Sakaka 72388, Saudi Arabia
| | - Mohammad H. Abuadas
- Faculty of Nursing, King Khalid University, Khamis Mushait 62529, Saudi Arabia;
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9
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Fabrizio T, Guarro G, Filippini A, La Torre G, Grieco MP. INDICATIONS FOR LIMITATIONS OF THE OMENTAL PEDICLE FLAP IN IMMEDIATE BREAST RECONSTRUCTION - SURGICAL RESULTS EVALUATION AND BREAST-Q© 2.0 SURVEY. J Plast Reconstr Aesthet Surg 2022; 75:1352-1359. [PMID: 34930701 DOI: 10.1016/j.bjps.2021.11.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/14/2021] [Accepted: 11/11/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIM Immediate reconstruction with an omental flap is a recognized suitable method for a full-thickness breast reconstruction or implant coverage for well-selected cases of nipple or skin-sparing mastectomies as well as cases of skin-reducing mastectomies. The authors' aim is the evaluation of indications and limitations of this technique with an original approach and also based on the analysis of patients' global satisfaction using the BREAST-Q 2.0© survey. MATERIALS AND METHODS From January 2014 to March 2018, 12 women aged between 29 to 67 years old (mean age: 49 years) underwent immediate breast reconstruction alone or with a definitive implant covered by a pedicled omental flap. All of them were asked to fill out the BREAST-Q© 2.0 survey. CONCLUSIONS The careful analysis of the cases shows that the indications for the immediate breast reconstruction based on the omental flap with a minimal resulting donor-site morbidity are strictly linked to its limitations, which are correctly reported in the study, but in the same way, it suggests that patients who underwent implant-based immediate breast reconstruction with omental flap reported significant improvements in satisfaction and health-related quality of their life.
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Affiliation(s)
- Tommaso Fabrizio
- Division of Plastic Surgery, IRCCS - Centro di Riferimento Oncologico di Basilicata, Rionero in Vulture (Pz), Italy.
| | - Giuseppe Guarro
- Division of Plastic Surgery, IRCCS - Centro di Riferimento Oncologico di Basilicata, Rionero in Vulture (Pz), Italy
| | - Arnaldo Filippini
- Università degli Studi di Chieti "Gabriele D'Annunzio", Chieti, Italy
| | - Giuseppe La Torre
- Division of Senology, IRCCS - Centro di Riferimento Oncologico di Basilicata, Rionero in Vulture (Pz), Italy
| | - Michele P Grieco
- Division of Plastic Surgery, IRCCS - Centro di Riferimento Oncologico di Basilicata, Rionero in Vulture (Pz), Italy
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10
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Herman PM, Bucho-Gonzalez J, Menon U, Szalacha LA, Larkey L. Cost-Effectiveness of Community-to-Clinic Tailored Navigation for Colorectal Cancer Screening in an Underserved Population: Economic Evaluation Alongside a Group-Randomized Trial. Am J Health Promot 2022; 36:678-686. [PMID: 35081762 DOI: 10.1177/08901171211068454] [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: 11/16/2022]
Abstract
PURPOSE Although screening for colorectal cancer (CRC) lowers mortality and morbidity and is generally cost-effective, little is known about the cost-effectiveness of screening promotion. DESIGN Cost-effectiveness analysis alongside a group-randomized trial. Setting: Multicultural, underinsured communities in the Phoenix, Arizona, area. SUBJECTS English- or Spanish-speaking adults who were out of compliance for CRC screening guidelines. INTERVENTION All participants received community-based group education (GE), and the intervention group also received tailored community-to-clinic navigation (GE+TN). MEASURES Number of participants screened and costs of tailored navigation, clinic visits, and CRC screening tests. ANALYSIS Incremental cost per additional person screened from the perspective of the healthcare system with bootstrapped confidence intervals. RESULTS Community sites were recruited and randomized to GE (n = 120) and GE + TN (n = 119). Across these sites 1154 individuals were screened, 504 were eligible, and 345 attended the group education class (n = 134 GE; n = 211 GE + TN). Screening rates (26.5% GE + TN; 10.4% GE; 16.1% increase 95% CI: 7%, 23%) and costs per participant ($271 GE + TN; $167 GE; a net cost increase of $104 95% CI: $1, $189) were significantly higher in the intervention group. Incremental cost-effectiveness was $646 (95% CI: -$68, $953) per additional person screened. CONCLUSION Depending on the value placed on an additional person screened, the addition of community-to-clinic tailored navigation to a community-based CRC screening promotion program may be highly cost-effective.
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Affiliation(s)
| | - Julie Bucho-Gonzalez
- Edson College of Nursing and Health Innovation, 15679Arizona State University, Phoenix, AZ, USA
| | - Usha Menon
- College of Nursing, 7831University of South Florida, Tampa, FL, USA
| | - Laura A Szalacha
- Morsani College of Medicine and College of Nursing, 7831University of South Florida, Tampa, FL, USA
| | - Linda Larkey
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, 15679Arizona State University, Phoenix, AZ, USA
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11
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He Z, Li Y, Zeng W, Xu W, Liu J, Ma X, Wei J, Zeng H, Xu Z, Wang S, Wen C, Wu J, Feng C, Ma M, Qin G, Lu Y, Chen W. Can a Computer-Aided Mass Diagnosis Model Based on Perceptive Features Learned From Quantitative Mammography Radiology Reports Improve Junior Radiologists' Diagnosis Performance? An Observer Study. Front Oncol 2021; 11:773389. [PMID: 34976817 PMCID: PMC8719464 DOI: 10.3389/fonc.2021.773389] [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: 09/09/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Radiologists' diagnostic capabilities for breast mass lesions depend on their experience. Junior radiologists may underestimate or overestimate Breast Imaging Reporting and Data System (BI-RADS) categories of mass lesions owing to a lack of diagnostic experience. The computer-aided diagnosis (CAD) method assists in improving diagnostic performance by providing a breast mass classification reference to radiologists. This study aims to evaluate the impact of a CAD method based on perceptive features learned from quantitative BI-RADS descriptions on breast mass diagnosis performance. We conducted a retrospective multi-reader multi-case (MRMC) study to assess the perceptive feature-based CAD method. A total of 416 digital mammograms of patients with breast masses were obtained from 2014 through 2017, including 231 benign and 185 malignant masses, from which we randomly selected 214 cases (109 benign, 105 malignant) to train the CAD model for perceptive feature extraction and classification. The remaining 202 cases were enrolled as the test set for evaluation, of which 51 patients (29 benign and 22 malignant) participated in the MRMC study. In the MRMC study, we categorized six radiologists into three groups: junior, middle-senior, and senior. They diagnosed 51 patients with and without support from the CAD model. The BI-RADS category, benign or malignant diagnosis, malignancy probability, and diagnosis time during the two evaluation sessions were recorded. In the MRMC evaluation, the average area under the curve (AUC) of the six radiologists with CAD support was slightly higher than that without support (0.896 vs. 0.850, p = 0.0209). Both average sensitivity and specificity increased (p = 0.0253). Under CAD assistance, junior and middle-senior radiologists adjusted the assessment categories of more BI-RADS 4 cases. The diagnosis time with and without CAD support was comparable for five radiologists. The CAD model improved the radiologists' diagnostic performance for breast masses without prolonging the diagnosis time and assisted in a better BI-RADS assessment, especially for junior radiologists.
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Affiliation(s)
- Zilong He
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Li
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
| | - Weixiong Zeng
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weimin Xu
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jialing Liu
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiangyuan Ma
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
- Department of Biomedical Engineering, College of Engineering, Shantou University, Shantou, China
| | - Jun Wei
- Perception Vision Medical Technologies Ltd. Co., Guangzhou, China
| | - Hui Zeng
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zeyuan Xu
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Sina Wang
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chanjuan Wen
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiefang Wu
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chenya Feng
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mengwei Ma
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Genggeng Qin
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yao Lu
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China
- Guangdong Province Key Laboratory of Computational Science, Sun Yat-sen University, Guangzhou, China
| | - Weiguo Chen
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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12
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Fedewa SA, Yabroff KR, Bandi P, Smith RA, Nargis N, Zheng Z, Drope J, Jemal A. Unemployment and cancer screening: Baseline estimates to inform health care delivery in the context of COVID-19 economic distress. Cancer 2021; 128:737-745. [PMID: 34747008 PMCID: PMC8653134 DOI: 10.1002/cncr.33966] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/03/2021] [Accepted: 09/13/2021] [Indexed: 11/22/2022]
Abstract
Background During the coronavirus disease 2019 pandemic, US unemployment rates rose to historic highs, and they remain nearly double those of prepandemic levels. Employers are the most common source of health insurance among nonelderly adults. Thus, job loss may lead to a loss of health insurance and reduce access to cancer screening. This study examined associations between unemployment, health insurance, and cancer screening to inform the pandemic's potential impacts on early cancer detection. Methods Up‐to‐date and past‐year breast, cervical, colorectal, and prostate cancer screening prevalences were computed for nonelderly respondents (aged <65 years) with 2000‐2018 National Health Interview Survey data. Multivariable logistic regression models with marginal probabilities were used to estimate unemployed‐versus‐employed unadjusted and adjusted prevalence ratios. Results Unemployed adults (2000‐2018) were 4 times more likely to lack insurance than employed adults (41.4% vs 10.0%; P < .001). Unemployed adults had a significantly lower up‐to‐date prevalence of screening for cervical cancer (78.5% vs 86.2%; P < .001), breast cancer (67.8% vs 77.5%; P < .001), colorectal cancer (41.9 vs 48.5%; P < .001), and prostate cancer (25.4% vs 36.4%; P < .001). These differences were eliminated after accounting for health insurance coverage. Conclusions Unemployment was adversely associated with up‐to‐date cancer screening, and this was fully explained by a lack of health insurance. Ensuring the continuation of health insurance coverage after job loss may mitigate the pandemic's economic distress and future economic downturns' impact on cancer screening. Unemployment is adversely associated with up‐to‐date cancer screening, and this is fully explained by a lack of health insurance.
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Affiliation(s)
- Stacey A Fedewa
- Surveillance and Health Equity Sciences, Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia
| | - K Robin Yabroff
- Surveillance and Health Equity Sciences, Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia
| | - Priti Bandi
- Surveillance and Health Equity Sciences, Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia
| | - Robert A Smith
- Early Detection and Screening, Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia
| | - Nigar Nargis
- Surveillance and Health Equity Sciences, Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia
| | - Zhiyuan Zheng
- Surveillance and Health Equity Sciences, Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia
| | - Jeffrey Drope
- Healthy Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Ahmedin Jemal
- Surveillance and Health Equity Sciences, Office of Cancer Research and Implementation, American Cancer Society, Atlanta, Georgia
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13
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Zhang J, Cai L, Chen L, Pang X, Chen M, Yan D, Liu J, Luo L. Re-evaluation of high-risk breast mammography lesions by target ultrasound and ABUS of breast non-mass-like lesions. BMC Med Imaging 2021; 21:156. [PMID: 34702200 PMCID: PMC8549220 DOI: 10.1186/s12880-021-00665-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of this study was to reevaluate the high-risk breast non-mass-like lesions (NMLs) in mammography (MG) by target ultrasound (US) and Automated breast ultrasonography (ABUS), and to analyze the correlation between different imaging findings and the factors influencing the classification of lesions. METHODS A total of 161 patients with 166 breast lesions were recruited in this retrospectively study. All cases were diagnosed as BI-RADS 4 or 5 by MG and as NML on ultrasound. While all NMLs underwent mammography, target US and ABUS before breast surgery or biopsy in the consistent position of breast. The imaging and pathological features of all cases were collected. All lesions were classified according to the lexion of ACR BI-RADS®. RESULTS There were significant differences between benign and malignant breast NML in all the features of target US and ABUS. US, especially ABUS, was superior to MG in determining the malignant breast NML. There was a significant difference in the detection rate of calcification between MG and Target US (P < 0.001), and there was a significant difference in the detection rate of structural distortion between ABUS and MG (P < 0.001). CONCLUSIONS Target US, especially ABUS, can significantly improve the sensitivity, specificity and accuracy of the diagnosis of high-risk NMLs in MG. The features of Target US and ABUS such as blood supply, hyperechogenicity, ductal changes, peripheral changes and coronal features could be employed to predict benign and malignant lesions. The coronal features of ABUS were more sensitive than those of Target HHUS in showing structural abnormalities. Target US was less effective than MG in local micro-calcification.
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Affiliation(s)
- Jianxing Zhang
- Department of Medical Imaging Center, Jinan University First Affiliated Hospital, No. 613, Huangpu Road West, Tianhe District, Guangzhou, 510630, Guangdong Province, China.
- Department of Ultrasound, 2Nd Clinical Hospital of Guangzhou Chinese Traditional Medicine College: Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111, Dade Road, Yuexiu District, Guangzhou, 510120, Guangdong Province, China.
| | - Lishang Cai
- Department of Ultrasound, Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, No. 16, Jichang Road, Baiyun District, Guangzhou, 510403, Guangdong Province, China
| | - Ling Chen
- Department of Ultrasound, 2Nd Clinical Hospital of Guangzhou Chinese Traditional Medicine College: Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111, Dade Road, Yuexiu District, Guangzhou, 510120, Guangdong Province, China
| | - Xiyan Pang
- Department of Ultrasound, 2Nd Clinical Hospital of Guangzhou Chinese Traditional Medicine College: Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111, Dade Road, Yuexiu District, Guangzhou, 510120, Guangdong Province, China
| | - Miao Chen
- Department of Ultrasound, 2Nd Clinical Hospital of Guangzhou Chinese Traditional Medicine College: Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111, Dade Road, Yuexiu District, Guangzhou, 510120, Guangdong Province, China
| | - Dan Yan
- Department of Ultrasound, 2Nd Clinical Hospital of Guangzhou Chinese Traditional Medicine College: Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111, Dade Road, Yuexiu District, Guangzhou, 510120, Guangdong Province, China
| | - Jia Liu
- Department of Ultrasound, 2Nd Clinical Hospital of Guangzhou Chinese Traditional Medicine College: Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 111, Dade Road, Yuexiu District, Guangzhou, 510120, Guangdong Province, China
| | - Liangping Luo
- Department of Medical Imaging Center, Jinan University First Affiliated Hospital, No. 613, Huangpu Road West, Tianhe District, Guangzhou, 510630, Guangdong Province, China.
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14
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Zhao Y, Jin LJ, Zhang XY. Exosomal miRNA-205 promotes breast cancer chemoresistance and tumorigenesis through E2F1. Aging (Albany NY) 2021; 13:18498-18514. [PMID: 34292880 PMCID: PMC8351670 DOI: 10.18632/aging.203298] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/19/2021] [Indexed: 01/09/2023]
Abstract
Breast cancer (BC) is a common malignant tumor in females. The challenge in treating BC is overcoming chemoresistance. Exosome-mediated transfer of miRNAs is a molecule-shuttle in intercellular communication. Thus, we aimed to investigate whether exosomal miRNA-205 could affect chemoresistance and tumorigenesis in recipient tumor cells and to elucidate the underlying mechanism in vivo and in vitro. Microarray and qRT-PCR assays demonstrated that miRNA-205 was upregulated in tamoxifen resistance MCF-7/TAMR-1 (M/T) cells and M/T cell-derived exosomes (M/T-Exo). The M/T-Exo was internalized by human BC cells (BCCs), causing increased expression of miRNA-205 in BCCs. Coculturing with M/T-Exo promoted tamoxifen resistance, proliferation, migration, and invasion while suppressed apoptosis in recipient BCCs, which were associated with activating the caspase pathway and phosphorylating Akt. Luciferase reporter assays showed that miRNA-205 directly targeted E2F Transcription Factor 1 (E2F1) in BCCs. Furthermore, knockdown of miRNA-205 or overexpression of E2F1 reversed the roles of M/T-Exo in BCCs. In vivo experiments showed that the intratumoral injection of M/T-Exo caused greater tamoxifen resistance and larger tumor size relative to mice treated with miRNA-205-knockdown or E2F1-overexpressing BCCs. Together, the results suggest that exosomal miRNA-205 may promote tamoxifen resistance and tumorigenesis in BC through targeting E2F1 in vivo and in vitro.
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Affiliation(s)
- Yan Zhao
- Thyroid and Breast Department, Extra-Thyroid and Breast Neoplasms, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Li-Jun Jin
- Department of Thyroid and Breast III, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Xiao-Yu Zhang
- Department of Thyroid and Breast III, Cangzhou Central Hospital, Cangzhou, Hebei, China
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15
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Peng S, Yang Y, Liu W, Li F, Liao X. Discriminant Projection Shared Dictionary Learning for Classification of Tumors Using Gene Expression Data. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2021; 18:1464-1473. [PMID: 31675339 DOI: 10.1109/tcbb.2019.2950209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
With a variety of tumor subtypes, personalized treatments need to identify the subtype of a tumor as accurately as possible. The development of DNA microarrays provides an opportunity to predict tumor classification. One strategy is to use gene expression profiling to extend current biological insights into the disease. However, overfitting problems exist in most machine learning methods when classifying tumor gene expression profile data characterized by high dimensional, small samples and nonlinearities. As a new machine learning methods, dictionary learning has become a more effective algorithm for gene expression profile classification. Here, a new method called discriminant projection shared dictionary learning (DPSDL) is proposed for classifying tumor subtypes using LINCS gene expression profile data. The method trains a shared dictionary, embeds Fisher discriminant criteria to obtain a class-specific sub-dictionary and coding coefficients. At the same time, a projection matrix is trained to widen the distance between different classes of samples. Experimental results show that our method performs better classification based on gene expression profile than the other dictionary learning methods and machine learning methods.
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16
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Wan Y, Zheng Z, Liu R, Zhu Z, Zhou H, Zhang X, Boumaraf S. A Multi-Scale and Multi-Level Fusion Approach for Deep Learning-Based Liver Lesion Diagnosis in Magnetic Resonance Images with Visual Explanation. Life (Basel) 2021; 11:life11060582. [PMID: 34207262 PMCID: PMC8234101 DOI: 10.3390/life11060582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/10/2021] [Accepted: 06/16/2021] [Indexed: 02/08/2023] Open
Abstract
Many computer-aided diagnosis methods, especially ones with deep learning strategies, of liver cancers based on medical images have been proposed. However, most of such methods analyze the images under only one scale, and the deep learning models are always unexplainable. In this paper, we propose a deep learning-based multi-scale and multi-level fusing approach of CNNs for liver lesion diagnosis on magnetic resonance images, termed as MMF-CNN. We introduce a multi-scale representation strategy to encode both the local and semi-local complementary information of the images. To take advantage of the complementary information of multi-scale representations, we propose a multi-level fusion method to combine the information of both the feature level and the decision level hierarchically and generate a robust diagnostic classifier based on deep learning. We further explore the explanation of the diagnosis decision of the deep neural network through visualizing the areas of interest of the network. A new scoring method is designed to evaluate whether the attention maps can highlight the relevant radiological features. The explanation and visualization make the decision-making process of the deep neural network transparent for the clinicians. We apply our proposed approach to various state-of-the-art deep learning architectures. The experimental results demonstrate the effectiveness of our approach.
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Affiliation(s)
- Yuchai Wan
- Beijing Key Laboratory of Big Data Technology for Food Safety, Beijing Technology and Business University, Beijing 100048, China; (H.Z.); (X.Z.)
- Correspondence: (Y.W.); (Z.Z.)
| | - Zhongshu Zheng
- Beijing Lab of Intelligent Information Technology, School of Computer Science, Beijing Institute of Technology, Beijing 100081, China;
| | - Ran Liu
- China South-to-North Water Diversion Corporation Limited, Beijing 100038, China;
| | - Zheng Zhu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17, Panjiayuan NanLi, Chaoyang District, Beijing 100021, China
- Correspondence: (Y.W.); (Z.Z.)
| | - Hongen Zhou
- Beijing Key Laboratory of Big Data Technology for Food Safety, Beijing Technology and Business University, Beijing 100048, China; (H.Z.); (X.Z.)
| | - Xun Zhang
- Beijing Key Laboratory of Big Data Technology for Food Safety, Beijing Technology and Business University, Beijing 100048, China; (H.Z.); (X.Z.)
| | - Said Boumaraf
- Centre d’Exploitation des Systèmes de Télécommunications Spatiales (CESTS), Agence Spatiale Algérienne, Algiers, Algeria;
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17
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Raya-Povedano JL, Romero-Martín S, Elías-Cabot E, Gubern-Mérida A, Rodríguez-Ruiz A, Álvarez-Benito M. AI-based Strategies to Reduce Workload in Breast Cancer Screening with Mammography and Tomosynthesis: A Retrospective Evaluation. Radiology 2021; 300:57-65. [PMID: 33944627 DOI: 10.1148/radiol.2021203555] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The workflow of breast cancer screening programs could be improved given the high workload and the high number of false-positive and false-negative assessments. Purpose To evaluate if using an artificial intelligence (AI) system could reduce workload without reducing cancer detection in breast cancer screening with digital mammography (DM) or digital breast tomosynthesis (DBT). Materials and Methods Consecutive screening-paired and independently read DM and DBT images acquired from January 2015 to December 2016 were retrospectively collected from the Córdoba Tomosynthesis Screening Trial. The original reading settings were single or double reading of DM or DBT images. An AI system computed a cancer risk score for DM and DBT examinations independently. Each original setting was compared with a simulated autonomous AI triaging strategy (the least suspicious examinations for AI are not human-read; the rest are read in the same setting as the original, and examinations not recalled by radiologists but graded as very suspicious by AI are recalled) in terms of workload, sensitivity, and recall rate. The McNemar test with Bonferroni correction was used for statistical analysis. Results A total of 15 987 DM and DBT examinations (which included 98 screening-detected and 15 interval cancers) from 15 986 women (mean age ± standard deviation, 58 years ± 6) were evaluated. In comparison with double reading of DBT images (568 hours needed, 92 of 113 cancers detected, 706 recalls in 15 987 examinations), AI with DBT would result in 72.5% less workload (P < .001, 156 hours needed), noninferior sensitivity (95 of 113 cancers detected, P = .38), and 16.7% lower recall rate (P < .001, 588 recalls in 15 987 examinations). Similar results were obtained for AI with DM. In comparison with the original double reading of DM images (222 hours needed, 76 of 113 cancers detected, 807 recalls in 15 987 examinations), AI with DBT would result in 29.7% less workload (P < .001), 25.0% higher sensitivity (P < .001), and 27.1% lower recall rate (P < .001). Conclusion Digital mammography and digital breast tomosynthesis screening strategies based on artificial intelligence systems could reduce workload up to 70%. Published under a CC BY 4.0 license.
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Affiliation(s)
- José Luis Raya-Povedano
- From the Breast Cancer Unit, Department of Radiology, Hospital Universitario Reina Sofía, Av Menéndez Pidal s/n, Córdoba 14004, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); Maimonides Institute for Biomedical Research of Córdoba, Córdoba, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); and Department of Clinical Science, ScreenPoint Medical, Nijmegen, the Netherlands (A.G.M., A.R.R.)
| | - Sara Romero-Martín
- From the Breast Cancer Unit, Department of Radiology, Hospital Universitario Reina Sofía, Av Menéndez Pidal s/n, Córdoba 14004, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); Maimonides Institute for Biomedical Research of Córdoba, Córdoba, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); and Department of Clinical Science, ScreenPoint Medical, Nijmegen, the Netherlands (A.G.M., A.R.R.)
| | - Esperanza Elías-Cabot
- From the Breast Cancer Unit, Department of Radiology, Hospital Universitario Reina Sofía, Av Menéndez Pidal s/n, Córdoba 14004, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); Maimonides Institute for Biomedical Research of Córdoba, Córdoba, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); and Department of Clinical Science, ScreenPoint Medical, Nijmegen, the Netherlands (A.G.M., A.R.R.)
| | - Albert Gubern-Mérida
- From the Breast Cancer Unit, Department of Radiology, Hospital Universitario Reina Sofía, Av Menéndez Pidal s/n, Córdoba 14004, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); Maimonides Institute for Biomedical Research of Córdoba, Córdoba, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); and Department of Clinical Science, ScreenPoint Medical, Nijmegen, the Netherlands (A.G.M., A.R.R.)
| | - Alejandro Rodríguez-Ruiz
- From the Breast Cancer Unit, Department of Radiology, Hospital Universitario Reina Sofía, Av Menéndez Pidal s/n, Córdoba 14004, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); Maimonides Institute for Biomedical Research of Córdoba, Córdoba, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); and Department of Clinical Science, ScreenPoint Medical, Nijmegen, the Netherlands (A.G.M., A.R.R.)
| | - Marina Álvarez-Benito
- From the Breast Cancer Unit, Department of Radiology, Hospital Universitario Reina Sofía, Av Menéndez Pidal s/n, Córdoba 14004, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); Maimonides Institute for Biomedical Research of Córdoba, Córdoba, Spain (J.L.R.P., S.R.M., E.E.C., M.Á.B.); and Department of Clinical Science, ScreenPoint Medical, Nijmegen, the Netherlands (A.G.M., A.R.R.)
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18
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Peng W, Carcioppolo N, Occa A, Ali K, Yang Q, Yang F. Feel Worried, Overloaded, or Fatalistic? The Determinants of Cancer Uncertainty Management Preferences. HEALTH COMMUNICATION 2021; 36:347-360. [PMID: 31760812 DOI: 10.1080/10410236.2019.1692489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Uncertainty in the context of cancer involves a complex and conflicting decision-making process. Individual preferences of seeking or avoiding information in the decisions of maintaining, reducing, or increasing uncertainty often depend on key cancer-related beliefs. The present study investigates whether cancer worry (CW), information overload (CIO), or fatalism (CF) can predict four constructs of uncertainty management preferences - avoid to maintain hope, avoid insufficient information, seek to increase uncertainty, and seek to reduce uncertainty. A hybrid model with structural and measurement components was specified and tested. The model analysis shows that cancer-related beliefs influenced individuals' needs and preferences for uncertainty management through seeking or avoiding information. CW was positively related to all but avoiding insufficient information. CIO was positively associated with all four preferences. CF was only associated with avoiding to maintain uncertainty. Theoretical and practical implications were discussed.
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Affiliation(s)
- Wei Peng
- School of Communication, University of Miami
| | | | - Aurora Occa
- Department of Communication, University of Kentucky
| | | | - Qinghua Yang
- Bob Schieffer College of Communication, Texas Christian University
| | - Fan Yang
- Department of Communication Studies, University of Alabama at Birmingham
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19
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Tron A, Caulliez S, Malmartel A. Comparison of mammography results from individual and organized screening for breast cancer. J Gynecol Obstet Hum Reprod 2020; 50:101926. [PMID: 33007526 DOI: 10.1016/j.jogoh.2020.101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND In France, the coexistence of individual screening (IS) and organized screening (OS) for breast cancer induces difficulties for primary care practitioners to position themselves. This study assessed whether the risk of having a mammography with a high risk of malignancy (BI-RADS 4 or 5) was different between patients aged from 50 to 74year performing it as part of an IS or of the OS. METHOD This cross-sectional multicenter study included women aged 50-74, with no personal history of breast cancer, performing mammography in radiology centers in Paris (France). The nature of the screening (OS or IS), breast cancer risk (high risk: BI-RADS 4 or 5), risk factors and clinical breast examination (CBE) abnormalities were collected. Patients in the IS and OS group were matched on age, breast density, history of benign lesions and family history of breast cancer using a propensity score. The association between the nature of screening and the risk of malignancy was evaluated by conditional logistic regression. RESULTS Among 2190 included patients, 77 % performed a mammography with the IS and had more CBE abnormalities (23 % vs 11 %, p<0,001), a history of benign lesion (15 % vs 11 %, p=0.01) and a family history of breast cancer (42 % vs 29 %, p<0,001). After matching 503 OS patients with 941 IS patients, the risk of malignancy and the nature of the screening were not associated (OR=0.72 [0.35-1.47], p=0.50). CONCLUSION The risk of malignancy was not different whether the mammography was performed as part of the OS or IS.
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Affiliation(s)
- Arthur Tron
- Université de Paris, Faculté de Santé, UFR de Médecine, Département de médecine générale, F-75014, Paris, France.
| | - Ségolène Caulliez
- Université de Paris, Faculté de Santé, UFR de Médecine, Département de médecine générale, F-75014, Paris, France
| | - Alexandre Malmartel
- Université de Paris, Faculté de Santé, UFR de Médecine, Département de médecine générale, F-75014, Paris, France
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20
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Sahoo S, Millar RJ, Yamashita T, Cummins PA. Problem-solving in technology-rich environments and cancer screening in later life. Eur J Cancer Prev 2020; 29:474-480. [PMID: 32740175 DOI: 10.1097/cej.0000000000000570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Routine cancer screening is widely recognized as an effective preventive strategy to reduce cancer mortality - the second leading cause of death in the US. However, cancer screening requires a complex array of tasks such as seeking up-to-date guidelines, making appointments, planning hospital visits, and communicating with health care professionals. Importantly, modern health care largely relies on technology to disseminate the latest information and administer the system. Yet, little is known about the technology-related skills that are relevant to regular cancer screening. This study examined the association between problem-solving skills in the technology-rich environment and cancer screening in later life. Using 2012/2014 Program for International Assessment of Adult Competencies data, binary logistic regressions with survey weights were used to estimate the association between problem-solving skills in the technology-rich environment and four cancer screening behaviors among the corresponding target populations aged between 45 and 74 years old (n = 1374 for cervical screening; n = 1373 for breast screening; n = 1166 for prostate screening; n = 2563 for colon screening). Results showed that greater problem-solving skills in the technology-rich environment scores (0-500 points) were significantly and positively associated with prostate cancer screening (odds ratio = 1.005, P < 0.05) among men, but not with colon (men and women) or cervical or breast (women) cancer screenings. Improvement in problem-solving skills in the technology-rich environment may promote specific cancer screening behaviors. Our findings inform future policy discussions and interventions that seek to improve cancer screening among a vulnerable section of older populations.
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Affiliation(s)
- Shalini Sahoo
- Department of Sociology, Anthropology, and Health Administration and Policy, University of Maryland, Baltimore County
- Gerontology Doctoral Program, University of Maryland, Baltimore County, Baltimore, Maryland
| | - Roberto J Millar
- Department of Sociology, Anthropology, and Health Administration and Policy, University of Maryland, Baltimore County
- Gerontology Doctoral Program, University of Maryland, Baltimore County, Baltimore, Maryland
| | - Takashi Yamashita
- Department of Sociology, Anthropology, and Health Administration and Policy, University of Maryland, Baltimore County
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21
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Kiani A, Behzadnia B, Jafarizadeh H. Study of the role of regular physical activity on promoting hedonism and eudaimonia in breast cancer survivors. J Family Med Prim Care 2020; 9:2286-2290. [PMID: 32754489 PMCID: PMC7380797 DOI: 10.4103/jfmpc.jfmpc_331_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/07/2020] [Accepted: 04/26/2020] [Indexed: 11/04/2022] Open
Abstract
Background Individuals who have completed cancer treatment may have psychological and physical challenges. Participating in regular physical activity is considered as one of the most important factors for improving postcancer experience. Aims The aim of this study was to examine the effect of participating in physical activities on hedonism and eudaimonia among breast cancer survivors. Methods The research method was a semi-experimental design in the form of time-series using two experimental and control groups. 42 breast cancer survivors participated in this study in Urmia. Data using motives for activation of hedonism and eudiamonia (HEMA) were gathered before the intervention program (pre-test), at the end of intervention (the first post-test), and two weeks after the first post-test (the second post-test). For data analysis, descriptive and inferential statistics (T-test, Chi-square, and repeated measures ANOVA) were used. Result Repeated measures ANOVA analysis in the three different periods of pre-test, post-test, and a month later post-test showed that changes in the mean score of hedonism and eudaimonia motivation were not similar in the two groups and indicated the improvement of dialysis adequacy in the intervention group compared with the control group. Conclusion Generally, the results showed that participating in regular physical activity is an effective intervention on enhancing the motives for hedonism and eduaimonia in breast cancer survivors.
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Affiliation(s)
- Arezou Kiani
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Behzad Behzadnia
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Hossein Jafarizadeh
- Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
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22
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Abstract
Current research on computer-aided diagnosis (CAD) of liver cancer is based on traditional feature engineering methods, which have several drawbacks including redundant features and high computational cost. Recent deep learning models overcome these problems by implicitly capturing intricate structures from large-scale medical image data. However, they are still affected by network hyperparameters and topology. Hence, the state of the art in this area can be further optimized by integrating bio-inspired concepts into deep learning models. This work proposes a novel bio-inspired deep learning approach for optimizing predictive results of liver cancer. This approach contributes to the literature in two ways. Firstly, a novel hybrid segmentation algorithm is proposed to extract liver lesions from computed tomography (CT) images using SegNet network, UNet network, and artificial bee colony optimization (ABC), namely, SegNet-UNet-ABC. This algorithm uses the SegNet for separating liver from the abdominal CT scan, then the UNet is used to extract lesions from the liver. In parallel, the ABC algorithm is hybridized with each network to tune its hyperparameters, as they highly affect the segmentation performance. Secondly, a hybrid algorithm of the LeNet-5 model and ABC algorithm, namely, LeNet-5/ABC, is proposed as feature extractor and classifier of liver lesions. The LeNet-5/ABC algorithm uses the ABC to select the optimal topology for constructing the LeNet-5 network, as network structure affects learning time and classification accuracy. For assessing performance of the two proposed algorithms, comparisons have been made to the state-of-the-art algorithms on liver lesion segmentation and classification. The results reveal that the SegNet-UNet-ABC is superior to other compared algorithms regarding Jaccard index, Dice index, correlation coefficient, and convergence time. Moreover, the LeNet-5/ABC algorithm outperforms other algorithms regarding specificity, F1-score, accuracy, and computational time.
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23
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Coretti S, Ruggeri M, Dibidino R, Gitto L, Marcellusi A, Mennini FS, Cicchetti A. Economic evaluation of colorectal cancer screening programs: Affordability for the health service. J Med Screen 2020; 27:186-193. [PMID: 31948342 DOI: 10.1177/0969141319898732] [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: 11/16/2022]
Abstract
OBJECTIVES To estimate the cost-effectiveness of the public colorectal cancer screening program in the Abruzzo region, Italy. METHODS Cost-effectiveness was analysed using a two-armed Markov model comparing: (1) Abruzzo screening program based on biennial faecal immunochemical occult blood testing, with colonoscopy as second level test for individuals with positive results, with (2) Treatment of symptomatic patients according to the stage of the neoplasm. Transition probabilities were adjusted for accuracy of tests and incidence of colorectal cancer. Diagnosis-related groups' charges and field collected data were used to estimate costs. Costs and benefits were discounted by 3.5%. Monte Carlo simulation confirmed the robustness of the model results. RESULTS Assuming a compliance rate of 64.7%, the incremental cost-effectiveness ratio for the current colorectal screening program was €433.06/quality adjusted life year gained, considerably lower than conventional thresholds (around €30,000). CONCLUSION Early detection and intervention programs help to avoid a large number of highly debilitating and expensive cancer treatments. These results show that the screening program currently implemented in Abruzzo should be considered as a good investment in health.
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Affiliation(s)
- Silvia Coretti
- Department of Economics and Management "Marco Fanno", University of Padova, Italy
| | - Matteo Ruggeri
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome , Italy
| | - Rossella Dibidino
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome , Italy
| | - Lara Gitto
- Dipartimento di Economia, Università degli Studi di Messina, Messina, Italy
| | - Andrea Marcellusi
- CEIS EEHTA (Economic Evaluation & HTA), University "Tor Vergata", Rome, Italy
| | | | - Americo Cicchetti
- Graduate School of Health Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome , Italy
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Kim BC, Kang M, Park E, Shim JI, Kang S, Lee J, Tchoe HJ, Kong KA, Kim DH, Kim YJ, Choi KS, Moon CM. Clinical Factors Associated with Adherence to the Follow-Up Examination after Positive Fecal Occult Blood Test in National Colorectal Cancer Screening. J Clin Med 2020; 9:E260. [PMID: 31963658 PMCID: PMC7019756 DOI: 10.3390/jcm9010260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background: The compliance with the follow-up examination after a positive fecal occult blood test (FOBT) is lower than expected. We aimed to evaluate the adherence rate to the follow-up examination in patients with a positive FOBT and to identify the clinical factors associated with this adherence. METHODS The study population comprised adults aged ≥50 years who participated in the National Cancer Screening Program for colorectal cancer (CRC) in 2013. Compliance was defined as undergoing follow-up examination within 1 year of a positive FOBT. RESULTS From 214,131 individuals with a positive FOBT, 120,911 (56.5%) were in the compliance group and 93,220 (43.5%) were in the non-compliance group. On multivariate analysis, good compliance was associated with men (odds ratio (OR) = 1.12, 95% confidence interval (CI) (1.09-1.15)), younger ages (70-79 years, OR = 2.19 (2.09-2.31); 60-69 years, OR = 3.29 (3.13-3.46); 50-59 years, OR = 3.57 (3.39-3.75) vs. >80 years), previous experience of CRC screening (a negative FOBT, OR = 1.18 (1.15-1.21); a positive FOBT, OR = 2.42 (2.31-2.54)), absent previous experience of colonoscopy or barium enema (OR = 2.06 (1.99-2.13)), higher economic income (quartile, 75%, OR = 1.14 (1.11-1.17); 100%, OR = 1.22 (1.19-1.25)), current smokers (OR = 1.12 (1.09-1.15)), alcohol intake (OR = 1.03 (1.01-1.05)), active physical activity (≥3 times/week, OR = 1.13 (1.11-1.15)), depression (OR = 1.11 (1.08-1.14)), and present comorbidities (Charlson Comorbidity Index, ≥1). CONCLUSION This study identified clinical factors, namely, male, younger ages, prior experience of fecal test, absent history of colonoscopy or double-contrast barium enema (DCBE) within 5 years, and high socioeconomic status to be associated with good adherence to the follow-up examination after a positive FOBT.
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Affiliation(s)
- Byung Chang Kim
- Center for Colorectal Cancer, Center for Cancer Prevention and Detection, Cancer Epidemiology Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Korea;
| | - Minjoo Kang
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Eunjung Park
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Jeong-Im Shim
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Shinhee Kang
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Jessie Lee
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Ha Jin Tchoe
- National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Korea; (M.K.); (E.P.); (J.-I.S.); (S.K.); (J.L.); (H.J.T.)
| | - Kyeong Ae Kong
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul 03760, Korea;
| | - Duk Hwan Kim
- Digestive Disease Center, Department of Internal Medicine, CHA University School of Medicine, Gyeonggi-do 11160, Korea;
| | - Yu Jin Kim
- Department of Internal Medicine, Hallym University College of Medicine, Gangwon-do 24252, Korea;
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Chang Mo Moon
- Department of Internal Medicine, College of Medicine, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, Korea
- Tissue Injury Defense Research Center, Ewha Womans University, Seoul 03760, Korea
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Tewari D, Patni P, Bishayee A, Sah AN, Bishayee A. Natural products targeting the PI3K-Akt-mTOR signaling pathway in cancer: A novel therapeutic strategy. Semin Cancer Biol 2019; 80:1-17. [PMID: 31866476 DOI: 10.1016/j.semcancer.2019.12.008] [Citation(s) in RCA: 291] [Impact Index Per Article: 58.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/01/2019] [Accepted: 12/03/2019] [Indexed: 02/07/2023]
Abstract
The phosphatidylinositol 3-kinase (PI3K)-Akt and the mammalian target of rapamycin (mTOR) represent two vital intracellular signaling pathways, which are associated with various aspects of cellular functions. These functions play vital roles in quiescence, survival, and growth in normal physiological circumstances as well as in various pathological disorders, including cancer. These two pathways are so intimately connected to each other that in some instances these are considered as one unique pathway crucial for cell cycle regulation. The purpose of this review is to emphasize the role of PI3K-Akt-mTOR signaling pathway in different cancer conditions and the importance of natural products targeting the PI3K-Akt-mTOR signaling pathway. This review also aims to draw the attention of scientists and researchers to the assorted beneficial effects of the numerous classes of natural products for the development of new and safe drugs for possible cancer therapy. We also summarize and critically analyze various preclinical and clinical studies on bioactive compounds and constituents, which are derived from natural products, to target the PI3K-Akt-mTOR signaling pathway for cancer prevention and intervention.
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Affiliation(s)
- Devesh Tewari
- Department of Pharmacognosy, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144 411, Punjab, India.
| | - Pooja Patni
- Sharda School of Pharmacy, Gujarat Technical University, Gandhinagar 382 610, Gujarat, India
| | | | - Archana N Sah
- Department of Pharmaceutical Sciences, Faculty of Technology, Bhimtal Campus, Kumaun University, Nainital 263 136, Uttarakhand, India
| | - Anupam Bishayee
- Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA.
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Bao Y, Tang J, Qian Y, Sun T, Chen H, Chen Z, Sun D, Zhong M, Chen H, Hong J, Chen Y, Fang JY. Long noncoding RNA BFAL1 mediates enterotoxigenic Bacteroides fragilis-related carcinogenesis in colorectal cancer via the RHEB/mTOR pathway. Cell Death Dis 2019; 10:675. [PMID: 31515468 PMCID: PMC6742644 DOI: 10.1038/s41419-019-1925-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 08/02/2019] [Accepted: 08/12/2019] [Indexed: 01/05/2023]
Abstract
Long noncoding RNAs (lncRNAs) contribute to many steps in carcinogenesis and often serve as biomarkers or therapeutic targets for tumor diagnosis and therapy. Although the role of lncRNAs in tumor formation is becoming clear, whether lncRNAs mediate gut microbiota-induced colorectal cancer (CRC) is largely unknown. Enterotoxigenic Bacteroides fragilis (ETBF) is a well-known tumor-inducing bacterium in the human gut; however, its tumorigenic effect remains to be explored. In the present study, we revealed the mechanism by which a lncRNA participates in gut bacteria-induced carcinogenesis: Bacteroides fragilis-associated lncRNA1 (BFAL1) in CRC tissues mediates ETBF carcinogenesis. BFAL1 was highly expressed in CRC tissues compared with that in adjacent normal tissues. In vitro, BFAL1 was upregulated in ETBF-treated CRC cells. Mechanistically, ETBF promoted tumor growth via BFAL1 by activating the Ras homolog, which is the MTORC1 binding/mammalian target of the rapamycin (RHEB/mTOR) pathway. Furthermore, BFAL1 regulated RHEB expression by competitively sponging microRNAs miR-155-5p and miR-200a-3p. Clinically, both high expression of BFAL1 and high abundance of ETBF in CRC tissues predicted poor outcomes for patients with CRC. Thus, BFAL1 is a mediator of ETBF-induced carcinogenesis and may be a potential therapeutic target for ETBF-induced CRC.
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Affiliation(s)
- Yujie Bao
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
- Department of Infectious Disease, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizhaoju Road, 200001, Shanghai, China
| | - Jiayin Tang
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 200001, Shanghai, China
| | - Yun Qian
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Tiantian Sun
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Huimin Chen
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Zhaofei Chen
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Danfeng Sun
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Ming Zhong
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 200001, Shanghai, China
| | - Haoyan Chen
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Jie Hong
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Yingxuan Chen
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China
| | - Jing-Yuan Fang
- State Key Laboratory for Oncogenes and Related Genes; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health; Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145 Middle Shandong Road, 200001, Shanghai, China.
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Aoun F, Slaoui A, Naoum E, Hassan T, Albisinni S, Azzo JM, Kallas-Chemaly A, Assenmacher G, Peltier A, Roumeguère T. Testicular microlithiasis: Systematic review and Clinical guidelines. Prog Urol 2019; 29:465-473. [DOI: 10.1016/j.purol.2019.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/24/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022]
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Owens OL, Wooten NR, Tavakoli AS. Development and initial psychometric evaluation of the computer-based prostate Cancer screening decision aid acceptance scale for African-American men. BMC Med Res Methodol 2019; 19:146. [PMID: 31291906 PMCID: PMC6617606 DOI: 10.1186/s12874-019-0776-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/11/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To reliably evaluate the acceptance and use of computer-based prostate cancer decision aids (CBDAs) for African-American men, culturally relevant measures are needed. This study describes the development and initial psychometric evaluation of the 24-item Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale among 357 African-American men. METHODS Exploratory factor analysis (EFA) with maximum likelihood estimation and polychoric correlations followed by Promax and Varimax rotations. RESULTS EFA yielded three factors: Technology Use Expectancy and Intention (16 items), Technology Use Anxiety (5 items), and Technology Use Self-Efficacy (3 items) with good to excellent internal consistency reliability at .95, .90, and .85, respectively. The standardized root mean square residual (0.035) indicated the factor structure explained most of the correlations. CONCLUSIONS Findings suggest the three-factor, 24-item Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale has utility in determining the acceptance and use of CBDAs among African-American men at risk for prostate cancer. Future research is needed to confirm this factor structure among socio-demographically diverse African-Americans.
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Affiliation(s)
- Otis L. Owens
- University of South Carolina, College of Social Work, 1514 Pendleton Street, Columbia, SC 29208 USA
| | - Nikki R. Wooten
- University of South Carolina, College of Social Work, 1514 Pendleton Street, Columbia, SC 29208 USA
| | - Abbas S. Tavakoli
- University of South Carolina, College of Nursing, 1601 Greene Street, Columbia, SC 29208 USA
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Can we reduce the workload of mammographic screening by automatic identification of normal exams with artificial intelligence? A feasibility study. Eur Radiol 2019; 29:4825-4832. [PMID: 30993432 PMCID: PMC6682851 DOI: 10.1007/s00330-019-06186-9] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/12/2019] [Accepted: 03/20/2019] [Indexed: 11/17/2022]
Abstract
Purpose To study the feasibility of automatically identifying normal digital mammography (DM) exams with artificial intelligence (AI) to reduce the breast cancer screening reading workload. Methods and materials A total of 2652 DM exams (653 cancer) and interpretations by 101 radiologists were gathered from nine previously performed multi-reader multi-case receiver operating characteristic (MRMC ROC) studies. An AI system was used to obtain a score between 1 and 10 for each exam, representing the likelihood of cancer present. Using all AI scores between 1 and 9 as possible thresholds, the exams were divided into groups of low- and high likelihood of cancer present. It was assumed that, under the pre-selection scenario, only the high-likelihood group would be read by radiologists, while all low-likelihood exams would be reported as normal. The area under the reader-averaged ROC curve (AUC) was calculated for the original evaluations and for the pre-selection scenarios and compared using a non-inferiority hypothesis. Results Setting the low/high-likelihood threshold at an AI score of 5 (high likelihood > 5) results in a trade-off of approximately halving (− 47%) the workload to be read by radiologists while excluding 7% of true-positive exams. Using an AI score of 2 as threshold yields a workload reduction of 17% while only excluding 1% of true-positive exams. Pre-selection did not change the average AUC of radiologists (inferior 95% CI > − 0.05) for any threshold except at the extreme AI score of 9. Conclusion It is possible to automatically pre-select exams using AI to significantly reduce the breast cancer screening reading workload. Key Points • There is potential to use artificial intelligence to automatically reduce the breast cancer screening reading workload by excluding exams with a low likelihood of cancer. • The exclusion of exams with the lowest likelihood of cancer in screening might not change radiologists’ breast cancer detection performance. • When excluding exams with the lowest likelihood of cancer, the decrease in true-positive recalls would be balanced by a simultaneous reduction in false-positive recalls.
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Luckmann R, Costanza ME, White MJ, Frisard CF, Rosal M, Sama S, Landry MR, Yood R. A 4-year randomized trial comparing three outreach interventions to promote screening mammograms. Transl Behav Med 2019; 9:328-335. [PMID: 29796649 DOI: 10.1093/tbm/iby031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
As population health has become a focus of health care payers and providers, interest has grown in mail, phone, and other forms of outreach for improving population rates of cancer screening. Translational research is needed to compare the effectiveness and cost of low- and high-intensity behavioral outreach interventions for promoting cancer screening. The purpose of the article is to compare the effectiveness in promoting biannual mammograms of three interventions delivered over 4 years to a primary care population with a high baseline mammography adherence of 83.3%. We randomized women aged 40-84 to reminder letter only (LO arm), letter + reminder call (RC arm), and two letters + counseling call (CC arm) involving tailored education and motivational interviewing. Mammography adherence (≥1 mammogram in the previous 24 months) at four time points was determined from insurance claims records. Over 4 years, 30,162 women were randomized. At the end of 4 years, adherence was highest in the RC arm (83.0%) compared with CC (80.8%) and LO (80.8%) arms (p = .03). Only 23.5% of women in the CC arm were reached and accepted full counseling. The incremental cost per additional mammogram for RC arm women was $30.45 over the LO arm cost. A simple reminder call can increase screening mammogram adherence even when baseline adherence is high. Some more complex behavioral interventions delivered by mail and phone as in this study may be less effective, due to limited participation of patients, a focus on ambivalence, lack of follow-up, and other factors.
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Affiliation(s)
- Roger Luckmann
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Mary E Costanza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Mary Jo White
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christine F Frisard
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Milagros Rosal
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Susan Sama
- Department of Research, Reliant Medical Group, Worcester, MA, USA
| | - Michelle R Landry
- Center for Health Policy and Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - Robert Yood
- Department of Medical Specialties, Reliant Medical Group, Worcester, MA, USA
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Tsiakanikas P, Kontos CK, Kerimis D, Papadopoulos IN, Scorilas A. High microRNA-28-5p expression in colorectal adenocarcinoma predicts short-term relapse of node-negative patients and poor overall survival of patients with non-metastatic disease. Clin Chem Lab Med 2019; 56:990-1000. [PMID: 29688883 DOI: 10.1515/cclm-2017-0430] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/17/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND MicroRNAs (miRNAs) may function either as oncogenes or tumor suppressors and are heavily involved in the initiation and progression of cancer, and in metastasis of tumor cells. MicroRNA-28-5p (miR-28-5p) targets several cancer-related genes and is hence involved in cell proliferation, migration, invasion and epithelial-mesenchymal transition. In this study, we investigated the potential diagnostic and prognostic significance of miR-28-5p expression in colorectal adenocarcinoma, the most frequent type of colorectal cancer (CRC). METHODS Therefore, we isolated total RNA from 182 colorectal adenocarcinoma specimens and 86 paired non-cancerous colorectal mucosae. After polyadenylation of 2 μg total RNA and its reverse transcription using an oligo-dT-adapter primer, we quantified miR-28-5p levels using an in-house-developed reverse-transcription real-time quantitative polymerase chain reaction (RT-qPCR) method, based on the SYBR Green chemistry. RESULTS Comparison of miR-28-5p levels among 86 pairs of colorectal tumors and their adjacent non-cancerous mucosae uncovered the downregulation of miR-28-5p expression in the majority of malignant colorectal tumors. More importantly, high miR-28-5p expression predicts poor disease-free survival (DFS) and overall survival (OS) of colorectal adenocarcinoma patients. Multivariate Cox regression analysis revealed that miR-28-5p overexpression is a significant predictor of poor prognosis in colorectal adenocarcinoma, independent of tumor size, histological grade, TNM staging, radiotherapy and chemotherapy. Interestingly, strong miR-28-5p expression retains its predictive potential regarding relapse among patients with negative regional lymph nodes, and predicts poor OS in patients diagnosed with non-metastatic colorectal adenocarcinoma. CONCLUSIONS High miR-28-5p expression predicts poor DFS and OS of colorectal adenocarcinoma patients, independently of clinicopathological prognosticators and standard patient treatment, including radiotherapy and chemotherapy.
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Affiliation(s)
- Panagiotis Tsiakanikas
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos K Kontos
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kerimis
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Andreas Scorilas
- Department of Biochemistry and Molecular Biology, National and Kapodistrian University of Athens, Athens, Greece, Phone: +30 2107274306, Fax: +30 2107274158
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Clendenen TV, Ge W, Koenig KL, Afanasyeva Y, Agnoli C, Brinton LA, Darvishian F, Dorgan JF, Eliassen AH, Falk RT, Hallmans G, Hankinson SE, Hoffman-Bolton J, Key TJ, Krogh V, Nichols HB, Sandler DP, Schoemaker MJ, Sluss PM, Sund M, Swerdlow AJ, Visvanathan K, Zeleniuch-Jacquotte A, Liu M. Breast cancer risk prediction in women aged 35-50 years: impact of including sex hormone concentrations in the Gail model. Breast Cancer Res 2019; 21:42. [PMID: 30890167 PMCID: PMC6425605 DOI: 10.1186/s13058-019-1126-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/05/2019] [Indexed: 12/28/2022] Open
Abstract
Background Models that accurately predict risk of breast cancer are needed to help younger women make decisions about when to begin screening. Premenopausal concentrations of circulating anti-Müllerian hormone (AMH), a biomarker of ovarian reserve, and testosterone have been positively associated with breast cancer risk in prospective studies. We assessed whether adding AMH and/or testosterone to the Gail model improves its prediction performance for women aged 35–50. Methods In a nested case-control study including ten prospective cohorts (1762 invasive cases/1890 matched controls) with pre-diagnostic serum/plasma samples, we estimated relative risks (RR) for the biomarkers and Gail risk factors using conditional logistic regression and random-effects meta-analysis. Absolute risk models were developed using these RR estimates, attributable risk fractions calculated using the distributions of the risk factors in the cases from the consortium, and population-based incidence and mortality rates. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory accuracy of the models with and without biomarkers. Results The AUC for invasive breast cancer including only the Gail risk factor variables was 55.3 (95% CI 53.4, 57.1). The AUC increased moderately with the addition of AMH (AUC 57.6, 95% CI 55.7, 59.5), testosterone (AUC 56.2, 95% CI 54.4, 58.1), or both (AUC 58.1, 95% CI 56.2, 59.9). The largest AUC improvement (4.0) was among women without a family history of breast cancer. Conclusions AMH and testosterone moderately increase the discriminatory accuracy of the Gail model among women aged 35–50. We observed the largest AUC increase for women without a family history of breast cancer, the group that would benefit most from improved risk prediction because early screening is already recommended for women with a family history. Electronic supplementary material The online version of this article (10.1186/s13058-019-1126-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tess V Clendenen
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY, 10016, USA
| | - Wenzhen Ge
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY, 10016, USA
| | - Karen L Koenig
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY, 10016, USA
| | - Yelena Afanasyeva
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY, 10016, USA
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Farbod Darvishian
- Department of Pathology, New York University School of Medicine, New York, NY, USA.,Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Joanne F Dorgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Göran Hallmans
- Department of Biobank Research, Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Susan E Hankinson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Judith Hoffman-Bolton
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK.,Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Patrick M Sluss
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Malin Sund
- Department of Surgery, Umeå University Hospital, Umeå, Sweden
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY, 10016, USA.,Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY, 10016, USA. .,Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA.
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Arora M, Baldi A, Kapila N, Bhandari S, Jeet K. Impact of Probiotics and Prebiotics on Colon Cancer: Mechanistic Insights and Future Approaches. CURRENT CANCER THERAPY REVIEWS 2019. [DOI: 10.2174/1573394714666180724122042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Colon cancer is one of the most common and most diagnosed types of cancer. It is a
major cause of increased rate of morbidity and mortality across the globe. Currently, the focus has
been shifted towards natural remedies for the treatment of colon cancer. These new methods of
treatment include prebiotics and probiotics, as they offer great potential for alleviating symptoms
of cancer. These are more promising and have lesser side effects than existing medications. Probiotics
are living organisms which confer health benefits when ingested into adequate amounts.
Prebiotics are non-digestible ingredients which promote the growth of beneficial bacteria, which
produce metabolites for stimulation of apoptosis of colonic cancer cell lines. Apart from it,
prebiotics are helpful to modify the activity of enzymes to be produced by beneficial bacteria as
well as for inhibition of several bacteria able to produce carcinogenic enzymes. This review has
been collated to present tremendous benefits and future potential of pro- and prebiotics in the
treatment of colon cancer and to overview the mechanisms of probiotic actions along with their
impact on humans.
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Affiliation(s)
- Malika Arora
- Multi Disciplinary Research Unit, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Ashish Baldi
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Nitesh Kapila
- Department of Quality Assurance, Faculty of Pharmacy, I.S.F. College of Pharmacy, Moga, Punjab, India
| | - Saurav Bhandari
- Department of Quality Assurance, Faculty of Pharmacy, I.S.F. College of Pharmacy, Moga, Punjab, India
| | - Kamal Jeet
- IKG Punjab Technical University, Jalandhar, Punjab, India
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Cai SR, Huang YQ, Zhang SZ, Li QR, Ma XY, Zheng S. Effects of subitems in the colorectal cancer screening protocol on the Chinese colorectal cancer screening program: an analysis based on natural community screening results. BMC Cancer 2019; 19:47. [PMID: 30630450 PMCID: PMC6327475 DOI: 10.1186/s12885-018-5191-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 12/06/2018] [Indexed: 02/08/2023] Open
Abstract
Background To date, no single colorectal cancer (CRC) screening strategy has been determined to be applicable worldwide. In China, a CRC screening protocol that combines double fecal immunochemical tests (FITs) and a high-risk factor questionnaire (HRFQ) as the first stage of screening and colonoscopy as the second stage of screening (scenario A) was adapted by the Chinese Ministry of Health in 2006. However, applying this CRC screening protocol nationally remains difficult because its effectiveness and convenience are controversial. This study evaluated the effects of subitems of the CRC screening protocol in China. Methods CRC screening results (scenario A) from Jiashan County, China, (2007–2009) were used to analyze the detection rates of CRC and advanced neoplasms as well as the cost-effectiveness of the protocol. Scenario A was divided into scenarios B–G (by selecting some items at the first stage of screening) for analysis. Results Compared with scenario A, removing the whole HRFQ (scenario F) reduced advanced neoplasm and adenoma detections by 29.8 and 41.2%, respectively, whereas the whole HRFQ accounted for 10.1% of the total screening cost. Removing FITs (scenario G) reduced CRC, advanced neoplasm and adenoma detections by 71.8, 56.9 and 47.7%, respectively, and the costs per case of CRC and advanced neoplasm were 82.0 and 19.1% higher, respectively, than those in scenario A. In scenarios B–E (deleting some high-risk factor questions on the HRFQ), the odds ratios (ORs) of the detection rates and costs per CRC, advanced neoplasm, adenoma, and neoplasm case were near 1.00. Scenarios C and D reduced the high-risk population and total screening costs by less than 6.0 and 4.1%, respectively. Scenarios E and B (FITs and a personal history of cancer or colorectal adenoma were reserved) reduced the high-risk population by 17.6 and 24.2% and the total screening costs by 11.2 and 15.4%, respectively, while the numbers of CRC cases were not missed, and advanced neoplasms detected decreased by only 5 and 11%, respectively. Conclusion The results of this study demonstrate that FITs and a personal history of colorectal adenoma are the most effective items in the Chinese CRC screening protocol.
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Affiliation(s)
- Shan-Rong Cai
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Ministry of Education of China, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Yan-Qin Huang
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Ministry of Education of China, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Su-Zhan Zhang
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Ministry of Education of China, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Qi-Rong Li
- Institute of Oncology Prevention and Treatment, Jia-Shan, Zhejiang, 314100, People's Republic of China
| | - Xin Yuan Ma
- Institute of Oncology Prevention and Treatment, Jia-Shan, Zhejiang, 314100, People's Republic of China
| | - Shu Zheng
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Ministry of Education of China, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China.
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Rodríguez-Ruiz A, Krupinski E, Mordang JJ, Schilling K, Heywang-Köbrunner SH, Sechopoulos I, Mann RM. Detection of Breast Cancer with Mammography: Effect of an Artificial Intelligence Support System. Radiology 2018; 290:305-314. [PMID: 30457482 DOI: 10.1148/radiol.2018181371] [Citation(s) in RCA: 260] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose To compare breast cancer detection performance of radiologists reading mammographic examinations unaided versus supported by an artificial intelligence (AI) system. Materials and Methods An enriched retrospective, fully crossed, multireader, multicase, HIPAA-compliant study was performed. Screening digital mammographic examinations from 240 women (median age, 62 years; range, 39-89 years) performed between 2013 and 2017 were included. The 240 examinations (100 showing cancers, 40 leading to false-positive recalls, 100 normal) were interpreted by 14 Mammography Quality Standards Act-qualified radiologists, once with and once without AI support. The readers provided a Breast Imaging Reporting and Data System score and probability of malignancy. AI support provided radiologists with interactive decision support (clicking on a breast region yields a local cancer likelihood score), traditional lesion markers for computer-detected abnormalities, and an examination-based cancer likelihood score. The area under the receiver operating characteristic curve (AUC), specificity and sensitivity, and reading time were compared between conditions by using mixed-models analysis dof variance and generalized linear models for multiple repeated measurements. Results On average, the AUC was higher with AI support than with unaided reading (0.89 vs 0.87, respectively; P = .002). Sensitivity increased with AI support (86% [86 of 100] vs 83% [83 of 100]; P = .046), whereas specificity trended toward improvement (79% [111 of 140]) vs 77% [108 of 140]; P = .06). Reading time per case was similar (unaided, 146 seconds; supported by AI, 149 seconds; P = .15). The AUC with the AI system alone was similar to the average AUC of the radiologists (0.89 vs 0.87). Conclusion Radiologists improved their cancer detection at mammography when using an artificial intelligence system for support, without requiring additional reading time. Published under a CC BY 4.0 license. See also the editorial by Bahl in this issue.
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Affiliation(s)
- Alejandro Rodríguez-Ruiz
- From the Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, the Netherlands (A.R.R., I.S., R.M.M.); Department of Radiology & Imaging Sciences, Emory University, Atlanta, Ga (E.K.); ScreenPoint Medical BV, Nijmegen, the Netherlands (J.J.M.); Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital, Boca Raton, Fla (K.S.); Referenzzentrum Mammographie Munich, Brustdiagnostik München and FFB, Munich, Germany (S.H.H.); and Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.)
| | - Elizabeth Krupinski
- From the Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, the Netherlands (A.R.R., I.S., R.M.M.); Department of Radiology & Imaging Sciences, Emory University, Atlanta, Ga (E.K.); ScreenPoint Medical BV, Nijmegen, the Netherlands (J.J.M.); Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital, Boca Raton, Fla (K.S.); Referenzzentrum Mammographie Munich, Brustdiagnostik München and FFB, Munich, Germany (S.H.H.); and Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.)
| | - Jan-Jurre Mordang
- From the Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, the Netherlands (A.R.R., I.S., R.M.M.); Department of Radiology & Imaging Sciences, Emory University, Atlanta, Ga (E.K.); ScreenPoint Medical BV, Nijmegen, the Netherlands (J.J.M.); Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital, Boca Raton, Fla (K.S.); Referenzzentrum Mammographie Munich, Brustdiagnostik München and FFB, Munich, Germany (S.H.H.); and Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.)
| | - Kathy Schilling
- From the Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, the Netherlands (A.R.R., I.S., R.M.M.); Department of Radiology & Imaging Sciences, Emory University, Atlanta, Ga (E.K.); ScreenPoint Medical BV, Nijmegen, the Netherlands (J.J.M.); Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital, Boca Raton, Fla (K.S.); Referenzzentrum Mammographie Munich, Brustdiagnostik München and FFB, Munich, Germany (S.H.H.); and Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.)
| | - Sylvia H Heywang-Köbrunner
- From the Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, the Netherlands (A.R.R., I.S., R.M.M.); Department of Radiology & Imaging Sciences, Emory University, Atlanta, Ga (E.K.); ScreenPoint Medical BV, Nijmegen, the Netherlands (J.J.M.); Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital, Boca Raton, Fla (K.S.); Referenzzentrum Mammographie Munich, Brustdiagnostik München and FFB, Munich, Germany (S.H.H.); and Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.)
| | - Ioannis Sechopoulos
- From the Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, the Netherlands (A.R.R., I.S., R.M.M.); Department of Radiology & Imaging Sciences, Emory University, Atlanta, Ga (E.K.); ScreenPoint Medical BV, Nijmegen, the Netherlands (J.J.M.); Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital, Boca Raton, Fla (K.S.); Referenzzentrum Mammographie Munich, Brustdiagnostik München and FFB, Munich, Germany (S.H.H.); and Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.)
| | - Ritse M Mann
- From the Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Geert Grooteplein 10, 6525 GA, Post 766, Nijmegen, the Netherlands (A.R.R., I.S., R.M.M.); Department of Radiology & Imaging Sciences, Emory University, Atlanta, Ga (E.K.); ScreenPoint Medical BV, Nijmegen, the Netherlands (J.J.M.); Lynn Women's Health & Wellness Institute, Boca Raton Regional Hospital, Boca Raton, Fla (K.S.); Referenzzentrum Mammographie Munich, Brustdiagnostik München and FFB, Munich, Germany (S.H.H.); and Dutch Expert Centre for Screening, Nijmegen, the Netherlands (I.S.)
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Herrmann A, Hall A, Proietto A. Using the Health Belief Model to explore why women decide for or against the removal of their ovaries to reduce their risk of developing cancer. BMC Womens Health 2018; 18:184. [PMID: 30428865 PMCID: PMC6236993 DOI: 10.1186/s12905-018-0673-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 10/28/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Women at an increased risk of ovarian cancer often have to decide for or against the surgical removal of their healthy ovaries to reduce their cancer risk. This decision can be extremely difficult. Despite this, there is a lack of guidance on how to best support women in making this decision. Research that is guided by theoretical frameworks is needed to help inform clinical practice. We explored the decision-making process of women who are at an increased risk of developing ovarian cancer and had to decide for or against the removal of their ovaries. METHODS A qualitative study of 18 semi-structured interviews with women who have attended a cancer treatment centre or cancer counselling and information service in New South Wales, Australia. Data collection and analysis were informed by the Health Belief Model (HBM). Data was analysed using qualitative content analysis. RESULTS The paper describes women's decision making with the help of the four constructs of the HBM: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. The more anxious and susceptible women felt about getting ovarian cancer, the more likely they were to have an oophorectomy. Women's anxiety was often fuelled by witnessing family members suffer or die from cancer. Women considered a number of barriers and potential benefits to having the surgery but based their decision on "gut feeling" and experiential factors, rather than statistical risk assessment. Age, menopausal status and family commitments seemed to influence but not determine women's decisions on oophorectomy. Women reported a lack of decision support and appreciated if their doctor explained their treatment choice, provided personalised information, involved their general practitioner in the decision-making process and offered a second consultation to follow-up on any questions women might have. CONCLUSIONS These findings suggest that deciding on whether to have an oophorectomy is a highly personal decision which can be described with the help of the HBM. The results also highlight the need for tailored decision support which could help improve doctor-patient-communication and patient-centred care related to risk reducing surgery in women at an increased risk of ovarian cancer.
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Affiliation(s)
- Anne Herrmann
- Priority Research Centre for Health Behaviour, Health Behaviour Research Collaborative, University of Newcastle and Hunter Medical Research Institute, University Drive, Callaghan, 2308 Australia
| | - Alix Hall
- Priority Research Centre for Health Behaviour, Health Behaviour Research Collaborative, University of Newcastle and Hunter Medical Research Institute, University Drive, Callaghan, 2308 Australia
| | - Anthony Proietto
- Cancer Services and Cancer Network, Hunter New England Local Health District, Newcastle, Australia
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Xu CH, Ren DY, Wang YC, Zhang Q, Zhang XW, Qian LH, Shao JB. Diagnostic value of serum dihydrodiol dehydrogenase 2 levels in patients with non-small-cell lung cancer. Int J Biol Markers 2018; 33:1724600818776832. [PMID: 29874986 DOI: 10.1177/1724600818776832] [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: 11/16/2022]
Abstract
OBJECTIVES Dihydrodiol dehydrogenase 2 (DDH2) plays an important role in pathogenesis of non-small-cell lung cancer (NSCLC). This study aimed to evaluate the value of serum DDH2 levels in NSCLC patients. METHODS Serum samples were obtained from 863 NSCLC patients and 439 healthy controls. The samples were randomly divided into a training set and a test set. Serum DDH2 levels were assayed by enzyme-linked immunosorbent assay (ELISA). RESULTS The levels of DDH2 in NSCLC patients were significantly higher than those in healthy controls ( P < 0.001). The diagnostic use of DDH2 in lung adenocarcinoma was significantly greater than that of carcinoembryonic antigen, cytokeratin 19 fragment (CYFRA21-1), and carbohydrate antigen 125 ( P < 0.001). Combining DDH2 with carcinoembryonic antigen, CYFRA21-1, and carbohydrate antigen 125 was more effective for lung adenocarcinoma diagnosis than DDH2 alone. In addition, the levels of DDH2 could contribute to the diagnosis of lung squamous cell carcinoma. CONCLUSIONS The measurement of serum DDH2 is a valuable diagnostic marker for NSCLC patients.
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Affiliation(s)
- Chun-Hua Xu
- 1 Endoscopic Center of Nanjing Chest Hospital, Nanjing, Jiangsu, China
- 2 Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, Jiangsu, China
| | - Ding-Yu Ren
- 3 Department of Science and Education, Nanjing Chest Hospital, Nanjing, Jiangsu, China
| | - Yu-Chao Wang
- 1 Endoscopic Center of Nanjing Chest Hospital, Nanjing, Jiangsu, China
- 2 Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, Jiangsu, China
| | - Qian Zhang
- 1 Endoscopic Center of Nanjing Chest Hospital, Nanjing, Jiangsu, China
- 2 Clinical Center of Nanjing Respiratory Diseases and Imaging, Nanjing, Jiangsu, China
| | - Xiu-Wei Zhang
- 4 Department of Respiratory Medicine, Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Li-Hua Qian
- 5 Department of Respiratory Medicine, Nanjing Pukou Central Hospital, Nanjing, Jiangsu, China
| | - Jie-Bao Shao
- 6 Center of Laboratory, Nanjing Chest Hospital, Nanjing, Jiangsu, China
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Sabbath EL, Sparer EH, Boden LI, Wagner GR, Hashimoto DM, Hopcia K, Sorensen G. Preventive care utilization: Association with individual- and workgroup-level policy and practice perceptions. Prev Med 2018; 111:235-240. [PMID: 29567439 PMCID: PMC6028933 DOI: 10.1016/j.ypmed.2018.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 02/05/2018] [Accepted: 03/14/2018] [Indexed: 01/13/2023]
Abstract
Preventive medical care may reduce downstream medical costs and reduce population burden of disease. However, although social, demographic, and geographic determinants of preventive care have been studied, there is little information about how the workplace affects preventive care utilization. This study examines how four types of organizational policies and practices (OPPs) are associated with individual workers' preventive care utilization. We used data collected in 2012 from 838 hospital patient care workers, grouped in 84 patient care units at two hospitals in Boston. Via survey, we assessed individuals' perceptions of four types of OPPs on their work units. We linked the survey data to a database containing detailed information on medical expenditures. Using multilevel models, we tested whether individual-level perceptions, workgroup-average perceptions, and their combination were associated with individual workers' preventive care utilization (measured by number of preventive care encounters over a two-year period). Adjusting for worker characteristics, higher individual-level perceptions of workplace flexibility were associated with greater preventive care utilization. Higher average unit-level perceptions of people-oriented culture, ergonomic practices, and flexibility were associated with greater preventive care utilization. Overall, we find that workplace policies and practices supporting flexibility, ergonomics, and people-oriented culture are associated with positive preventive care-seeking behavior among workers, with some policies and practices operating at the individual level and some at the group level. Improving the work environment could impact employers' health-related expenditures and improve workers' health-related quality of life.
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Affiliation(s)
- Erika L Sabbath
- Boston College, School of Social Work, Chestnut Hill, MA, United States.
| | - Emily H Sparer
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Leslie I Boden
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States
| | - Gregory R Wagner
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Dean M Hashimoto
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, MA, United States; Boston College Law School, Chestnut Hill, MA, United States
| | - Karen Hopcia
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, MA, United States
| | - Glorian Sorensen
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Zheng L, Zhang Z, Zhang S, Guo Q, Zhang F, Gao L, Ni H, Guo X, Xiang C, Xi T. RNA Binding Protein RNPC1 Inhibits Breast Cancer Cell Metastasis via Activating STARD13-Correlated ceRNA Network. Mol Pharm 2018; 15:2123-2132. [PMID: 29733656 DOI: 10.1021/acs.molpharmaceut.7b01123] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Lufeng Zheng
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Zhiting Zhang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Shufang Zhang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Qianqian Guo
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Feng Zhang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Lanlan Gao
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Haiwei Ni
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Xinwei Guo
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Chenxi Xiang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
| | - Tao Xi
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
- Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University, Nanjing 210009, People’s Republic of China
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miR-15a-5p, A Novel Prognostic Biomarker, Predicting Recurrent Colorectal Adenocarcinoma. Mol Diagn Ther 2018; 21:453-464. [PMID: 28405803 DOI: 10.1007/s40291-017-0270-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Colorectal cancer is one of the most common gastrointestinal diseases and the second leading cause of cancer-associated deaths among adults. miR-15a-5p is a post-transcriptional regulator of the proto-oncogene MYB, a transcription factor essential for prolonged cancer cell proliferation and survival. In the current study, we assessed the potential diagnostic and prognostic utility of miR-15a-5p expression in colorectal adenocarcinoma. METHODS To accomplish this goal, total RNA was extracted from 182 colorectal adenocarcinoma specimens and 86 non-cancerous colorectal mucosae. After polyadenylation by poly(A) polymerase and subsequent reverse transcription with an oligo-dT adapter primer, miR-15a-5p expression was analyzed using an in-house developed reverse transcription quantitative real-time PCR method, based on SYBR Green chemistry. SNORD43 (RNU43) was used as an internal control gene. RESULTS miR-15a-5p was significantly upregulated in colorectal tumors compared to non-cancerous colorectal mucosae, while ROC analysis suggested its potential use for diagnostic purposes. Moreover, miR-15a-5p overexpression predicts poor disease-free survival (DFS) and overall survival (OS). Multivariate Cox regression analysis confirmed that miR-15a-5p overexpression is a significant unfavorable prognosticator of DFS in colorectal adenocarcinoma, independent of other established prognostic factors plus treatment of patients. Importantly, miR-15a-5p overexpression retains its unfavorable prognostic value in patients with T3 colorectal adenocarcinoma and in those without distant metastasis (M0). More importantly, the cumulative DFS probability of patients with early stage disease was significantly lower for those with colorectal adenocarcinoma overexpressing miR-15a-5p. DISCUSSION In conclusion, elevated expression of the cancer-associated miR-15a-5p predicts poor DFS and OS of colorectal adenocarcinoma patients. The prognostic value of miR-15a-5p expression regarding DFS is independent of clinicopathological factors currently used for colorectal adenocarcinoma prognosis.
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Hu W, Tan C, He Y, Zhang G, Xu Y, Tang J. Functional miRNAs in breast cancer drug resistance. Onco Targets Ther 2018; 11:1529-1541. [PMID: 29593419 PMCID: PMC5865556 DOI: 10.2147/ott.s152462] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Owing to improved early surveillance and advanced therapy strategies, the current death rate due to breast cancer has decreased; nevertheless, drug resistance and relapse remain obstacles on the path to successful systematic treatment. Multiple mechanisms responsible for drug resistance have been elucidated, and miRNAs seem to play a major part in almost every aspect of cancer progression, including tumorigenesis, metastasis, and drug resistance. In recent years, exosomes have emerged as novel modes of intercellular signaling vehicles, initiating cell–cell communication through their fusion with target cell membranes, delivering functional molecules including miRNAs and proteins. This review particularly focuses on enumerating functional miRNAs involved in breast cancer drug resistance as well as their targets and related mechanisms. Subsequently, we discuss the prospects and challenges of miRNA function in drug resistance and highlight valuable approaches for the investigation of the role of exosomal miRNAs in breast cancer progression and drug resistance.
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Affiliation(s)
- Weizi Hu
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University.,School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University.,Nanjing Medical University Affiliated Cancer Hospital
| | - Chunli Tan
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University.,School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University.,Nanjing Medical University Affiliated Cancer Hospital
| | - Yunjie He
- The First Clinical School of Nanjing Medical University
| | - Guangqin Zhang
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University
| | - Yong Xu
- Nanjing Medical University Affiliated Cancer Hospital.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Nanjing Medical University, Nanjing, People's Republic of China
| | - Jinhai Tang
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University
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Mensah KB, Oosthuizen F, Bonsu AB. Cancer awareness among community pharmacist: a systematic review. BMC Cancer 2018; 18:299. [PMID: 29548307 PMCID: PMC5857088 DOI: 10.1186/s12885-018-4195-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/07/2018] [Indexed: 11/17/2022] Open
Abstract
Background The WHO recognises that community pharmacists are the most accessible healthcare professionals to the general public. Most patients regularly visit community pharmacies for health information and also seek advice from pharmacists with respect to signs and symptoms of cancer. As readily accessible health care professionals, community pharmacists are also in the best position to include cancer-screening initiatives into their practice. Pharmacists are therefore in a good position to raise awareness when they counsel people who buy over-the-counter medication for the control of possible cancer-related symptoms. The aim of this review was to critically appraise evidence gathered from studies that; (1) explore or assess knowledge of community pharmacist on signs and symptoms of cancer, (2) explore or assess knowledge of community pharmacist on cancer screening. Methods EMBASE (ovid), CINAHL (EBSCOhost) and MEDLINE (EBSCOhost) were systematically searched for studies conducted between 2005 to July 2017. Studies that focused on knowledge of community pharmacist in cancer screening, signs and symptoms were included. Results A total of 1538 articles were identified from the search, of which 4 out of the 28 potentially relevant abstracts were included in the review. Findings of the selected studies revealed lack of sufficient knowledge on breast cancer screening, signs and symptoms. Both studies attributed knowledge limitation as the cause of reason for the key findings of their studies. Conclusion The selected studies focused largely on breast cancer, which hinder the generalizability and transferability of the findings. Hence there is a need for more studies to be conducted in this area to draw a better conclusion.
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Affiliation(s)
- Kofi Boamah Mensah
- National Center for Radiotherapy & Nuclear Medicine, Directorate of Oncology, Komfo Anokye Teaching Hospital, Box 1934, Kumasi, Ghana. .,University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, College of Health Sciences, Westville Campus, University Road, Durban, South Africa.
| | - Frasia Oosthuizen
- University of KwaZulu-Natal, Discipline of Pharmaceutical Sciences, College of Health Sciences, Westville Campus, University Road, Durban, South Africa
| | - Adwoa Bemah Bonsu
- Kwame Nkrumah University of Science & Technology, Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
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Wang KH, Thompson TA, Galusha D, Friedman H, Nazario CM, Nunez M, Maharaj RG, Adams OP, Nunez-Smith M. Non-communicable chronic diseases and timely breast cancer screening among women of the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study. Cancer Causes Control 2018; 29:315-324. [PMID: 29423760 PMCID: PMC6587190 DOI: 10.1007/s10552-018-1005-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 01/30/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE The Caribbean population faces a growing burden of multiple non-communicable chronic diseases (NCDs). Breast cancer is the leading cause of cancer death for women in the Caribbean. Given the substantial burden of NCDs across the region, cancer prevention and control strategies may need to be specifically tailored for people with multiple co-morbidities. Preventive screening, such as timely mammography, is essential but may be either facilitated or hampered by chronic disease control. The main objective of this study is to examine the relationship between a chronic disease and timely breast cancer screening. METHODS We conducted a cross-sectional data analysis using baseline data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study-ECS. Our independent variables were presence of chronic diseases (hypertension or diabetes), defined as having been told by a clinical provider. Our dependent variable was timely screening mammography, as defined by receipt of mammography within the past 2 years. We examined bivariate and multivariate associations of covariates and timely screening mammography. RESULTS In our sample (n = 841), 52% reported timely screening mammography. Among those with timely screening, 50.8% reported having hypertension, and 22.3% reported having diabetes. In our bivariate analyses, both diabetes and hypertension were associated with timely screening mammography. In partially adjusted models, we found that women with diabetes were significantly more likely to report timely screening mammography than women without diabetes. In our fully adjusted models, the association was no longer significant. Having a usual source of healthcare and a woman's island of residence were significantly associated with timely screening mammography (p < 0.05). CONCLUSIONS We found that half of eligible women received timely screening mammography. Diabetes and hypertension, though common, are not associated with timely screening mammography. Usual source of care remains an important factor to timely breast cancer screening.
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Affiliation(s)
- K H Wang
- Equity Research and Innovation Center, Yale University School of Medicine, New Haven, USA.
| | - T A Thompson
- Equity Research and Innovation Center, Yale University School of Medicine, New Haven, USA
| | - D Galusha
- Equity Research and Innovation Center, Yale University School of Medicine, New Haven, USA
| | - H Friedman
- Equity Research and Innovation Center, Yale University School of Medicine, New Haven, USA
| | - C M Nazario
- School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - M Nunez
- School of Nursing, University of the Virgin Islands, Saint Thomas, US Virgin Islands
| | - R G Maharaj
- Faculty of Medical Sciences, University of the West Indies at St. Augustine, Saint Augustine, Trinidad and Tobago
| | - O P Adams
- Faculty of Medical Sciences, University of the West Indies at Cave Hill, Cave Hill, Barbados
| | - M Nunez-Smith
- Equity Research and Innovation Center, Yale University School of Medicine, New Haven, USA
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Eivazzadeh-Keihan R, Pashazadeh-Panahi P, Baradaran B, Maleki A, Hejazi M, Mokhtarzadeh A, de la Guardia M. Recent advances on nanomaterial based electrochemical and optical aptasensors for detection of cancer biomarkers. Trends Analyt Chem 2018. [DOI: 10.1016/j.trac.2017.12.019] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Abstract
BACKGROUND Nonalcoholic fatty liver disease, the hepatic manifestation of metabolic syndrome, is associated with increased risk of colorectal adenoma, a precursor of colorectal cancer. Because nonalcoholic fatty liver disease and colorectal adenoma share many common risk factors of metabolic syndrome, the association between these 2 pathological findings has been investigated in multiple studies, but the results have been conflicting. OBJECTIVE The present study aimed to assess the relationship between the fatty liver index, a predictor of nonalcoholic fatty liver disease, and the prevalence of colorectal adenomas. DESIGN This is a retrospective observational study. SETTINGS This study was conducted at a single expert center. PATIENTS A total of 2976 consecutive subjects over 40 years of age undergoing routine checkups including abdominal ultrasonography and colonoscopy at Chung-Ang University Hospital Health Care Center were included. MAIN OUTCOME MEASURES The primary outcome measured was the prevalence of colorectal adenomas according to fatty liver index. RESULTS Among these subjects, 932 (31.3%) had colorectal adenoma, 691 (23.2%) had metabolic syndrome, and 1512 (50.8%) had fatty liver on ultrasonography. In multivariate analysis, fatty liver index ≥30 was associated with an increased risk of colorectal adenoma (OR, 1.269; 95% CI, 1.06-1.49; p = 0.008). The fatty liver index-high group (fatty liver index ≥30) had more colorectal adenomas and more advanced colorectal adenomas than the fatty liver index-low group (fatty liver index <30) (p < 0.001 and p = 0.042). The prevalence of colorectal adenomas increased with increasing quartile of fatty liver index (p < 0.05). LIMITATIONS The study was limited by a relatively healthy Asian population. CONCLUSION The high fatty liver index may be a useful predictor of colorectal adenoma. See Video Abstract at http://links.lww.com/DCR/A478.
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Scheel JR, Molina Y, Coronado G, Bishop S, Doty S, Jimenez R, Thompson B, Lehman CD, Beresford SAA. Healthcare Factors for Obtaining a Mammogram in Latinas With a Variable Mammography History. Oncol Nurs Forum 2017; 44:66-76. [PMID: 27991613 DOI: 10.1188/17.onf.66-76] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To understand the relationship between mammography history and current thoughts about obtaining a mammogram among Latinas and examine the mediation effects of several healthcare factors.
. DESIGN Cross-sectional survey.
. SETTING Federally qualified health centers (Sea Mar Community Health Centers) in western Washington.
. SAMPLE 641 Latinas nonadherent and adherent with screening mammography.
. METHODS Baseline survey data from Latinas with a mammography history of never, not recent (more than two years), or recent (less than two years) were analyzed. Preacher and Hayes methods were used to estimate the mediation effect of healthcare factors.
. MAIN RESEARCH VARIABLES The survey assessed mammography history, sociodemographic and healthcare factors, and current thoughts about obtaining a mammogram.
. FINDINGS Latinas' thoughts about obtaining a mammogram were associated with mammography history. Having had a clinical breast examination mediated 70% of differences between Latinas with a never and recent mammography history. Receipt of a provider recommendation mediated 54% of differences between Latinas with and without a recent mammography history.
. CONCLUSIONS These findings emphasize the importance of the patient-provider relationship during a clinic visit and help inform how nurses may be incorporated into subsequent screening mammography interventions tailored to Latinas.
. IMPLICATIONS FOR NURSING As providers, health educators, and researchers, nurses have critical roles in encouraging adherence to screening mammography guidelines among Latinas.
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Fedewa SA, Sauer AG, DeSantis C, Siegel RL, Jemal A. Disparities in cancer screening by occupational characteristics. Prev Med 2017; 105:311-318. [PMID: 28987332 DOI: 10.1016/j.ypmed.2017.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/20/2017] [Accepted: 10/03/2017] [Indexed: 11/25/2022]
Abstract
Cancer screening patterns according to occupation characteristics in the United States are not well known, but could be used to help inform cancer control efforts. We examined cervical (CC), breast (BC) and colorectal cancer (CRC) screening prevalence and prevalence ratios (PR) by occupational characteristics in 2010, 2013 and 2015 National Health Interview Surveys (NHIS) among eligible US workers (CC women 21-65years; n=20,997), (BC women ≥40years; n=14,258) and (CRC men and women ≥50years; n=17,333). Cervical, breast and colorectal cancer screening prevalence among US workers was 84.0%, 68.9%, and 56.8%, respectively. Unadjusted prevalence ratios for cervical (PR=0.92, 95%CI 0.90, 0.94), breast (PR=0.86, 95%CI 0.83, 0.90) and colorectal cancer screening (PR=0.83, 95%CI 0.80, 0.87) were lower among workers in small (<25 employees) compared to large organizations (≥500 employees). People in food service, construction, production, and sales occupations were 13-26%, 17-28% and 9-30% less likely to be up to date with cervical, breast, and colorectal cancer screening, respectively, compared to healthcare professionals. Adjustment for socioeconomic factors and insurance status eliminated most associations. Disparities in cancer screening by occupational characteristics were mostly attributed to lower socioeconomic status and lack of insurance. These findings underscore the need for innovative public health strategies to improve cancer screening in vulnerable populations.
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Affiliation(s)
- Stacey A Fedewa
- Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, United States.
| | - Ann Goding Sauer
- Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, United States
| | - Carol DeSantis
- Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, United States
| | - Rebecca L Siegel
- Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, United States
| | - Ahmedin Jemal
- Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, United States
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Urban/Rural Differences in Breast and Cervical Cancer Incidence: The Mediating Roles of Socioeconomic Status and Provider Density. Womens Health Issues 2017; 27:683-691. [PMID: 29108988 DOI: 10.1016/j.whi.2017.09.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 09/11/2017] [Accepted: 09/18/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Breast and cervical cancer incidence vary by urbanicity, and several ecological factors could contribute to these patterns. In particular, cancer screening or other sociodemographic and health care system variables could explain geographic disparities in cancer incidence. METHODS Governmental and research sources provided data on 612 counties in the Surveillance, Epidemiology, and End Results program for rural-urban continuum code, socioeconomic status (SES) quintile, percent non-Hispanic White residents, density of primary care physicians, cancer screening, and breast and cervical cancer incidence rates (2009-2013). Ecological mediation analyses used weighted least squares regression to examine whether candidate mediators explained the relationship between urbanicity and cancer incidence. RESULTS As urbanicity increased, so did breast cancer incidence (βˆ = 0.23; p < .001). SES quintile and density of primary care physicians mediated this relationship, whereas percent non-Hispanic White suppressed it (all p < .05); county-level mammography levels did not contribute to the relationship. After controlling for these variables, urbanicity and breast cancer incidence were no longer associated (βˆ = 0.11; p > .05). In contrast, as urbanicity increased, cervical cancer incidence decreased (βˆ = -0.33; p < .001). SES quintile and density of primary care physicians mediated this relationship (both p < .05); percent non-Hispanic White and Pap screening levels did not contribute to the relationship. After controlling for these variables, the relationship between urbanicity and cervical cancer incidence remained significant (βˆ = -0.13; p < .05). CONCLUSIONS County-level SES and density of primary care physicians explained the relationships between urbanicity and breast and cervical cancer incidence. Improving these factors in more rural counties could ameliorate geographic disparities in breast and cervical cancer incidence.
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Kistler CE, Golin C, Morris C, Dalton AF, Harris RP, Dolor R, Ferrari RM, Brewer NT, Lewis CL. Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults. Clin Trials 2017; 14:648-658. [PMID: 29025270 DOI: 10.1177/1740774517725289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Appropriate colorectal cancer screening in older adults should be aligned with the likelihood of net benefit. In general, patient decision aids improve knowledge and values clarity, but in older adults, they may also help patients identify their individual likelihood of benefit and foster individualized decision-making. We report on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. This report includes a description of the baseline characteristics of participants. METHODS English-speaking primary care patients aged 70-84 years who were not currently up to date with screening were recruited into a randomized clinical trial comparing a tailored colorectal cancer screening decision aid with an attention control. The intervention group received a decision aid that included a values clarification exercise and individualized decision-making worksheet, while the control group received an educational pamphlet on safe driving behaviors. The primary outcome was appropriate screening at 6 months based on chart review. We used a composite measure to define appropriate screening as screening for participants in good health, a discussion about screening for patients in intermediate health, and no screening for patients in poor health. Health state was objectively determined using patients' Charlson Comorbidity Index score and age. RESULTS A total of 14 practices in central North Carolina participated as part of a practice-based research network. In total, 424 patients were recruited to participate and completed a baseline visit. Overall, 79% of participants were White and 58% female, with a mean age of 76.8 years. Patient characteristics between groups were similar by age, gender, race, education, insurance coverage, or work status. Overall, 70% had some college education or more, 57% were married, and virtually all had Medicare insurance (90%). The three primary medical conditions among the cohort were a history of diabetes, pneumonia, and cancer (28%, 26%, and 21%, respectively). CONCLUSION We designed a randomized clinical trial to test a novel use of a patient decision aid to promote appropriate colorectal cancer screening and have recruited a diverse study population that seems similar between the intervention and control groups. The study should be able to determine the ability of a patient decision aid to increase individualized and appropriate colorectal cancer screening.
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Affiliation(s)
- Christine E Kistler
- 1 Department of Family Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,2 UNC Lineberger Comprehensive Cancer Center, Departments of Medicine and Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,3 Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carol Golin
- 3 Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,4 Departments of Medicine and Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carolyn Morris
- 5 Center for Gastrointestinal Biology and Disease, Department of Medicine, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexandra F Dalton
- 6 Division of General Internal Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Russell P Harris
- 2 UNC Lineberger Comprehensive Cancer Center, Departments of Medicine and Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,3 Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rowena Dolor
- 7 Duke Clinical Research Institute, Department of Medicine, School of Medicine, Duke University, Durham, NC, USA
| | - Renée M Ferrari
- 3 Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Noel T Brewer
- 3 Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,8 Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,9 Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carmen L Lewis
- 6 Division of General Internal Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
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Record RA, Scott AM, Shaunfield S, Jones MG, Collins T, Cohen EL. Lay Epistemology of Breast Cancer Screening Guidelines Among Appalachian Women. HEALTH COMMUNICATION 2017; 32:1112-1120. [PMID: 27566238 DOI: 10.1080/10410236.2016.1214217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Recent changes to the U.S. Preventive Services Task Force guidelines for breast cancer screening have contributed to increased patient uncertainty regarding the timing and appropriateness of screening behaviors. To gain insight into the lay epistemology of women regarding breast cancer screening practices, we conducted in-depth, face-to-face interviews with 24 adult women living in a medically underserved Appalachian region. We found that women were unaware of breast cancer screening guidelines (i.e., start age, frequency, stop age). Qualitative analysis revealed two lay epistemological narratives establishing (a) uncertain knowledge and ambiguity about breast cancer screening guidelines but certain knowledge of other women's experiences with breast cancer diagnoses, and (b) feelings of knowing one's own body best and seeing the value in "overscreening" to save even one life. Our findings have theoretical and practical implications for scholars and practitioners seeking to improve knowledge or behavior regarding adherence to breast cancer screening recommendations.
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Affiliation(s)
| | | | - Sara Shaunfield
- c Department of Medical Social Sciences , Northwestern University Feinberg School of Medicine
| | | | - Tom Collins
- d College of Public Health , University of Kentucky
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