Su1489 Comparing Polyp and Cancer Detection Rate Between Asymptomatic Patients With a Positive Family History of Colon Cancer or Polyps and Asymptomatic Patients of a Similar Age Range Who Have Average Risk of Colon Cancer

1 Background: Breast-MRI is currently recommended for screening women at high-risk of breast-cancer only. However, despite decades of mammographic-screening, breast-cancer continues to represent a major cause of cancer-death also for women at average-risk – suggesting a need for improved methods for early diagnosis also for these women. Therefore, we investigated the utility of supplemental MRI-screening of women who carry an average-risk of breast-cancer. Methods: Prospective observational cohort-study conducted in two academic breast-centers on asymptomatic women at average-risk in the usual age range for screening-mammography (40 to 70). Women underwent DCE-breast-MRI in addition to mammography every 12, 24, or 36 months, plus follow-up of 2 years to establish a standard-of-reference. We report on the supplemental-cancer-yield, interval-cancer-rate, diagnostic accuracy of screening-MRI, and biologic profiles of additional, MRI-detected breast-cancers. Results: 2120 women underwent a total 3861 MRI-studies covering 7007 women-years. Breast-cancer was diagnosed in 61/2120 women (DCIS: 20, invasive: 41), and ADH/LIN in another 21. Interval-cancer-rate was 0%, irrespective of screening interval. Forty-eight women were diagnosed with breast-cancer at prevalence-screening by MRI alone (supplemental cancer-detection-rate: 22.6 per 1000); 13 women were diagnosed with breast-cancer in 1741 incidence-screening-rounds collected over 4887 women-years. A total 12 of these 13 incident cancers were diagnosed by screening-MRI alone (supplemental-cancer-detection-rate: 6.9 per 1000), one by MRI and mammography, none by mammography alone. Supplemental-cancer-detection-rate was independent of mammographic breast-density. Invasive cancers were small (mean size: 8mm), node-negative in 93.4%, ER/PR-negative in 32.8%, and de-differentiated in 41.7% at prevalence, and 46.0% at incidence-screening. Specificity of MRI-screening was 97.1%, False-Positive-Rate 2.9%. Conclusions: MRI-screening improves detection of biologically relevant breast-cancer in women at average-risk, and reduces the interval-cancer-rate down to 0%, at a low false-positive rate.

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122 Prevalence of Adenomas in 40-49 Year Olds With Family History of Colon Cancer vs. Average-Risk 40-49 Year Olds: A Multi-Center, Prospective, Cross-Sectional Study

Gastroenterology ◽

10.1016/s0016-5085(14)60117-7 ◽

2014 ◽

Vol 146 (5) ◽

pp. S-34

Author(s):

Philip S. Schoenfeld ◽

Stephanie Foster ◽

Hyungjin Kim ◽

Fadi Antaki ◽

Naresh T. Gunaratnam ◽

...

Keyword(s):

Colon Cancer ◽

Family History ◽

Cross Sectional Study ◽

Average Risk ◽

Sectional Study ◽

Cross Sectional ◽

History Of

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Digital Breast Tomosynthesis Changes Management in Patients Seen at a Tertiary Care Breast Center

ISRN Radiology ◽

10.1155/2014/658929 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

L. Margolies ◽

A. Cohen ◽

E. Sonnenblick ◽

J. Mandeli ◽

P. H. Schmidt ◽

...

Keyword(s):

Cancer Detection ◽

Detection Rate ◽

Univariate Analysis ◽

Tertiary Care ◽

Digital Breast Tomosynthesis ◽

Cancer Detection Rate ◽

Breast Tomosynthesis ◽

Full Field ◽

Management Change ◽

Asymptomatic Patients

Objectives. To study factors that predict changes in management with digital breast tomosynthesis (DBT). Methods. The Institutional Review Board approved this HIPAA compliant study. 996 patients had DBT with full field digital mammography (FFDM). Univariate analysis evaluated predictors of management change and cancer detection. Results. DBT changed management in 109 of 996 (11%); 77 (71%) required less imaging. Recalled patients after abnormal FFDM screen were most likely to have management change—25% (24 of 97 patients) compared to 8% (13/163) of symptomatic patients and 10% (72/736) of screening patients (P<0.001). Dense breasted patients had a higher likelihood of having DBT change management: 13% (68/526) compared to 9% (41/470) (P=0.03). Of the 996 patients, 19 (2%) were diagnosed with breast cancer. 15 cancers (83%) were seen on FFDM and DBT; 3 (17%) were diagnosed after DBT (0.3%, 95%CI: 0.1–0.9%). One recurrence was in the skin and was not seen on DBT nor was it seen on FFDM. The increase in cancer detection rate was 17% for asymptomatic patients, 0% for symptomatic patients, and 100% for recalled patients. Conclusions. DBT increased cancer detection rate by 20% and decreased the recall rate in 8–25%. Advances in Knowledge. DBT led to a doubling of the cancer detection rate in recalled patients.

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Is colonoscopic screening appropriate in asymptomatic patients with family history of colon cancer?

Diseases of the Colon & Rectum ◽

10.1007/bf02051067 ◽

1991 ◽

Vol 34 (9) ◽

pp. 763-768 ◽

Cited By ~ 20

Author(s):

Martin A. Luchtefeld ◽

Dale Syverson ◽

Mark Solfelt ◽

John M. MacKeigan ◽

Randall Krystosek ◽

...

Keyword(s):

Colon Cancer ◽

Family History ◽

Asymptomatic Patients ◽

History Of

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Diagnostic performances of supplemental breast ultrasound screening in women with personal history of breast cancer

Acta Radiologica ◽

10.1177/0284185117725779 ◽

2017 ◽

Vol 59 (5) ◽

pp. 533-539 ◽

Cited By ~ 6

Author(s):

Sung Eun Song ◽

Nariya Cho ◽

Jung Min Chang ◽

A Jung Chu ◽

Ann Yi ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Detection ◽

Detection Rate ◽

Interval Cancer ◽

Cancer Detection Rate ◽

Personal History ◽

Ultrasound Screening ◽

Cancer Rate ◽

Interval Cancer Rate ◽

History Of

Background Supplemental breast ultrasonography (US) has been used as a surveillance imaging method in women with personal history of breast cancer (PHBC). However, there have been limited data regarding diagnostic performances. Purpose To evaluate diagnostic performances of supplemental breast US screening for women with PHBC and to compare with those for women without PHBC. Material and Methods Between 2011 and 2012, 12,230 supplemental US exams were performed in 12,230 women with negative mammograms: 6584 women with PHBC and 5646 women without PHBC. Cancer detection rate, interval cancer rate, abnormal interpretation rate, positive predictive values (PPVs), sensitivity, and specificity were calculated and compared. Results Overall cancer detection rate and first-year interval cancer rate were 1.80/1000 exams and 0.91/1000 negative exams, both of which were higher in women with PHBC than in women without PHBC (2.88 vs. 0.53 per 1000, P = 0.003; 1.50 vs. 0.20 per 1000, P = 0.027). Abnormal interpretation rate was lower in the women with PHBC than in women without PHBC (9.1% vs. 12.1%, P < 0.001). Sensitivity was not different (67.9% vs. 75.0%, P = 1.000), whereas specificity and PPV3 were higher in women with PHBC than in women without PHBC (91.2% vs. 88.0%, P < 0.001; 22.6% vs. 3.1%, P < 0.001). The majority of detected cancers in women with PHBC (78.9%, 15/19) were stage 0 or 1. Conclusion Supplemental breast US screening increases early stage second breast cancers with high specificity and PPV3 in women with PHBC, however, high interval cancer rate in younger women with PHBC should be noted.

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Colonoscopic screening of asymptomatic patients with a family history of colon cancer

Diseases of the Colon & Rectum ◽

10.1007/bf02139100 ◽

1990 ◽

Vol 33 (11) ◽

pp. 926-930 ◽

Cited By ~ 32

Author(s):

James W. Baker ◽

Byron J. Gathright ◽

Alan E. Timmcke ◽

Terrell C. Hicks ◽

Bernard T. Ferrari ◽

...

Keyword(s):

Colon Cancer ◽

Family History ◽

Asymptomatic Patients ◽

History Of

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Patients Undergoing Colorectal Cancer Screening Underestimate Their Cancer Risk and Delay Presentation for Screening

Canadian Journal of Gastroenterology ◽

10.1155/2012/937184 ◽

2012 ◽

Vol 26 (7) ◽

pp. 419-423 ◽

Cited By ~ 1

Author(s):

Haili Wang ◽

Nicholas Gies ◽

Clarence Wong ◽

Dan Sadowski ◽

Barbara Moysey ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Family History ◽

Screening Program ◽

Positive Family History ◽

Average Risk ◽

Current Guideline ◽

Polyp Detection Rate ◽

History Of ◽

First Time

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in Canada. Screening guidelines recommend that first-time screening should occur at 50 years of age for average-risk individuals and at 40 years of age for those with a family history of CRC.OBJECTIVE: To examine whether persons with a positive CRC family history were achieving screening at 40 years of age and whether average-risk persons were achieving screening at 50 years of age.METHODS: The present study was a cross-sectional analysis of subjects who entered a colon cancer screening program and were undergoing CRC screening for the first time.RESULTS: A total of 778 individuals were enrolled in the present study: 340 (174 males) with no family history of CRC, and 438 (189 males) with a positive family history of CRC. For the group with a positive family history, the mean (± SD) age for primary screening was 54.4±8.5 years, compared with 58.2±6.4 years for the group with no family history. On average, those with a positive family history initiated screening 3.8 years (95% CI 2.8 to 4.8; P<0.05) earlier than those without. Adenoma polyp detection rate for the positive family history group was 20.8% (n=91) compared with 23.5 % (n=80) for the group with no family history.CONCLUSIONS: Individuals with a positive CRC family history are initiating screening approximately four years earlier than those without a family history; nevertheless, both groups are undergoing screening well past current guideline recommendations.

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Which Individuals with Positive Family History of Gastric Can-cer Urgently Need Intensive Screening and Eradication of Heli-cobacter Pylori? A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v50i12.7922 ◽

2021 ◽

Author(s):

Gui He ◽

Xuanke Ji ◽

Yali Yan ◽

Kunyan Wang ◽

Chunhua Song ◽

...

Keyword(s):

Family History ◽

Fixed Effects ◽

Positive Family History ◽

Case Control ◽

Average Risk ◽

Case Control Studies ◽

Parental History ◽

Increased Risk ◽

History Of ◽

H Pylori

Background: Family history may inform individuals that they are at risk of gastric cancer (GC). However, it is too extensive to conduct intensive screening strategies for all individuals with family history of GC instead of average-risk screening. To establish more precise prevention strategies, accurate risk estimates are necessary for individuals with family history of GC. Methods: We searched PubMed, EMBASE and Cochrane for all relevant studies from their inception to May 21, 2020, for cohort and case-control studies investigating the association between family history of GC and its risk. Relative risk (RR) and 95% confidence interval (CI) were pooled from studies using random-effects or fixed effects. Results: The RR of GC was 2.08 (95% CI=1.86-2.34) in individuals with family history of GC according to twenty-nine case-control studies and 1.83 (95%CI=1.67-2.01) from six cohort studies. The increased risk was higher in individuals with sibling history of GC than those with parental history of GC (RR=3.18, 95% CI=2.12-4.79 vs. RR=1.66, 95% CI=1.46-1.89, P=0.021). For individuals with 2 or more first-degree relatives (FDRs) with GC, the RR was 2.81(95% CI=1.89-3.99). Subjects with both family history and Helicobacter pylori (H. pylori) infection confer a higher risk of GC (RR = 4.03, 95%CI=2.46-6.59). Conclusion: The RR of GC among FDRs is lower than in previous studies. However, the risk of GC is markedly increased in individuals having a sibling with GC, more than 2 FDRs with GC. Intensified screening and eradication therapy for H. pylori could be considered for these individuals.

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