scholarly journals The prevalence of occult ovarian cancer in the series of 155 consequently operated high risk asymptomatic patients – Slovenian population based study

2020 ◽  
Vol 54 (2) ◽  
pp. 180-186
Author(s):  
Andreja Gornjec ◽  
Sebastijan Merlo ◽  
Srdjan Novakovic ◽  
Vida Stegel ◽  
Barbara Gazic ◽  
...  
Keyword(s):  
High Risk ◽  
Population Based ◽  
Ca 125 ◽  
High Grade ◽  
Childbearing Age ◽  
Peritoneal Cancer ◽  
Pathogenic Variants ◽  
Occult Cancer ◽  
Asymptomatic Patients ◽  
Negative Woman

AbstractBackgroundWe assessed the prevalence, localization, type and outcome of occult cancer at risk-reducing salpingo-oophorectomy or salpingectomy (RRSO) in asymptomatic carriers of pathogenic or likely pathogenic BRCA1/2 variants and high-risk BRCA1/2 negative women.Patients and methodsA retrospective analysis of all consecutive gynaecologic preventive surgeries from January 2009 to December 2015 was performed. Participants underwent genetic counselling and BRCA1/2 testing before the procedure. Data on clinical parameters, adjuvant treatment and follow-up were collected and analysed.ResultsOne hundred and fifty-five RRSO were performed in 110 BRCA1, 35 BRCA2 carriers of pathogenic or likely pathogenic variants and 10 high-risk BRCA1/2 negative women, at the mean age of 48.3 years. Nine occult cancers (9/155, 5.8%) were identified; eight in BRCA1 positive women and one in high-risk BRCA1/2 negative woman. We identified four non-invasive serous intraepithelial tubal carcinomas (3 in BRCA1 carriers and 1 in a high-risk BRCA1/2 negative woman) and five invasive tubo-ovarian high grade serous cancers (all detected in BRCA1 carriers). Only one out of nine patients (11.1%) with occult cancer had a slightly elevated CA-125 value preoperatively.ConclusionsA 5.8% prevalence of occult invasive and noninvasive tubo-ovarian serous cancer after RRSO was found in high risk asymptomatic and screen negative women. We conclude that RRSO should be performed in BRCA1/2 carriers and in high-risk BRCA1/2 negative women. Age of preventive gynaecologic surgery should be carefully planned, taking into account the completion of childbearing age and type of mutation. The results favour the tubal hypothesis of tubal origin of high grade serous ovarian and peritoneal cancer. Cytology result of peritoneal cavity washing was important for the decision making process in determining treatment. Cytology examination should be performed in all cases of RRSO. CA-125 assay did not prove to be an effective screening tool for early cancer detection in our patients.

scholarly journals Development, validation, and evaluation of prediction models to identify individuals at high risk of lung cancer for screening in the English primary care population using the QResearch database: research protocol and statistical analysis plan

2022 ◽  
Author(s):  
Weiqi Liao ◽  
Judith Burchardt ◽  
Carol Coupland ◽  
Fergus Gleeson ◽  
Julia Hippisley-Cox ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
High Risk ◽  
Prediction Models ◽  
Lung Cancer Screening ◽  
Population Based ◽  
Primary Care Population ◽  
Asymptomatic Patients ◽  
Diagnosis Of Lung Cancer

Background and research aim: Lung cancer is a research priority in the UK. Early diagnosis of lung cancer can improve patients' survival outcomes. The DART-QResearch project is part of a larger academic-industrial collaborative initiative, using big data and artificial intelligence to improve patient outcomes with thoracic diseases. There are two general research aims in the DART-QResearch project: (1) to understand the natural history of lung cancer, (2) to develop, validate, and evaluate risk prediction models to select patients at high risk for lung cancer screening. Methods: This population-based cohort study uses the QResearch database (version 45) and includes patients aged between 25 and 84 years old and without a diagnosis of lung cancer at cohort entry (study period: 1 January 2005 to 31 December 2020). The team conducted a literature review (with additional clinical input) to inform the inclusion of variables for data extraction from the QResearch database. The following statistical techniques will be used for different research objectives, including descriptive statistics, multi-level modelling, multiple imputation for missing data, fractional polynomials to explore non-linear relationships between continuous variables and the outcome, and Cox regression for the prediction model. We will update our QCancer (lung, 10-year risk) algorithm, and compare it with the other two mainstream models (LLP and PLCOM2012) for lung cancer screening using the same dataset. We will evaluate the discrimination, calibration, and clinical usefulness of the prediction models, and recommend the best one for lung cancer screening for the English primary care population. Discussion: The DART-QResearch project focuses on both symptomatic presentation and asymptomatic patients in the lung cancer care pathway. A better understanding of the patterns, trajectories, and phenotypes of symptomatic presentation may help GPs consider lung cancer earlier. Screening asymptomatic patients at high risk is another route to achieve earlier diagnosis of lung cancer. The strengths of this study include using large-scale representative population-based clinical data, robust methodology, and a transparent research process. This project has great potential to contribute to the national cancer strategic plan and yields substantial public and societal benefits through earlier diagnosis of lung cancer.

scholarly journals Risk of high‐grade precancerous lesions and invasive cancers in high‐risk HPV‐positive women with normal cervix or CIN 1 at baseline—A population‐based cohort study

2017 ◽  
Vol 140 (8) ◽  
pp. 1850-1859 ◽  
Author(s):  
Srabani Mittal ◽  
Partha Basu ◽  
Richard Muwonge ◽  
Dipanwita Banerjee ◽  
Ishita Ghosh ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Precancerous Lesions ◽  
Population Based ◽  
High Grade ◽  
Normal Cervix ◽  
High Risk Hpv

scholarly journals Factors associated with high-risk human papillomavirus infection and high-grade cervical neoplasia: A population-based study in Paraguay

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0218016 ◽  
Author(s):  
Elena Kasamatsu ◽  
María Isabel Rodríguez Riveros ◽  
Ana María Soilan ◽  
Marina Ortega ◽  
Pamela Mongelós ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Population Based ◽  
Cervical Neoplasia ◽  
High Grade ◽  
Population Based Study ◽  
Factors Associated ◽  
Human Papillomavirus Infection ◽  
Papillomavirus Infection

scholarly journals Colorectal cancer risk following polypectomy in a multicentre, retrospective, cohort study: an evaluation of the 2020 UK post-polypectomy surveillance guidelines

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323411
Author(s):  
Amanda J Cross ◽  
Emma C Robbins ◽  
Kevin Pack ◽  
Iain Stenson ◽  
Bhavita Patel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
General Population ◽  
Cox Regression ◽  
Population Based ◽  
Low Risk ◽  
High Grade Dysplasia ◽  
High Grade ◽  
High Risk Patients ◽  
Risk Patients

ObjectiveColonoscopy surveillance aims to reduce colorectal cancer (CRC) incidence after polypectomy. The 2020 UK guidelines recommend surveillance at 3 years for ‘high-risk’ patients with ≥2 premalignant polyps (PMPs), of which ≥1 is ‘advanced’ (serrated polyp (or adenoma) ≥10 mm or with (high-grade) dysplasia); ≥5 PMPs; or ≥1 non-pedunculated polyp ≥20 mm; ‘low-risk’ patients without these findings are instead encouraged to participate in population-based CRC screening. We examined the appropriateness of these risk classification criteria and recommendations.DesignRetrospective analysis of patients who underwent colonoscopy and polypectomy mostly between 2000 and 2010 at 17 UK hospitals, followed-up through 2017. We examined CRC incidence by baseline characteristics, risk group and number of surveillance visits using Cox regression, and compared incidence with that in the general population using standardised incidence ratios (SIRs).ResultsAmong 21 318 patients, 368 CRCs occurred during follow-up (median: 10.1 years). Baseline CRC risk factors included age ≥55 years, ≥2 PMPs, adenomas with tubulovillous/villous/unknown histology or high-grade dysplasia, proximal polyps and a baseline visit spanning 2–90 days. Compared with the general population, CRC incidence without surveillance was higher among those with adenomas with high-grade dysplasia (SIR 1.74, 95% CI 1.21 to 2.42) or ≥2 PMPs, of which ≥1 was advanced (1.39, 1.09 to 1.75). For low-risk (71%) and high-risk (29%) patients, SIRs without surveillance were 0.75 (95% CI 0.63 to 0.88) and 1.30 (1.03 to 1.62), respectively; for high-risk patients after first surveillance, the SIR was 1.22 (0.91 to 1.60).ConclusionThese guidelines accurately classify post-polypectomy patients into those at high risk, for whom one surveillance colonoscopy appears appropriate, and those at low risk who can be managed by non-invasive screening.

scholarly journals Genotype-first approach to the detection of hereditary breast and ovarian cancer risk, and effects of risk disclosure to biobank participants

2020 ◽  
Author(s):  
Liis Leitsalu ◽  
Marili Palover ◽  
Timo Tõnis Sikka ◽  
Anu Reigo ◽  
Mart Kals ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
High Risk ◽  
Population Based ◽  
Return Of Results ◽  
Ovarian Cancer Risk ◽  
Risk Disclosure ◽  
Breast And Ovarian Cancer ◽  
Cascade Screening ◽  
Pathogenic Variants ◽  
Clinically Significant

ABSTRACTGenotype-first approach allows to systematically identify carriers of pathogenic variants in BRCA1/2 genes conferring a high risk of familial breast and ovarian cancer. Participants of the Estonian biobank have expressed support for the disclosure of clinically significant findings. With an Estonian biobank cohort, we applied a genotype-first approach, contacted carriers and offered return of results with genetic counseling. We evaluated participants’ responses to and the clinical utility of the reporting of actionable genetic findings. Twenty-two of 40 contacted carriers of 17 pathogenic BRCA1/2 variants responded and chose to receive results. Eight of these 22 participants qualified for high-risk assessment based on National Comprehensive Cancer Network criteria. Twenty of 21 counseled participants appreciated being contacted. Relatives of 10 participants underwent cascade screening. Five of 16 eligible female BRCA1/2 variant carriers chose to undergo risk-reducing surgery, and 10 adhered to surveillance recommendations over the 30-month follow-up period. We recommend the return of results to population-based biobank participants; this approach could be viewed as a model for population-wide genetic testing. The genotype-first approach permits the identification of individuals at high risk who would not be identified by application of an approach based on personal and family histories only.

Is Colour Doppler Ultrasound a Sensitive Screening Method in Diagnosing Deep Vein Thrombosis after Hip Surgery ?

1996 ◽  
Vol 75 (02) ◽  
pp. 242-245 ◽  
Author(s):  
Marie Magnusson ◽  
Bengt I Eriksson ◽  
Peter Kãlebo ◽  
Ramon Sivertsson
Keyword(s):  
Deep Vein Thrombosis ◽  
High Risk ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Screening Method ◽  
Colour Doppler ◽  
Vein Thrombosis ◽  
Colour Doppler Ultrasound ◽  
Asymptomatic Patients ◽  
Deep Vein

SummaryPatients undergoing orthopedic surgery are at high risk of developing deep vein thrombosis. One hundred and thirty-eight consecutive patients undergoing total hip replacement or hip fracture surgery were included in this study. They were surveilled with colour Doppler ultrasound (CDU) and bilateral ascending contrast phlebography. The prevalence of proximal and distal DVT in this study was 5.8% and 20.3% respectively.CDU has a satisfactory sensitivity in patients with symptomatic deep vein thrombosis, especially in the proximal region. These results could not be confirmed in the present study of asymptomatic patients. The sensitivity was 62.5% (95% confidence interval: C.I. 24-91%) and the specificity 99.6% (C.I. 98-100%) for proximal DVT; 53.6% (C.I. 34-73%) and 98% (C.I. 96-99%) respectively for distal thrombi. The overall sensitivity was 58.1% (C.I. 39-75%) and the specificity 98% (C.I. 96-99%). The positive predictive value was 83.3% (C.I. 36-99%) and 75% (C.I. 51-91%) for proximal and distal DVT respectively. The negative predictive value was 98.9% (C.I. 98-100%) and 94.9% (C.I. 92-98%) for proximal and distal DVT respectively. The results of this study showed that even with a highly specialised and experienced investigator the sensitivity of CDU was too low to make it suitable for screening purposes in a high risk surgical population.

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