scholarly journals Sharing With Patients the Uncertainties Regarding the Management of Dyspepsia

2021 ◽  
Vol 8 ◽  
Author(s):  
Jochanan Benbassat
Keyword(s):  
Gastric Cancer ◽  
Patient Satisfaction ◽  
High Risk ◽  
Life Expectancy ◽  
Early Diagnosis ◽  
Cancer Detection ◽  
Symptom Relief ◽  
Management Strategies ◽  
Detection Rates ◽  
Test And Treat

Background: The management of patients with dyspepsia is uncertain. Some authors advocate endoscopy for all; others restrict endoscopy only to patients at high risk of gastric cancer, namely to those above an age threshold, or with a family history, dysphagia, loss of weight, anemia, or a childhood in Asian countries. Still others recommend various combinations between test-and-treat for Helicobacter pylori, anti-secretory treatment, and/or endoscopy.Objective: To highlight the uncertainties in the choice between the various strategies and argue that these uncertainties should be shared with the patient.Method: An overview of reported life expectancy, patient satisfaction, gastric cancer detection rates, symptom relief, and cost effectiveness of the management strategies for dyspepsia.Main Findings: There are no randomized controlled trials of the effect of screening by endoscopy on mortality of patients with gastric cancer. Lower grades of evidence suggest that early diagnosis reduces this mortality. Analyses, which assume a survival benefit of early diagnosis, indicate that mass screening in countries of high incidence gastric cancer (> 10 cases per 100,000) and targeted screening of high-risk persons in countries of low-intermediate incidence (<10 cases per 100,000) is cost-effective at a willingness to pay of $20,000–50,000 per QALY. Prompt endoscopy appears to be best for patient satisfaction and gastric cancer detection, and test-and-treat for H pylori—for symptom relief and avoiding endoscopies.Conclusions: The gain in life expectancy is the main source of uncertainty in the choice between management strategies. This choice should be shared with the patients after explaining uncertainties and eliciting their preferences.

P1.06-017 Lung Cancer Detection Rates for National Comprehensive Cancer Network Group 2 High Risk Individuals

2017 ◽  
Vol 12 (11) ◽  
pp. S1992
Author(s):  
A. Borondy Kitts ◽  
S. Regis ◽  
K. Reiger-Christ ◽  
J. Sands ◽  
A. Mckee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
National Comprehensive Cancer Network ◽  
Cancer Detection ◽  
Detection Rates ◽  
Group 2 ◽  
Cancer Network ◽  
Lung Cancer Detection

What we could know from the semiannually repeated screening with low-dose helical CT in a high-risk cohort over 10 years: Update of Anti-Lung Cancer Association project

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7568-7568
Author(s):  
N. Seki ◽  
K. Eguchi ◽  
M. Kaneko ◽  
H. Ohmatsu ◽  
R. Kakinuma ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Cancer Detection ◽  
Detection Rate ◽  
Low Dose ◽  
Risk Group ◽  
Helical Ct ◽  
High Risk Group ◽  
Invasive Adenocarcinoma ◽  
Detection Rates

7568 Background: There have been several randomized trials of low-dose helical CT (LDCT) screening for lung cancer. However, all trials are in progress. Therefore, before they are completed, we summarized what we could know from an update of Anti-Lung Cancer Association project, which was regarded as a longer-term study with LDCT performed at shorter intervals and with a larger number of detected cancers than any other single-armed studies. Methods: Among 2,120 participants, 1,877 (mean age 64 years, 88% male, and 84% smoker) underwent semiannually repeated screening from 1993 to 2004 (median, 3.5 years). We investigated (1) survival of patients with screening detected lung cancers, (2) presence of a stage shift (indicator of a mortality benefit), (3) appropriate duration of repeated screening, (4) identification of high-risk group by age, sex, and smoking, and (5) appropriate screening intervals by high-risk group (6 months or 1 year). Results: (1) The 5- and 10-year survival rates were 84.5% and 84.5%, respectively, in repeated screening group (n = 57) and were 68.7% and 38.1%, respectively, in initial screening group (n = 19) (P = 0.208). (2) Only in invasive adenocarcinoma, both proportion of stage II to IV and tumor size were negatively correlated with duration of repeated screening (r = −0.77, P = 0.007 and r = − 0.60, P = 0.029, respectively). (3) Detection rate of all incidence cancers were positively correlated with duration of repeated screening (r = 0.50, P = 0.020). However, detection rate remained unchanged until 5 years of repeated screening. Moreover, stage shift did not occur until 5 years of repeated screening. (4) Female sex (HR 2.9, P = 0.015) and smoking (HR 2.7, P = 0.046) were demographic risk factors for lung cancer detection at repeated screening. The accumulated 10-year detection rates for female smokers (n = 91), male smokers (n = 1,557), and non-smokers (n = 229) were 15.1%, 6.2%, and 4.3%, respectively (P = 0.002). (5) The estimated relative cancer detection powers of annual screening to semiannual screening were 50% and 57% for female and male smokers with lung cancer, respectively. Conclusions: Semiannually repeated LDCT screening over 5 years might be beneficial to smokers, especially female smokers. No significant financial relationships to disclose.

scholarly journals Guidelines for Follow-Up of Women at High Risk for Inherited Breast Cancer: Consensus Statement from the Biomed 2 Demonstration Programme on Inherited Breast Cancer

1999 ◽  
Vol 15 (1-3) ◽  
pp. 207-211 ◽  
Author(s):  
P. Møller ◽  
G. Evans ◽  
N. Haites ◽  
H. Vasen ◽  
M. M. Reis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Early Diagnosis ◽  
Brca1 Mutation ◽  
Breast Cancers ◽  
Management Options ◽  
Detection Rates ◽  
Inherited Breast Cancer

Protocols for activity aiming at early diagnosis and treatment of inherited breast or breast-ovarian cancer have been reported. Available reports on outcome of such programmes are considered here. It is concluded that the ongoing activities should continue with minor modifications. Direct evidence of a survival benefit from breast and ovarian screening is not yet available. On the basis of expert opinion and preliminary results from intervention programmes indicating good detection rates for early breast cancers and 5-year survival concordant with early diagnosis, we propose that women at high risk for inherited breast cancer be offered genetic counselling, education in ‘breast awareness’ and annual mammography and clinical expert examination from around 30 years of age. Mammography every second year may be sufficient from 60 years on. BRCA1 mutation carriers may benefit from more frequent examinations and cancer risk may be reduced by oophorectomy before 40–50 years of age. We strongly advocate that all activities should be organized as multicentre studies subjected to continuous evaluation to measure the effects of the interventions on long-term mortality, to match management options more precisely to individual risks and to prepare the ground for studies on chemoprevention.

Gastric Carcinoma: Preliminary Data of a Cooperative Program for Early Diagnosis

1980 ◽  
Vol 66 (3) ◽  
pp. 349-356 ◽  
Author(s):  
Giancarlo Maltoni ◽  
Franco Pacini ◽  
Massimo Moriani ◽  
Dino Amadori ◽  
Angelo Ravaioli ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Early Gastric Cancer ◽  
Cancer Detection ◽  
Risk Indicators ◽  
X Ray ◽  
Screening Programs ◽  
Cooperative Program ◽  
Multiple Biopsies ◽  
Medical Examinations

The results of a program of early gastric cancer detection, carried out in the Oncologic Institutes of Genoa, Forlì and Florence, are evaluated. General practitioners screened subjects, according to possible anamnestic and clinical risk indicators (age, family history, previous gastric lesions, digestive complaints, etc.). The diagnostic procedure consisted of medical examinations, endoscopy with cytology and/or directed biopsy, and possibly air contrast barium X-ray. Of 3,180 subjects examined, 224 had gastric cancers (7 %), 29 of which were early cancers, and 688 had high risk lesions; 1,478 cases of other pathology were detected. The authors stress that the proportion of early cancer is clearly higher than that found in routine diagnosis, yet still lower compared to the results of screening programs carried on the general population. Moreover, the high diagnostic sensitivity of each method in early gastric cancer detection and, on the other hand, the difficulties in the detection of high risk lesions, which require systematic multiple biopsies, are emphasized.

scholarly journals Digital technologies in prostate cancer prevention and early diagnosis

2020 ◽  
Vol 25 (6) ◽  
pp. 192-199
Author(s):  
A. F. Lazarev ◽  
Valentina D. Petrova ◽  
V. P. Pokornyak ◽  
S. A. Lazarev ◽  
V. A. Marchkov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Early Diagnosis ◽  
Cancer Registry ◽  
Cancer Detection ◽  
Group Formation ◽  
Digital Technologies ◽  
Malignant Neoplasms ◽  
Prostate Cancer Detection ◽  
Prostate Cancer Prevention

Background. Prostate cancer is one of the most common malignant neoplasms in males. The Russian Federation observed the same patterns: the incidence of prostate cancer is steadily growing, without the tendency to decrease. Currently, no effective methods are available for prostate cancer early diagnosis and screening. Aim. To improve the effectiveness of prostate cancer prevention and early diagnosis with new digital technologies for high-risk cancer group formation Material and methods. Data from the Cancer Registry population in the Altai regional cancer center, Barnaul City was used. The Cancer Registry includes information about 253,000 patients with malignant neoplasms, including 14,482 males suffering from prostate cancer. Based on the targeted prevention method of A.F. Lazarev, Method for determining the risk of prostate cancer (Patent 2692987) and Automated program for early diagnosis of prostate cancer (certificate of state registration of the computer program No. 2019663514) was developed, which simplifies the stage of forming groups of precancerous high oncorisk and increases prostate cancer detection, as well as develops personalized targeted preventive measures for each patient. Results. The study formed a group of 328 patients with precancerous high oncorisk for prostate cancer in the Cancer Registry, wherein an in-depth examination revealed 26 patients with prostate cancer, which was 7.9%. Stages I and II were established in 97.8%. Conclusion. The web application Automated program for early diagnosis of prostate cancer allows the group formation of high-risk patients who are a targeted search for prostate cancer. The testing process allows a large number of patients to be examined in a short time. The automated program for the early diagnosis of prostate cancer allows a statistically significant increased prostate cancer detection, as well as personalized preventive measure suggestions for each patient.

Computer-assisted Diagnosis of Dyspepsia — Report on Transferability of a System, with Emphasis on Early Diagnosis of Gastric Cancer

1977 ◽  
Vol 16 (02) ◽  
pp. 89-92 ◽  
Author(s):  
N. Zoltie ◽  
J. C. Horrocks ◽  
F. T. de Dombal
Keyword(s):  
Gastric Cancer ◽  
Retrospective Study ◽  
High Risk ◽  
Early Diagnosis ◽  
Computer Assisted ◽  
Computer Assisted Diagnosis ◽  
Risk Patients ◽  
Intensive Investigation ◽  
Assisted Diagnosis ◽  
Assisted Analysis

This paper reports a retrospective study of computer-assisted diagnosis of 86 cases of >dyspepsia< in Bristol, England; the computer-assisted diagnosis making use of a database provided by 360 patients from Leeds, England. The computer’s diagnostic prediction proved to be correct in 63 out of the 86 cases — an overall accuracy of 73.3%. The system correctly diagnosed 14 out of 18 cases of gastric cancer (77.8%) at the expense of only three false positives.These results (1) confirm that gastric cancer can be diagnosed in most cases on the history alone; (2) suggest that this method of assisting diagnosis can be transferred successfully to different localities without loss of accuracy; and (3) indicate that a detailed structured computer-assisted analysis of the patient’s symptoms may be of value in selecting high-risk patients for intensive investigation.

UPDATE ON THE DIAGNOSIS AND MANAGEMENT OF EARLY GASTRIC CANCER

2015 ◽  
pp. 5-14
Author(s):  
Van Huy Tran ◽  
Quang Trung Tran
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Early Diagnosis ◽  
Cancer Diagnosis ◽  
Good Prognosis ◽  
Accurate Diagnosis ◽  
White Light Endoscopy ◽  
Key Factor ◽  
Magnified Endoscopy ◽  
Endoscopic Characteristics

The prognosis of gastric cancer depends principally upon an early diagnosis. An early and accurate diagnosis of gastric cancer needs some basic knowledges about the endoscopic characteristics of white light endoscopy, chromoendoscopy, magnified endoscopy, FICE and NBI…A strategy of screening is also a key factor for early diagnosis. The treatment of early gastric cancer by endoscopy techniques have showed more and more advantages. Beside of EMR, the technique of ESD is now applied more widely and lead to a very good prognosis and nearly a curative treatment for the patients with early gastric cancer. Key words: gastric cancer, early gastric cancer, diagnosis, endoscopy

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