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Image based screening is now routinely available for early detection of cancer and other diseases. Quantitative analysis for effects of risk factors on digital images is important to extract biological insights for modifiable factors in prevention studies and understand pathways for targets in preventive drugs. However, current approaches are restricted to summary measures within the image with the assumption that all relevant features needed to characterize an image can be identified and appropriately quantified. Motivated by data challenges in breast cancer, we propose a nonparametric statistical framework for risk factor screening that uses the whole mammogram image as outcome. The proposed permutation test allows assessment of whether a set of scalar risk factors is associated with the whole image in the presence of correlated residuals across the spatial domain. We provide extensive simulation studies and illustrate an application to the Joanne Knight Breast Health Cohort using the mammogram imaging data., (© 2024 John Wiley & Sons Ltd.)

Lung nodules are frequently detected on low-dose computed tomography scans performed for lung cancer screening and incidentally detected on imaging performed for other reasons. There is wide variability in how lung nodules are managed by general practitioners and subspecialists, with high rates of guideline-discordant care. This may be due in part to the level of evidence underlying current practice guideline recommendations (primarily based on findings from uncontrolled studies of diagnostic accuracy). The primary aims of lung nodule management are to minimize harms of diagnostic evaluations while expediting the evaluation, diagnosis, and treatment of lung cancer. Potentially useful tools such as lung cancer probability calculators, automated methods to identify patients with nodules in the electronic health record, and multidisciplinary team evaluation are often underused due to limited availability, accessibility, and/or provider knowledge. Finally, relatively little attention has been paid to identifying and reducing disparities among individuals with screening-detected or incidentally detected lung nodules. This contribution to the American Cancer Society National Lung Cancer Roundtable Strategic Plan aims to identify and describe these knowledge gaps in lung nodule management and propose recommendations to advance clinical practice and research. Major themes that are addressed include improving the quality of evidence supporting lung nodule evaluation guidelines, strategically leveraging information technology, and placing emphasis on equitable approaches to nodule management. The recommendations outlined in this strategic plan, when carried out through interdisciplinary efforts with a focus on health equity, ultimately aim to improve early detection and reduce the morbidity and mortality of lung cancer. PLAIN LANGUAGE SUMMARY: Lung nodules may be identified on chest scans of individuals who undergo lung cancer screening (screening-detected nodules) or among patients for whom a scan was performed for another reason (incidental nodules). Although the vast majority of lung nodules are not lung cancer, it is important to have evidence-based, standardized approaches to the evaluation and management of a lung nodule. The primary aims of lung nodule management are to diagnose lung cancer while it is still in an early stage and to avoid unnecessary procedures and other harms., (© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

The incidence of colorectal cancer (CRC) is increasingly affecting younger populations, with its mortality rate rising annually. However, current clinical diagnostic techniques, such as colonoscopy and CEA antigen testing, remain invasive and prone to false-positive results, complicating early diagnosis and intervention. Glycosylation, a key post-translational modification, plays an essential role in cellular function, physiological regulation, and disease processes. In recent years, mass spectrometry technology has emerged as a powerful tool for screening glycan biomarkers, owing to its exceptional separation capabilities and sensitivity. This review encompasses the advancements in CRC glycan biomarkers from 2016 to 2024, with particular emphasis placed on N/O-glycan biomarkers identified through mass spectrometry. Nonetheless, the intrinsic low abundance and polyhydroxy nature of glycans hinder the specificity and sensitivity of current glycan biomarkers. To overcome these limitations, this article outlines pretreatment strategies for N/O-glycans, including glycan release, enrichment, purification, and derivatization, in conjunction with relative quantification techniques and high-throughput bioinformatics tools for biomarker screening. These strategies are anticipated to enhance the efficiency and precision of glycan biomarker identification through mass spectrometry. These advancements hold significant promise for enhancing CRC prevention, diagnosis, and treatment, thereby potentially improving patient outcomes and quality of life., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: The purpose of this study was to analyze the effectiveness of the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, 2016-2023., Methods: A questionnaire for risk factors of lung, breast, upper gastrointestinal, liver, and colorectal cancers was administered to urban residents aged 40-74 years in five cities to assess their cancer risk. High-risk participants were invited for screening and classified into five groups on the basis of the number of cancer types that were assessed to be high risk. The participation and positive outcome rates were analyzed. The incidence and the mortality of five types of cancer and all-cause mortality of the screened and nonscreened participants were calculated via inverse probability weighting., Results: A total of 237,975 eligible participants were enrolled in our study and 118,339 participants (49.94%) were assessed to be at high risk for one or more of the five cancer types. The number of screenings performed was 103,824, with a screening participation rate of 40.49%. Among the 57,315 screening participants, 9077 (15.84%) had positive cancer diagnoses and 871 (1.52%) were diagnosed with suspected cancer. Compared with the participants at high risk for a single cancer type, the participation and positive outcome rate increased by 45% and 71.5% in the participants at high risk for multiple cancer types. Compared with the non-screened participants, the screened participants had a 27.0% decrease in mortality due to the five types of cancer and a 45.8% decrease in all-cause mortality., Conclusion: A combined screening program for multiple cancers could increase participation and positive outcome rates. It could also decrease the five types of cancer mortality and all-cause mortality. Our findings highlight the effectiveness of combined screening for multiple cancers with limited health care resources, and may provide foundational evidence for the feasibility of conducting combined screening programs., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Self-sampling for oncogenic human papillomavirus (HPV) offers an alternative to the Papanicolaou (Pap) test for cervical cancer screening. We aimed to assess Inuit women's cervical cancer screening preferences. Eligible Inuit women aged between 25 and 65 in 2022-2023 were given the choice between self-sampling, sampling performed solely by the nurse or the Pap test and were administered a questionnaire on screening preference. Thematic analysis was performed on qualitative data collected through a questionnaire asking if and why women prefer HPV self-sampling or the Pap test for cervical cancer screening. A total of 103 women agreed to participate. Of these, 12 (11.6%) chose to have the nurse perform the HPV test rather than self-collect. Among the 91 left for analysis, 80.2% (73) of women who self-sampled preferred self-sampling to the Pap test and 82.4% (75) would prefer self-sampling in the future. The most common reason given was comfortability (54.9%) and privacy (25.2%). Participants that did not prefer self-sampling ( n  = 7) expressed desire for a physical exam by the nurse or a lack of confidence in their ability to collect the sample. Eleven either did not indicate a preference, were unsure, or indifferent to cervical cancer screening method. This represents an improvement from a previously conducted study in 2012 among the same population who reported a preference for HPV self-sampling of 56%.

Objective: The risk of gastric cancer can be predicted by gastroscopic manifestation recognition and the Kyoto Gastritis Score. This study aims to validate the applicability of AI approaches for recognizing gastroscopic manifestations according to the definition of Kyoto Gastritis Score, with the goal of improving early gastric cancer detection and reducing gastric cancer mortality., Methods: In this retrospective study, 29013 gastric endoscopy images were collected and carefully annotated into five categories according to the Kyoto Gastritis Score, i.e. atrophy (A), diffuse redness (DR), enlarged folds (H), intestinal metaplasia (IM), and nodularity (N). As a multi-label recognition task, we propose a deep learning approach composed of five GAM-EfficientNet models, each performing a multiple classification to quantify gastroscopic manifestations, i.e. no presentation or the severity score 0-2. This approach was compared with endoscopists of varying years of experience in terms of accuracy, specificity, precision, recall, and F1 score., Results: The approach demonstrated good performance in identifying the five manifestations of the Kyoto Gastritis Score, with an average accuracy, specificity, precision, recall, and F1 score of 78.70%, 91.92%, 80.23%, 78.70%, and 0.78, respectively. The average performance of five experienced endoscopists was 72.63%, 90.00%, 77.68%, 72.63%, and 0.73, while that of five less experienced endoscopists was 66.60%, 87.44%, 70.88%, 66.60%, and 0.66, respectively. The sample t-test indicates that the approach's average accuracy, specificity, precision, recall, and F1 score for identifying the five manifestations were significantly higher than those of less experienced endoscopists, experienced endoscopists, and all endoscopists on average ( p  < 0.05)., Conclusion: Our study demonstrates the potential of deep learning approaches on gastric manifestation recognition over junior, even senior endoscopists. Thus, the deep learning approach holds potential as an auxiliary tool, although prospective validation is still needed to assess its clinical applicability.

Objective: To investigate the epidemiological characteristics of hepatocellular carcinoma in Xiamen and offer recommendations for its control and prevention., Methods: Data obtained from liver cancer screening in 2016-2018 and 2019-2020 in patients with hepatocellular carcinoma in Xiamen were collected using Xiamen Healthcare Big Data Platform. Epidemiological characteristics were analyzed descriptively by different years., Results: From 2016-2020, there were 3740 patients with hepatocellular carcinoma in Xiamen. In the patients, the percentage of males was higher than that of females (83.13 % vs 16.87 %). From 2019-2020, there was an increase in the detection rates for disorders including hepatitis B, hypertension, diabetes, fatty liver and cirrhosis of the liver, and there was a decrease in the prevalence of hepatitis C. There was an increase in the values of all hematological indicators of infection in patients with liver cancer in 2019-2020 compared with the previous three years. From 2016-2020, there was a year-on-year increase in the prevalence of liver cancer and fatty liver. From 2018-2020, there was an increasing trend in the prevalence of liver cancer in overweight patients in the population with fatty liver., Conclusion: In 2019-2020, there was an increase in the prevalence of chronic diseases in patients with hepatocellular carcinoma. Comprehensive liver cancer screening provides an important guide for the prevention, early diagnosis and treatment of liver cancer and for clinicians to assess patients' condition., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The VALHUDES initiative was established to assess the clinical accuracy of HPV assays to detect cervical precancers using urine and vaginal self-samples compared to cervical clinician-collected samples. Here, the clinical performance of OncoPredict HPV Quantitative Typing (QT) assay (OncoPredict QT) was evaluated., Methods: 490 women referred to colposcopy self-collected a urine and a vaginal specimen using Colli-Pee and FLOQSwab, respectively. Subsequently, a colposcopy was performed, and a cervical sample was collected with Cervex-Brush, followed by biopsy if clinically indicated. Vaginal samples were transported dry and resuspended in 5 mL of eNAT medium, whilst cervical brushings were immediately transferred in 20 mL ThinPrep., Results: The clinical sensitivity of OncoPredict HPV QT testing for CIN2+ in urine and vaginal self-samples was similar to cervical samples (ratios of 0.99 [95 % CI 0.94-1.05] and 1.00 [95 % CI 0.96-1.04]), respectively, when manufacturer's cut-offs were applied. The specificity for

Early detection and intervention of cancer or precancerous lesions hold great promise to improve patient survival. However, the processes of cancer initiation and the normal-precancer-cancer progression within a non-cancerous tissue context remain poorly understood. This is, in part, due to the scarcity of early-stage clinical samples or suitable models to study early cancer. In this Review, we introduce clinical samples and model systems, such as autochthonous mice and organoid-derived or stem cell-derived models that allow longitudinal analysis of early cancer development. We also present the emerging techniques and computational tools that enhance our understanding of cancer initiation and early progression, including direct imaging, lineage tracing, single-cell and spatial multi-omics, and artificial intelligence models. Together, these models and techniques facilitate a more comprehensive understanding of the poorly characterized early malignant transformation cascade, holding great potential to unveil key drivers and early biomarkers for cancer development. Finally, we discuss how these new insights can potentially be translated into mechanism-based strategies for early cancer detection and prevention., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. Springer Nature Limited.)

Aims: Lung adenocarcinoma (LUAD) is the most prominent histological subtype among the lung cancer which is a leading cause in the cancer mortality rate. High mutational and glycolytic rates are the major reported alterations in the lung cancer. Here in our study we are elucidating the structural and functional role of key glycolytic enzyme Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) and associated SNPs in LUAD progression., Materials and Methods: Our gene expression analysis reveals high expression of GAPDH in the LUAD. In silico tools and analysis were used for the identification and characterization of the deleterious SNPs. Molecular Docking and dynamics simulations (MDS) studies characterized the structural consequences of prioritized deleterious mutations., Key Findings: The sequence based analysis to identify SNPs in GAPDH resulted in 28 deleterious SNPs and 6 SNPs among them showed deleterious and damaging effect. The structural based analysis resulted in 2 stabilizing SNPs of rs ids rs11549328 (D39Y) and rs200102749 (S51Y) in the conserved domain. The IDR and PTM analysis of the GAPDH sequence resulted an IDR region from 191 to 194 positions with an IDR score of 0.511, 0.520, 0.517 and 0.503 with the PTM modifications., Significance: The identified deleterious SNPs (D39Y and S51Y) fall in the functional and conserved domain of GAPDH. In addition, the existence of PTMs within the IDR region of the GAPDH may contribute to its enhanced glycolytic activity in LUAD. The results of our study provide potential background deleterious mutants the pathological aspect of GAPDH in LUAD progression., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This is a systematic review and meta-analysis evaluating the uptake of cascade genetic testing for hereditary breast and ovarian cancer syndrome. Among 30 studies included for meta-analysis, the uptake of cascade genetic testing was 33% (95% CI 25%-42%), with higher uptake rates among females compared with male relatives, and among first-degree compared with second-degree relatives. These findings indicate suboptimal uptake of cascade genetic testing among people at risk for hereditary breast and ovarian cancer syndrome, representing a missed opportunity for cancer prevention and early detection. There is a need for interventions to improve uptake rates., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Lynch syndrome (LS) is an autosomal dominant genetic disorder that results in an increased risk of ovarian and endometrial cancers. The aim of this paper was to explore the management of this risk through screening and prevention. Published materials and evidence were explored and summarized. This paper demonstrated that while there has been increased awareness and advances in the identification and diagnosis of patients with LS, recommendations for screening and prevention remain less evidence-based. In decisions of management of patients with LS, a shared decision-making model should be used considering individual patient goals., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Human papillomavirus (HPV) infections are the leading cause of cervical cancer, the fourth most common cancer among women worldwide. Despite concerted efforts to combat this preventable disease through HPV vaccination and cancer screening have helped reduce morbidity and mortality levels, the burden persists in both developing and developed countries due to insufficient vaccination and screening coverage. Urinary HPV testing has emerged as a noninvasive detection method, offering significant advantages in cervical cancer management and vaccine surveillance. Notably, it boasts high acceptance rates, ease of self-collection, user-friendly implementation, and relatively low cost. Various urinary HPV detection methods have been explored, predominantly relying on nucleic acid amplification and signal amplification, targeting a variety of biomarkers in urine, such as HPV DNA, RNA, and oncoproteins. Existing literature underscores urine as a promising specimen for HPV testing, demonstrating comparable detection performance to cervical and vaginal samples in several studies. However, the lack of standardized and authoritative protocols in sample collection, storage, preparation, DNA extraction, and amplification necessitates further evaluation for the comprehensive utilization of urinary HPV testing in clinical and epidemiological settings. This study aims to review pertinent publications and offer insights into the rationale, common strategies, and limitations of urinary HPV testing, with the ultimate goal of maximizing its utility in practice., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: HPV self sampling can act as a tool to engage women in cervical screening and population based studies can inform optimal implementation of this approach., Methods: Self sampling kits were mailed to women who had defaulted from routine screening resident in an entire territorial health board in Scotland. Kit return rates and compliance to colposcopy follow up in those who were HPV mRNA positive were assessed. Concordance of the self-sample with samples taken later at colposcopy was measured alongside PPV of an mRNA positive result for CIN2+., Results: Of 4173 women invited to participate, 20.5 %, returned their kit and a greater return rate with increasing age was observed. HPV mRNA positivity was 12.0 %, and invalidity rate was approximately 3 %. Compliance to colposcopy follow up was 88.3 % and the PPV for an mRNA test for CIN2+ on a self sample was 25.6 %. hr-HPV concordance on the initial swab and the follow up swab and liquid based cytology (LBC) sample taken at colposcopy was 67.1 % and 30 % respectively., Conclusions: HPV self sampling using a "mail to all" approach is feasible in Scotland although only 1 in 5 actively responded to the offer. Future work to monitor screening behaviours in those who were invited but did not engage initially will help quantify any additional benefit(s) incurred., Competing Interests: Declaration of competing interest Hologic provided gratis assays and consumables required for the project and resource to support laboratory work, however all analysis was performed independently. RB, KC, HE and LCs institution has received research funding or gratis consumables to support research from the following commercial entities in the last 3 years: Euroimmun, GeneFirst, SelfScreen, Hiantis, Seegene, Roche, Hologic, Abbott, Barinthus Biotherapeutics PLC & Daye. KC has attended advisory board meetings for Hologic and Barinthus Biotherapeutics PLC; no personal renumeration occurred but UK travel covered., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)

Purpose: In BRCA germline pathogenic sequence variants (PSV) carriers aged 30-39 years imaging is recommended at six-month intervals. The European society for medical oncology recommendation of the use of 6-monthly MRI six-monthly MRI screening is being considered at our institution, particularly for younger carriers under the age of 35, although it is not mandatory. If 6-monthly MRI is unavailable, annual MRI may be supplemented by ultrasound (with or without mammography). The aim of this study was to evaluate the utility of ultrasound screening added to mammography, as a 6-month supplement to annual MRI in BRCA PSV carriers aged 30-39 years., Materials and Methods: This IRB approved retrospective study included BRCA PSV carriers aged 30-39 years, who underwent breast cancer screening at our institution between January 2015 and March 2023. Participants were divided into two groups, those who had supplemental whole-breast US and mammography at six months and underwent screening before March 2019, and those who had only mammography without supplemental US and enrolled in screening after March 2019. Patient characteristics, cancer detection rates and cancer characteristics were compared between the two groups., Results: Overall, 200 asymptomatic BRCA1/2 PSV carriers undergoing screening in our institution were included in the study. Mean age was 35.7 ± 3.5 years, and mean follow-up time was 37.4 ± 38.0 months. There were 118 (59 %) women screened with supplemental US, and 82 (41 %) women without. Eight cancers were diagnosed during the study period, four in women with supplemental US and four in women without. The sensitivity of whole-breast screening US was 25 % (1/4), specificity 85.7 % (222/259), PPV 2.6 % (1/38), and NPV 98.7 % (222/225). Of the four cancers detected in women screened with supplemental US, one was diagnosed by whole-breast US, two by MRI, and one by mammography. Of eight cancers included in this study, two were not detectable by targeted second-look US. All eight cancers were detectable by MRI., Conclusion: The addition of whole-breast ultrasound to mammography and MRI screening in BRCA PSV carriers aged 30-39 years offered limited incremental benefit. MRI with 6 months supplemental mammography without US detected all cancer cases., Competing Interests: Declaration of competing interest All authors declare none., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To assess the performance of simultaneous endometrial aspiration and sonohysterography to screen for endometrial cancer or hyperplasia in women aged 50 years or older., Methods: We conducted a prospective study from February 2014 to October 2020 at the ultrasound unit of a large urban academic medical center. The study included 1,635 women aged 50 years or older referred for endometrial evaluation, with follow-up through January 2021. Participants underwent saline infusion sonohysterography combined with ultrasound-guided endometrial aspiration. The primary outcome measured was a diagnosis of endometrial cancer or hyperplasia within 1 year from screening. The diagnostic accuracy of the combined evaluation method, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), was assessed., Results: Of 1,170 women who completed the study protocol, 82 (7.0%) had endometrial cancer and 42 (3.6%) had endometrial hyperplasia. Of all patients who developed cancer during the follow-up period, 85.5% were diagnosed within 1 year after evaluation. The application of simultaneous endometrial aspiration and sonohysterography together demonstrated a sensitivity of 99.1%, specificity of 24.9%, PPV of 11.8%, and NPV of 99.6%. Using a theoretical sequential approach, assuming an endometrial aspiration is performed only in patients determined to be high risk by sonohysterography, demonstrated a sensitivity of 93.4%, specificity of 99.9%, PPV of 99.0%, and NPV of 99.3%., Conclusion: Simultaneous endometrial aspiration and sonohysterography is an effective one-stop outpatient screening tool for detecting endometrial cancer and hyperplasia in women aged 50 years or older. With the integration of two screening modalities into a single procedure, simultaneous endometrial aspiration and sonohysterography may overcome the limitations inherent in each of the currently recommended methods individually, potentially improving patient prognosis and streamlining the diagnostic process., Competing Interests: Financial Disclosure Haotian Wu disclosed receiving payments from Montefiore. The other authors did not report any potential conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: To investigate the association between maternal cervical cancer (CC) screening status and child human papillomavirus (HPV) vaccination uptake. To understand if child sex or social deprivation index (SDI) modify this association., Methods: We used a national cohort of children linked to at least one parent using electronic health record (EHR) data from a network of community health centers across the United States. We used SDI scores and child sex as moderating variables. We performed the analysis (1) for the whole sample (with SDI and child sex added as covariates), (2) stratified by SDI quartile (with child sex added as a covariate), and (3) stratified by SDI quartile and child sex, to examine whether associations vary by SDI quartile and by child sex., Results: N = 52,919 linked mother-child pairs. Mother's receipt of CC screening was positively associated with the linked child's odds of receiving HPV vaccination [adjusted odds ratio (AOR) 1.39, 95% confidence interval (CI) 1.32, 1.47]. Neither sex or SDI modified this association. There were no significant differences in odds of HPV vaccination in children between SDI quartiles or between male and female children., Conclusions for Practice: An effective way to improve rates of HPV vaccination among children and adolescents may be to target attention towards increasing CC screening rates among mothers. Further, focusing resources and efforts on CC screenings and care of both mothers and their children may be more worthwhile than isolated efforts targeting HPV vaccination for children and adolescents., Competing Interests: Declarations Conflict of interest The authors have no conflict of interest to disclose. Ethical Approval This study was approved by the Oregon Health and Science University Institutional Review Board [ID#: STUDY00019958]. Consent to Participant The IRB approved a waiver of consent due to the low risk posed to patients. Consent for Publication Not applicable., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Breast cancer (BC) remains a global health challenge, devastatingly impacting women's lives. Low-and-middle-income countries (LMIC), such as India, experience a concerning upward trend in BC incidence, necessitating the implementation of cost-effective screening methods. While mammography, ultrasonography, and magnetic resonance imaging are preferred screening modalities in resource-rich settings, limited resources in LMICs make clinical breast examination (CBE) the method of choice. This review explores the merits of CBE, its coverage, barriers, and facilitators in the Indian context for developing strategies in resource-constrained settings. CBE has shown significant down-staging and cost-effectiveness. Performed by trained health workers in minutes, CBE offers an opportunity for education about BC. Various individual and health system barriers, such as stigma, financial constraints, and the absence of opportunistic screening hinder CBE coverage. Promising facilitators include awareness programs, capacity building, and integrating CBE through universal health care. No healthcare provider must miss any screening opportunity through CBE., (© 2024 The Author(s). Asia‐Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd.)

Detection of cancer early, when it is most treatable, remains a significant challenge because of the lack of diagnostic methods sufficiently sensitive to detect nascent tumors. Early-stage tumors are small relative to their tissue of origin, heterogeneous, and infrequently manifest in clinical symptoms. The detection of early-stage tumors is challenging given the lack of tumor-specific indicators (ie, protein biomarkers, circulating tumor DNA) to enable detection using a noninvasive diagnostic assay. To overcome these obstacles, we have developed a liquid biopsy assay that interrogates circulating extracellular vesicles (EVs) to detect tumor-specific biomarkers colocalized on the surface of individual EVs. We demonstrate the technical feasibility of this approach in human cancer cell line-derived EVs, where we show strong correlations between assay signal and cell line gene/protein expression for the ovarian cancer-associated biomarkers bone marrow stromal antigen-2, folate receptor-α, and mucin-1. Furthermore, we demonstrate that detecting distinct colocalized biomarkers on the surface of EVs significantly improves discrimination performance relative to single biomarker measurements. Using this approach, we observe promising discrimination of high-grade serous ovarian cancer versus benign ovarian masses and healthy women in a proof-of-concept clinical study., Competing Interests: Disclosure Statement D.P.S., L.T.B., I.O.Z., A.D.C., S.B., D.M.B., M.S.K., L.T.C., T.S.-H., G.N.B., K.S.Y., T.G., and D.R.M. are current employees of Mercy BioAnalytics Inc. E.S.W.-D. is a retired Mercy BioAnalytics employee (December 31, 2023) and is currently a paid consultant of Mercy BioAnalytics Inc. She was a full-time employee when this work was performed. K.M.B., P.A.D., J.G., D.G., B.F.H., E.K.H., C.R.S., and J.C.S. are former employees of Mercy BioAnalytics Inc., who were active employees at the time this work was performed. R.W.S. is a paid consultant of Mercy BioAnalytics. L.T.B. and D.P.S. are inventors on US patent number 11,085,089 B2, Systems, Compositions and Methods for Target Entity Detection (issued August 10, 2021). L.T.B., D.P.S., E.S.W.-D., D.G., K.M.B., E.K.H., and A.D.C. are inventors on US patent application 63/417309, Composition and Methods for Detection of Ovarian Cancer (filed October 18, 2022)., (Copyright © 2024 Association for Molecular Pathology and American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)

The low incidence of ovarian cancer (OC) dictates that any screening strategy needs to be both highly sensitive and highly specific. This study explored the utility of detecting multiple colocalized proteins or glycosylation epitopes on single tumor-associated extracellular vesicles from blood. The novel Mercy Halo Ovarian Cancer Test (OC Test) uses immunoaffinity capture of tumor-associated extracellular vesicles, followed by proximity-ligation real-time quantitative PCR to detect combinations of up to three biomarkers to maximize specificity, and measures multiple combinations to maximize sensitivity. A high-grade serous carcinoma (HGSC) case-control training set of EDTA plasma samples from 397 women was used to lock down the test design, the data interpretation algorithm, and the cutoff between cancer and noncancer. Performance was verified and compared with cancer antigen 125 in an independent blinded case-control set of serum samples from 390 women (132 controls, 66 HGSC, 83 non-HGSC OC, and 109 benign). In the verification study, the OC Test showed a specificity of 97.0% (128/132; 95% CI, 92.4%-99.6%), a HGSC sensitivity of 97.0% (64/66; 95% CI, 87.8%-99.2%), and an area under the curve of 0.97 (95% CI, 0.93-0.99) and detected 73.5% (61/83; 95% CI, 62.7%-82.6%) of the non-HGSC OC cases. This test exhibited fewer false positives in subjects with benign ovarian tumors, nonovarian cancers, and inflammatory conditions when compared with cancer antigen 125. The combined sensitivity and specificity of this new test suggests that it may have potential in OC screening., Competing Interests: Disclosure Statement L.T.B., A.D.C., D.P.S., S.B., I.O.Z., D.M.B., M.S.K., L.T.C., B.J.M., T.B.H., T.G., and D.M. are current employees of Mercy BioAnalytics Inc. E.S.W.-D. is a retired Mercy BioAnalytics employee and is currently a paid consultant of Mercy BioAnalytics Inc. She was a full-time employee when this work was performed. K.M.B., P.A.D., J.G., D.G., B.F.H., and C.R.S. are former employees of Mercy BioAnalytics Inc., who were active employees at the time this work was performed. S.J.S. and K.C. are paid consultants for Mercy BioAnalytics Inc. A.J., J.N.M., and D.H. are employees of University of British Columbia and provided the patient samples used for the training study. A.G.-M., S.A., and U.M. are employees of University College London and provided the patient samples used for the verification study. They also report research collaborations with Cambridge University, QIMR Berghofer Medical Research Institute, Intelligent Lab on Fiber, RNA Guardian, Micronoma, Imperial College London, University of Innsbruck, and Dana Farber USA in the area of early detection of cancer. U.M. had stock ownership (2011 to 2021) awarded by University College London in Abcodia, which held the license for the Risk of Ovarian Cancer Algorithm. She has received grant funding from the Medical Research Council, Cancer Research UK, the National Institute for Health Research UK, the Eve Appeal, and the Australian National Health and Medical Research Council. She is also a member of Tina's Wish Scientific Advisory Board (United States) and the Research Advisory Panel, Yorkshire Cancer Research (United Kingdom). L.T.B. and D.P.S. are inventors on US patent number 11,085,089 B2, Systems, Compositions and Methods for Target Entity Detection (issued August 10, 2021). L.T.B., D.P.S., E.S.W.-D., D.G., K.M.B., and A.D.C. are inventors on US patent application 63/417309, Composition and Methods for Detection of Ovarian Cancer (filed October 18, 2022). U.M. holds patent number EP10178345.4 for Breast Cancer Diagnostics., (Copyright © 2024 Association for Molecular Pathology and American Society for Investigative Pathology. All rights reserved.)

Background: Individuals in a vulnerable position are generally less inclined to participate in population-based cancer screening. Digital tools, such as educational videos, narratives or decision aids, show promise in reaching and informing these invitees by tailoring information needs based on their preferences. This review aims to provide an overview of design features and reported outcomes of digital tools intended to support informed decision making among screening invitees in a vulnerable position., Methods: The review was conducted according to the Preferred Reporting Items for Scoping Reviews guidelines. We searched PubMed, Scopus/MEDLINE and Web of Science and included studies when the effectiveness of the digital tool was assessed and focussed on reaching and/or informing screening invitees in a vulnerable position for breast, cervical or colorectal cancer screening. For each included study, the study population, type of digital tool, the development process, reported design features and reported effects were extracted., Findings: We found 448 articles, and finally 13 were included in this review after reading full text. Study designs included randomised controlled trials (n = 5), pre-post-test design (n = 7) and experimental design (n = 1). Six different types of digital tools were identified: decision aids (n = 6), educational programs (n = 3), narrative video (n = 1), text-messaging intervention (n = 1), animation video (n = 1), and iPad program (n = 1). A population specific design was applied in 12/13 interventions, such as avoiding jargon and using a voice over function. Reported outcomes measures regarding reaching and informing the target population were: knowledge, attitude, screening intention, self-efficacy, susceptibility, feeling informed, values clarity, and screening uptake. All digital tools reported a significant improvement on at least one of the reported outcome measures., Principal Conclusions: The use of digital tools seems to contribute to reach or inform screening invitees in a vulnerable position for cancer screening. However, insufficient evidence was found regarding the development process of the tools and their effects on outcome measures related to reaching and informing the screening invitees in a vulnerable position. Future research may look in to combining multiple digital tools and animated visual information in combination with spoken text to improve reaching and informing screening invitees in a vulnerable position., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The prevalence of human papillomavirus (HPV) genotype and cervical neoplasia in women older than 64 years, who are outside the age demographic of cervical cancer screening in China, has been under-researched. This study conducts a retrospective analysis of women from a tertiary hospital in Guangzhou, with the aim to offer valuable insights for cervical cancer prevention and control in elderly women. The study incorporated 876 women, all aged 64 and above. In this age bracket, the prevalence rate of any HPV genotype was found to be 19.27%. The top six HR HPV genotypes were HPV 16, HPV 52, HPV 58, HPV 31, HPV 33, and HPV 18. The persistence rate of any HPV type over a 24-month period in this age group was as high as 33.33%. Among women over 64, around 16.47% of HPV-positive patients were diagnosed with cervical cancer. HPV 58 infection was the most substantial risk factor for histological CIN2+ (OR 3.556; 95% CI, 1.107-11.415; p  = 0.032) in women over 64 years of age with HPV-positive/NILM status. In conclusion, the burden of HPV infection is significant among women over 64 years in Guangzhou. Re-evaluation of cervical cancer screening strategies for women after the age of 64 is imperative. Moreover, the HPV 16/18/52/58 genotype model could serve as an alternative triage approach to identify histological CIN2+ among elderly women with HPV-positive/NILM status.

Objectives: Despite the established benefits and availability of mammographic breast screening, participation rates remain suboptimal. Women with higher BMIs may not screen regularly, despite being at increased risk of postmenopausal breast cancer and worse outcomes. This study investigated the association between prospective changes in BMI and longitudinal adherence to mammographic screening among women with overweight or obesity., Methods: Retrospective cohort study of women (N = 2822) participating in the Australian Longitudinal Study on Women's Health with an average follow-up of 20 years, with screening participation enumerated via BreastScreen NSW, Australia clinical records over the period 1996-2016. Association between BMI and subsequent adherence to screening was investigated in a series of marginal structural models, incorporating a time variant/invariant socio-demographic, clinical, and health behaviour confounders. Models were also stratified by a proxy measure of socio-economic status (education)., Results: Participants with overweight/obesity were less adherent to mammography screening, compared to healthy/underweight participants (OR=1.29, 95 % CI=1.07, 1.55). The association between overweight/obesity and non-adherence was higher among those who ever had private health insurance (OR=1.30, 95 % CI=1.05, 1.61) compared to those who never had private health insurance and among those with lower educational background (OR=1.38, 95 % CI=1.08, 1.75) compared to those with higher educational background., Conclusions: Long-term impacts on screening participation exist among women with higher BMI, who are less likely to participate in routinely organised breast screening. Women with a higher BMI should be a focus of efforts to improve breast screening participation, particularly given their increased risk of breast cancer and association of higher BMI with worse breast cancer outcomes among older women., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

More than a decade has passed since researchers in the Early Lung Cancer Action Project and the National Lung Screening Trial demonstrated the ability to save lives of high-risk individuals from lung cancer through regular screening by low dose computed tomography scan. The emergence of the most recent findings in the Dutch-Belgian lung-cancer screening trial (Nederlands-Leuvens Longkanker Screenings Onderzoek [NELSON]) further strengthens and expands on this evidence. These studies demonstrate the benefit of integrating lung cancer screening into clinical practice, yet lung cancer continues to lead cancer mortality rates in the United States. Fewer than 20% of screen eligible individuals are enrolled in lung cancer screening, leaving millions of qualified individuals without the standard of care and benefit they deserve. This article, part of the American Cancer Society National Lung Cancer Roundtable (ACS NLCRT) strategic plan, examines the impediments to successful adoption, dissemination, and implementation of lung cancer screening. Proposed solutions identified by the ACS NLCRT Implementation Strategies Task Group and work currently underway to address these challenges to improve uptake of lung cancer screening are discussed. PLAIN LANGUAGE SUMMARY: The evidence supporting the benefit of lung cancer screening in adults who previously or currently smoke has led to widespread endorsement and coverage by health plans. Lung cancer screening programs should be designed to promote high uptake rates of screening among eligible adults, and to deliver high-quality screening and follow-up care., (© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Background: Colorectal cancer (CRC) screenings can improve detection and prevent precancerous polyps from becoming malignant tumors. In 2008, the United States Preventive Services Task Force (USPSTF) updated their policy and no longer recommended that adults over age 75 screen for CRC. We evaluated how this policy update impacted screening behaviors and CRC outcomes in older adults., Methods: We obtained data from the Behavioral Risk Factor Surveillance System to analyze blood stool and colonoscopy screening, the Surveillance, Epidemiological, End Results program to analyze CRC staging and survival, the National Association of Centralized Cancer Registries to analyze CRC incidence, and the National Center for Health Statistics to analyze mortality. With a difference-in-differences design, we compared the changes in outcome trends of the exposed group (age 75+), before and after 2008, with the changes in trends of a similar unexposed group (age 65-74)., Results: There was no association between the 2008 update and blood stool tests in older adults. We did, however, find that the update was associated with a 3.0 %-point decline in the probability of older adults completing a colonoscopy within the past two years (C.I. = -4.0, -2.0). Among older adults diagnosed with CRC, the update was associated with a 1.5 %-point increase in the probability of presenting at an advanced stage (C.I. = 1.1, 1.9). Finally, the update was also associated with lower CRC incidence (Est. = -13.9 cases/100,000 population; C.I. = -22.6, -5.1) and mortality rates (Est. = -5.6 deaths/100,000 population; C.I. = -10.1, -1.1). We observed the largest associations between the policy and CRC outcomes in adults age 85+., Discussion: The USPSTF's 2008 recommendation was associated with reduced colonoscopies, especially in adults over age 85. Whether this recommendation, or the 2021 updated guidance, optimizes population health by reducing the burden of CRC screening in older adults remains unknown., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Current imaging methods for diagnosing breast cancer (BC) are associated with limited sensitivity and specificity and modest positive predictive power. The recent progress in image analysis using artificial intelligence (AI) has created great promise to improve BC diagnosis and subtype differentiation. In this case, novel quantitative computational methods, such as radiomics, have been developed to enhance the sensitivity and specificity of early BC diagnosis and classification. The potential of radiomics in improving the diagnostic efficacy of imaging studies has been shown in several studies. In this review article, we discuss the radiomics workflow and current handcrafted radiomics methods in the diagnosis and classification of BC based on the most recent studies on different imaging modalities, e.g., MRI, mammography, contrast-enhanced spectral mammography (CESM), ultrasound imaging, and digital breast tumosynthesis (DBT). We also discuss current challenges and potential strategies to improve the specificity and sensitivity of radiomics in breast cancer to help achieve a higher level of BC classification and diagnosis in the clinical setting. The growing field of AI incorporation with imaging information has opened a great opportunity to provide a higher level of care for BC patients., Competing Interests: Declarations. Conflict of interest: The authors declare that the research was conducted without commercial or financial relationships, which could be considered a potential conflict of interest. Ethical approval: Since this article is a review manuscript and no specific patient or animal material has been used, the ethics approval is not applicable to this study. Informed consent: Not applicable., (© 2024. The Author(s), under exclusive licence to Japanese Society of Radiological Technology and Japan Society of Medical Physics.)

Objective: To assess the rates of adherence to triage testing after positive screening results and referral to treatment for precancerous lesions in global cervical cancer screening programs., Data Sources: We searched three electronic databases (Medline, EMBASE, and Web of Science) for articles published in the English language from January 1, 2018, to December 31, 2023. We included studies reporting the compliance rate of triage testing and precancer treatment in cervical cancer screening programs. ClinicalTrials.gov was reviewed, and no more studies were identified., Methods of Study Selection: The combined search strategies identified 1,673 titles, of which 858 titles and abstracts were screened and 113 full-text articles were assessed for eligibility. A total of 33 studies met the inclusion criteria and were included in the meta-analysis., Tabulation, Integration, and Results: Thirty-three studies were included in the systematic review and meta-analysis. The average compliance rate for women screening positive was 77.1% for triage testing and 69.4% for referral to treatment. Compliance varied by country income level, screening guideline approach, and target population., Conclusion: The current compliance rate was lower than the 90% target set by the World Health Organization's global strategy to eliminate cervical cancer. Inadequate follow-up of participants screening positive revealed a gap between the screening program and clinical care., Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest., (Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Introduction/background: From 2012 to 2022 there have been numerous revisions in the United States Preventative Task Force guidelines for prostate cancer screening, including advising against PSA testing to allowing shared-decision making for men aged 55 to 69. We sought to observe trends in PSA testing rates in relation to the changing guidelines. Conversely, colorectal cancer screening recommendations remained consistent for patients aged 50-75 and we sought to use this as a comparison to observe the effect of differing guidelines., Methods: The Centers for Disease Control Behavioral Risk Factor Surveillance System is a national database of surveys on health-related behaviors and preventive medical services. We extracted responses from 2012 to 2022 regarding both prostate and colorectal cancer screening. Our primary variable of interest was prostate cancer screening while colorectal cancer screening served as a positive control., Results: Prostate cancer screening decreased among respondents from 70.1% in 2012 to 59.7% in 2022. However, there was a significant rebound in prostate cancer screening prevalence in 2022. In contrast, colorectal cancer screening rates steadily increased from 70.7% in 2012 to 78% in 2022. The annual percentage of men who had received prostate cancer screening was statistically different year to year., Conclusions: Trends in the rate of screening for prostate and colorectal cancer appeared to adapt to the updated recommendations. However, further investigation regarding lower income levels, minority groups, and uninsured men are essential to address the social and racial disparities seen in prostate cancer screening. Efforts to promote shared-decision making may improve effective cancer screening., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Competing Interests: The authors declare that they have no conflict of interest.

Background: Prostate cancer (PCa) screening recommendations do not support prostate-specific antigen (PSA) screening for older men. Such screening often occurs, however. It is, therefore, important to understand how frequently and among which subgroups screening occurs, and the extent of distant stage PCa diagnoses among screened older men., Methods: Using the 2014-2016 linked Ohio Cancer Incidence Surveillance System (OCISS) and Medicare administrative database, we identified men 68 and older diagnosed with PCa and categorized their PSA testing in the three years preceding diagnosis as screening or diagnostic. We conducted multivariable logistic regression analysis to identify correlates of screening PSA and to determine whether screening PSA is independently associated with distant stage disease., Results: Our study population included 3034 patients (median age: 73 years). 62.1% of PCa patients underwent at least one screening-based PSA in the three years preceding diagnosis. Older age (75-84 years: aOR [95% CI]: 0.84 [0.71, 0.99], ≥ 85: aOR: 0.27 [0.19, 0.38]), and frailty (aOR: 0.51 [0.37, 0.71]) were associated with lower screening. Screening was associated with decreased odds of distant stage disease (aOR: 0.55 [0.42, 0.71]). However, older age (75-84 years: aOR: 2.43 [1.82, 3.25], ≥ 85: aOR: 10.57 [7.05, 15.85]), frailty (aOR: 5.00 [2.78, 9.31]), and being separated or divorced (aOR: 1.64 [1.01, 2.60]) were associated with increased distant stage PCa., Conclusion: PSA screening in older men is common, though providers appear to curtail PSA screening as age and frailty increase. Screened older men are diagnosed at earlier stages, but the harms of screening cannot be assessed., Competing Interests: Declarations Conflict of interest The authors declare no competing interests. Ethical approval This study was approved by the Case Western Reserve University Institutional Review Board (#20120107), the Ohio Department of Health Institutional Review Board (#2018-05), and the Centers for Medicare and Medicaid Services Privacy board (DUA# 2012-23469)., (© 2024. The Author(s).)

Ovarian cancer (OC) is one of the three major gynecologic malignancies and has the highest mortality rate because of the late diagnosis. Liquid biopsy based on serum protein biomarkers has demonstrated great potential for early diagnosis but remains limited by the analysis performance of conventional immunoassay technologies, such as chemiluminescence, and biomarkers, such as CA125. To address this challenge and achieve accurate early-stage diagnosis of OC, we developed a digital immunoassay on a SlipChip (DiSC) for quantitative analysis of a potential serum protein biomarker, Spondin-1 (SPON1). The DiSC system achieved a limit of detection (LoD) of 23 fg/μL for digital quantification of SPON1. The DiSC system was utilized to quantify the serum level of SPON1 in 357 clinical serum samples, including 63 from patients with benign ovarian tumors and 294 from patients with malignant ovarian cancer, ranging from stages I to IV. SPON1 concentrations were significantly different in samples from patients with malignant ovarian cancer. Notably, significantly different SPON1 levels were observed in early stages (I and II), in lymph node-negative cases (N 0 ), and before metastasis (M 0 ), suggesting that SPON1 could serve as a sensitive diagnostic biomarker for early-stage OC. The differential diagnostic model based on SPON1 levels quantified using DiSC demonstrated an area under the curve (AUC) of 0.8187 for early-stage OC, a significant improvement over CA-125 (AUC = 0.6967). For OC of all stages, the AUC was 0.8225, which could be further increased to 0.8750 when combined with CA-125. This showcases the potential of SPON1 as a novel biomarker for sensitive early-stage diagnosis of ovarian cancer and the capability of the DiSC system in discovering low-abundance biomarkers for disease diagnosis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objective: The incidence of melanoma has increased dramatically over the past four decades, while overall mortality has remained stable. This increase in incidence without a change in overall mortality may be due to overdiagnosis through skin cancer screening. Despite the USPSTF citing insufficient evidence for or against professional skin cancer screening in average-risk adults, U.S. skin cancer screening practices may be leading to overdiagnosis of skin cancers., Methods: Two reviewers examined the online recommendations for skin cancer screening of 1113 U.S. cancer centers accredited by the Commission on Cancer, including 66 designated by the National Cancer Institute (NCI). Recommendations on skin cancer screening, such as age, frequency, and patient population (i.e. high-risk of developing skin cancer, "people of color") were documented., Results: We found that 18% of centers (202) recommended professional screening in average-risk adults, 35.8% (399) advised regular self-examination, and only 3.4% (38) cited insufficient evidence for screening practices; 49% of NCI centers (32/66) recommended screening in high-risk adults compared to 13% of non-NCI centers (135/1047; p  = 0.0004); 0.45% of centers (5) mentioned the potential harms of screening, while 3.5% (39) specifically recommended screening for people of color., Conclusion: Our study reveals that many U.S. cancer centers advise some form of skin cancer screening despite a lack of evidence for or against these practices. Few centers mentioned the potential harms of screening, including overdiagnosis. This indicates a need for stronger evidence for specific screening guidelines and for greater public awareness of the potential benefits and harms of routine skin cancer screening., Competing Interests: Declaration of conflicting interestsDr Deborah Korenstein's husband consults for and serves on the scientific advisory board of Vedanta Biosciences, and also consults for Opentrons and Fimbrio.

Objective: This study aims to assess the diagnostic utility of circulating tumor cells (CTCs) in conjunction with low-dose computed tomography (LDCT) for differentiating between benign and malignant pulmonary nodules and to substantiate the foundation for their integration into clinical practice., Methods: A systematic literature review was performed independently by two researchers utilizing databases including PubMed, Web of Science, The Cochrane Library, Embase, and Medline, to collate studies up to September 15, 2023, that investigated the application of CTCs in diagnosing pulmonary nodules. A meta-analysis was executed employing Stata 15.0 and Revman 5.4 to calculate the pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curve (AUC). Additionally, trial sequential analysis was conducted using dedicated TSA software., Results: The selection criteria identified 16 studies, encompassing a total of 3409 patients. The meta-analysis revealed that CTCs achieved a pooled sensitivity of 0.84 (95% CI 0.80 to 0.87), specificity of 0.80 (95% CI 0.73 to 0.86), PLR of 4.23 (95% CI 3.12 to 5.72), NLR of 0.20 (95% CI 0.16 to 0.25), DOR of 20.92 (95% CI 13.52 to 32.36), and AUC of 0.89 (95% CI 0.86 to 0.93)., Conclusions: Circulating tumor cells demonstrate substantial diagnostic accuracy in distinguishing benign from malignant pulmonary nodules. The incorporation of CTCs into the diagnostic protocol can significantly augment the diagnostic efficacy of LDCT in screening for malignant lung diseases., Competing Interests: Conflict of interest The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Ethical approval Institutional Review Board approval was not required because this article is a review. Informed consent Written informed consent was not required for this study because this article is a review., (© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)

Objective: To quantify the associations between time to colonoscopy after a positive fecal immunochemical test (FIT+) and colorectal cancer (CRC)-related outcomes in the context of a provincial, population-based CRC screening program., Setting: Population-based, retrospective cohort study in Alberta, Canada, including Albertans aged 50-74 with at least one FIT+ in 2014-2017., Methods: Study outcomes were CRC diagnosis after a FIT+ and a diagnostic follow-up colonoscopy in 2014-2019 and CRC stage at diagnosis. Multivariable logistic regression models were used to evaluate the relative risk of any CRC or advanced-stage CRC. Results were presented as crude odds ratio (OR) and adjusted OR (aOR) with 95% confidence intervals (CIs)., Results: Of the 787,967 participants who had a FIT, 63,232 (8%) had a FIT+ and met the study's eligibility criteria. The risk of any CRC or advanced-stage CRC stayed high and was relatively consistent for follow-up colonoscopies performed within 1-12 months of the FIT+. After 12 months, the risk of CRC was considerably higher, particularly for advanced-stage CRC. The OR and aOR for any CRC were 1.40 (95% CI: 1.13-1.73; p  < 0.05) and 1.20 (95% CI: 0.96-1.49), respectively, and the OR and aOR for advanced-stage CRC were 1.42 (95% CI: 0.98-2.08) and 0.88 (95% CI: 0.59-1.32), respectively, for colonoscopy follow-up within 12-18 months versus 1-2 months., Conclusions: For Albertans who used FIT for CRC screening, a longer time interval between a FIT+ and follow-up colonoscopy, particularly over 12 months, increases the risk of having CRC and decreases the effectiveness of CRC screening programs., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The Baveno VII guidelines were proposed to identify which patients could safely avoid screening esophagogastroduodenoscopy (EGD) for gastroesophageal varices. We aimed to evaluate the frequency of gastric neoplasia in compensated advanced chronic liver disease (cACLD) patients who underwent EGD for screening of gastroesophageal varices (GOEV) compared to a healthy population., Methods: Retrospective study that enrolled all cACLD patients who underwent EGD for GOEV screening (January 2008-June 2018) in a tertiary reference center. cACLD patients were compared with asymptomatic healthy individuals who underwent EGD in a private hospital setting (April 2017-March 2018)., Results: We evaluated 1845 patients (481 cACLD patients, 1364 healthy individuals). A significantly higher frequency of gastric neoplasia was observed in patients with cACLD compared to healthy individuals (4.0% vs. 1.0 %; p < 0.001). Rare histopathological subtypes (WHO Classification) accounted for 28.7 % of gastric carcinoma cases in the cACLD cohort. Seven cases of gastric neoplasia (36.8 % of gastric neoplasia cases in the cACLD patients) were diagnosed in patients who, according to the Baveno VII criteria, would have not been submitted to EGD., Conclusion: We found an increased frequency of gastric neoplasia in patients with cACLD in comparison with healthy individuals. In countries with intermediate-high risk for GC, continuing to perform EGD could be beneficial., Competing Interests: Conflict of interest None., (Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

National screening programs for gastric, colorectal, lung, breast, and cervical cancers are offered in Japan. The initial introduction of cancer screening programs was decided based on experts' opinions. Since 2003, the research groups funded by the National Cancer Center have published screening guidelines for gastric, colorectal, lung, prostate, cervical, and breast cancers. Although such guidelines have increasingly contributed to promoting evidence-based screening, it is still insufficient. Cancer screenings have mainly been provided in communities and workplaces. Compared with the average of OECD countries, participation rates in breast and cervical cancer screening are lower. Participation rates cannot be accurately calculated due to a lack of comprehensive cancer screening registries at the national level. Alternatively, estimates are derived from questionnaire surveys conducted on randomly selected samples from the national population. The quality assurance system has been limited to community-based screening and was not adapted to workplace screening until 2018. While there is a long history of cancer screening, the complex program delivery system might be a barrier to increasing the participation rate. Continued efforts are necessary to offer evidence-based cancer screening and establish an effective quality assurance system., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Pancreatic cancer (PaC) incidence is increasing, but our current screening and diagnostic strategies are not very effective. However, screening could be helpful in the case of PaC, as recent evidence shows that the disease progresses gradually. Unfortunately, there is no ideal screening method or program for detecting PaC in its early stages. Conventional imaging techniques, such as abdominal ultrasound, CT, MRI, and EUS, have not been successful in detecting early-stage PaC. On the other hand, biomarkers may be a more effective screening tool for PaC and have greater potential for further evaluation compared to imaging. Recent studies on biomarkers and artificial intelligence (AI)-enhanced imaging have shown promising results in the early diagnosis of PaC. In addition to proteins, non-coding RNAs are also being studied as potential biomarkers for PaC. This review consolidates the current literature on PaC screening modalities to provide an organized framework for future studies. While conventional imaging techniques have not been effective in detecting early-stage PaC, biomarkers and AI-enhanced imaging are promising avenues of research. Further studies on the use of biomarkers, particularly non-coding RNAs, in combination with imaging modalities may improve the accuracy of PaC screening and lead to earlier detection of this deadly disease., Competing Interests: Compliance with Ethical Standards Conflict of interest The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To analyze differences between screen-detected and non-screen-detected invasive breast cancers by tumour characteristics and age at diagnosis in the nationwide population-based mammography screening program in Sweden., Methods: Data were retrieved from the National Quality Register for Breast Cancer for 2008-2017. Logistic regression analysis was used to estimate the likelihood for a tumour to be screen-detected by tumour characteristics and age group at diagnosis., Results: In total there were 51,429 invasive breast cancers in the target age group for mammography screening of 40-74 years. Likelihood of screen detection decreased with larger tumour size, lymph node metastases, higher histological grade and distant metastasis. Odds ratios (ORs) for negative oestrogen (ER) and progesterone (PgR) were 0.41 and 0.57; for positive HER2, 0.62; for Ki-67 high versus low, 0.49. Molecular sub-types had OR of 0.56, 0.40 and 0.28, respectively, for luminal B-like, HER2-positive and triple negative versus luminal A-like. Adjusting for tumour size (T), lymph node status (N), age, year and county at diagnosis slightly elevated the ORs. Statistically significant interactions between tumour characteristics and age were found ( p  < 0.05) except for ER and PgR. The age group 40-49 deviated most from the other age groups., Conclusions: Our study demonstrates that screen-detected invasive breast cancers had more favourable tumour characteristics than non-screen-detected after adjusting for age, year and county of diagnosis, and even after adjusting for T and N. The trend towards favourable tumour characteristics was less pronounced in the 40-49 age group compared to the other age groups, except for ER and PgR., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Late-stage cancer incidence has been proposed as an early surrogate for mortality in randomized controlled trials (RCTs) of cancer screening; however, its validity has not been systematically evaluated across screening RCTs of different cancers., Methods: We conducted a meta-regression analysis of cancer screening RCTs that reported both late-stage cancer incidence and cancer mortality. Based on a systematic literature review, we included 33 RCTs of screening programs targeting seven cancer types, including lung ( n  = 12), colorectal ( n  = 8), breast ( n  = 5), and prostate ( n  = 4), among others. We regressed the relative reduction of cancer mortality on the relative reduction of late-stage cancer incidence, inversely weighted for each RCT by the variance of estimated mortality reduction., Results: Across cancer types, the relative reduction of late-stage cancer incidence was linearly associated with the relative reduction of cancer mortality. Specifically, we observed this association for lung ( R 2   = 0.79 and 0.996 in three recent large trials), breast ( R 2   = 0.94), prostate ( R 2   = 0.98), and colorectal cancer ( R 2   = 0.75 for stage III/IV cancers and 0.93 for stage IV cancers). Trials with a 20% or greater reduction in late-stage cancers were more likely to achieve a significant reduction in cancer mortality. Our results also showed that no reduction of late-stage cancer incidence was associated with no or minimal reduction in cancer mortality., Conclusions: Meta-regression of historical screening RCTs showed a strong linear association between reductions in late-stage cancer incidence and cancer mortality., Competing Interests: Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JYD, ETC, CAC, EAH, and NZ are employees of GRAIL, LLC, and report other support from GRAIL, LLC, during the conduct of the study. In addition, EAH has multiple patents in the field of cancer detection pending to GRAIL, LLC. EGL reports receiving consulting fees from GRAIL, LLC.

Competing Interests: The authors declare that they have no conflict of interest.

Population-wide skin cancer screening is not currently recommended in most countries. Instead, most clinical guidelines incorporate risk-based recommendations for skin checks, despite limited evidence around implementation and adherence to recommendations in practice. We aimed to determine adherence to personal risk-tailored melanoma skin check schedules and explore reasons influencing adherence. Patients (with/without a previous melanoma) attending tertiary dermatology clinics at the Melanoma Institute Australia, Sydney, Australia, were invited to complete a melanoma risk assessment questionnaire via iPad and provided with personal risk information alongside a risk-tailored skin check schedule. Data were collected from the risk tool, clinician-recorded data on schedule deviations, and appointment booking system. Post-consultation, we conducted semi-structured interviews with patients and clinic staff. We used a convergent segregated mixed methods approach for analysis. Interviews were audio recorded, transcribed and data were analysed thematically. Participant data were analysed from clinic records (n = 247) and interviews (n = 29 patients, 11 staff). Overall, there was 62% adherence to risk-tailored skin check schedules. In cases of non-adherence, skin checks tended to occur more frequently than recommended. Decisions to deviate were similarly influenced by patients (44%) and clinicians (56%). Themes driving non-adherence among patients included anxiety and wanting autonomy around decision-making, and among clinicians included concerns around specific lesions and risk estimate accuracy. There was moderate adherence to a clinical service program of personal risk-tailored skin check recommendations. Further adherence may be gained by incorporating strategies to identify and assist patients with high levels of anxiety and supporting clinicians to communicate risk-based recommendations with patients., (© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)

Rationale and Objective: There is a notable absence of robust evidence on the efficacy of ultrasound-based breast cancer screening strategies, particularly in populations with a high prevalence of dense breasts. Our study addresses this gap by evaluating the effectiveness of such strategies in Chinese women, thereby enriching the evidence base for identifying the most efficacious screening approaches for women with dense breast tissue., Methods: Conducted from October 2018 to August 2022 in Central China, this prospective cohort study enrolled 8996 women aged 35-64 years, divided into two age groups (35-44 and 45-64 years). Participants were screened for breast cancer using hand-held ultrasound (HHUS) and automated breast ultrasound system (ABUS), with the older age group also receiving full-field digital mammography (FFDM). The Breast Imaging Reporting and Data System (BI-RADS) was employed for image interpretation, with abnormal results indicated by BI-RADS 4/5, necessitating a biopsy; BI-RADS 3 required follow-up within 6-12 months by primary screening strategies; and BI-RADS 1/2 were classified as negative., Results: Among the screened women, 29 cases of breast cancer were identified, with 4 (1.3‰) in the 35-44 years age group and 25 (4.2‰) in the 45-64 years age group. In the younger age group, HHUS and ABUS performed equally well, with no significant difference in their AUC values (0.8678 vs. 0.8679, P > 0.05). For the older age group, ABUS as a standalone strategy (AUC 0.9935) and both supplemental screening methods (HHUS with FFDM, AUC 0.9920; ABUS with FFDM, AUC 0.9928) outperformed FFDM alone (AUC 0.8983, P < 0.05). However, there was no significant difference between HHUS alone and FFDM alone (AUC 0.9529 vs. 0.8983, P > 0.05)., Conclusion: The findings indicate that both HHUS and ABUS exhibit strong performance as independent breast cancer screening strategies, with ABUS demonstrating superior potential. However, the integration of FFDM with these ultrasound techniques did not confer a substantial improvement in the overall effectiveness of the screening process., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Huifang Xu reports financial support was provided by Henan Institute of Science and Technology. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Background: Genetic testing, to identify pathogenic or likely pathogenic variants in prostate cancer, is valuable in guiding treatment decisions for men with prostate cancer and to inform cancer prevention and early detection options for their immediate blood relatives. There are various guidelines and consensus statements for genetic testing in prostate cancer. Our aim is to review genetic testing recommendations across current guidelines and consensus statements and the level of evidence supporting those recommendations., Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) guidelines. Electronic database searches and manual searches of grey literature, including websites of key organisations were conducted. Using the Population, Concept, Context (PCC) framework, this scoping review included: men with prostate cancer or men at high risk of prostate cancer and their biological families; existing guidelines and consensus statements with supporting evidence for genetic testing of men with prostate cancer from any geographical location worldwide., Results: Of the 660 citations identified, 23 guidelines and consensus statements met the inclusion criteria for the scoping review. Based on different levels of evidence about who should be tested and how, a diverse range of recommendations were identified. There was general consensus among the guidelines and consensus statements that men with metastatic disease be offered genetic testing; however, there was less consensus in relation to genetic testing in localised prostate cancer. While there was some consensus in relation to which genes to test, recommendations varied regarding who to test, testing methods and implementation., Conclusion: While genetic testing in prostate cancer is routinely recommended and numerous guidelines exist, there is still considerable lack of consensus regarding who should be tested and how they should be tested. Further evidence is needed to inform value-based genetic testing strategies for implementation in practice., (© 2023. The Author(s).)

Background: One of the ailments with the greatest fatality rates in the 21st century is cancer. Globally, molecular methods are widely employed to treat cancer-related disorders, and the body of research on this subject is growing yearly. A thorough and critical summary of the data supporting molecular methods for illnesses linked to cancer is required., Objective: In order to guide clinical practice and future research, it is important to examine and summarize the systematic reviews (SRs) that evaluate the efficacy and safety of molecular methods for disorders associated to cancer., Methods: We developed a comprehensive search strategy to find relevant articles from electronic databases like PubMed, Google Scholar, Web of Science (WoS), or Scopus. We looked through the literature and determined which diagnostic methods in cancer genetics were particularly reliable. We used phrases like 'cancer genetics', genetic susceptibility, Hereditary cancer, cancer risk assessment, 'cancer diagnostic tools', cancer screening', biomarkers, and molecular diagnostics, reviews and meta-analyses evaluating the efficacy and safety of molecular therapies for cancer-related disorders. Research that only consider treatment modalities that don't necessitate genetic or molecular diagnostics fall under the exclusion criteria., Results: The results of this comprehensive review clearly demonstrate the transformative impact of molecular methods in the realm of cancer genetics.This review underscores how these technologies have empowered researchers and clinicians to identify and understand key genetic alterations that drive malignancy, ranging from point mutations to structural variations. Such insights are instrumental in pinpointing critical oncogenic drivers and potential therapeutic targets, thus opening the door for methods in precision medicine that can significantly improve patient outcomes., Limitation: The search does not specify a timeframe for publication inclusion, it may have missed recent advancements or changes in the field's landscape of molecular methods for cancer. As a result, it may not have included the most recent developments in the field., Conclusion: After conducting an in-depth study on the molecular methods in cancer genetics, it is evident that these cutting-edge technologies have revolutionized the field of oncology, providing researchers and clinicians with powerful tools to unravel the complexities of cancer at the genetic level. The integration of molecular methods techniques has not only enhanced our understanding of cancer etiology, progression, and treatment response but has also opened new avenues for personalized medicine and targeted therapies, leading to improved patient outcomes.

Ultrafast fluorescent confocal microscopy is a hypothetical approach for breast cancer detection because of its potential to achieve instantaneous, high-resolution images of cellular-level tissue features. Traditional approaches such as mammography and biopsy are laborious, invasive, and inefficient; confocal microscopy offers many benefits over these approaches. However, confocal microscopy enables the exact differentiation of malignant cells, the expeditious examination of extensive tissue sections, and the optical sectioning of tissue samples into tiny slices. The primary goal should be to prevent cancer altogether, although detecting it early can help achieve that objective. This research presents a novel Breast Histopathology Convolutional Neural Network (BHCNN) for feature extraction and recursive feature elimination method for selecting the most significant features. The proposed approach utilizes full slide images to identify tissue in regions affected by invasive ductal carcinoma. In addition, a transfer learning approach is employed to enhance the performance and accuracy of the models in detecting breast cancer, while also reducing computation time by modifying the final layer of the proposed model. The results showed that the BHCNN model outperformed other models in terms of accuracy, achieving a testing accuracy of 98.42% and a training accuracy of 99.94%. The confusion matrix results show that the IDC positive (+) class achieved 97.44% accuracy and 2.56% inaccurate results, while the IDC negative (-) class achieved 98.73% accuracy and 1.27% inaccurate results. Furthermore, the model achieved less than 0.05 validation loss. RESEARCH HIGHLIGHTS: The objective is to develop an innovative framework using ultra-fast fluorescence confocal microscopy, particularly for the challenging problem of breast cancer diagnosis. This framework will extract essential features from microscopy and employ a gradient recurrent unit for detection. The proposed research offers significant potential in enhancing medical imaging through the provision of a reliable and resilient system for precise diagnosis of breast cancer, thereby propelling the progression of state-of-the-art medical technology. The most suitable feature was determined using BHRFE optimization techniques after retrieving the features by proposed model. Finally, the features chosen are integrated into a proposed methodology, which is then classified using a GRU deep model. The aforementioned research has significant potential to improve medical imaging by providing a complex and reliable system for precise evaluation of breast cancer, hence advancing the development of cutting-edge medical technology., (© 2024 Wiley Periodicals LLC.)

Objectives: Primary human papillomavirus (HPV) testing by clinician-collection is endorsed by U.S. guideline organizations for cervical cancer screening, but uptake remains low and insights into patients' understanding are limited. This study aims to primarily address patient awareness of primary HPV screening by clinician-collection and acceptance of primary HPV screening by clinician- and self-collection, and secondarily assess factors associated with awareness and acceptance., Setting: Primary care practices affiliated with an academic medical center., Methods: A cross-sectional survey study of screening-eligible women aged 30-65 years was conducted to assess awareness and acceptability of primary HPV screening. We analyzed bivariate associations of respondent characteristics with awareness of primary HPV screening by clinician-collection, willingness to have clinician- or self-collected primary HPV testing, and reasons for self-collection preference., Results: Respondents (n = 351; response rate = 23.4%) reported cervical cancer screening adherence of 82.8% but awareness of clinician-collected primary HPV as an option was low (18.9%) and only associated with HPV testing with recent screening ( p  = 0.003). After reviewing a description of primary HPV screening, willingness for clinician-collected (81.8%) or home self-collected (76.1%) HPV testing was high, if recommended by a provider. Acceptability of clinician-collected HPV testing was associated with higher income ( p  = 0.009) and for self-collection was associated with higher income ( p  = 0.002) and higher education ( p  = 0.02). Higher education was associated with reporting self-collection as easier than clinic-collection ( p  = 0.02). Women expected self-collection to be more convenient (94%), less embarrassing (85%), easier (85%), and less painful (81%) than clinician-collection., Conclusions: Educational interventions are needed to address low awareness about the current clinician-collected primary HPV screening option and to prepare for anticipated federal licensure of self-collection kits. Informing women about self-collection allows them to recognize benefits which could address screening barriers., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Hepatocellular carcinoma (HCC) is one of the most common primary malignancies of the liver and a leading cause for cancer-related deaths worldwide. HCC surveillance aims at early detection. The recommended strategy for screening HCC is biannual ultrasound with or without alpha-fetoprotein. However, this strategy is associated with sub-optimal sensitivity. Abbreviated magnetic resonance imaging (AMRI) is a promising alternative to ultrasound (US) for surveillance of HCC. The data regarding the role of AMRI in HCC screening is evolving. There are different AMRI protocols, each having its merits and disadvantages. In this review, we discuss the need for AMRI, protocols of AMRI and hindrances to widespread adoption of AMRI., (© 2024. Indian Society of Gastroenterology.)

Objective: Uveal melanoma is the most common intraocular malignancy in adults. Current screening and triaging methods for melanocytic choroidal tumours face inherent limitations, particularly in regions with limited access to specialized ocular oncologists. This study explores the potential of machine learning to automate tumour segmentation. We develop and evaluate a machine-learning model for lesion segmentation using ultra-wide-field fundus photography., Method: A retrospective chart review was conducted of patients diagnosed with uveal melanoma, choroidal nevi, or congenital hypertrophy of the retinal pigmented epithelium at a tertiary academic medical centre. Included patients had a single ultra-wide-field fundus photograph (Optos PLC, Dunfermline, Fife, Scotland) of adequate quality to visualize the lesion of interest, as confirmed by a single ocular oncologist. These images were used to develop and test a machine-learning algorithm for lesion segmentation., Results: A total of 396 images were used to develop a machine-learning algorithm for lesion segmentation. Ninety additional images were used in the testing data set along with images of 30 healthy control individuals. Of the images with successfully detected lesions, the machine-learning segmentation yielded Dice coefficients of 0.86, 0.81, and 0.85 for uveal melanoma, choroidal nevi, and congenital hypertrophy of the retinal pigmented epithelium, respectively. Sensitivities for any lesion detection per image were 1.00, 0.90, and 0.87, respectively. For images without lesions, specificity was 0.93., Conclusion: Our study demonstrates a novel machine-learning algorithm's performance, suggesting its potential clinical utility as a widely accessible method of screening choroidal tumours. Additional evaluation methods are necessary to further enhance the model's lesion classification and diagnostic accuracy., Competing Interests: Footnotes and Disclosure Darvin Yi and Michael J. Heiferman contributed equally to this article. The authors have no proprietary or commercial interest in any materials discussed in this article. Supported by: This work was supported by the National Eye Institute (P30 EY001792); Research to Prevent Blindness, New York, NY; and the VitreoRetinal Surgery Foundation, Minneapolis, MN., (Published by Elsevier Inc.)

Background: Artificial intelligence (AI) shows promising potential to enhance human decision-making as synergistic augmented intelligence (AuI), but requires critical evaluation for skin cancer screening in a real-world setting., Objectives: To investigate the perspectives of patients and dermatologists after skin cancer screening by human, artificial and augmented intelligence., Methods: A prospective comparative cohort study conducted at the University Hospital Basel included 205 patients (at high-risk of developing melanoma, with resected or advanced disease) and 8 dermatologists. Patients underwent skin cancer screening by a dermatologist with subsequent 2D and 3D total-body photography (TBP). Any suspicious and all melanocytic skin lesions ≥3 mm were imaged with digital dermoscopes and classified by corresponding convolutional neural networks (CNNs). Excisions were performed based on dermatologist's melanoma suspicion, study-defined elevated CNN risk-scores and/or melanoma suspicion by AuI. Subsequently, all patients and dermatologists were surveyed about their experience using questionnaires, including quantification of patient's safety sense following different examinations (subjective safety score (SSS): 0-10)., Results: Most patients believed AI could improve diagnostic performance (95.5%, n = 192/201). In total, 83.4% preferred AuI-based skin cancer screening compared to examination by AI or dermatologist alone (3D-TBP: 61.3%; 2D-TBP: 22.1%, n = 199). Regarding SSS, AuI induced a significantly higher feeling of safety than AI (mean-SSS (mSSS): 9.5 vs. 7.7, p < 0.0001) or dermatologist screening alone (mSSS: 9.5 vs. 9.1, p = 0.001). Most dermatologists expressed high trust in AI examination results (3D-TBP: 90.2%; 2D-TBP: 96.1%, n = 205). In 68.3% of the examinations, dermatologists felt that diagnostic accuracy improved through additional AI-assessment (n = 140/205). Especially beginners (<2 years' dermoscopic experience; 61.8%, n = 94/152) felt AI facilitated their clinical work compared to experts (>5 years' dermoscopic experience; 20.9%, n = 9/43). Contrarily, in divergent risk assessments, only 1.5% of dermatologists trusted a benign CNN-classification more than personal malignancy suspicion (n = 3/205)., Conclusions: While patients already prefer AuI with 3D-TBP for melanoma recognition, dermatologists continue to rely largely on their own decision-making despite high confidence in AI-results., Trial Registration: ClinicalTrials.gov (NCT04605822)., (© 2024 European Academy of Dermatology and Venereology.)

Hepatocellular carcinoma (HCC) represents a significant health burden in Egypt, largely attributable to the endemic prevalence of hepatitis B and C viruses. Early identification of HCC remains a challenge due to the lack of widespread screening among at-risk populations. The objective of this study was to assess the utility of machine learning in predicting HCC by analyzing the combined expression of lncRNAs and conventional laboratory biomarkers. Plasma levels of four lncRNAs (LINC00152, LINC00853, UCA1, and GAS5) were quantified in a cohort of 52 HCC patients and 30 age-matched controls. The individual diagnostic performance of each lncRNA was assessed using ROC curve analysis. Subsequently, a machine learning model was constructed using Python's Scikit-learn platform to integrate these lncRNAs with additional clinical laboratory parameters for HCC diagnosis. Individual lncRNAs exhibited moderate diagnostic accuracy, with sensitivity and specificity ranging from 60 to 83% and 53-67%, respectively. In contrast, the machine learning model demonstrated superior performance, achieving 100% sensitivity and 97% specificity. Notably, a higher LINC00152 to GAS5 expression ratio significantly correlated with increased mortality risk. The integration of lncRNA biomarkers with conventional laboratory data within a machine learning framework demonstrates significant potential for developing a precise and cost-effective diagnostic tool for HCC. To enhance the model's robustness and prognostic capabilities, future studies should incorporate larger cohorts and explore a wider array of lncRNAs., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics: The research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. Information revealing the patient’s identity has been avoided. All patients have been identified by numbers or aliases and not by their real names. Study approval statement: The protocol was approved by the ethical committee of Shefaa Al Orman Oncology Hospital., (© 2024. The Author(s).)