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Background: Technological advances in the field of virtual reality (VR) offer new opportunities in many areas of life, including medical education. The University of Münster has been using VR scenarios in the education of medical students for several years, especially for situations that are difficult to reproduce in reality (e.g., brain death). Due to the consistently positive feedback from students, a dermatological VR scenario for skin cancer screening was developed. Objectives: Presentation and first evaluation of the skin cancer screening VR scenario to determine to what extent the technical implementation of the scenario was evaluated overall by the students and how their subjective competence to perform a skin cancer screening changed over the course of the teaching unit (theory seminar, VR scenario, theoretical debriefing). Methods: Students (n = 140) participating in the curricular pilot project during the 2023 summer term were surveyed throughout the teaching unit using several established questionnaires (System Usability Scale, Simulation Task‐Load‐Index, Realism and Presence Questionnaire) as well as additional questions on cybersickness and subjective learning. Results: (i) The use of VR is technically feasible, (ii) students evaluate the VR scenario as a useful curricular supplement, and (iii) from the students' subjective perspective, a good learning outcome is achieved. Although preparation and follow‐up appear to be important for overall learning, the greatest increase in subjective competence to perform a skin cancer screening is achieved by the VR scenario. Conclusions: Technically feasible and positively evaluated by students, VR can already be a useful addition to dermatology education, although costs are still high. As a visual discipline, dermatology offers special opportunities to create VR scenarios that are not always available or comfortable for patients in reality. Additionally, VR scenarios guarantee the same conditions for all students, which is essential for a high‐quality education. [ABSTRACT FROM AUTHOR]

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). [ABSTRACT FROM AUTHOR]

Skin cancer poses a significant health hazard, necessitating the utilization of advanced diagnostic methodologies to facilitate timely detection, owing to its escalating prevalence in recent years. This paper proposes a novel approach to tackle the issue by introducing a method for detecting skin cancer that uses MixNets to enhance diagnosis and leverages mobile network-based transfer learning. Skin cancer has diverse forms, each distinguishable by its structural attributes, morphological characteristics, texture, and coloration. The pressing demand for accurate and efficient diagnostic instruments has spurred the investigation of novel techniques. The present study utilizes the ISIC dataset, comprising a validation set of 660 images and a training set of 2637 images. Moreover, the research employs a combination of MixNets and mobile network-based transfer learning as its chosen approach. Transfer learning is a technique that leverages preexisting models to enhance the diagnostic capabilities of the proposed system. Integrating MobileNet and MixNets allows for utilizing their respective functionalities, resulting in a dual-model methodology that enhances the comprehensiveness of skin cancer diagnosis. The results demonstrate impressive performance metrics, with MobileNet and MixNets models, and the proposed approach achieves an outstanding accuracy rate of 99.58%. The above findings underscore the efficacy of the dual-model method in effectively discerning between benign and malignant skin lesions. Moreover, the present study aims to examine the potential integration of emerging technologies to enhance the accuracy and practicality of diagnostics within real-world healthcare settings. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate a cancer detecting artificial intelligence (AI) algorithm on serial biopsies in patients with prostate cancer on active surveillance (AS). Patients and methods: A total of 180 patients in the Prostate Cancer Research International Active Surveillance (PRIAS) cohort were prospectively monitored using pre‐defined criteria. Diagnostic and re‐biopsy slides from 2011 to 2020 (n = 4744) were scanned and analysed by an in‐house AI‐based cancer detection algorithm. The algorithm was analysed for sensitivity, specificity, and for accuracy to predict need for active treatment. Prognostic properties of cancer size, prostate‐specific antigen (PSA) level and PSA density at diagnosis were evaluated. Results: The sensitivity and specificity of the AI algorithm was 0.96 and 0.73, respectively, for correct detection of cancer areas. Original pathology report diagnosis was used as the reference method. The area of cancer estimated by the pathologists correlated highly with the AI detected cancer size (r = 0.83). By using the AI algorithm, 63% of the slides would not need to be read by a pathologist as they were classed as benign, at the risk of missing 0.55% slides containing cancer. Biopsy cancer content and PSA density at diagnosis were found to be prognostic of whether the patient stayed on AS or was discontinued for active treatment. Conclusion: The AI‐based biopsy cancer detection algorithm could be used to reduce the pathologists' workload in an AS cohort. The detected cancer amount correlated well with the cancer length measured by the pathologist and the algorithm performed well in finding even small areas of cancer. To our knowledge, this is the first report on an AI‐based algorithm in digital pathology used to detect cancer in a cohort of patients on AS. [ABSTRACT FROM AUTHOR]

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. Significance: What is already known on this subject?: Human papillomavirus (HPV) vaccination reduces risk of cervical cancer. HPV vaccination rates are lower among children than other vaccination rates. Mothers' healthcare visits are associated with their child's healthcare visits. What does this study add?: Children of mothers up-to-date on cervical cancer screening have higher odds of HPV vaccination than children of mothers who have not received recommended cervical cancer screenings. These findings suggest that interventions that focus on cervical cancer screenings and care of both mothers and their children may help to increase HPV rates among children. Multigenerational approaches to cervical cancer prevention may be an important part of the elimination of this cancer. [ABSTRACT FROM AUTHOR]

Objectives: This review aimed to synthesize the available evidence on exploring various factors that affect knowledge, attitudes, and practices (KAP) in colorectal cancer (CRC) screening. Methods: A systematic search across five databases was performed to identify factors influencing KAP scores towards CRC screening. The PRISMA guidelines were used to conduct the literature search, and the time spanned is from March to June 2023. The search included observational studies published between January 2000 and June 2023 that met the predetermined review criteria. Data were extracted following the Joanna Briggs Institute (JBI) appraisal checklist to evaluate the quality of the articles. Results: Out of 16,904 records, 1174 articles were reviewed in full text, resulting in 43 high‐quality studies included based on the JBI checklist. These studies assessed knowledge (42), attitudes (26), and practices (11) related to CRC screening. Key factors to improving KAP towards CRC screening in the general public were sociodemographic, social media influence, and physician recommendations. For healthcare professionals, factors promoting KAP included screening methods, guidelines, qualifications, and understanding of CRC screening. Educators lacked awareness of CRC symptoms and needed training to teach CRC screening and prevention. Pharmacists showed positive attitudes towards early CRC detection but had varying knowledge levels. Conclusions: KAP towards CRC screening is suboptimal among the general public, healthcare professionals, students, educators, and pharmacists worldwide. Routine CRC screening counselling is paramount to improving screening rates. Continuous medical education and training programmes are essential for healthcare professionals to enhance their KAP towards CRC screening. Students and university teachers should be educated and trained about CRC screening to improve their knowledge and foster positive behavioural changes. These comprehensive measures are critical for establishing an effective screening programme. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to assess the knowledge, attitudes and practices (KAP) towards cervical cancer screening among ethnic minorities in Inner Mongolia, China. Methods: A cross‐sectional study was conducted in Inner Mongolia between May and September, 2023, and recruiting participants undergoing dual‐cancer screening. Demographic characteristics and KAP status were assessed using a self‐administered questionnaire. Results: A total of 533 valid questionnaires were collected, with 53.66% aged 40 years or younger. Mean scores for knowledge, attitude, and practice were 13.58 ± 5.41, 41.06 ± 4.53, and 13.35 ± 1.53, respectively. Positive associations were found between knowledge and attitude (r = 0.348, p < 0.001), knowledge and practice (r = 0.288, p < 0.001), and attitude and practice (r = 0.817, p < 0.001). Structural equation modelling confirmed direct positive associations between knowledge and attitude (path coefficient = 0.307, p < 0.001) and attitude and practice (path coefficient = 0.270, p < 0.001). Additionally, knowledge demonstrated an indirectly positive association with practice (path coefficient = 0.083, p = 0.007). Conclusion: Ethnic minorities in Inner Mongolia exhibit insufficient knowledge, positive attitudes, and proactive practices toward cervical cancer screening. Implementing targeted educational initiatives is crucial to enhance their KAP. Plain language summary: This study assesses cervical cancer screening knowledge, attitudes and practices among ethnic minorities in Inner Mongolia, revealing insufficient knowledge, positive attitudes, and proactive practices. Findings underscore the need for targeted educational initiatives to enhance screening awareness and practices in this specific population. [ABSTRACT FROM AUTHOR]

Objectives: Among the provisions within the Affordable Care Act (ACA), expanding Medicaid was arguably the greatest contributor to increasing access to care. For over a decade, researchers have investigated how Medicaid expansion impacted cancer outcomes. Over this same decade, statistical theory illuminated how state‐based policy research could be compromised by invalid inference. After reviewing the literature to identify the inference strategies of state‐based cancer registry Medicaid expansion research, this study aimed to assess how inference decisions could change the interpretation of Medicaid expansion's impact on staging, treatment, and mortality in cancer patients. Data sources: Cancer case data (2000–2019) was obtained from the Surveillance, Epidemiology, End Results (SEER) programme. Cases included all cancer sites combined, top 10 cancer sites combined, and three screening amenable cancers (colorectal, female breast, female cervical). Study design: A Difference‐in‐Differences design estimated the association between Medicaid expansion and four binary outcomes: distant stage, initiating treatment >1 month after diagnosis, no surgery recommendation, and death. Three inference techniques were compared: (1) traditional, (2) cluster, and (3) Wild Cluster Bootstrap. Data collection: Data was accessed via SEER*Stat. Principal findings: Estimating standard errors via traditional inference would suggest that Medicaid expansion was associated with delayed treatment initiation and surgery recommendations. Traditional and clustered inference also suggested that Medicaid expansion reduced mortality. Inference using Wild Cluster Bootstrap techniques never rejected the null hypotheses. Conclusions: This study reiterates the importance of explicit inference. Future state‐based, cancer policy research can be improved by incorporating emerging techniques. These findings warrant caution when interpreting prior SEER research reporting significant effects of Medicaid expansion on cancer outcomes, especially studies that did not explicitly define their inference strategy. [ABSTRACT FROM AUTHOR]

We present methods for estimating loss‐based measures of the performance of a prediction model in a target population that differs from the source population in which the model was developed, in settings where outcome and covariate data are available from the source population but only covariate data are available on a simple random sample from the target population. Prior work adjusting for differences between the two populations has used various weighting estimators with inverse odds or density ratio weights. Here, we develop more robust estimators for the target population risk (expected loss) that can be used with data‐adaptive (e.g., machine learning‐based) estimation of nuisance parameters. We examine the large‐sample properties of the estimators and evaluate finite‐sample performance in simulations. Last, we apply the methods to data from lung cancer screening using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) and extend our methods to account for the complex survey design of the NHANES. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer death in the United States and across the world. The American Cancer Society National Lung Cancer Roundtable (ACS NLCRT) was established in 2017 as a consortium of public, private, and voluntary organizations with a mission to lower the impact of lung cancer via prevention, early detection, and optimal therapy. The ACS NLCRT supports a comprehensive scope of work that covers the lung cancer continuum, from risk reduction, tobacco prevention and control, and early detection (screening and incidental lung nodule management) to guideline‐based staging, biomarker testing, treatment, and survivorship and overarching issues such as stigma and nihilism, health equity, and tactical approaches such as state coalition efforts and policy initiatives. Applying a multidimensional and multisector approach, over 220 public, private, and government agency member organizations and 250 volunteer experts, patients, and caregiver advocate representatives collaborate to address challenges across the lung cancer continuum by catalyzing action to conceive, build, and strengthen innovative solutions. The wide‐ranging membership allows the ACS NLCRT to harness the collective power and expertise of the entire lung cancer community by connecting leaders, communities, and systems to improve equity and access. These national, state, and local relationships provide partnerships for the dissemination of ACS NLCRT–developed tools and resources. This article describes the ACS NLCRT and introduces the series of accompanying and future articles that together make up the ACS NLCRT strategic plan, which provides a roadmap for future research, investment, and collaboration to reduce lung cancer mortality and lung cancer–related stigma and enhance survivorship. The American Cancer Society National Lung Cancer Roundtable (ACS NLCRT) is a consortium of organizations and experts dedicated to reducing deaths from lung cancer. This article introduces the ACS NLCRT strategic plan. [ABSTRACT FROM AUTHOR]

Shared decision making (SDM) between health care professionals and patients is essential to help patients make well informed choices about lung cancer screening (LCS). Patients who participate in SDM have greater LCS knowledge, reduced decisional conflict, and improved adherence to annual screening compared with patients who do not participate in SDM. SDM tools are acceptable to patients and clinicians. The importance of SDM in LCS is emphasized in recommendations from professional organizations and highlighted as a priority in the 2022 President's Cancer Panel Report. The updated 2022 national coverage determination from the Centers for Medicare & Medicaid Services reaffirms the value of SDM in offering LCS to eligible beneficiaries. The Shared Decision‐Making Task Group of the American Cancer Society National Lung Cancer Roundtable undertook a group consensus process to identify priorities for research and implementation related to SDM for LCS and then evaluated current knowledge in these areas. Priority areas included: (1) developing feasible, adaptable SDM training programs for health care professionals; (2) understanding the impact of alternative health system LCS models on SDM practice and outcomes; (3) developing and evaluating new patient decision aids for use with diverse populations and in varied settings; (4) offering conceptual clarity about what constitutes a high‐quality decision and developing appropriate quality measures; and (5) studying the use of prediction‐augmented screening to support SDM in practice. Gaps in current research in all areas were observed. The authors conclude with a research and implementation agenda to advance the quality and implementation of SDM for persons who might benefit from LCS. Patients who participate in shared decision making about lung cancer screening have greater knowledge, lower decisional conflict, and better adherence to screening compared with patients who do not participate. The American Cancer Society Shared Decision‐Making Task Group identified five priority areas for research and to improve the implementation of lung cancer screening in the United States. [ABSTRACT FROM AUTHOR]

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. This component 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, and follows with proposed solutions identified by the ACS NLCRT Implementation Strategies Task Group as well as initiatives currently underway to address the challenges to improving the uptake of lung cancer screening. [ABSTRACT FROM AUTHOR]

The American Cancer Society National Lung Cancer Roundtable strategic plan for provider engagement and outreach addresses barriers to the uptake of lung cancer screening, including lack of provider awareness and guideline knowledge about screening, concerns about potential harms from false‐positive examinations, lack of time to implement workflows within busy primary care practices, insufficient infrastructure and administrative support to manage a screening program and patient follow‐up, and implicit bias based on sex, race/ethnicity, social class, and smoking status. Strategies to facilitate screening include educational programming, clinical reminder systems within the electronic medical record, decision support aids, and tools to track nodules that can be implemented across a diversity of practices and health care organizational structures. Plain language summary: The American Cancer Society National Lung Cancer Roundtable strategic plan to reduce deaths from lung cancer includes strategies designed to support health care professionals, to better understand lung cancer screening, and to support adults who are eligible for lung cancer screening by providing counseling, referral, and follow‐up. The American Cancer Society National Lung Cancer Roundtable (ACS NLCRT) strategic plan includes an emphasis on provider engagement and outreach to address challenges in identifying and counseling patients at‐risk for lung cancer, referrals to screening, follow‐up, diagnostic evaluation, treatment, and overcoming bias based on sex, race/ethnicity, social class, and smoking status. In this contribution to the ACS NLCRT strategic plan, the Provider Engagement and Outreach Task Group provide strategies to support providers in referring appropriate individuals for lung cancer screening. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 (R2 = 0.79 and 0.996 in three recent large trials), breast (R2 = 0.94), prostate (R2 = 0.98), and colorectal cancer (R2 = 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. [ABSTRACT FROM AUTHOR]

This study aimed to estimate participation in private breast screening in Queensland, Australia, where public-funded screening is implemented, and to identify factors associated with the screening setting, using an online survey (999 female respondents aged 40–74). Screening-specific and socio-demographic factors were collected. Multivariable logistic regression was used to identify factors associated with screening setting (public vs private) and screening recency (<2 vs ≥2 years). Participation estimates were 53.2% (95% confidence interval, CI: 50.0%–56.3%) and 10.9% (9.0%–13.0%) for national screening program and private screening, respectively. In the screening setting model, participation in private screening was significantly associated with longer time since last screening (>4 versus <2 years, odds ratio (OR) = 7.3, 95%CI: 4.1–12.9, p < 0.001), having symptoms (OR = 9.5, 5.8–15.5, p < 0.001), younger age (40–49 versus 50–74 years, OR = 1.8, 1.1–3.0, p = 0.018) and having children <18 years in household (OR = 2.4, 1.5–3.9, p < 0.001). In the screening recency model, only screening setting was statistically significant and private screening was associated with screening recency ≥2 years (OR = 4.0, 2.8–5.7, p < 0.001). Around one in nine women screen outside of the BreastScreen Queensland program. Clinical and socio-demographic factors associated with participation in private screening were identified, providing knowledge relevant to the program's endeavours to improve screening participation. [ABSTRACT FROM AUTHOR]

Objective: In 2018, the United States Preventive Services Task Force promoted shared decision making between healthcare provider and patient for men aged 55 to 69. This study aimed to analyze rates of prostate-specific antigen (PSA) testing across racial and ethnic groups following this new recommendation. Methods: A secondary analysis was conducted of the 2020–2021 Behavioral Risk Factor Surveillance System database to assess men aged 55 or older without a history of prostate cancer. We defined four race-ethnicity groups: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), Hispanics, and Other. The primary outcome was the most recent PSA test (MRT), defined as the respondent's most recent PSA test occurring pre-2018 or post-2018 guidelines. Logistic regression adjusted for covariates including age, socioeconomic status factors, marital status, smoking history, and healthcare access factors. Results: In the age 55 to 69 study sample, NHW men had the greatest proportion of MRT post-2018 guidelines (n = 15,864, 72.5%). NHB men had the lowest percentage of MRT post-2018 guidelines (n = 965, 66.6%). With NHW as referent, the crude odds of the MRT post-2018 guidelines was 0.68 (95% confidence interval (CI) = 0.53–0.90) for NHB. The maximally adjusted odds ratio was 0.78 (0.59–1.02). Conclusions: We found that NHB aged 55 to 69 reported decreased rates of PSA testing after 2018 when compared to NHW. This was demonstrated on crude analysis but not after adjustment. Such findings suggest the influence of social determinants of health on preventative screening for at-risk populations. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Despite higher income and education, there are profound health disparities among Asian Americans. These disparities are highlighted in particular by screening behaviors for cancer. Between 1998 and 2008, cancer rates increased threefold among Indian Americans, raising concern that cancer screening in this group may be especially low. To better understand cancer screening behavior, we collected data from a total of 157 self-identifying Indian Americans residing in the greater Philadelphia area. Nearly all participants reported having health insurance (98.7%), and most had received a physical exam within a year (87.3%). Only17.4% of the participants were referred for mammography, while 30% of participants over age 30 were referred for ovarian cancer screening. Just 4 participants were recommended for pancreatic cancer screening. The findings contribute new information to the understanding of health needs of Indian Americans residing in the greater Philadelphia region and reveal a need for greater focus on preventive care. [ABSTRACT FROM AUTHOR]

Objective: To compare rates of participation in the National Bowel Cancer Screening Program (NBCSP) and follow‐up for people with severe mental illness with those for people without severe mental illness or not prescribed antidepressants. Study design: Retrospective cohort study; analysis of de‐identified linked NBCSP, Pharmaceutical Benefits Scheme (PBS), and Medicare Benefits Schedule (MBS) data. Setting: Australia, 2006–2019. Participants: People aged 50–74 years (NBCSP‐eligible) with severe mental illness, defined as those dispensed two or more prescriptions for second generation antipsychotics or for lithium (PBS data), and a random sample of people aged 50–74 years eligible for Medicare‐subsidised services but never prescribed psychotropic medications (antipsychotics, lithium, antidepressants). Main outcome measures: NBCSP participation (returned faecal occult blood test sample), valid test result, positive test result, and follow‐up colonoscopy rates. Results: A total of 119 475 people with severe mental illness and 1 090 574 control group people were included in our analyses. The proportion of women was larger in the severe mental illness group (51.3%) than the control group (48.7%), as were the proportions who lived in inner regional areas (23.5% v 19.1%) or in areas in the lowest socio‐economic quintile (21.8% v 14.7%). The NBCSP participation rate was lower among people with severe mental illness (adjusted incidence rate ratio [IRR], 0.70; 95% confidence interval [CI], 0.69–0.84). The proportion of valid test results was smaller for people with severe mental illness (95.9% v 98.7%; adjusted IRR, 0.97; 95% CI, 0.96–0.99), and the positive test result proportion larger (12.3% v 6.6%; adjusted IRR, 2.01; 95% CI, 1.94–2.09). The proportion of positive test results followed by colonoscopy was smaller for people with severe mental illness (71.7% v 82.6%; adjusted IRR, 0.88; 95% CI, 0.85–0.92). Conclusions: People with severe mental illness were less likely to participate in the NBCSP or to undergo colonoscopy after a positive test result than other Australians. These differences may contribute to higher colorectal cancer mortality among people with severe mental illness. The contributions of differences in cancer stage at diagnosis and subsequent treatment to higher colorectal cancer mortality require further study. [ABSTRACT FROM AUTHOR]

Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the head and neck region, and its treatment is limited by hypoxia and inadequate oxygen supply. Continuous oxygen delivery combined with photodynamic therapy (PDT) is the key to addressing this issue. Here, a dual-enzyme activity sea urchin-like Au@Pt-Ce6-HN-1 nanoplatform was designed to serve as an "oxygen pump" to alleviate tumor hypoxia for synergistic photodynamic/photothermal therapy (PTT). In this design, the photosensitizer chlorin e6 (Ce6) is covalently linked to the Au@Pt nanozyme for PDT treatment. The Au@Pt nanozyme exhibits catalase-like activity, continuously decomposing H 2 O 2 in the tumor microenvironment to enhance O 2 levels, thereby achieving efficient PDT. Furthermore, Au@Pt can perform PTT and increase oxygen levels under NIR-II light to further promote PDT. The Au@Pt nanozyme also exhibits peroxidase-like activity, generating ·OH for chemodynamic therapy (CDT). Additionally, HN-1 guides the direction of "sniping" OSCC, and its high specificity benefits Au@Pt-Ce6-HN-1 at the tumor site. Au@Pt-Ce6-HN-1 exhibits bright fluorescence (FL), strong CT signal, and photothermal imaging capabilities, laying the foundation for subsequent guided PDT/PTT. This nanoplatform, which combines advantages such as continuous oxygen production, tumor targeting, and multimodal imaging, is expected to provide valuable insights into the treatment of OSCC. Accurate clinical diagnosis and treatment of OSCC are challenging. We report a dual-enzyme activity sea urchin-like Au@Pt-Ce6-HN-1 nanoplatform, serving as an "oxygen pump" to guide photodynamic therapy (PDT) and photothermal therapy (PTT) for OSCC. This nanoplatform targets OSCC for preoperative CT diagnosis and offers fluorescence visualization for surgical navigation, demonstrating potential in clinical cancer detection and surgery guidance. This innovative approach addresses OSCC hypoxia and enhances treatment efficacy through continuous oxygen production, tumor targeting, and multimodal imaging, significantly improving patient outcomes in OSCC treatment. [Display omitted] [ABSTRACT FROM AUTHOR]

Early detection is paramount in the fight against breast cancer, as it can significantly improve a patient's survival chances. Studies suggest early detection can increase survival rates. The elusive nature of breast cancer's exact cause underscores the critical role of early detection in reducing mortality rates. In diagnosing breast cancer, radiologists rely on analyzing images obtained from mammograms, X-rays, or MRIs to identify any abnormalities. While highly skilled radiologists play a crucial role in breast cancer detection, diagnosing subtle abnormalities like micro calcifications, lumps, and masses can be challenging. This can lead to both false positives and false negatives. However, recent breakthroughs in image processing and deep learning offer exciting possibilities. This research explores the development of various Convolutional Neural Network (CNN) architectures for early breast cancer detection. These architecture segment and classify diverse breast abnormalities, including calcifications, masses, asymmetry, and carcinomas. This approach goes beyond existing research that primarily classifies cancer as benign or malignant, thereby contributing to improved disease management. This paper investigates the impact of CNN architectures complexities and various regularization techniques on classification accuracy. This study conducted experiment with four different CNN architectures such as CNN, VGG16, ResNet50 and MobileNet, progressively increasing the number of layers and filters. This study employs data normalization and augmentation techniques to address over-fitting. Regularization techniques, such as dropout, L2 regularization, and data augmentation, are evaluated for their effectiveness in improving model performance. Among four CNN architectures CNN model which have additional convolutional block with 256 features and a reduced learning rate decay factor gives the better results than others. [ABSTRACT FROM AUTHOR]

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Copyright of Die Ophthalmologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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. [ABSTRACT FROM AUTHOR]

Skin cancer has been recognized as one of the most lethal and complex types of cancer for over a decade. The diagnosis of skin cancer is of paramount importance, yet the process is intricate and challenging. The analysis and modeling of human skin pose significant difficulties due to its asymmetrical nature, the visibility of dense hair, and the presence of various substitute characteristics. The texture of the epidermis is notably different from that of normal skin, and these differences are often evident in cases of unhealthy skin. As a consequence, the development of an effective method for monitoring skin cancer has seen little progress. Moreover, the task of diagnosing skin cancer from dermoscopic images is particularly challenging. It is crucial to diagnose skin cancer at an early stage, despite the high cost associated with the procedure, as it is an expensive process. Unfortunately, the advancement of diagnostic techniques for skin cancer has been limited. To address this issue, there is a need for a more accurate and efficient method for identifying and categorizing skin cancer cases. This involves the evaluation of specific characteristics to distinguish between benign and malignant skin cancer occurrences. We present and evaluate several techniques for segmentation, categorized into three main types: thresholding, edge-based, and region-based. These techniques are applied to a dataset of 200 benign and melanoma lesions from the Hospital Pedro Hispano (PH2) collection. The evaluation is based on twelve distinct metrics, which are designed to measure various types of errors with particular clinical significance. Additionally, we assess the effectiveness of these techniques independently for three different types of lesions: melanocytic nevi, atypical nevi, and melanomas. The first technique is capable of classifying lesions into two categories: atypical nevi and melanoma, achieving the highest accuracy score of 90.00% with the Otsu (3-level) method. The second technique also classifies lesions into two categories: common nevi and melanoma, achieving a score of 90.80% with the Binarized Sauvola method. [ABSTRACT FROM AUTHOR]

Mammography images are the most commonly used tool for breast cancer screening. The presence of pectoral muscle in images for the mediolateral oblique view makes designing a robust automated breast cancer detection system more challenging. Most of the current methods for removing the pectoral muscle are based on traditional machine learning approaches. This is partly due to the lack of segmentation masks of pectoral muscle in available datasets. In this paper, we provide the segmentation masks of the pectoral muscle for the INbreast, MIAS, and CBIS-DDSM datasets, which will enable the development of supervised methods and the utilization of deep learning. Training deep learning-based models using segmentation masks will also be a powerful tool for removing pectoral muscle for unseen data. To test the validity of this idea, we trained AU-Net separately on the INbreast and CBIS-DDSM for the segmentation of the pectoral muscle. We used cross-dataset testing to evaluate the performance of the models on an unseen dataset. In addition, the models were tested on all of the images in the MIAS dataset. The experimental results show that cross-dataset testing achieves a comparable performance to the same-dataset experiments. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is a common cancer among young women aged 25–29 in England, and the NHS cervical screening leaflet is the first point of contact for those being invited for their first screening. This study aimed to explore how young women (18–24) understand and engage with the leaflet, as well as the barriers and facilitators associated with its interpretation, engagement, and screening intentions. Methods: The study used a mixed-methods approach, including a survey (n = 120) to identify interpretation difficulties and how they were affected by different characteristics, and a follow-up interview (n = 10) to assess the utility of the leaflet, identify issues with its practicality, and determine the factors that influence screening intentions. Results: The survey results showed that interpretation difficulties were common, particularly regarding HPV assessment, screening results, additional tests/treatment, and screening risks. Lower interpretation accuracy was associated with lower numeracy scores and non-white ethnicity. Despite these difficulties, participants had high confidence and motivation to engage with the leaflet. The interviews revealed knowledge gaps, issues with the leaflet's practicality, and a preference for digital information. Factors that were identified as barriers and facilitators of leaflet interpretation, engagement, and screening intentions included knowledge, social influence, beliefs about consequences, environmental context and resources, social role and identity, emotions and intentions. Conclusion: The current leaflet does not provide enough information for young women to make an informed decision about screening attendance. Implementing a digital invitation featuring simplified gist representation, targeted behaviour change techniques (BCTs), videos, and interactive tools can enhance education and promote screening behaviour. Future research should consider using digital tools and strategies to address existing barriers related to interpretation and engagement. [ABSTRACT FROM AUTHOR]

Bladder cancer (BC) is the most common neoplasm of the urinary system and ranks tenth in global cancer incidence. Due to its high recurrence rate and the need for continuous monitoring, it is the cancer with the highest cost per patient. Cystoscopy is the traditional method for its detection and surveillance; however, this is an invasive technique, while non-invasive methods, such as cytology, have a limited sensitivity. For this reason, new non-invasive strategies have emerged, analyzing useful markers for BC detection from urine samples. The identification of tumor markers is essential for early cancer detection and treatment. Urine analysis offers a non-invasive method to identify these markers. Microsatellite instability (MSI) has been proposed as a promising marker for tumor cell detection and guided targeted therapies. Therefore, this review aims to explore the evidence supporting the identification of MSI in exfoliated bladder tumor cells (EBTCs) in the urine, emphasizing its potential as a non-invasive and clinically effective alternative for tumor identification. Furthermore, establishing clinical guidelines is crucial for standardizing its application in oncological screening and validating its clinical utility. [ABSTRACT FROM AUTHOR]

Background: The humoral immune response against human papillomavirus (HPV) has been suggested as a source of biomarkers for the early detection of cervical cancer (CC). Therefore, we aimed to characterize the antibody response against HPV16 E5 in the natural history of cervical cancer and to determine its usefulness as a biomarker of HPV-associated cervical lesions. Methods: This study was conducted at the Cuautla General Hospital, Morelos, Mexico, with women (18 to 64 years) who agreed to participate. Samples were obtained from 335 women with cervical lesions and 150 women with negative Papanicolaou tests. HPV genotyping was performed by PCR and pyrosequencing, and anti-E5 antibodies were detected by slot blot. Results: The overall anti-E5 antibodies prevalence in the study was 17.9%, with the higher prevalence observed in the no lesion (NL, 49.4%) group, and with a downward trend according to the degree of the cervical lesion, from cervical intraepithelial neoplasia-1 (CIN1, 32.2%) to CIN2 (11.5%) and CIN3/CC (6.9%). The logistic regression model showed negative associations of anti-E5 antibodies with CIN1 (OR = 0.38), CIN2 (OR = 0.42), and CIN3/CC (OR = 0.32) groups, being statistically significant. Contrast analysis showed an inverse relationship between anti-E5 antibodies with HPV DNA and the CIN1 (OR = 0.35), CIN2 (OR = 0.39), and CIN3/CC (OR = 0.31) groups. Conclusions: These results suggest that anti-E5 antibodies could be associated with clearance of infection in women without lesions and with CIN1 lesions since an inverse relationship was observed between the presence of HPV DNA and anti-E5 antibodies. In contrast, with progression from CIN2/CIN3 to CC, the relationship was reversed, as the anti-E5 antibodies disappeared, and the frequency of the viral genome increased. [ABSTRACT FROM AUTHOR]

Despite available treatments for acute lymphoblastic leukemia (ALL), the disease's high clinical variability necessitates new therapeutic strategies, particularly for patients with high-risk features. The tumor suppressor protein p53, encoded by the TP53 gene and known as the guardian of the genome, plays a crucial role in preventing tumor development. Over 90% of ALL cases initially harbor wild-type TP53. Reactivation of p53, which is encoded from the wild type TP53 but lost its function for several reasons, is an attractive therapeutic approach in cancer treatment. p53 can be activated in a non-genotoxic manner by targeting its primary repressor, the MDM2 protein. Clinical trials involving MDM2 inhibitors are currently being conducted in a growing body of investigation, reflecting of the interest in incorporating these treatments into cancer treatment strategies. Early-phase clinical trials have demonstrated the promise of idasanutlin (RG7388), one of the developed compounds. It is a second-generation MDM2-p53 binding antagonist with enhanced potency, selectivity, and bioavailability. The aim of this study is to evaluate the efficacy of RG7388 as a therapeutic strategy for ALL and to investigate its potential impact on improving treatment outcomes for high-risk patients. RG7388 potently decreased the viability in five out of six ALL cell lines with diverse TP53 mutation profiles, whereas only one cell line exhibited high resistance. RG7388 induced a pro-apoptotic gene expression signature with upregulation of p53-target genes involved in the intrinsic and extrinsic pathways of apoptosis. Consequently, RG7388 led to a concentration-dependent increase in caspase-3/7 activity and cleaved poly (ADP-ribose) polymerase. In this research, RG7388 was investigated with pre-clinical methods in ALL cells as a novel treatment strategy. This study suggests further functional research and in-vivo evaluation, and it highlights the prospect of treating p53-functional ALL with MDM2 inhibitors. [ABSTRACT FROM AUTHOR]

Simple Summary: Recent research suggests that once nanoparticles (NPs) come into contact with the biological fluid of cancer patients, they are covered by proteins, forming a "protein corona" composed of hundreds of plasma proteins. The concept of a personalized, disease-specific protein corona, demonstrating substantial differences in NP corona profiles between patients with and without cancer, has been introduced. Our experimental design makes a significant contribution to the field of specific protein corona nanoparticles as molecular biomarkers differentiating between benign and malignant prostatic pathology. Above all, these can be used as an indicator of the response to systemic therapy for metastatic PCa in a sector where the therapeutic choices are numerous and require increasingly valid precision medicine. The National Cancer Institute (NCI) recognizes the potential of technologies based on the use of nanoparticles (NPs) in revolutionizing clinical approaches to the diagnosis and prognosis of cancer. Recent research suggests that once NPs come into contact with the biological fluid of cancer patients, they are covered by proteins, forming a "protein corona" composed of hundreds of plasma proteins. The concept of a personalized, disease-specific protein corona, demonstrating substantial differences in NP corona profiles between patients with and without cancer, has been introduced. We developed the design of an experimental prospective single-center study with patients allocated in a 1:1:1 ratio of one of three arms: untreated patients with benign prostatic hyperplasia (BPH), untreated patients with non-metastatic prostate cancer (PCa), and metastatic prostate cancer patients starting systemic therapies with new androgen-targeted agents or taxanes. The protocol aims to develop and implement sensitive nanotools with two distinct objectives: First, to design NPs capable of selectively binding and detecting biomarkers in order to build a predictive diagnostic model to effectively discriminate between patient sera affected by BPH and PCa. Secondly, within the population with PCa, in the case of initial advanced metastatic diagnosis, the objective is to find biomarkers capable of predicting the response to systemic treatments to improve the precision and efficiency of monitoring treatment outcomes. For protein and metabolite corona experiments, we developed a cross-reactive sensor array platform with cancer detection capacity made of three liposomal formulations with different surface charges. For proteomic-NP studies, proteins were identified and quantified using nano-high-performance LC (nanoHPLC) coupled with MS/MS (nanoHPLC−MS/MS). Metabolites were instead analyzed using an untargeted metabolomic approach. Compared with previous review articles, the novelty of this review is represented by the analysis of the possible clinical applications of protein corona NPs focused on PCa and the presentation of a new clinical protocol in the metastatic phase of PCa. [ABSTRACT FROM AUTHOR]

Breast cancer is a type of cancer that is common in women worldwide, which emphasises its significance in identification with preventative treatment methods. The invented Photonic Crystal Fibre (PCF) exhibits outstanding performance in detecting Breast Cancer. The suggested model of the authors includes Hybrid layout within clad surface alongside Square Core. Introduced PCF detector exhibits max Relative Sensitivity (RS) of 96.82% as well 96.74% for breast cancer cell MCF‐7 as well MDA‐MB‐231 correspondingly. The authors also investigated the Confinement Loss of 1.642 × 10−10 dB/m, 2.461 × 10−10 dB/m with Effective Material Loss of 0.0473, 0.0565 cm−1 for the mentioned cells. Increased outcomes, customised therapy, plus quick action are made possible by swift identification in breast carcinoma. Timely malignancy detection reduces requirements to severe therapy by enabling simpler medicines. Additionally, making continuous illness detection easier, improving patient treatment. Furthermore, reliable evaluation contributes for investigating advancements that improve worldwide recognition as well as therapy alternatives. The introduced PCF Perhaps crucial in quick identification of these deadly cells as it has an extraordinary sensing ability. In conclusion, it has numerous possibilities in the healthcare sector. [ABSTRACT FROM AUTHOR]

Objectives The benefits of liquid-based cytology (LBC) in routine cervical cancer screening are often associated with the availability of instrumented platforms and economic considerations. A low-cost alternative to LBC in low-volume settings remains an unmet need. Methods A multisite evaluation of the BD SurePath (SurePath) LBC Direct to Slide (DTS) method was conducted. The DTS preparations were evaluated across 3 sites. Cytology features for DTS preparation included predetermined thresholds for total cellularity, cell distribution, cellular preservation, and stain quality. Rare event detection was evaluated using SiHa cells spiked into pools from negative cytology specimens. Concordance between Bethesda classification results was evaluated for SurePath LBC and DTS methods using routinely collected SurePath specimens in a split-sample study design. Results The DTS specimens met criteria for total cellularity, cell distribution, cellular preservation, and stain quality in more than 98% of all cases. Rare event detection was observed with an average detection of 5 SiHa cells per 2 mL of specimen. Concordant cervical cytology classifications were observed between SurePath LBC and DTS methods. Conclusions The results demonstrate that the DTS process is suitable for routine cervical cytology evaluation. The procedure is reproducible and detected abnormal cervical cells in concordance with standard SurePath LBC preparation. [ABSTRACT FROM AUTHOR]

Cervical cancer is one of the most common cancers in women. Non-invasive cytopathological methods are becoming increasingly important in the routine surveillance and early diagnosis of cervical cancer. However, reliable approaches are usually based on an extended staining process with subjective interpretation. Early detection of cervical cancer increases survival rates. Using unstained Differential Interference Contrast (DIC) images, the current study reveals the morphological changes in cervical cells towards cancer progression. To overcome the challenges of overlapping cells, the Voronoi-based mixed-breed active contour (VMAC) method was applied to segment overlapping cells in cytopathological images. In VMAC-based segmentation, a Voronoi diagram divides the preprocessed input image. In addition to that, the energy associated with the information stored by each individual cell is reduced through the use of the Voronoi diagram and the active contour model. Although region-based active contour model is well suited for segmenting images with imprecise edges, their applications to images with variation in intensities lead to an objective interpretation. An experimental result shows that the validation of the proposed method provides accurate results for 2 to 10 cells, with an average false negative rate of 0.1. The proposed model has an accuracy and true positive rate of 0.97 and 0.96, respectively. [ABSTRACT FROM AUTHOR]

Introduction: Colorectal cancer screening programs are effective in reducing incidence and mortality. In Europe, every FIT+ patient is referred to colonoscopy. The available data show that ~75.0% of these patients are negative. It is desirable to select patients at a greater risk of having a positive colonoscopy. Materials and Methods: 711 subjects, aged 50–74, attending the screening program of ASL-NA-3-SUD (Naples, Italy), were enrolled in a cross-sectional study to evaluate the performance of the QuantiDNA™ test and the non-inferiority of an alternative approach (AAP). This evaluation is based on FIT+ and QuantiDNA™+ patients referred to colonoscopy, compared to Standard of Care (SOC) colonoscopy following a FIT+ test alone. A non-inferiority margin (NIM) for colorectal neoplasia (CN) and advanced adenomas (AA) was set at −10% and at −3.8% for CRC. Results: The odds ratio was 1.76 (p-value = 0.009). The detection rate of AAP was 15.9% for colorectal neoplasia, 13.0% for advanced adenoma, and 3.0% for CRC. The risk difference between AAP and SOC was −5.07% (95% C.I. −9.23, −0.90) for colorectal neoplasia, −4.02% (95% C.I. −7.89, −0.16) for advanced adenomas, and −1.04% (95% C.I. −3.16, 1.07) for CRC. This data suggests that AAP is non-inferior to SOC for detecting CN, AA, and CRC. The expected decrease in colonoscopies is 33.4%. Conclusions: The QuantiDNA™ test is straightforward, non-invasive, and well-tolerated. Data from this study indicate that it is effective in the reduction of the need for colonoscopy examinations (−33.4%) and is non-inferior to SOC in the detection of significant colorectal lesions. [ABSTRACT FROM AUTHOR]

This study examined social determinants associated with Korean American immigrant women's mammography use in Korea after immigration to the United States. Data from a cross-sectional survey were obtained from 187 women in Los Angeles County, California. More than one-quarter (28.3%) of the respondents reported returning to Korea for a mammogram after immigrating to the United States. Multivariable logistic regression revealed that compared to those who had their first mammogram in Korea, Korean American immigrant women who had their first mammogram in the United States were less likely to return to Korea for subsequent screenings (AOR = 0.02, 95% CI: <0.001, 0.05); also, those who had employer-based health insurance in the United States were less likely to get a mammogram in Korea after immigration (AOR = 0.01, 95% CI: <0.01, 0.18). Findings suggest that women familiar with the Korean healthcare system and who are uninsured or have inconsistent healthcare coverage in the United States may seek care in Korea. To promote adherence to breast cancer screening guidelines among Korean American immigrant women residing in the United States, greater access to free or low-cost screening services and breast cancer screening education is warranted to reduce the risk of later stage breast cancer detection resulting from medical tourism. [ABSTRACT FROM AUTHOR]

Background/Objectives: Women's health represents an integral component of public health. With breast cancer being the first worldwide and cervical cancer the fourth most common cancer among women, and while habits of intimate hygiene remain mediocre, it is crucial to address these issues. We aimed to evaluate the efficacy of a community-based intervention on the knowledge and preventive measures (K&P) of women toward breast cancer, cervical cancer, and intimate hygiene. Methods: This longitudinal multicentric prospective interventional study was conducted on women residing in Lebanon aged 18–83 years old. The awareness sessions took place either in person or online to address these three topics, covering the eight governorates of Lebanon. Our sample included women both from the general population and from Order of Malta Lebanon (OML)'s centers and mobile medical units. A stratified randomized sampling method was implemented using age and governorates. Women were interviewed before (pre-test) and after (post-test) the awareness session. The K&P score and the improvement post-intervention were represented in a function of all the study variables. A p ˂ 0.05 was found statistically significant. Results: A total of 657 women, with the majority being nonsmokers and having a bachelor's degree as their highest level of education, completed surveys before and after the intervention, showcasing a significant overall K&P mean score improvement of 50.48% in the pre- vs. post-test (an average score of 22.01 ± 5.95 over 38 (57.93% of correct answers) vs. 33.12 ± 3.41 over 38 (89.58% of correct answers), respectively, p < 0.001). A significant difference was also noted between pre- and post-test (p < 0.001) in each of the three topics individually, with improvements of 52.39% for breast cancer, 60.00% for cervical cancer, and 22.27% for intimate hygiene. Conclusions: National awareness campaigns are key to shedding light on breast and cervical cancer matters and improving women's reproductive health and intimate hygiene in Lebanon. Addressing the knowledge gaps and promoting early screening and healthy habits through national public health policies can empower women to protect their health and well-being. [ABSTRACT FROM AUTHOR]

Lung cancer is the most common type of cancer diagnosed worldwide and is also among the most fatal. Early detection, before symptoms become evident, is fundamental for patients' survival. Therefore, several lung cancer biomarkers have been proposed to enable a prompt diagnosis, including neuron-specific enolase (NSE) and carcinoembryonic antigen (CEA). NSE and CEA are two serum proteins whose elevated levels have been associated with lung cancer. Hence, in this study, impedimetric biosensors (immunosensors) able to quantify NSE and CEA were developed as proof-of-concept devices for lung cancer diagnosis. The sensing platform exploited for the immunosensors comprises a novel combination of a magnetic platform, screen-printed gold electrode (SPGE), and magnetic nanobeads (MB). The MB were functionalized with antibodies to capture the analyte from the sample and to move it over the sensing area. The immunosensors were then developed by immobilizing another set of antibodies for either CEA or NSE on the SPGE through formation of self-assembled monolayer (SAM). The second set of antibodies enabled a sandwich assay to be formed on the surface of the sensor, while MB manipulation was applied during the sensor performance to depict a microfluidic system and increase antigen–antibody complex formation prior to CEA or NSE detection and quantification. The optimized immunosensors were successfully tested to measure various concentrations of CEA and NSE (0–100 ng/mL) in both phosphate buffer and 100% human serum samples. Clinically relevant detection limits of 0.26 ng/mL and 0.18 ng/mL in buffer and 0.76 ng/mL and 0.52 ng/mL in 100% serum for CEA and NSE, respectively, were achieved via electrochemical impedance spectroscopy with the use of potassium ferri/ferrocyanide as a redox probe. Hence, the two immunosensors demonstrated great potential as tools to be implemented for the early detection of lung cancer. [ABSTRACT FROM AUTHOR]

Enzyme-based portable amperometric biosensors are precise and low-cost medical devices used for rapid cancer biomarker screening. Sarcosine (Sar) is an ideal biomarker for prostate cancer (PCa). Because human serum and urine contain complex interfering substances that can directly oxidize at the electrode surface, rapid Sar screening biosensors are relatively challenging and have rarely been reported. Therefore, highly sensitive and selective amperometric biosensors that enable real-time measurements within <1.0 min are needed. To achieve this, a chitosan–polyaniline polymer nanocomposite (CS–PANI NC), a carrier for dispersing mesoporous carbon (MC), was synthesized and modified on a screen-printed carbon electrode (SPCE) to detect hydrogen peroxide (H2O2). The sarcosine oxidase (SOx) enzyme-immobilized CS–PANI–MC-2 ternary NCs were referred to as supramolecular architectures (SMAs). The excellent electron transfer ability of the SMA-modified SPCE (SMA/SPCE) sensor enabled highly sensitive H2O2 detection for immediate trace Sar biomarker detection. Therefore, the system included an SMA/SPCE coupled to a portable potentiostat linked to a smartphone for data acquisition. The high catalytic activity, porous architecture, and sufficient biocompatibility of CS–PANI–MC ternary NCs enabled bioactivity retention and immobilized SOx stability. The fabricated biosensor exhibited a detection limit of 0.077 μM and sensitivity of 8.09 μA mM−1 cm−2 toward Sar, demonstrating great potential for use in rapid PCa screening. [ABSTRACT FROM AUTHOR]

In this study, we detected the expression levels of miR-21 in 38 clinical urine samples, obtained from 10 patients with PCa (with each sample obtained at three time points: before surgery, 1 month after surgery, and 3 months after surgery), 3 patients with benign prostatic hypertrophy (BPH), and 5 healthy subjects (as a control group). All of the samples were examined using a silver nanoparticle-based biosensor, and the sensitivity of the biosensor was simultaneously confirmed via qRT-PCR. The results were further analyzed together with clinical data such as PSA values and cancer stages. The sensitivity of the biosensor ranged up to 100 fM, and it presented a rather high selectivity rate. Our results indicated a significantly decreased expression level of miR-21 in the patient cases at 3 months post-surgery when compared with pre-surgery levels (p-value < 0.001). In addition, when distinguishing the differences in the expression level of miR-21 between healthy subjects and patients with PCa or BPH, both groups showed highly significant differences (p = 0.008 and p < 0.001, respectively). The results strongly suggest that the proposed miR-21 biosensor can be used as an auxiliary screening tool for the early detection of PCa and may effectively facilitate tracking of the progression of PCa, thus enabling more accurate healthcare decision making. [ABSTRACT FROM AUTHOR]

The activated carbon from marigold flowers (MG) was used to make an unlabeled electrochemical immunosensor to determine prostate cancer. MG was synthesized by hydrothermal carbonization and pyrolysis. MG had a large surface area, was highly conductive, and biocompatible. MG modified with graphene quantum dots produced excellent electron transfer for grafting poly(thionine) (PTH). The amine group of PTH bonded with anti-prostate-specific antigen (Anti-PSA) via glutaraldehyde, forming a layer that improved electron transfer. The binding affinity of the immunosensor, presented as the dissociation constant (Kd), was calculated using the Langmuir isotherm model. The results showed that a lower Kd value indicated greater antibody affinity. The immunosensor exhibited two different linear ranges under optimized conditions: 0.0125 to 1.0 ng mL−1 and 1.0 to 80.0 ng mL−1. The sensor could detect concentrations as low as 0.005 ng mL−1, and had a quantification limit of 0.017 ng mL−1. This immunosensor accurately quantified PSA levels of human serum, and the results were validated using enzyme-linked fluorescence assay (ELFA). [ABSTRACT FROM AUTHOR]

PURPOSE: Persons experiencing homelessness (PEHs) represent a medically underserved population with a disproportionately high rate of late-stage cancer diagnoses and cancer mortality. During mobile onsite mammography and breast health education events, we studied PEH's barriers to and uptake of cancer screenings. METHODS: This study used patient surveys and review of the electronic health record. The main outcome measures included mammogram and diagnostic imaging (as needed) results. A questionnaire assessed patient's views and barriers related to social determinants of health. The study included women accessing community organization resources who were 40 years or older or who met criteria for screening mammography. RESULTS: Forty-six individuals completed mammograms and 41 individuals participated in the survey, for a response rate of 89%. Thirty-five participants (85%) held health insurance provided by a Medicaid managed plan. Thirty-six participants (87%) received a negative mammogram result, and five participants (12%) required follow-up for abnormal results. Of these five, two participants completed diagnostic follow-up with negative results, and three did not complete diagnostic follow-up. In addition to barriers related to housing insecurity, five patients (12%) reported transportation barriers. A majority (n = 28, 68%) disagreed or strongly disagreed with the statement, "I'm afraid the mammogram will be painful." A majority (n = 31, 76%) disagreed or strongly disagreed with the statement, "I'm busy and do not have time." Nearly all participants (n = 37, 90%) responded yes to the statement, "I believe in preventative care screenings." Eight participants (20%) completed at least one additional cancer screening. CONCLUSION: By creating enduring programs offering screening, navigation, and education, academic-community partnerships may begin to address the increased cancer mortality among PEHs by improving screening adherence. [ABSTRACT FROM AUTHOR]

PURPOSE: Patients with hereditary cancer syndromes face increased medical management recommendations to address their cancer risks. As multigene panels are the standard of testing today, more patients needing clinical intervention are being identified. This study calculates the downstream revenue (DSR) generated by patients ascertained by a genetic counselor (GC) with a hereditary cancer likely pathogenic/pathogenic variant (LPV/PV). METHODS: Retrospective chart review was performed for patients seen in a high-volume cancer genetics clinic between October 1, 2009, and December 31, 2021, with LPV/PVs in hereditary cancer predisposition genes. DSR and work relative value units (wRVUs) were calculated for each patient before and after they met with a GC. Subgroup analyses calculated DSR/wRVUs from patients affected and unaffected with cancer and those whose genetic counseling visit was the first at the institution (naїve). RESULTS: A total of 978 patients were available for analysis after exclusions were applied. Patients generated $73.06 million (M) in US dollars (USD) in DSR and 54,814 wRVUs after their initial genetic counseling visit. Unaffected patients (n = 370, 37.8%) generated $11.38M (USD) and 13,879 wRVUs; affected patients (n = 608, 62.2%) generated $61.68M (USD) and 40,935 wRVUs. Naïve patients (n = 367, 37.5%) generated $15.39M (USD) and 11,811 wRVUs; established patients (n = 611, 62.5%) generated $57.67M (USD) and 43,003 wRVUs. Unaffected, naïve patients (n = 204, 20.9%) generated $5.48M (USD) and 5,186 wRVUs. CONCLUSION: By identifying patients with hereditary cancer, GCs can bring in substantial DSR for their institution. Naïve and unaffected patients provide the greatest GC value-add as these patients represent new business and revenue sources to the institution. As multigene panels continue to expand, the number of patients needing downstream services will increase. Recognizing patients at increased cancer risk will improve patient outcomes while simultaneously providing DSR for institutions. [ABSTRACT FROM AUTHOR]

Breast cancer remains one of the primary causes of cancer-related deaths among women globally. Early detection via mammography is essential for improving prognosis and survival rates. However, mammogram diagnostic accuracy is severely hindered by dense breast tissue, which can obstruct potential malignancies, complicating early detection. To tackle this pressing issue, this study introduces an innovative approach that leverages Generative Adversarial Networks (GANs), specifically CycleGAN and GANHopper, to transform breast density in mammograms. The aim is to diminish the masking effect of dense tissue, thus enhancing the visibility of underlying malignancies. The method uses unsupervised image-to-image translation to gradually alter breast density (from high (ACR-D) to low (ACR-A)) in mammographic images, detecting obscured lesions while preserving original diagnostic features. We applied this approach to multiple mammographic datasets, demonstrating its effectiveness in diverse contexts. Experimental results exhibit substantial improvements in detecting potential malignancies concealed by dense breast tissue. The method significantly improved precision, recall, and F1-score metrics across all datasets, revealing previously obscured malignancies and image quality assessments confirmed the diagnostic relevance of transformed images. The study introduces a novel mammogram analysis method using advanced machine-learning techniques, enhancing diagnostic accuracy in dense breasts and potentially improving early breast cancer detection and patient outcomes. [ABSTRACT FROM AUTHOR]