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Quantitative faecal immunochemical tests (FITs) are no longer reserved for the organised colorectal cancer screening programme. Biogroup laboratories in some area have been replacing qualitative FITs with a quantitative FIT (FOB Gold) for around 1 year, with automated analysis using a multi-purpose routine machine. The sensitivity of qualitative FITs for detecting an advanced neoplasm (CRC or advanced adenoma, i.e. adenoma ≥ 10 mm or high-grade dysplasia or villous or tubulocaval) varies considerably (30% to 73%). In the symptomatic population, sensitivity for CRC is also highly variable, ranging from 82% to 100%, with positivity rates varying from 22% to 35%. These poor results point to the obsolescence of qualitative FITs. In asymptomatic people at average risk of CRC, the sensitivity of the quantitative FIT for diagnosing CRC is 76% at the 10 μg/g threshold and 65% at the 20 μg/g threshold. Lowering the threshold to 20 μg/g would offer better sensitivity, estimated at between 87% and 91% (21% and 25% for advanced adenoma) for a positivity rate of 5.3%, which is perfectly manageable for French gastroenterologists. In symptomatic patients, the performances of the quantitative FITs have sensitivities for the diagnosis of CRC of 91.0% and 94.7% for thresholds set at 10 μg/g and at the limit of detection (2 μg/g). To date, three countries have published recommendations on the use of quantitative FITs for the investigation of symptomatic patients in general practice: the United Kingdom, Spain and Australia, all at a threshold of ≥ 10 μg/g. At the threshold of 2 μg/g, the sensitivity of the quantitative FIT for CRC is evaluated at 94.7% (between 93% and 100% depending on the study), equivalent to that of colonoscopy, and enables colonoscopy to be avoided in 66% of cases. It has been shown that only a minority of people with a family history of CRC are properly screened. It is paradoxical and counter-productive that 50-74-year-olds at high or supposedly high risk of CRC should be subject to the vagaries of opportunistic screening and excluded from the organised screening programme. This is a French exception: most organised screening programmes invite the entire population in the age group concerned to undergo screening, unless they expressly object. [ABSTRACT FROM AUTHOR]

The article in the Clinical & Translational Medicine journal discusses the validation of plasma microRNA ratios as biomarkers for early breast cancer detection in a screening setting. The study confirmed the discriminatory ability of these miRNA ratios, along with nonmolecular predictors, using a standard and noninvasive technique. The research involved a discovery case-control set nested within a large mammographic screening cohort, with subsequent validation on a new set of women. The study highlights the potential of plasma miRNAs for precision breast cancer screening, emphasizing the need for further research on larger datasets. [Extracted from the article]

Background and Aim: Periodic endoscopic screening for gastric cancer (GC) is widely performed in East Asia; however, the optimal screening strategy remains unclear. This study aimed to determine the most cost‐effective endoscopic screening strategy for the detection and treatment of GC in a cohort with a low Helicobacter pylori prevalence. Methods: The following data were retrospectively extracted from participants who received screening endoscopy between April 2019 and March 2023: age, H. pylori infection status, presence of intestinal metaplasia, pathological diagnosis of GC, and the interval between the most recent endoscopies. A Markov state transition model was constructed based on the cohort data. The cost‐effectiveness of 15 strategies with different starting ages (40/50/60 years) and screening intervals (1/2/3/4/5 years) was compared. The net monetary benefit (NMB) and incremental cost‐effectiveness ratio (ICER) of quality‐adjusted life‐years gained by treatment were used as outcomes. Results: A simulation model was constructed based on the cohort data of 94 137 participants (mean age 54.5 years, males 57.9%; 74.4% H. pylori‐naïve, 94.2% intestinal metaplasia‐negative). The results of the base‐case analysis showed that the screening strategy of 4‐year intervals starting at the age of 40 years had the highest NMB (97 401 578 yen). In both the Monte Carlo simulation and one‐way sensitivity analysis with a varying probability of H. pylori infection status transition, the ICER was superior in the screening strategy every 4 years, starting at age 40 years. Conclusions: Our simulation showed that endoscopic screening at 4‐year intervals starting at the age of 40 years was the most cost‐effective method. [ABSTRACT FROM AUTHOR]

Metamaterials for refractive index sensing applications have garnered significant attention in recent years. However, achieving an optimal balance between high sensitivity and quality factor, which together determine the Figure of Merit of sensors, necessitates extensive optimization efforts. In this paper, we present the metaheuristic optimization of a refractive index-based plasmonic sensor operating at a wavelength of 1500 nm, which has the potential to open new avenues for applications in biomedical sensing and beyond. Particle Swarm Optimization is utilized to maximize the performance of the proposed infrared metamaterial sensor. The proposed design features two overlapping E-shaped silver patches placed on top of a grounded Al 2 O 3 substrate. This configuration results in a narrow-band absorption spectrum with peak resonances caused by the confinement of the electric field within the gaps of the E-shaped metallic arms. The metaheuristic optimization process yielded sensor dimensions that achieve a high sensitivity of 834.7 nm/RIU,Q = 865 and a Figure of Merit of 481.34 RIU - 1 , demonstrating outstanding performance in cancer cell detection. [ABSTRACT FROM AUTHOR]

In this paper, we present a graphene-based band-pass filter featuring rectangular-shaped resonators, based on research into the sensing characteristics of surface plasmon polaritons (SPP). The finite-difference time-domain (FDTD) method and simulations reveal that the transmission spectrum of this structure exhibits a dual-mode spectrum. This structure operates at two functional modes with wavelengths of 1135 nm and 1705 nm, and its compact size measures 330 nm × 480 nm. We investigated the effect of geometric parameters on the pass bands, finding transmission rates as high as 0.97 and 0.88, sensitivities of 2166.6 nm/RIU and 2000 nm/RIU, and figures of merit (FOM) of 50.38 and 38.46 RIU−1. Due to the minimal difference in the RI of cancer cells and the high sensitivity of the sensor, it is highly effective for cancer cell detection. Additionally, the accuracy of the sensor's performance is validated using a one-sample T-test, which confirms the precision and reliability of the designed sensor. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the effectiveness of face‐to‐face (F2F) and online OralDETECT training programme in enhancing early detection skills for oral cancer. Methods: A total of 328 final‐year dental students were trained across six cohorts. Three cohorts (175 students) received F2F training from the academic years 2016/2017 to 2018/2019, and the remaining three (153 students) underwent online training during the Covid‐19 pandemic from 2019/2020 to 2021/2022. Participant scores were analysed using the Wilcoxon signed rank test, the Mann‐Whitney test, Cohen's d effect size, and multiple linear regression. Results: Both F2F and online training showed increases in mean scores from pre‐test to post‐test 3: from 67.66 ± 11.81 to 92.06 ± 5.27 and 75.89 ± 11.03 to 90.95 ± 5.22, respectively. Comparison between F2F and online methods revealed significant differences in mean scores with large effect sizes at the pre‐test stage (p < 0.001), while significant differences with small effect sizes were noted for post‐test 1 (p = 0.002) and post‐test 3 (p = 0.041). Regression analysis indicated that the delivery method is associated with the participants' final scores. Conclusion: F2F and online versions of the OralDETECT training programme significantly enhance participants' knowledge and skills in oral cancer detection. Although F2F appeared to be more effective, the difference was not substantial enough to be considered educationally meaningful. [ABSTRACT FROM AUTHOR]

Normative issues associated with the design and implementation of population-based lung cancer screening policies are underexamined. This study was an exposition of the ethical justification for screening and potential ethical issues and their solutions in Canadian jurisdictions. A qualitative description study was conducted. Key informants, defined as policymakers, scientists and clinicians who develop and implement lung cancer screening policies in Canada, were purposively sampled and interviewed using a semi-structured guide informed by population-based disease screening principles and ethical issues in cancer screening. Interview data were analyzed using qualitative content analysis. Fifteen key informants from seven provinces were interviewed. Virtually all justified screening by beneficence, describing that population benefits outweigh individual harms if high-risk people are screened in organized programs according to disease screening principles. Equity of screening access, stigma and lung cancer primary prevention were other ethical issues identified. Key informants prioritized beneficence over concerns for group-level justice issues when making decisions about whether to implement screening policies. This prioritization, though slight, may impede the implementation of screening policies in a way that effectively addresses justice issues, a goal likely to require justice theory and critical interpretation of disease screening principles. [ABSTRACT FROM AUTHOR]

The bio-imaging technology is one of the most significant modern applications used in several fields, including early diagnosis of many illnesses that are most important diseases facing humanity and other vital uses. The primary advancement in nanotechnology is the creation of innovative fluorescence probes called quantum dots (QDs). The use of molecular tagging in research, in vivo, and in vitro studies is revolutionized by quantum dots. The application of QD indicates conversion in natural imaging and photography has demonstrated extraordinary appropriateness in bio-imaging, the discovery of novel drugs, and delivery of targeted genes, biosensing, photodynamic therapy, and diagnosis. New potential methods of early cancer detection and treatment management are being researched as a result of the special physical and chemical characteristics of QD probes. The bio-imaging technique depends on the fluorescent emission of the used materials, which is paired with living cells that are easy to see it in 3D without any surgical intervention. Therefore, the use of QDs many types that have unique and appropriate properties for use in that application; In terms of fluorescent emission strength, duration and luminosity.This review article displays some methods of preparation for QDs nanomaterials and the devices used in this. In addition, it presentssome of challenges that must be avoided for the possibility of using them in the bio-imaging field; as toxicity, bio-compatibility, and hydrophilization. It's reviewed some of the devices that use QDs in bio-imaging technique, the QDs application in cell analysis-imaging, and QDs application in vivo imaging. [ABSTRACT FROM AUTHOR]

Objective: Computer-aided diagnosis (CAD) significantly enhances the accurate and early detection of breast cancer. The segmentation step, which is crucial in CAD methods, employs different algorithms for image segmentation as documented in the literature. Segmentation in detecting breast lesions using CAD may affect the features extracted from the images and, accordingly, the classification results. These segmentation methods have advantages and limitations when compared to each other. No study in the literature has yet explored feature matrices obtained by different segmentation methods using different performance criteria. This study aims to investigate the effects of different segmentation methods used in image processing on mammography images for breast cancer detection. Materials and Methods: In the preprocessing step, images are enhanced using median filtering, Contrast Limited Adaptive Histogram Equalization (CLAHE), and unsharp masking. Texture features are extracted from the regions of interest (ROI) using texture analysis techniques, coupled with an elastic network technique for feature reduction. Results: The performance of five different segmentation algorithms was compared using various performance measures such as accuracy, sensitivity, and specificity, alongside different classification methods. The k-means algorithm showed higher performance compared to other segmentation methods. It exhibited high efficacy, achieving an accuracy of 1.00 and 0.989 with Support Vector Machine (SVM) and Random Forest (RF) classifiers, respectively. Conclusion: Segmentation methods used in image processing were found to have an impact on classification results. These computer-aided systems can be instrumental in patient classification. [ABSTRACT FROM AUTHOR]

Annually, many people worldwide lose their lives due to breast cancer, making it one of the most prevalent cancers in the world. Since the disease is becoming more common, early detection of breast cancer is essential to avoiding serious complications and possibly death as well. This research provides a novel Breast Cancer Discovery (BCD) strategy to aid patients by providing prompt and sensitive detection of breast cancer. The two primary steps that form the BCD are the Breast Cancer Discovery Step (BCDS) and the Pre-processing Step (P2S). In the P2S, the needed data are filtered from any non-informative data using three primary operations: data normalization, feature selection, and outlier rejection. Only then does the diagnostic model in the BCDS for precise diagnosis begin to be trained. The primary contribution of this research is the novel outlier rejection technique known as the Combined Outlier Rejection Technique (CORT). CORT is divided into two primary phases: (i) the Quick Rejection Phase (QRP), which is a quick phase utilizing a statistical method, and (ii) the Accurate Rejection Phase (ARP), which is a precise phase using an optimization method. Outliers are rapidly eliminated during the QRP using the standard deviation, and the remaining outliers are thoroughly eliminated during ARP via Binary Harris Hawk Optimization (BHHO). The P2S in the BCD strategy indicates that data normalization is a pre-processing approach used to find numeric values in the datasets that fall into a predetermined range. Information Gain (IG) is then used to choose the optimal subset of features, and CORT is used to reject incorrect training data. Furthermore, based on the filtered data from the P2S, an Ensemble Classification Method (ECM) is utilized in the BCDS to identify breast cancer patients. This method consists of three classifiers: Naïve Bayes (NB), K-Nearest Neighbors (KNN), and Support Vector Machine (SVM). The Wisconsin Breast Cancer Database (WBCD) dataset, which contains digital images of fine-needle aspiration samples collected from patients' breast masses, is used herein to compare the BCD strategy against several contemporary strategies. According to the outcomes of the experiment, the suggested method is very competitive. It achieves 0.987 accuracy, 0.013 error, 0.98 recall, 0.984 precision, and a run time of 3 s, outperforming all other methods from the literature. [ABSTRACT FROM AUTHOR]

The most commonly occurring cancer in the world is breast cancer with more than 500,000 cases across the world. The detection mechanism for breast cancer is endoscopist-dependent and necessitates a skilled pathologist. However, in recent years many computer-aided diagnoses (CADs) have been used to diagnose and classify breast cancer using traditional RGB images that analyze the images only in three-color channels. Nevertheless, hyperspectral imaging (HSI) is a pioneering non-destructive testing (NDT) image-processing technique that can overcome the disadvantages of traditional image processing which analyzes the images in a wide-spectrum band. Eight studies were selected for systematic diagnostic test accuracy (DTA) analysis based on the results of the Quadas-2 tool. Each of these studies' techniques is categorized according to the ethnicity of the data, the methodology employed, the wavelength that was used, the type of cancer diagnosed, and the year of publication. A Deeks' funnel chart, forest charts, and accuracy plots were created. The results were statistically insignificant, and there was no heterogeneity among these studies. The methods and wavelength bands that were used with HSI technology to detect breast cancer provided high sensitivity, specificity, and accuracy. The meta-analysis of eight studies on breast cancer diagnosis using HSI methods reported average sensitivity, specificity, and accuracy of 78%, 89%, and 87%, respectively. The highest sensitivity and accuracy were achieved with SVM (95%), while CNN methods were the most commonly used but had lower sensitivity (65.43%). Statistical analyses, including meta-regression and Deeks' funnel plots, showed no heterogeneity among the studies and highlighted the evolving performance of HSI techniques, especially after 2019. [ABSTRACT FROM AUTHOR]

Breast cancer is a leading cause of mortality among women, emphasizing the critical need for precise early detection and prognosis. However, conventional methods often struggle to differentiate precancerous lesions or tailor treatments effectively. Thermal imaging, capturing subtle temperature variations, presents a promising avenue for non‐invasive cancer detection. While some studies explore thermography for breast cancer detection, integrating it with advanced machine learning for early diagnosis and personalized prediction remains relatively unexplored. This study proposes a novel hybrid machine learning system (HMLS) incorporating deep autoencoder techniques for automated early detection and prognostic stratification of breast cancer patients. By exploiting the temporal dynamics of thermographic data, this approach offers a more comprehensive analysis than static single‐frame approaches. Data processing involves splitting the dataset for training and testing. A predominant infrared image was selected, and matrix factorization was applied to capture temperature changes over time. Integration of convex factor analysis and bell‐curve membership function embedding for dimensionality reduction and feature extraction. The autoencoder deep neural network further reduces dimensionality. HMLS model development included feature selection and optimization of survival prediction algorithms through cross‐validation. Model performance was assessed using accuracy and F‐measure metrics. HMLS, integrating clinical data, achieved 81.6% accuracy, surpassing 77.6% using only convex‐NMF. The best classifier attained 83.2% accuracy on test data. This study demonstrates the effectiveness of thermographic imaging and HMLS for accurate early detection and personalized prediction of breast cancer. The proposed framework holds promise for enhancing patient care and potentially reducing mortality rates. [ABSTRACT FROM AUTHOR]

The role of digital rectal examination (DRE) in the early detection of significant prostate cancer (PCa) is being questioned in the era of magnetic resonance imaging (MRI). However, some men with suspected PCa may still be identified solely through DRE, even with low serum prostate-specific antigen (PSA) levels. Additionally, most predictive models designed to improve significant PCa diagnostic pathways incorporate DRE findings. We assessed the role of DRE among 5005 men with serum PSA levels > 3.0 ng/mL and/or suspicious DRE findings, who underwent pre-biopsy MRI and targeted and/or systematic biopsies, as part of the significant PCa opportunistic screening program in Catalonia (Spain) between 2016 and 2023. Significant PCa, defined as grade group > 2, was detected in 2097 men (41.9%). Suspicion of PCa was based solely on DRE in 206 cases (4.1%) with significant PCa detected in 50 of them (2.4%). Two pathways using the Barcelona predictive models, before and after MRI, with and without DRE findings showed specificities of 52.8 and 38.7%, respectively (p < 0.001), after fixing sensitivity at 90%. Prostate biopsy was avoided in 35.1 and 26.7%, respectively (p < 0.001), while its efficacy increased from 52.8 to 58%. We conclude that DRE improved the effectiveness of an opportunistic significant PCa-screening program. [ABSTRACT FROM AUTHOR]

Background/Aims: This study aimed to evaluate the effectiveness of the GI Genius (Medtronic) module in clinical practice, focusing on the adenoma detection rate (ADR) during colonoscopy. Computer-aided polyp detection (CADe) systems using artificial intelligence have been shown to improve adenoma detection in controlled trials. However, the effectiveness of these systems in clinical practice has recently been questioned. Methods: This single-center prospective observational study was conducted at the University Hospital of Southern Denmark and included all individuals referred for colonoscopy between November 2020 and January 2021. The primary outcome was ADR, comparing patients examined with CADe to those examined without it. The selection of patients to be examined with the CADe module was completely random. Results: A total of 502 patients were analyzed (318 in the control group and 184 in the CADe group). The overall ADR was 32.1% with a slight increase in the CADe group (34.7% vs. 30.5%). Multivariable analysis showed a very modest and statistically insignificant increase in ADR (risk ratio, 1.12; 95% confidence interval, 0.88–1.43). Conclusions: The use of CADe in clinical practice did not increase ADR with statistical significance when compared to colonoscopy without CADe. These findings suggest that the impact of CADe systems in everyday clinical practice are modest. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to assess the impact of disability on participation in CRC screening and to determine the overall effect size. Methods: We conducted a systematic review and meta-analysis to compare CRC screening participation in individuals with and without disabilities. The search encompassed five databases (PubMed, EMBASE, Scopus, Google Scholar, medRxiv). Pooled estimates were calculated for each type of CRC screening and disability categories to synthesize the findings. The participation in CRC screening was derived using a random effects model. Results: A total of 20 articles were included, most of them from the USA. Based on pooled estimates, individuals with disabilities have lower odds of undergoing CRC screening versus those without disabilities (OR = 0.80, 95%CI 0.73–0.87). Analysis by screening type indicated that individuals with a disability have lower odds of a fecal occult blood test or a fecal immunochemical test (OR: 0.72, 95%CI 0.65–0.81), with no significant difference for a colonoscopy. Individuals with intellectual disabilities had significantly lower rates of CRC screening participation (OR = 0.65, 95%CI 0.53–0.79), especially for FOBT/FIT (OR = 0.58, 95%CI 0.49–0.69). Conclusions: Disparities exist for CRC screening participation in people with disabilities. Further research and coordinated efforts are essential to develop interventions for improving early cancer diagnosis for this non-negligible patient group. [ABSTRACT FROM AUTHOR]

The lifetime risk of breast and ovarian cancer increases substantially for individuals with mutations in BRCA1/2. The evidence indicates that BRCA1/2 mutation carriers benefit from early cancer detection and prevention strategies. However, data on the patterns of risk-reducing interventions are lacking. This study investigated the patterns of surveillance and risk-reducing interventions among unaffected BRCA1/2 mutation carriers. A cohort of unaffected BRCA1/2 mutation carriers was identified from the Korean Hereditary Breast cAncer (KOHBRA) study database, and a telephone survey was conducted. The survey included questions on the incidence of new cancers, patterns of cancer (breast, ovarian, prostate, other) surveillance, chemoprevention, risk-reducing surgery, and reasons for participating in risk-reducing strategies. Between November 2016 and November 2020, 192 BRCA1/2 mutation carriers were contacted, of which 83 responded. After excluding 37 responders who refused to participate, 46 participants (15 males, 31 females) were included in the analysis. The mean ± SD follow-up time was 103 ± 17 months (median 107, range 68~154), and the mean ± SD age was 31 ± 8 years. Ten BRCA1/2 mutation carriers developed breast cancer, one developed ovarian cancer, and three developed other cancers. Six BRCA1/2 mutation carriers (19.4%) underwent annual breast cancer surveillance as recommended by guidelines, while none underwent ovarian or prostate cancer surveillance. Three carriers (9.7%) used chemoprevention for breast cancer. Risk-reducing salpingo-oophorectomy was performed on only one BRCA1/2 mutation carrier. The rates of breast/ovarian cancer surveillance, chemoprevention, and risk-reducing surgery were low among unaffected Korean BRCA1/2 mutation carriers. Given this cohort's relatively high risk of developing breast cancer, strategies to encourage active participation in risk reduction are needed. [ABSTRACT FROM AUTHOR]

Background: Although screening for distress is recommended by many cancer care guidelines, the uptake of such screening in cancer centers remains limited. Improving the acceptability of screening programs in cancer centers requires a reduction in clinical burden and an improved detection of distress. The purpose of this study was to validate the performance of the two-step screening algorithm used in the Distress Assessment and Response Tool (DART) for identifying cases of anxiety and depression. Methods: This retrospective validation study consisted of patients at the Princess Margaret Cancer Centre (PM) who completed the DART, which includes the Edmonton Symptom Assessment System depression (ESAS-D) and anxiety (ESAS-A) items, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7). We evaluated the performance of a two-step screening approach, which modeled the ESAS-D, followed by the PHQ-9 and ESAS-A, then the GAD-7 for predicting a diagnosis of depression and anxiety disorders, respectively. A clinical psychiatric assessment was used as the gold standard reference. Results: A total of 172 patients with cancer were included in this study. A total of 59/172 (34%) and 39/172 (23%) were diagnosed with a depression or anxiety disorder, respectively. The sequential administration of the PHQ-9 ≥15 following the ESAS-D (>2) significantly increased the post-test probability of depression from 37% to 60% and improved the performance of predicting depression compared to both the ESAS-D or the PHQ-9 as standalone tests. The sequential administration of the GAD-7 after the ESAS-A did not improve the predictability of an anxiety diagnosis beyond the performance of the ESAS-A or the GAD-7 as standalone tests. Conclusions: The present study is among the first to demonstrate that a two-step screening algorithm for depression may improve depression screening in cancer using real-world data. Further research on optimal screening approaches for anxiety in cancer is warranted. [ABSTRACT FROM AUTHOR]

Background: Several screening models have recently been applied to study awareness and help people make informed decisions regarding cancer screening. Aims: This study aimed to explore the knowledge, attitudes, and lung cancer screening health beliefs (LCSHBs) among Jordanians. Moreover, we intended to translate the LCSHBs scale into the Arabic language and test its validity and reliability. Methods: An online survey (Google Forms) was completed by 916 participants in Jordan via snowball sampling technique from February 10, 2024, to March 2, 2024, assessing lung cancer screening knowledge, lung cancer preventive attitudes, screening‐related health beliefs, and stages of screening adoption. Linear regression analysis, correlations, and non‐parametric statistics were utilized for statistical inference. Results: Participants had high mean percentage scores of 86.56% and 85.75% for knowledge and preventive attitudes towards lung cancer screening, respectively. The Arabic version of the LCSHBs model was found to be a valid and reliable tool, as indicated by principal component analysis extraction and Cronbach's alpha values. Lung cancer screening knowledge was positively associated with perceived benefits and negatively associated with perceived barriers to screening. Knowledge, perceived barriers, perceived risk of lung cancer, self‐efficacy (SE) to screen, and lung cancer preventive attitudes were significantly associated with the perceived benefits of lung cancer screening (p < 0.05). We also found that the higher the SE, the higher the physical activity and the lower the perceived barriers. Conclusion: The Arabic version of the LCSHBs model is valid and reliable for assessing health beliefs toward lung cancer screening. We recommend enhancing targeted interventions, educational outreach, and improving health insurance access to reduce lung cancer incidence in Jordan and promote screening behaviors. [ABSTRACT FROM AUTHOR]

INTRODUCTION: To evaluate the effect of Embrella, a novel-designed colonoscopic distal attachment, on adenoma detection rate (ADR) and adenoma per colonoscopy (APC), compared with standard colonoscopy in routine practice. METHODS: All consecutive participants who underwent routine colonoscopic examinations at 3 endoscopy centers in China were enrolled. Participants were randomly assigned in a 1:1 ratio to the Embrella-assisted colonoscopy (EAC) or standard colonoscopy (SC) groups. ADR, APC, inspection time, pain scores, and adverse events were recorded. RESULTS: Overall, 1,179 participants were randomized into the EAC (n = 593) and SC groups (n = 586). EAC increased the overall ADR from 24.6% to 34.2% (P < 0.001) and improved APC from 0.44 to 0.64 (P = 0.002). Subgroup analyses indicated that EAC significantly improved ADR for adenomas < 10 mm (13.8% vs 8.5%, P = 0.004 for 5-9 mm and 27.0% vs 17.2%, P < 0.001 for < 5 mm), nonpedunculated adenomas (26.6% vs 18.8%, P < 0.001), and adenomas in the transverse (10.8% vs 6.1%, P = 0.004) and left colon (21.6% vs 13.7%, P < 0.001). APC in the subgroup analyses was consistent with ADR. The mean inspection time was shorter with EAC (6.52 vs 6.68 minutes, P = 0.046), with no significant impact on participants' pain scores (P = 0.377). Moreover, no EAC-related adverse events occurred. DISCUSSION: EAC significantly increased ADR and APC compared with SC, particularly for adenomas <10 mm, nonpedunculated adenomas, and adenomas in the transverse and left colon. [ABSTRACT FROM AUTHOR]

Background: A screening tool was devised to aid the diagnosis and treatment of ground‐glass nodules (GGNs). Methods: The current ambispective cohort study included retrospective collation of 20 variables synthesizing a patient's clinical characteristics, serum tumor markers, and CT results, which allowed division into noninvasive (benign, atypical adenomatous hyperplasia, and adenocarcinoma in situ) and invasive (minimally invasive and invasive adenocarcinomas) tumors to build a prediction nomogram and GGN screening scale. The model was verified internally. A prospective cohort of patients was randomly divided by envelope method into those assessed by the GGN screening scale and those assessed via CT values. The diagnostic efficiencies were compared to allow external verification of the model. Result: A total of 223 patients with 225 GGNs were recruited into the retrospective cohort between January 2021 and December 2022. Multivariable analysis showed sex, diameter, air bronchogram, and vessel convergence sign to be independent factors for prediction of noninvasive and invasive GGNs. Internal verification showed the model had a sensitivity of 70.7% and specificity of 75.0% with the Youden index at 0.457 and area under the curve (AUC) of 0.793 (95% CI: 0.734–0.852). Calibration curves indicated good internal stability (p = 0.357). Between January 2023 and March 2023, 147 patients with 148 GGNs were recruited into the prospective cohort. External verification showed the model had a sensitivity of 92.4% and specificity of 40.0% with the Youden index at 0.324 and AUC of 0.678 (95% CI: 0.509–0.847). Calibration curves indicated good external stability (p = 0.088). The scale was shown to have a sensitivity of 75.00%, specificity of 37.50%, positive predictive value of 91.53%, negative predictive value of 14.29%, and accuracy of 71.25%. Conclusion: The GGN screening scale has high sensitivity and accuracy, making it suitable for diagnosis of GGNs. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the Health Belief Model (HBM) constructs associated with Pap screening adherence among a sample of African American and sub-Saharan African immigrant women in the United States. Methods: A descriptive cross-sectional study was conducted via an online survey. Participants were recruited from central Kentucky counties. Ninety-one eligible women participated (mean age 38 ± 12 years), 49.5% identified as African American. Twenty-nine percent indicated never being screened or not being up-to-date. Self-reported demographic data, HBM constructs for Pap screening, and Pap screening history were collected. Bivariate and logistic regressions were performed. Results: There was a significant negative association between perceived barriers and being up-to-date. For every one-point increase in perceived barriers, the odds of being up-to-date decreased by 81%, (p = 0.004; CI: 0.06–0.60), findings from further evaluation of the barrier construct showed that barriers significantly associated with screening include items related to lack of knowledge about where to get a Pap screening, lack of time to attend the screening, screening-associated shame and pain, negligence, and age. There were no other significant HBM constructs associated with up-to-date Pap screening status. There was no difference in perceived barriers between African American and sub-Saharan African women. Conclusions: Despite public health efforts to decrease screening barriers, a perception of barriers exists among Black women. Continued efforts to address screening barriers as well as the perception of barriers are warranted among Black women. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Colorectal cancer (CRC) has surged to prominence as the leading cancer affecting men and the second most common affecting women in Saudi Arabia. The need for preventative screening is underscored by the rising prevalence of precancerous polyps, early-stage colorectal cancer, and the fact that these conditions often manifest without symptoms. Methods: This study utilized a cross-sectional descriptive design and employed data from a sample of 425 residents of Qassim region in Saudi Arabia. The participants guaranteed their confidentiality when completing self-administered online questionnaires. Results: Nearly half, 209 (49.2%), of the participants indicated that there were increasing incidences of colon cancer in Saudi Arabia. A considerable number [122 (28.7%)] of respondents believed that family history was the risk factor for colorectal cancer. A total of 203 (47.8%) knew that CRC could develop without symptoms. Common symptoms of CRC were cited as bleeding per rectum 300 (70.6%) and abdominal pain 259 (60.9%). The majority, 384 (90.4%), of the respondents believed that CRC could be prevented and cured if detected early, 415 (97.6%). The results noted that more females knew that there were increasing incidences of CRC in KSA (P = 0.03). Older participants were more likely to understand the function of the colon and rectum (P < 0.001**), the risk factors (P < 0.001**), and the symptoms of CRC (P < 0.001**), as well as their willingness to choose colonoscopy to conduct colon follow-up screening even without symptoms (P < 0.001**). Married participants had a higher likelihood of knowing the ranking of CRC among the most common tumors in both sexes in KSA (P = 0.027*). Participants with a higher education level were more likely to know the ranking of CRC among the common tumors in the KSA (P = 0.004**), the functions of colon and rectum (0.003**), and the symptoms of CRC (P < 0.001**). Conclusion: The study revealed considerably below-average knowledge about the general public's screening for CRC in the Qassim region of Saudi Arabia. Although a substantial proportion of participants demonstrated knowledge about the risk factors, symptoms, and prevention of CRC, there is limited knowledge about screening programs in the region. This underscores the need for public awareness campaigns and concerted efforts to eliminate the obstacles preventing more people from getting screened with colonoscopies for early detection and prevention of CRC. [ABSTRACT FROM AUTHOR]

Skin cancer (SC) is one of the three most common cancers worldwide. Melanoma has the deadliest potential to spread to other parts of the body among all SCs. For SC treatments to be effective, early detection is essential. The high degree of similarity between tumor and non-tumors makes SC diagnosis difficult even for experienced doctors. To address this issue, authors have developed a novel Deep Learning (DL) system capable of automatically classifying skin lesions into seven groups: actinic keratosis (AKIEC), melanoma (MEL), benign keratosis (BKL), melanocytic Nevi (NV), basal cell carcinoma (BCC), dermatofibroma (DF), and vascular (VASC) skin lesions. Authors introduced the Multi-Grained Enhanced Deep Cascaded Forest (Mg-EDCF) as a novel DL model. In this model, first, researchers utilized subsampled multigrained scanning (Mg-sc) to acquire micro features. Second, authors employed two types of Random Forest (RF) to create input features. Finally, the Enhanced Deep Cascaded Forest (EDCF) was utilized for classification. The HAM10000 dataset was used for implementing, training, and evaluating the proposed and Transfer Learning (TL) models such as ResNet, AlexNet, and VGG16. During the validation and training stages, the performance of the four networks was evaluated by comparing their accuracy and loss. The proposed method outperformed the competing models with an average accuracy score of 98.19%. Our proposed methodology was validated against existing state-of-the-art algorithms from recent publications, resulting in consistently greater accuracies than those of the classifiers. [ABSTRACT FROM AUTHOR]

Anal squamous cell carcinoma disproportionally affects people with HIV (PWH); however, engagement in anal cancer screening is low in many settings. This study was conducted to assess knowledge and perceptions of anal cancer screening to identify factors in the engagement and retention in prevention services among PWH. Semistructured interviews were conducted among adult PWH eligible for anal cancer screening in our Ryan White HIV/AIDS Program clinic. Descriptive statistics were tabulated; thematic analyses were performed to identify emerging motivators, facilitators, and barriers. Among 26 PWH, 9 had not been screened, 8 had undergone Papanicolaou (Pap) testing alone, and 9 had undergone anoscopy. The median age of the cohort was 55.2 years; 54% identified as men who have sex with men, and 54% identified as Black. In the unscreened cohort, participants were motivated by investing in their health and positive attitudes toward cancer prevention however were deterred by a lack of referral and low awareness about screening. Among those who had Pap testing, trust in healthcare providers and abnormal testing results were motivators to engagement, whereas lack of perceived risk of anal cancer and worry about pain of an anoscopy were prominent barriers. Among those who had anoscopy, perceived risk, positive experience with the procedure, and use of anxiolytics prior to anoscopy were motivators, whereas anxiety around a new cancer diagnosis and negative experience with anoscopy were barriers. Clinics seeking to build or strengthen their anal cancer screening programs can address the barriers described in this study to promote access to anal cancer screening among PWH. [ABSTRACT FROM AUTHOR]

Background: Unnecessary group and screens (G&S) can lead to unnecessary antibody investigations, use of technologist time, and laboratory resources. Local Problem: A baseline audit at our institution identified that 25% of G&S from the cancer center were unnecessary. We aimed to reduce the ratio of monthly G&S to CBC samples processed from the cancer center by 10% (from 0.034 to 0.031) by January 2024. Methods: This represents an interrupted time series design from November 2022 to January 2024. Using Plan Do Study Act (PDSA) cycles, we aimed to increase the use of an existing reflex testing system, termed "do not test." When this option is selected, the blood bank will only process the G&S sample if specific CBC criteria are met (e.g., hemoglobin <9.0 g/dL). Educational sessions increased awareness of this feature and sought feedback from end‐users on its usability. With feedback, the design was updated to include a modifiable hemoglobin threshold for G&S testing, automatic re‐selection of the "do not test" feature for future G&S orders, and aesthetic changes to make the feature more visible. Results: The percentage of samples with "do not test" selected increased from 7.2% to 63.0% (p <.0001) and the ratio of G&S to CBC specimens improved from 0.034 to 0.028, exceeding the target of 0.031. We noted an improvement in the appropriateness of G&S orders from 75% at baseline (n = 20) to 97.5% (n = 80) post intervention (p =.003). Conclusions: We describe an effective strategy to improve G&S utilization at our institution's cancer center using a reflex testing system. [ABSTRACT FROM AUTHOR]

Studies have found that matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) play an important role in tumorigenesis. In order to detect MMP-9 and IL-6 concentrations with high sensitivity and specificity, an efficient microfluidic-SERS sensing system was prepared based on surface-enhanced Raman scattering (SERS). The aptamer recognition-release mechanism and the dual signal amplification strategy were applied in the sensing system. The sensor system was developed using two kinds of nanomaterials with excellent SERS properties, namely gold-coated iron tetroxide particles (Fe3O4@AuNPs) and gold nanocages (AuNCs). In addition, Fe3O4@AuNPs also has magnetic adsorption properties. In the sensing system, single-stranded DNA1 (ssDNA1) and aptamer were modified on Fe3O4@AuNPs. Single-stranded DNA2 (ssDNA2) and Raman tags were modified on AuNCs. When the target was present, the aptamer bound to the target and detached from the Fe3O4@AuNPs, and ssDNA2 bound to the exposed ssDNA1. At this time, the Fe3O4@AuNPs@AuNCs@SERS tag complex was formed, and the SERS signal was enhanced for the first time. Under the action of an external magnet on the microfluidic chip, the complex was magnetized and enriched. The SERS signal was enhanced for the second time. Due to the high affinity between the aptamer and the target object, the sensing system has a strong specificity. The double amplification of the SERS signal gave the system excellent sensitivity. The limit of detection (LOD) relative to MMP-9 and IL-6 were as low as 0.178 pg/mL and 0.165 pg/mL, respectively. The microfluidic-SERS sensing system has a feasible prospect in the early screening of gastric cancer. [ABSTRACT FROM AUTHOR]

Early detection of ovarian cancer (OC) is crucial for effective management and treatment, as well as reducing mortality rates. However, the current diagnostic methods for OC are time-consuming and have low accuracy. Surface plasmon resonance (SPR) biosensors offer a promising alternative to conventional techniques, as they enable rapid and less invasive screening of various circulating indicators. These biosensors are widely used for biomolecular interaction analysis and detecting tumor markers, and they are currently being investigated as a rapid diagnostic tool for early-stage cancer detection. Our main focus is on the fundamental concepts and performance characteristics of SPR biosensors. We also discuss the latest advancements in SPR biosensors that enhance their sensitivity and enable high-throughput quantification of OC biomarkers, including CA125, HE4, CEA, and CA19-9. Finally, we address the future challenges that need to be overcome to advance SPR biosensors from research to clinical applications. The ultimate goal is to facilitate the translation of SPR biosensors into routine clinical practice for the early detection and management of OC. [ABSTRACT FROM AUTHOR]

Background: With the increasing use of lung cancer screening, the detection of ground glass nodules (GGNs) has risen. However, the natural course of GGNs and their relationship to pathologic features remains unclear. Differentiating between invasive and pre‐invasive lesions based on GGN growth may improve clinical intervention timing. Ki‐67, a proliferation marker, holds value in assessing tumor malignancy. This study analyzes the association between GGN growth, pathology, and Ki‐67 expression to provide new insights into early‐stage lung cancer management. Methods: We retrospectively evaluated 183 GGNs with at least two preoperative CT scans. Nodule location, type, natural course, and volume doubling time (VDT) were compared between invasive adenocarcinoma (IAC) and pre‐IAC groups. We also assessed differences in Ki‐67 expression and correlated VDT with Ki‐67 levels. Results: A total of 183 nodules were finally included; gender, nodule location, smoking history, and duration of follow‐up did not differ between the IAC group and the pre‐IAC group, whereas age was statistically different between the two groups. Of the 183 nodules, 52 showed growth and the predominant pathologic type was IAC, these IACs showed more PSN in nodule type, while the IAC group showed more significant differences in nodule type, nodules growth, and VDT than the pre‐IAC group. There were also differences in pathologic type and VDT between different Ki‐67 expression groups, and Ki‐67 expression gradually increased as VDT decreased. Conclusion: Lung adenocarcinoma (LUAD) presenting as GGNs exhibit distinct natural courses among pathologic subtypes. VDT effectively distinguishes these growth characteristics, with IACs showing shorter VDT. The significant correlation between VDT and Ki‐67 expression suggests that combining these parameters may provide valuable insights into the biological behavior and invasiveness of LUAD. [ABSTRACT FROM AUTHOR]

Introduction: Individuals who develop new‐onset diabetes have been identified as a high‐risk cohort for pancreatic cancer (PC), exhibiting an incidence rate nearly 8 times higher than the general population. Hence, the targeted screening of this specific cohort presents a promising opportunity for early pancreatic cancer detection. We aimed to develop and validate a novel model capable of identifying high‐risk individuals among those with new‐onset diabetes. Methods: Employing the UK Biobank cohort, we focused on those developing new‐onset diabetes during follow‐up. Genetic and clinical characteristics available at registration were considered as candidate predictors. We conducted univariate regression analysis to identify potential indicators and used a 5‐fold cross‐validation method to select optimal predictors for model development. Five machine learning algorithms were used for model development. Results: Among 12,735 patients with new‐onset diabetes, 100 (0.8%) were diagnosed with PC within 2 years. The final model (area under the curve, 0.897; 95% confidence interval, 0.865–0.929) included 5 clinical predictors and 24 single nucleotide polymorphisms. Two threshold cut‐offs were established: 1.28% and 5.26%. The recommended 1.28% cut‐off, based on model performance, reduces definitive testing to 13% of the total population while capturing 76% of PC cases. The high‐risk threshold is 5.26%. Utilizing this threshold, only 2% of the population needs definitive testing, capturing nearly half of PC cases. Conclusions: We, for the first time, combined clinical and genetic data to develop and validate a model to determine the risk of pancreatic cancer in patients with new‐onset diabetes using machine learning algorithms. By reducing the number of unnecessary tests while ensuring that a substantial proportion of high‐risk patients are identified, this tool has the potential to improve patient outcomes and optimize healthcare sources. [ABSTRACT FROM AUTHOR]

Background: The increasing incidence of endometrial cancer (EC) has highlighted the need for improved early detection methods. This study aimed to develop and validate a novel DNA methylation classifier, EMPap, for EC detection using cervical scrapings. Methods: EMPap incorporated the methylation status of BHLHE22 and CDO1, along with age and body mass index (BMI), into a logistic regression model to calculate the endometrial cancer methylation (EM) score for identifying EC in cervical scrapings. We enrolled 1297 patients with highly suspected EC, including 196 confirmed EC cases, and assessed the EMPap performance in detecting EC. Results: EMPap demonstrated robust diagnostic accuracy, with an area under the curve of 0.93, sensitivity of 90.3%, and specificity of 89.3%. It effectively detected EC across various disease stages, grades, and histological subtypes, and consistently performed well across patient demographics and symptoms. EMPap correctly identified 87.5% of the type II ECs and 53.8% of premalignant lesions. Notably, compared with transvaginal ultrasonography (TVS) in patients with postmenopausal bleeding, EMPap exhibited superior sensitivity (100% vs. 82.0%) and specificity (85.2% vs. 38.5%). In asymptomatic postmenopausal women, EMPap maintained high sensitivity (89.5%) and negative predictive value (NPV) (98.3%). Conclusions: This study demonstrated the potential of EMPap as an effective tool for EC detection. Despite the limited sample size, EMPap showed promise for identifying type II EC and detecting over 50% of premalignant lesions. As a DNA methylation classifier, EMPap can reduce unnecessary uterine interventions and improve diagnosis and outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Multicancer detection tests (MCDs) are blood‐based tests designed to detect multiple cancer types. It is currently unclear whether these cancer screening tests improve mortality. To understand awareness of MCDs among providers and patients, as well as explore how they perceive the benefits, harms, and acceptability of MCDs, we have undertaken a focus group study in primary care physicians (PCPs) and laypersons to explore knowledge, attitudes, and expectations of cancer screening using MCDs. Methods: We conducted six focus groups with 45 PCP participants and 12 focus groups with 80 layperson participants. Participants were identified via a consumer research firm and found eligible following the completion of a screener survey. Moderators used a semi‐structured guide containing open‐ended questions and prompts to facilitate the discussion. Recordings were transcribed and coded line by line using a codebook developed based on questions and emerging discussion concepts, and emergent themes were identified. Results: Both PCP and layperson participants felt the that benefits of MCDs included ease of use and potential ability to detect cancers early. However, they felt that additional data is needed to overcome some of the concerns related to MCDs. PCP participants expressed concerns related to lack of practice guidelines, cost of diagnostic follow‐ups, privacy and insurance issues, fear/anxiety related to confirmation of MCD results, and malpractice liability related to perceived false negative test results. Layperson participants expressed concerns related to costs, insurance coverage, and privacy, as well as anxiety over the confirmation of a positive test result. Conclusions: There is a major need for more rigorous data regarding MCDs to inform the development of guidelines for use as cancer screening tools. [ABSTRACT FROM AUTHOR]

This analysis assessed the association between regional income, screening coverage for cervical and breast cancer, and temporal trends in mortality from these cancers in different Brazilian health regions. Spatiotemporal ecological study across 450 health regions of Brazil. Data from 2010 Demographic Census were used to assess income. Variations in income distribution within health regions were measured using the Gini index. Data on screening coverage were obtained from the Ambulatory Information System (SIA/SUS). Mortality was assessed from the Global Burden of Disease Study 2019 data. The average annual percentage change (AAPC) in cervical and breast cancer mortality rates, 2010–2018, was calculated by health regions. Results were presented in regional maps. The associations between income, screening coverage and mortality changes were estimated by bivariate spatial correlation. Health regions located in the South and Southeast regions of Brazil had the greatest percentages of screening coverage and highest per capita incomes with the lowest Gini index values. From 2010 to 2018, mortality rates for cervical cancer were highest in the North and Northeast health regions. Breast cancer mortality rates were highest in the South and Southeast health regions. The AAPC in breast and cervical cancer mortality had a negative association with per capita income and screening coverage, and a positive association with the Gini index. There are large regional variations in income, screening coverage, and mortality rates for women with breast and cervical cancer. These inequities could be mitigated by policies to address income disparities and improved access to screening. [ABSTRACT FROM AUTHOR]

The burden of cancer is increasing rapidly in Latin America. Primary care has an essential role in cancer prevention, but implementation levels of prevention practices are not well known. This study evaluated implementation levels and associated factors of cancer preventive practices in primary care over time. The study incorporated a retrospective multicentre cohort study. A population of 59,949 patients registered at three primary care clinics was followed from January 2018 to December 2022 in Santiago, Chile. We studied human papillomavirus (HPV) and hepatitis B virus (HBV) immunisation, brief counselling for smoking cessation and alcohol consumption, and cervical and breast cancer screening practices. Standardised electronic medical records were utilised as the source of information. Social, clinical, and organisational factors associated with prevention practices were studied. The cohort attrition level was 17.1%. Most of the population was of a low socioeconomic status, and 70% visited a primary health centre yearly. Implementation rates of immunisation practices were 90.84% for HPV and 80.94% for HBV in 2022. In contrast, brief counselling for smoking and alcohol consumption was below 20% during the study period. Cervical cancer screening decreased by 25.58% between 2018 and 2022, whereas breast cancer screening reached only 41.71% of the target population. Opportunistic medical visits were strongly associated with brief counselling and breast cancer screening. Implementation practices for cancer prevention in a Chilean primary care cohort are high for immunisation and very low for brief counselling and screening practices. A comprehensive non-medical-based model is needed to improve cancer prevention in primary care. [ABSTRACT FROM AUTHOR]

Bladder cancer is a common malignancy worldwide, with substantial morbidity and mortality. This study aimed to assess the global, regional, and national burden of bladder cancer from 1990 to 2019 using data from the Global Burden of Disease (GBD) 2019 study and to analyze the trends using an age-period-cohort (APC) model. In this cross-sectional study, secondary analyses were conducted to assess the burden of bladder cancer using data from GBD 2019. Bladder cancer prevalence, incidence, mortality, disability-adjusted life years (DALYs), and their age-standardized rates (ASRs) were obtained from the GBD 2019 study. The estimated annual percentage changes (EAPCs) were calculated to quantify the trends in ASRs. An APC analysis was performed to distinguish the effects of age, period, and cohort on the observed temporal trends. The global prevalence of bladder cancer increased substantially from 1990 to 2019, reaching 2,869,046.4 cases (95% UI: 2,614,200.3–3,114,474.4) in 2019. The age-standardized prevalence rate rose from 20.9 per 100,000 population in 1990 to 37.1 per 100,000 population in 2019, with an EAPC of 1.97 (95% CI: 1.93–2.01). The global burden of bladder cancer, as measured by DALYs, increased from 48.0 per 100,000 population in 1990 to 56.8 per 100,000 population in 2019, with an EAPC of 0.47 (95% CI: 0.4–0.53), demonstrating the growing impact of this disease on population health. This study demonstrates a significant increase in prevalence, incidence, mortality, and DALYs, with substantial variations across sociodemographic index (SDI) quintiles and GBD regions. The findings emphasize the need for concerted efforts at the global, regional, and national levels to reduce the burden of bladder cancer through primary prevention, early detection, and improved access to treatment services. [ABSTRACT FROM AUTHOR]

Background The current recommended starting age for gastric cancer screening lacks unified guideline and individualized criteria. We aimed to determine the risk-stratified starting age for gastric cancer screening in China based on individuals' risk profiles and to develop an online calculator for clinical application. Methods In this multicenter, population-based, prospective study, we allocated participants enrolled between 2015 and 2017 (N = 59 771, aged 40-69 years) to screened and unscreened groups and observed them for primary endpoints: gastric cancer occurrence as well as all-cause and gastric cancer–specific death. Median follow-up was 6.07 years. To determine the reference starting age, the effectiveness of gastric cancer screening was assessed by age group after propensity score matching. Further, we categorized the calculated individual risk scores (using well-established risk factors) by quantile. Subsequently, we used age-specific, 10-year cumulative risk curves to estimate the risk-stratified starting age—that is, when the individual's risk level matches the reference starting age risk threshold. Results During follow-up, 475 gastric cancer case patients, 182 gastric cancer–related deaths, and 1860 all-cause deaths occurred. All-cause and gastric cancer–specific mortality decreased among screened individuals 45 years of age and older and 50 to 59 years of age, respectively. Thus, the average population (referent) starting age was set as 50 years. The 10-year cumulative risk of gastric cancer in the average population aged 50 years was 1.147%. We stratified the starting age using 8 risk factors and categorized participants as low-risk, medium-risk, and high-risk individuals whose risk-stratified starting age was 58, 50, and 46 years, respectively. Conclusion Although high-risk individuals warrant starting gastric cancer screening 3 to 5 years earlier than for the average population (aged 50 years), low-risk individuals can tolerate delayed screening. Our online, personalized starting age calculator will help with risk-adapted gastric cancer screening (https://web.consultech.com.cn/gastric/#/). [ABSTRACT FROM AUTHOR]

We conducted a cross-sectional, multicenter study to compare the demographics, clinical characteristics, and lung cancer screening results among individuals eligible for lung cancer screening per 2013 vs 2021 US Preventive Services Task Force recommendations. Statistical tests are 2 sided, with P  less than  .05 considered statistically significant. Among 17 702 screened individuals (85.2% 2013 eligible, 14.8% 2021 newly eligible), a higher proportion of individuals screened per 2021 vs 2013 criteria were female (56.1% vs 48.1%, P  < .001) and non-Hispanic Black (19.3% vs 13.4%, P  < .001). The risk of developing and dying from lung cancer per 1000 people was statistically significantly higher among individuals eligible per 2013 vs 2021 criteria. A higher proportion of lung cancer screening exams had an increased suspicion of lung cancer in the 2013 vs 2021 criteria groups. Our data suggest that, as intended, updated 2021 US Preventive Services Task Force recommendations are leading to a higher proportion of lung cancer screening exams among non-Hispanic Black individuals and women. [ABSTRACT FROM AUTHOR]

Fe3O4 magnetic nanoparticles exhibit significant potential for cancer detection due to their unique magnetic properties and versatility. This review examines their role in enhancing cancer biomarker detection, focusing on synthesis methods, surface modifications and diagnostic accuracy. Fe3O4 nanoparticles serve as sensitive MRI contrast agents, facilitating early cancer diagnosis and improving patient prognosis. Synthesis techniques influence their properties, morphology and dimensions, which affect performance. Surface modifications enhance targeting and reduce immunological reactions, enabling precise biomarker detection and effective drug delivery to tumours, minimizing damage to healthy tissue. Despite these advantages, challenges remain in optimizing delivery efficiency and overcoming medication resistance. Further research is required to understand the pharmacokinetics and pharmacodynamics of these nanoparticles, including their distribution, metabolism and physiological impacts. This review provides insights into the potential of Fe3O4 magnetic nanoparticles as cancer detection agents, aiming to guide future research towards developing safer and more efficient applications in medical diagnostics and treatment. [ABSTRACT FROM AUTHOR]

Language is important in health policy development. Policy changes in Australia to increase cervical screening offers a timely case example to explore the function of inclusive language in health policy. Gender and sexuality diverse people with a cervix have been largely invisible within health promotion programs, which has led to reduced awareness of, and access to, cervical screening. Twenty-eight semi-structured interviews were conducted with 29 key informants between April and October 2022 about the role of inclusive language in cervical screening policy, promotion, and delivery in the context of a national program to promote cervical screening. Three themes were identified from what key informants believed to be the role of inclusive language: (1) the common goal of inclusive language as policy advocacy for broader inclusivity; (2) the inevitable partiality of inclusive language in policy as an opportunity to start conversation; and (3) policy as a bridge between essential but diffuse components of the health sector with multidirectional influences. Inclusive language was seen to operationalise equity in health policy within the broader aim of eliminating cervical cancer among under-screened populations. [ABSTRACT FROM AUTHOR]

This study evaluates the performance of the MaskFormer model for segmenting and classifying breast lesions using ultrasound images, addressing ultrasound's limitations. Ultrasound used for breast cancer detection faces challenges like low image contrast and difficulty in the detection of small or multiple lesions, further complicated by variability based on operator skill. Initial experiments with U-Net and other CNN-based models revealed constraints, such as early plateauing in model loss, which indicated suboptimal learning and performance. In contrast, MaskFormer demonstrated continuous improvement, achieving higher precision in breast lesion segmentation and significantly reducing both false positives and false negatives. Comparative analysis showed MaskFormer's superior performance, with the highest precision and recall rates for malignant lesions and an overall mean average precision (mAP) of 0.943. The model's ability to detect a diverse range of breast lesions, including those potentially missed by the human eye, especially by less experienced practitioners, underscores its potential. These findings suggest that integrating AI models like MaskFormer could greatly enhance ultrasound performance for breast cancer detection, providing reliable, operator-independent image analysis and potentially improving patient outcomes on a global scale. [ABSTRACT FROM AUTHOR]

The development of a sensitive and specific blood test for the early detection of breast cancer is crucial to improve screening and patient outcomes. Existing methods, such as mammography, have limitations, necessitating the exploration of alternative approaches, including circulating factors. Using 598 prospectively collected blood samples, a multivariate plasma-derived lipid biomarker signature was developed that can distinguish healthy control individuals from those with breast cancer. Liquid chromatography with high-resolution and tandem mass spectrometry (LC-MS/MS) was employed to identify lipids for both extracellular vesicle-derived and plasma-derived signatures. For each dataset, we identified a signature of 20 lipids using a robust, statistically rigorous feature selection algorithm based on random forest feature importance applied to cross-validated training samples. Using an ensemble of machine learning models, the plasma 20-lipid signature generated an area under the curve (AUC) of 0.95, sensitivity of 0.91, and specificity of 0.79. The results from this study indicate that lipids extracted from plasma can be used as target analytes in the development of assays to detect the presence of early-stage breast cancer. [ABSTRACT FROM AUTHOR]

Background: Early cancer detection is crucial for improving patient outcomes. Molecular imaging biomarkers offer the potential for non-invasive, early-stage cancer diagnosis. Objectives: To evaluate the effectiveness and accuracy of molecular imaging biomarkers for early cancer detection across various imaging modalities and cancer types. Methods: A comprehensive search of PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus was performed, covering the period from January 2010 to December 2023. Eligibility criteria included original research articles published in English on molecular imaging biomarkers for early cancer detection in humans. The risk of bias for included studies was evaluated using the QUADAS-2 tool. The findings were synthesized through narrative synthesis, with quantitative analysis conducted where applicable. Results: In total, 50 studies were included. Positron emission tomography (PET)-based biomarkers showed the highest sensitivity (mean: 89.5%, range: 82–96%) and specificity (mean: 91.2%, range: 85–100%). Novel tracers such as [68Ga]-PSMA for prostate cancer and [18F]-FES for breast cancer demonstrated promising outcomes. Optical imaging techniques showed high specificity in intraoperative settings. Conclusions: Molecular imaging biomarkers show significant potential for improving early cancer detection. Integration into clinical practice could lead to earlier interventions and improved outcomes. Further research is needed to address standardization and cost-effectiveness. [ABSTRACT FROM AUTHOR]

Background: Lung cancer, also known as lung carcinoma, has a high mortality rate; however, an early prediction helps to reduce the risk. In the current literature, various approaches have been developed for the prediction of lung carcinoma (at an early stage), but these still have various issues, such as low accuracy, high noise, low contrast, poor recognition rates, and a high false-positive rate, etc. Thus, in this research effort, we have proposed an advanced algorithm and combined two different types of deep neural networks to make it easier to spot lung melanoma in the early phases. Methods: We have used WDSI (weakly supervised dense instance-level lung segmentation) for laborious pixel-level annotations. In addition, we suggested an SS-CL (deep continuous learning-based deep neural network) that can be applied to the labeled and unlabeled data to improve efficiency. This work intends to evaluate potential lightweight, low-memory deep neural net (DNN) designs for image processing. Results: Our experimental results show that, by combining WDSI and LSO segmentation, we can achieve super-sensitive, specific, and accurate early detection of lung cancer. For experiments, we used the lung nodule (LUNA16) dataset, which consists of the patients' 3D CT scan images. We confirmed that our proposed model is lightweight because it uses less memory. We have compared them with state-of-the-art models named PSNR and SSIM. The efficiency is 32.8% and 0.97, respectively. The proposed lightweight deep neural network (DNN) model archives a high accuracy of 98.2% and also removes noise more effectively. Conclusions: Our proposed approach has a lot of potential to help medical image analysis to help improve the accuracy of test results, and it may also prove helpful in saving patients' lives. [ABSTRACT FROM AUTHOR]

Objectives: Despite cervical cancer (CC) being a preventable disease, its incidence remains high in marginalized communities due to inequalities that restrict access to health services. This article investigates the experiences, perceptions, and attitudes regarding the screening of indigenous women in a region of the Colombian Amazon during a cervical cancer prevention initiative facilitated by community participation. Design: Qualitative study based on interviews conducted with women and indigenous leaders from Paujil reserve. They participated in research focused on cervical cancer prevention, which employed a methodology of collaboration between academia and communities aimed at enhancing women's health and reducing inequalities in access to healthcare services. The analysis utilized a deductive and inductive approach. Results: Five main themes were addressed: 'Barriers within health services'; 'Individual and cultural constraints'; 'Motivations and facilitators'; 'Positive experiences within the research framework'; and 'Suggestions for encouraging women's participation.' Challenges related to appointment scheduling and result delivery were frequently cited as obstacles to access. Misinformation, feelings of shame, fear, and distrust towards health services played significant roles in the reluctance to undergo screening. Factors such as support from family and community networks, respectful treatment, ease of scheduling appointments, the presence of female healthcare professionals, and involvement of leaders fluent in indigenous languages were identified as positive facilitators of screening acceptance. Conclusion: Understanding the factors that influence access to screening is crucial for reducing inequalities in service delivery for indigenous women. The involvement of trained leaders who can identify these factors and motivate women can have a positive impact on the acceptance and guidance of cervical cancer prevention programs. [ABSTRACT FROM AUTHOR]

Simple Summary: This study focused on the identification of rare variants that are associated with high-risk colorectal cancer (CRC) from the Middle Eastern region. This study analyzed DNA samples from 146 patients with CRC and from 1395 healthy individuals. We identified rare inactivating variants in the APC gene that are strongly linked to CRC, increasing the risk approximately 60-fold. Other significant genes harboring rare damaging variants were also identified. These results may have implications for genetic counseling and the early detection of CRC in the Middle Eastern population. Background: Colorectal cancer (CRC) displays a complex pattern of inheritance. It is postulated that much of the missing heritability of CRC is enriched in high-impact rare alleles, which might play a crucial role in the etiology and susceptibility of CRC. Methods: In this study, an exome-wide association analysis was performed in 146 patients with high-risk CRC in the Middle East and 1395 healthy controls. The aim was to identify rare germline variants in coding regions and their splicing sites associated with high-risk CRC in the Middle Eastern population. Results: Rare inactivating variants (RIVs) in APC had the strongest association with high-risk CRC (6/146 in cases vs. 1/1395 in controls, OR = 59.7, p = 5.13 × 10−12), whereas RIVs in RIMS1, an RAS superfamily member, were significantly associated with high-risk CRC (5/146 case vs. 2/1395 controls, OR = 24.7, p = 2.03 × 10−8). Rare damaging variants in 17 genes were associated with high-risk CRC at the exome-wide threshold (p < 2.5 × 10−6). Based on the sequence kernel association test, nonsynonymous variants in six genes (TNXB, TAP2, GPSM3, ADGRG4, TMEM229A, and ANKRD33B) had a significant association with high-risk CRC. RIVs in APC—the most common high-penetrance genetic factor—were associated with patients with high-risk CRC in the Middle East. Individuals who inherited APC RIVs had an approximate 60-fold increased risk of developing CRC and were likely to develop the disease earlier. Conclusions: We identified new potential CRC predisposition variants in other genes that could play a role in CRC inheritance. However, large collaborative studies are needed to confirm the association of these variants with high-risk CRC. These results provide information for counseling patients with high-risk CRC and their families in our population. [ABSTRACT FROM AUTHOR]

Simple Summary: Environmental pollution caused by nano- and microplastics (MPs) is widespread and has become a global issue. There is a confirmed accumulation of MPs in animal and human tissues, raising concerns about potential health effects. The accumulation of NMPs in human tissues, as well as their genotoxicity, mutagenicity, and impact on cancer development, is a relatively new area of research that presents several challenges, mainly related to instrumental limitations and ensuring quality assurance and quality control (QA/QC) in studies of both exposure and subsequent fate in the body, such as translocation and possible accumulation. Background: Humans cannot avoid plastic exposure due to its ubiquitous presence in the natural environment. The waste generated is poorly biodegradable and exists in the form of MPs, which can enter the human body primarily through the digestive tract, respiratory tract, or damaged skin and accumulate in various tissues by crossing biological membrane barriers. There is an increasing amount of research on the health effects of MPs. Most literature reports focus on the impact of plastics on the respiratory, digestive, reproductive, hormonal, nervous, and immune systems, as well as the metabolic effects of MPs accumulation leading to epidemics of obesity, diabetes, hypertension, and non-alcoholic fatty liver disease. MPs, as xenobiotics, undergo ADMET processes in the body, i.e., absorption, distribution, metabolism, and excretion, which are not fully understood. Of particular concern are the carcinogenic chemicals added to plastics during manufacturing or adsorbed from the environment, such as chlorinated paraffins, phthalates, phenols, and bisphenols, which can be released when absorbed by the body. The continuous increase in NMP exposure has accelerated during the SARS-CoV-2 pandemic when there was a need to use single-use plastic products in daily life. Therefore, there is an urgent need to diagnose problems related to the health effects of MP exposure and detection. Methods: We collected eligible publications mainly from PubMed published between 2017 and 2024. Results: In this review, we summarize the current knowledge on potential sources and routes of exposure, translocation pathways, identification methods, and carcinogenic potential confirmed by in vitro and in vivo studies. Additionally, we discuss the limitations of studies such as contamination during sample preparation and instrumental limitations constraints affecting imaging quality and MPs detection sensitivity. Conclusions: The assessment of MP content in samples should be performed according to the appropriate procedure and analytical technique to ensure Quality and Control (QA/QC). It was confirmed that MPs can be absorbed and accumulated in distant tissues, leading to an inflammatory response and initiation of signaling pathways responsible for malignant transformation. [ABSTRACT FROM AUTHOR]

Simple Summary: Patients with advanced stages of breast cancer are at high risk of the cancer metastasizing or spreading to areas of the central nervous system, including the brain, cerebrospinal fluid, and the protective tissue layers of the brain, termed leptomeninges. Although guidelines recommend screening for central nervous system disease in other cancers, such as non-small cell lung cancer, there are no such recommendations for patients with breast cancer unless they have symptoms such as headaches, weakness, or vomiting. This review discusses the evidence behind screening for breast cancer that has spread to the central nervous system, as well as new methods of diagnosis, including specialized imaging, serum testing, and cerebrospinal fluid analysis. Brain and leptomeningeal metastases are complications of breast cancer with high rates of morbidity and mortality and have an estimated incidence of up to 30%. While National Comprehensive Cancer Network (NCCN) guidelines recommend screening for central nervous system metastasis in other neurotropic cancers such as non-small cell lung cancer, there are no such recommendations for asymptomatic breast cancer patients at any stage of disease. This review highlights ongoing studies into screening and diagnostics for breast cancer with brain and leptomeningeal metastasis (BCBLM) as they relate to patient outcomes and prognostication. These include imaging methods such as MRI with novel contrast agents with or without PET/CT, as well as 'liquid biopsy' testing of the cerebrospinal fluid and serum to analyze circulating tumor cells, genomic material, proteins, and metabolites. Given recent advances in radiation, neurosurgery, and systemic treatments for BCBLM, screening for CNS involvement should be considered in patients with advanced breast cancer as it may impact treatment decisions and overall survival. [ABSTRACT FROM AUTHOR]

Simple Summary: A CRISPR knockout screen was performed targeting all genes of the human genome with about 12 knockout sgRNAs each. By comparing pancreatic cancer cells with high or low metastatic capacity, genes were identified that affect the viability of metastatic cells while not affecting cell viability of non-metastatic cells. Further functional studies looked at some of the identified candidate genes. For one of the metastasis-related genes—MYBL2—a change in its interaction with another regulator gene was found to be implicated in metastasis. Background/Objectives: Early and aggressive metastasis is a major feature of pancreatic ductal adenocarcinoma. Understanding the processes underlying metastasis is crucial for making a difference to disease outcome. Towards these ends, we looked in a comprehensive manner for genes that are metastasis-specific. Methods: A genome-wide CRISPR-Cas9 gene knockout screen with 259,900 single guide RNA constructs was performed on pancreatic cancer cell lines with very high or very low metastatic capacity, respectively. Functional aspects of some of the identified genes were analysed in vitro. The injection of tumour cells with or without a gene knockout into mice was used to confirm the effect on metastasis. Results: The knockout of 590 genes—and, with higher analysis stringency, 67 genes—affected the viability of metastatic cells substantially, while these genes were not vital to non-metastasizing cells. Further evaluations identified different molecular processes related to this observation. One of the genes was MYBL2, encoding for a well-known transcription factor involved in the regulation of cell survival, proliferation, and differentiation in cancer tissues. In our metastasis-focussed study, no novel functional activity was detected for MYBL2, however. Instead, a metastasis-specific transformation of its genetic interaction with FOXM1 was observed. The interaction was synergistic in cells of low metastatic capacity, while there was a strong switch to a buffering mode in metastatic cells. In vivo analyses confirmed the strong effect of MYBL2 on metastasis. Conclusions: The genes found to be critical for the viability of metastatic cells form a basis for further investigations of the processes responsible for triggering and driving metastasis. As shown for MYBL2, unexpected processes of regulating metastasis might also be involved. [ABSTRACT FROM AUTHOR]

Simple Summary: Lynch syndrome (LS) is an autosomal dominant disorder linked to increased risks of colorectal and endometrial cancers, caused by pathogenic variants in MMR genes (MLH1, MSH2, MSH6). In a cohort of 42,828 participants from the Taiwan Precision Medicine Initiative (TPMI), 89 individuals carried MMR gene variants: 25% MLH1, 53% MSH2, and 22% MSH6, with a prevalence of 1 in 481. Cancer incidence rates were 40.9% for MLH1, 29.8% for MSH2, and 40% for MSH6 carriers. Colonoscopy screening revealed no significant differences in polyp prevalence compared to controls. The study underscores the need for improved LS diagnosis and surveillance in the Taiwanese population. Lynch syndrome (LS) is an autosomal dominant disorder characterized by increased risks of colorectal and endometrial cancers. LS is defined by pathogenic variants in mismatch repair (MMR) genes, including MLH1, MSH2, and MSH6. Data on the prevalence and associated cancer risks of LS in the Han Chinese population remain limited. In this study, using a broad biobank approach through the Taiwan Precision Medicine Initiative (TPMI), we identified LS-associated MMR gene variants within a cohort of 42,828 participants from a Taiwanese medical center. A total of 89 individuals were found to carry pathogenic MMR variants: MLH1 (n = 22, 25%), MSH2 (n = 47, 53%), and MSH6 (n = 20, 22%). The overall prevalence of MMR variants was calculated, and cancer incidence rates among carriers were determined. The prevalence of MMR variants in the study population was 1 in 481. The distribution of MLH1, MSH2, and MSH6 variants were 24.7%, 52.8%, and 22.5%, respectively. Cumulative cancer incidence rates of carriers were 40.9% for MLH1 carriers, 29.8% for MSH2, and 40% for MSH6. Among the 19 individuals who underwent colonoscopy screening, the prevalence of polyps was similar to that of the control group (adenoma detection rate: 32% vs 26%, p = 0.585). A meticulous analysis of the detected polyps in seven participants, considering factors such as location, size, morphology, and pathological features, showed no significant differences from controls. A significant cancer risk is associated with LS-related MMR variants in the Taiwanese population. The apparent under diagnosis of LS highlights the urgent need for enhanced surveillance and genetic counseling in this demographic. Our findings suggest that adjustments in the current screening protocols may be warranted to better identify and manage at-risk individuals. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate cancer (PCa) is a heterogeneous disease and the second most diagnosticated cancer in men. Epidemiological information is essential to adopt the strategy of early detection. In Mexico there is paucity of epidemiological data. We observed that Mexican men present aggressive disease at diagnosis with metastatic symptoms. Seems the Mexican race is a risk factor for PCa, as African men. "OPUS program " is the actual screening protocol for Mexican men. We describe the concernment of early detection of PCa in the Mexican population to reduce the rate of metastases. Introduction: Epidemiological data are crucial for adopting primary and secondary prevention strategies and to develop screening protocols against prostate cancer (PCa). Despite the comprehensive characterization of PCa across White and Black men, there is a lack of data from the Mexican population. This manuscript presents data from the Can.Prost registry that captures PCa trends over the past two decades in Mexico City; furthermore, we aimed to compare clinical differences and oncological outcomes before and after the promotion of early detection actions through a campaign against PCa that occurred in 2014. Methods: A retrospective observational study on newly diagnosed Mexican PCa patients was carried out at the Instituto Nacional de Cancerología (INCan) in Mexico City. During 2014 and 2015, a project for the early diagnosis of PCa ("OPUS program") was launched in the aforementioned tertiary hospital. Starting at the age of 45 years, all men were invited for a PSA measurement and a specialist urologist consultation. All individuals with clinical or biochemical suspicion of PCa (PSA > 4 ng/mL), in the context of age and prostate volume, underwent ultrasound-guided transrectal prostate biopsy. Then, patients with pathologically confirmed prostate cancer were stratified according to the year of diagnosis: Group A accounted for those diagnosed between 2000 and 2014 and Group B for those patients diagnosed in the timeframe of 2015–2021. Comparisons of PCa characteristics, treatment modalities and oncologic outcomes between Group A and B were performed. Results: Overall, we collected data from 2759 PCa patients from 2000 to 2021. The median PSA at baseline was 32 ng/mL, and 25% had a family history of PCa. Overall, 25.8% were asymptomatic and 46% had a non-metastatic presentation. After the OPUS campaign, PSA at diagnosis was significantly lower across all age groups. The incidence of PCa diagnosis in asymptomatic men was higher (31.4% vs. 19.9%) and a higher proportion of men were diagnosed with organ-confined, palpable disease (46% vs. 28%) (p < 0.001). The rate of patients eligible for active/radical treatment was higher after the OPUS campaign (patients who received surgery increased from 12.78% to 32.41%; patients who underwent radiation increased from 28.38% to 49.61%). The proportion of patients diagnosed with non-clinically significant disease was negligible and remained stable across time. Conclusions: PCa in Mexican patients displays aggressive features at diagnosis, whereas the rate of non-significant disease is negligible. The introduction of early detection strategies may lead to lower symptomatic and metastatic PCa and higher opportunities for radical treatment. This emphasizes the need for public awareness and for adjustment of screening strategies to the peculiarities of the Mexican population. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate cancer is the second most common cancer diagnosed in men and yet is the second leading cause of cancer-related deaths worldwide. This is often due to the cancer being misdiagnosed as benign prostatic hyperplasia or missed entirely due to the limited nature of the most popular detection method, prostate-specific antigen levels. The aim of this study was to assess the potential of G-protein-coupled receptor-associated sorting protein 1 (GASP-1) as a valid prostate cancer biomarker. Prostate tissue samples from healthy, benign prostatic hyperplasia, and prostate cancer patients were subjected to anti-GASP-1 polyclonal antibodies in immunohistochemical staining and enzyme-linked immunosorbent assay analyses, showing that GASP-1 levels were significantly greater in prostate cancer patients when compared to benign prostatic hyperplasia and healthy patients. Specifically in prostate cancer patients, there was a positive correlation between GASP-1 overexpression and the severity of the prostate cancer. Background/Objectives: Prostate cancer (PCa) is a prevalent malignancy, necessitating accurate diagnostic methods to distinguish it from benign conditions such as benign prostatic hyperplasia (BPH). Current diagnostic tools, relying primarily on serum prostate-specific antigen (PSA) levels, lack specificity, leading to an over-diagnosis and unnecessary treatment of patients with benign conditions. This study explores G-protein-coupled receptor-associated sorting protein 1 (GASP-1) as a more sensitive biomarker for PCa detection. Methods: Prostate tissue microarrays of healthy, BPH, and prostate cancer patients with different Gleason scores were studied. Polyclonal antibodies targeted against GASP-1 were used for routine immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA) analyses. Results: The results indicated a 5-fold difference in serum GASP-1 levels between BPH and PCa, which was validated through GASP-1 IHC. Furthermore, a novel scoring system, the H-score, assesses GASP-1 granules' intensity and size, revealing a clear distinction between BPH and PCa. An additional analysis of GASP-1 expression between PCa cases with different Gleason scores reveals that GASP-1 overexpression correlates with PCa severity, providing insights into disease progression. Conclusions: The study supports GASP-1′s role as a promising diagnostic marker, supplementing PSA testing, and offering improved risk stratification for PCa. Additionally, an open-source software system is introduced for an efficient GASP-1 granule color analysis, enhancing diagnostic accuracy. [ABSTRACT FROM AUTHOR]