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Early detection of pancreatic cancer has been shown to improve patient survival rates. However, effective early detection tools to detect pancreatic cancer do not currently exist. The Avantect Pancreatic Cancer Test, leveraging the 5-hydroxymethylation [5-hydroxymethylcytosine (5hmC)] signatures in cell-free DNA, was developed and analytically validated to address this unmet need. We report a comprehensive analytical validation study encompassing precision, sample stability, limit of detection, interfering substance studies, and a comparison with an alternative method. The assay performance on an independent case-control patient cohort was previously reported with a sensitivity for early-stage (stage I/II) pancreatic cancer of 68.3% (95% CI, 51.9%-81.9%) and an overall specificity of 96.9% (95% CI, 96.1%-97.7%). Precision studies showed a cancer classification of 100% concordance in biological replicates. The sample stability studies revealed stable assay performance for up to 7 days after blood collection. The limit of detection studies revealed equal results between early- and late-stage cancer samples, emphasizing strong early-stage performance characteristics. Comparisons of concordance of the Avantect assay with the enzymatic methyl sequencing (EM-Seq) method, which measures both methylation (5-methylcytosine) and 5hmC, were >95% for all samples tested. The Avantect Pancreatic Cancer Test showed strong analytical validation in multiple validation studies required for laboratory-developed test accreditation. The comparison of 5hmC versus EM-Seq further validated the 5hmC approach as a robust and reproducible assay., Competing Interests: Disclosure Statement All authors are employees of ClearNote Health., (Copyright © 2024 Association for Molecular Pathology and American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)

Objective: To examine changes in late- versus early-stage diagnosis of cancer associated with the introduction of mandatory Medicaid managed care (MMC) in Pennsylvania., Data Sources and Study Setting: We analyzed data from the Pennsylvania cancer registry (2010-2018) for adult Medicaid beneficiaries aged 21-64 newly diagnosed with a solid tumor. To ascertain Medicaid and managed care status around diagnosis, we linked the cancer registry to statewide hospital-based facility records collected by an independent state agency (Pennsylvania Health Care Cost Containment Council)., Study Design: We leveraged a natural experiment arising from county-level variation in mandatory MMC in Pennsylvania. Using a stacked difference-in-differences design, we compared changes in the probability of late-stage cancer diagnosis among those residing in counties that newly transitioned to mandatory managed care to contemporaneous changes among those in counties with mature MMC programs., Data Collection/extraction Methods: N/A., Principal Findings: Mandatory MMC was associated with a reduced probability of late-stage cancer diagnosis (-3.9 percentage points; 95% CI: -7.2, -0.5; p = 0.02), particularly for screening-amenable cancers (-5.5 percentage points; 95% CI: -10.4, -0.6; p = 0.03). We found no significant changes in late-stage diagnosis among non-screening amenable cancers., Conclusions: In Pennsylvania, the implementation of mandatory MMC for adult Medicaid beneficiaries was associated with earlier stage of diagnosis among newly diagnosed cancer patients with Medicaid, especially those diagnosed with screening-amenable cancers. Considering that over half of the sample was diagnosed with late-stage cancer even after the transition to mandatory MMC, Medicaid programs and managed care organizations should continue to carefully monitor receipt of cancer screening and design strategies to reduce barriers to guideline-concordant screening or diagnostic procedures., (© 2024 Health Research and Educational Trust.)

Background and Aims: Screening colonoscopy, recommended every 10 years, reduces mortality from colorectal cancer (CRC) by early detection of prevalent but undiagnosed CRC, as well as by removal of precursor lesions. The aim of this study was to assess the relative contribution of both components to total CRC mortality reduction over time., Methods: Using a validated multistate Markov model, we simulated hypothetical cohorts of 100,000 individuals aged 55 to 64 years with and without screening at baseline. Main outcomes included proportions of prevented CRC deaths arising from (asymptomatic) CRC already present at baseline and from newly developed CRC during 15 years of follow-up, and mortality rate ratios of screened versus nonscreened groups over time., Results: Early detection of prevalent cases accounted for 52%, 30%, and 18% of deaths prevented by screening colonoscopy within 5, 10, and 15 years, respectively. Relative reduction of mortality was estimated to be much larger for mortality from incident cancers than for mortality from cancers that were already present and detected early at screening endoscopy and for total CRC mortality (ie, 88% versus 67% and 79%, respectively, within 10 years from screening)., Conclusions: Reduction of CRC mortality mainly arises from early detection of prevalent cancers during the early years after screening colonoscopy, but prevention of incident cases accounts for the majority of prevented deaths in the longer run. Prevention of incident cases leads to sustained strong reduction of CRC mortality, possibly warranting an extension of screening intervals., Competing Interests: Disclosure All authors disclosed no financial relationships. Financial support for this study was provided in part by grants by the German Federal Ministry of Education and Research (grant no. 01GL1712) and German Cancer Aid (grant no 70114735). The funding agreements ensured the authors’ independence in designing the study, interpreting the data, and writing and publishing the report., (Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Background: There are 54,000 new cases of oral cavity and oropharyngeal cancer in the United States and more than 476,000 worldwide each year. Oral cavity and oropharyngeal squamous cell carcinoma make up most tumors with five-year survival rates of 50% due to prevalence of late-stage diagnoses. Improved methods of early detection in high-risk individuals are urgently needed. We aimed to assess the tumorigenic biomarkers soluble CD44 (solCD44) and total protein (TP) measured using oral rinses as affordable convenient screening tools for cancer detection., Methods: In this prospective cohort study, we recruited 150 healthy current or former smokers through a community screening program. Baseline and four annual visits were conducted from March 2011-January 2016 with records followed until August 2020. Participants provided oral rinses, received head and neck exams, and completed questionnaires. SolCD44 and TP levels were measured and compared across groups and time. Participants were placed in the cancer group if malignancy developed in the study period, the suspicious group if physical exams were concerning for premalignant disease or cancer in the head and neck, and the healthy group if there were no suspicious findings. This analysis used two-sample t-test for comparison of means and two-sample Wilcoxon Test for comparison of medians. For subjects with follow-ups, estimated means of biomarkers were obtained from a fitted Repeated Measures Analysis of Variance (RANOVA) model including group, visit, and their interaction. Pairwise comparisons of mean solCD44 were made, including intergroup and intragroup comparison of values at different years., Results: Most participants were males (58.7%), < 60 years of age. (90.7%), and Black (100%). Baseline mean solCD44 was elevated (2.781 ng/ml) in the cancer group compared to the suspicious group (1.849 ng/ml) and healthy group (1.779 ng/ml)., Conclusion: This study supports the feasibility of a CD44-based oral rinse test as an affordable and convenient adjunctive tool for early detection of aerodigestive tract and other cancers in high-risk populations., (© 2024. The Author(s).)

Background: Diagnostic blood tests have the potential to identify lung cancer in people at high risk. We assessed the cost-effectiveness of a lung cancer screening intervention, using the EarlyCDT ® -Lung Test (ECLS) with subsequent X-ray and low-dose chest CT scans (LDCT) for patients with a positive test result, compared to both usual care and LDCT screening for the target population., Methods: We conducted a model-based lifetime analysis from a UK NHS and personal social services perspective. We estimated incremental net monetary benefit (NMB) for the ECLS intervention compared to no screening and to LDCT screening., Results: The incremental NMB of ECLS intervention compared to no screening was GBP 33,179 (95% CI: -GBP 81,396, GBP 147,180) and GBP 140,609 (95% CI: -GBP 36,255, GBP 316,612), respectively, for a cost-effectiveness threshold of GBP 20,000 and GBP 30,000 per quality-adjusted life year. The same figures compared with LDCT screening were GBP 162,095 (95% CI: GBP 52,698, GBP 271,735) and GBP 52,185 (95% CI: -GBP 115,152, GBP 219,711)., Conclusions: The ECLS intervention is the most cost-effective screening alternative, with the highest probability of being cost-effective, when compared to no screening or LDCT screening. This result may change with modifications of the parameters, suggesting that the three alternatives considered in the main analysis are potentially cost-effective., Competing Interests: All authors report grants from Oncimmune Ltd., and grants from the Scottish Government Health & Social Care Directorate of the Chief Scientist Office (CSO), during the conduct of the study.

Strategies for early detection and interception of cancer are based on 2 synergistic elements: proactive search for asymptomatic cancer, precancer, or cancer predisposition and proactive disruption of cancer evolution. Benefits and harms of both these elements will vary widely depending on the screened populations, the types of cancers targeted, the detection modalities, and the health care delivery approaches following diagnosis. This article attempts to identify common elements that can inform the evaluation of alternative strategies across many of these scenarios., Competing Interests: Disclosure G. Parmigiani is cofounder of Phaeno Biotechnologies, consultant for Delfi Diagnostics, and scientific collaborator of Ambry Genetics. We acknowledge the Lavine family for generous support., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Abstract Background There are 54,000 new cases of oral cavity and oropharyngeal cancer in the United States and more than 476,000 worldwide each year. Oral cavity and oropharyngeal squamous cell carcinoma make up most tumors with five-year survival rates of 50% due to prevalence of late-stage diagnoses. Improved methods of early detection in high-risk individuals are urgently needed. We aimed to assess the tumorigenic biomarkers soluble CD44 (solCD44) and total protein (TP) measured using oral rinses as affordable convenient screening tools for cancer detection. Methods In this prospective cohort study, we recruited 150 healthy current or former smokers through a community screening program. Baseline and four annual visits were conducted from March 2011-January 2016 with records followed until August 2020. Participants provided oral rinses, received head and neck exams, and completed questionnaires. SolCD44 and TP levels were measured and compared across groups and time. Participants were placed in the cancer group if malignancy developed in the study period, the suspicious group if physical exams were concerning for premalignant disease or cancer in the head and neck, and the healthy group if there were no suspicious findings. This analysis used two-sample t-test for comparison of means and two-sample Wilcoxon Test for comparison of medians. For subjects with follow-ups, estimated means of biomarkers were obtained from a fitted Repeated Measures Analysis of Variance (RANOVA) model including group, visit, and their interaction. Pairwise comparisons of mean solCD44 were made, including intergroup and intragroup comparison of values at different years. Results Most participants were males (58.7%),

Cancer is becoming a global pandemic, and its occurrence is increasing rapidly, putting a strain on people's families, health systems, and finances, in addition to their physical, mental, and emotional well-being. Many cancer types lack screening programs, and many people at high risk of developing cancer do not follow recommended medical screening regimens because of the nature of currently available screening tests and other compliance issues, despite cancer being the second leading cause of death worldwide. Furthermore, a lot of liquid biopsy methods for early cancer screening are not sensitive enough to catch cancer early. Cancer treatment costs increase with the time it takes to diagnose the disease; therefore, early detection is essential to enhance the quality of life and survival rates. The current status of the liquid biopsy sector is examined in this paper., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Hypoxia is a pathophysiological condition characterized by oxygen deficiency in tissues, which negatively affects normal biological functions. It is a typical microenvironment character of almost all solid tumours. Noncoding RNA are small functional RNA molecules that regulate gene expression at chromatin and posttranscriptional levels. Micro-RNAs (miRNAs) are a type of noncoding RNA and are ~12-22 nucleotides long that are crucial in regulating gene expression by partnering with the mRNAs of protein-coding genes. It is widely reported that miRs play an important role in various key processes and pathways during tumour formation, as well as advancement in hypoxic tumors by influencing the HIF pathway. The role of miRNAs in hypoxic tumours, namely in pancreatic, kidney, breast, lung and colorectal, are described. These miRNAs have immense potential as diagnostic and prognostic biomarkers for early cancer detection., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The early detection of cancers can significantly change outcomes even with existing treatments. However, ~50% of cancers still cannot be detected until they reach an advanced stage, highlighting the great challenges in the early detection. Here, an ultrasensitive deep near-infrared (dNIR) nanoprobe that is successively responsive to tumor acidity and hypoxia is reported. It is demonstrated that the new nanoprobe specifically detects tumor hypoxia microenvironment based on deep NIR imaging in ten different types of tumor models using cancer cell lines and patient-tissue derived xenograft tumors. By combining the acidity and hypoxia specific two-step signal amplification with a deep NIR detection, the reported nanoprobe enables the ultrasensitive visualization of hundreds of tumor cells or small tumors with a size of 260 µm in whole-body imaging or 115 µm metastatic lesions in lung imaging. As a result, it reveals that tumor hypoxia can occur as early as the lesions contain only several hundred cancer cells., (© 2023 Wiley-VCH GmbH.)

Cancer is a formidable threat to human life, a cure for which in advanced stages remains challenging. Early detection and treatment of cancer are paramount, yet a substantial number of cancer patients receive diagnoses at an advanced stage, resulting in a lower 5-year survival rate. Early-stage cancers, however, frequently elude detection. Conventional tumor screening techniques, such as tumor biopsy, serve as essential means for an early cancer diagnosis. However, these procedures are invasive and may inadvertently facilitate cancer metastasis. A current research focal point involves liquid biopsy technologies, offering a potential solution to mitigate the above-mentioned issues, but often exhibiting low sensitivity. A research team from the Massachusetts Institute of Technology has recently pioneered an innovative approach to enhance the sensitivity of liquid biopsy for cancer diagnosis. By administering a pre-treatment agent 1–2 h prior to sampling, a greater than 10-fold increase in collected ctDNA was obtained. Subsequent tumor analysis using ctDNA not only demonstrated heightened sensitivity in detecting small tumors (>75%) but also presented a promising avenue for early clinical cancer detection and diagnosis. This discovery holds significant potential for advancing the prospects of early cancer detection, diagnosis, and treatment.

Background: Diagnostic blood tests have the potential to identify lung cancer in people at high risk. We assessed the cost-effectiveness of a lung cancer screening intervention, using the EarlyCDT®-Lung Test (ECLS) with subsequent X-ray and low-dose chest CT scans (LDCT) for patients with a positive test result, compared to both usual care and LDCT screening for the target population. Methods: We conducted a model-based lifetime analysis from a UK NHS and personal social services perspective. We estimated incremental net monetary benefit (NMB) for the ECLS intervention compared to no screening and to LDCT screening. Results: The incremental NMB of ECLS intervention compared to no screening was GBP 33,179 (95% CI: −GBP 81,396, GBP 147,180) and GBP 140,609 (95% CI: −GBP 36,255, GBP 316,612), respectively, for a cost-effectiveness threshold of GBP 20,000 and GBP 30,000 per quality-adjusted life year. The same figures compared with LDCT screening were GBP 162,095 (95% CI: GBP 52,698, GBP 271,735) and GBP 52,185 (95% CI: −GBP 115,152, GBP 219,711). Conclusions: The ECLS intervention is the most cost-effective screening alternative, with the highest probability of being cost-effective, when compared to no screening or LDCT screening. This result may change with modifications of the parameters, suggesting that the three alternatives considered in the main analysis are potentially cost-effective.

In evidence-based medicine frameworks, the highest level of evidence is derived from quantitative synthesis of double-masked, high-quality, randomly assigned controlled trials. Meta-analyses of randomly assigned controlled trials have demonstrated that screening mammography reduces breast cancer deaths. In the United States, every major guideline-producing organization has recommended screening mammography in average-risk women; however, there are controversies about age and frequency. Carefully controlled observational research studies and statistical modeling studies can address evidence gaps and inform evidence-based, contemporary screening practices. As breast imaging radiologists develop and evaluate existing and new screening tests and technologies, they will need to understand the key methodological considerations and scientific criteria used by policy makers and health service researchers to support dissemination and implementation of evidence-based screening tests. The Wilson and Jungner principles and the U.S. Preventive Services Task Force general analytic framework provide structured evaluations of the effectiveness of screening tests. Key considerations in both frameworks include public health significance, natural history of disease, cost-effectiveness, and characteristics of screening tests and treatments. Rigorous evaluation of screening tests using analytic frameworks can maximize the benefits of screening tests while reducing potential harms. The purpose of this article is to review key methodological considerations and analytic frameworks used to evaluate screening studies and develop evidence-based recommendations., (© Society of Breast Imaging 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Colorectal cancer (CRC) screening can reduce both CRC incidence and mortality, and faecal immunochemical testing (FIT)-based screening programmes are therefore now being implemented in many countries. However, social inequality in FIT-based screening participation is well documented, and initiatives to address this challenge are understudied. We explored the perceptions of CRC screening and the perceived barriers and facilitators towards FIT-based CRC screening among men visiting a drop-in centre for people with severe social problems in Denmark., Methods: The study was a qualitative interview study. Participants were sixteen men visiting a drop-in centre in Denmark. A local staff member provided supplementary information and assisted with the recruitment process. The interviews were transcribed verbatim, followed by an inductive content analysis., Results: The men were often dealing with health and social problems, and they often had low self-esteem. At first, they stated that they did not think much about cancer and their own risk of being diagnosed with it. They argued that they had little time, energy, and resources to participating in, for example, CRC screening programmes, and barriers to participating were facts of life such as comorbidity and cognitive difficulties. Further, they were not sure how to participate, and some misunderstood the concept of screening. However, during the interviews, the main part of the participants became very keen to participate, and they suggested that in the future, they could receive regular information about cancer screening in face-to-face interactions with someone who cared and was interested in helping them., Conclusion: Men in a vulnerable position visiting a drop-in centre were interested in CRC screening. If we intervene in a way that meets the needs among these vulnerable citizens, it may contribute to reducing social inequality in FIT-based CRC screening programmes., (© 2024. The Author(s).)

Background: This cross-sectional study explored how masculinity beliefs may influence colorectal cancer (CRC) screening participation among ethnic subgroups of screening-age-eligible (45-75 years) Hispanic/Latino men., Methods: Using a consumer panel, we recruited self-identified Hispanic/Latino men fluent in English or Spanish, and residing in Florida, New York, or Texas. The Masculinity Barriers to Medical Care (MBMC) scale and its six subscales were used to assess masculinity beliefs. Multivariable logistic regression was used to estimate the association between MBMC and CRC screening participation, adjusting for Hispanic/Latino subgroup, marital status, survey language, age group, and health insurance status. Results were then stratified by Hispanic/Latino subgroup., Results: Of the participants (n=611), approximately 31% identified as Puerto Rican, 30% as other Hispanic/Latino, 26% as Mexican, and 14% as Cuban; 63% had ever been screened for CRC. We found no differences in the prevalence of screening participation by Hispanic/Latino subgroup. The majority of participants had completed both a stool-based test and an exam-based screening test (29.3%). After adjusting for confounding, MBMC reduced the odds of screening participation. Slight MBMC-subscale differences were observed by Hispanic/Latino subgroup. For example, higher scores on the Restrictive Emotionality subscale were associated with a lower likelihood of screening participation among Puerto Rican men, but higher odds of screening for Cuban men., Conclusions: Masculinity barriers to CRC screening may exist. Tailored interventions to address masculinity barriers among specific Latino subgroups may improve CRC screening uptake in this population., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Background: Early detection of lung cancer reduces cancer mortality; yet uptake for lung cancer screening (LCS) has been limited in Washington State. Geographic disparities contribute to low uptake, but do not wholly explain gaps in access for underserved populations. Other factors, such as an adequate workforce to meet population demand and the capacity of accredited screening facility sites, must also be considered., Research Question: What proportion of the eligible population for LCS has access to LCS facilities in Washington State?, Study Design and Methods: We used the enhanced two-step floating catchment area (E2SFCA) model to evaluate how geographic accessibility in addition to availability of LCS imaging centers contribute to disparities. We used available data on radiologic technologist volume at each American College of Radiology (ACR)-accredited screening facility site to estimate the capacity of each site to meet potential population demand. Spearman rank correlation coefficients of the spatial access ratios were compared with the 2010 Rural-Urban Commuting Area codes and area deprivation index quintiles to identify characteristics of populations at risk for lung cancer with greater and lesser levels of access., Results: A total of 549 radiologic technologists were identified across the 95 ACR-accredited screening facilities. We observed that 95% of the eligible population had proximate geographic access to any ACR facility. However, when we incorporated the E2SFCA method, we found significant variation of access for eligible populations. The inclusion of the availability measure attenuated access for most of the eligible population. Furthermore, we observed that rural areas were substantially correlated, and areas with greater socioeconomic disadvantage were modestly correlated, with lower access., Interpretation: Rural and socioeconomically disadvantaged areas face significant disparities. The E2SFCA models demonstrated that capacity is an important component and how geographic access and availability jointly contribute to disparities in access to LCS., Competing Interests: Financial/Nonfinancial Disclosures None declared, (Copyright © 2024 American College of Chest Physicians. All rights reserved.)

Background and Objective: Despite the proven effectiveness of organized PSA-based screening in reducing prostate cancer-related mortality, there is currently no program in Germany covered by statutory health insurance. In accordance with the EU Council Decision (2022/0290(NLE)), the German Society of Urology (DGU) has developed a concept for risk-adapted prostate cancer early detection., Materials and Methods: Based on a literature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed., Results: Risk-adapted prostate cancer screening involves PSA testing in the age group of 45-70 years, followed by PSA-based individual risk stratification and stepwise expansion of diagnostics through magnetic resonance imaging (MRI) to biopsy. While initially up to 2.6 million men will undergo PSA testing, a reduction in these initial examinations to fewer than 200,000 men per year will occur from year four onwards., Conclusions: The presented algorithm provides clear recommendations for risk-adapted PSA-based early detection for prostate cancer for urologists and patients. The goal is to improve diagnosis of clinically significant prostate cancer, while reducing overdiagnosis and overtreatment., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

In low- and middle-income countries most of the cancer patients attend the hospital at a late stage and treatment completion of these cases is challenging. The early detection program (EDP), in rural areas of Punjab state, India was initiated to identify breast, cervical, and oral cancer at an early stage by raising awareness and providing easy access to diagnosis and treatment. A total of 361 health education programs and 99 early detection clinics were organized. The symptomatic and self-interested (non-symptomatic individuals who opted for screening) cases visited the detection clinic. They were screened for breast, cervical, and/or oral cancer. Further diagnosis and treatment of screen-positive cases were carried out at Homi Bhabha Cancer Hospital (HBCH), Sangrur. Community leaders and healthcare workers were involved in all the activities. The EDP, Sangrur removed barriers between cancer diagnosis and treatment with the help of project staff. From 2019 to 2023, a total of 221,317 populations were covered. Symptomatic and self-interested individuals attended the breast (1627), cervical (1601), and oral (1111) examinations. 46 breast (in situ-4.3%; localized-52.2%), 9 cervical (localized-77.8%), and 12 oral (localized-66.7%) cancer cases were detected, and treatment completion was 82.6%, 77.8%, and 50.0%, respectively. We compared cancer staging and treatment completion of cases detected through EDP with the cases attended HBCH from Sangrur district in 2018; the difference between two groups is statistically significant. Due to the early detection approach, there is disease down-staging and improvement in treatment completion. This approach is feasible and can be implemented to control these cancers in low- and middle-income countries., (© 2024 UICC.)

Comprehensive health checkups in Japan are a preventive method to detect cancer and metabolic diseases. Unlike group medical examinations, individual examinations in health checkups are possible, with additional tests possible for disease detection. However, it is difficult to accurately ascertain the results from only the report after referral to a medical institution in individuals suspected of having cancer who need to be examined. We aimed to conduct a medical record survey of patients referred to the Hospital after undergoing a comprehensive health checkup and investigate the contribution of comprehensive health checkups to the detection of cancer more accurately. The subjects were 1763 examinees who were referred to various departments of our hospital because of doubtful cancer from 23,128 examinees who underwent comprehensive health checkups in our center from January 2018 to December 2022 for 5 years. The medical record survey demonstrated that cancer was detected in more than twice as many individuals as reported and other sources. Early-stage cancers require a significantly longer time to establish a definitive diagnosis. In conclusion, short-term reports from the referring hospital are insufficient for a final diagnosis, and long-term follow-up is extremely important to increase the diagnosis rates of cancer for comprehensive health checkups. [ABSTRACT FROM AUTHOR]

This review, which is part of the "Currents in One Health" series, describes and evaluates the current research on the utilization of trained medical scent detection, aka "sniffer" dogs for the detection of diseases, with particular emphasis on neoplasia, both within human and veterinary patients. A recent study by the authors that used sniffer dogs to detect differences in saliva from dogs diagnosed with various neoplastic processes compared with healthy control dogs is described. The concept of One Health is explored by the description of previous studies that have utilized sniffer dogs in the detection of human neoplasia (focusing on lung, prostate, and breast cancer) and veterinary neoplasia and demonstrating that further research in this arena can benefit multiple species. Future avenues of research and utilization of these findings are outlined. The companion Currents in One Health by Ungar et al, JAVMA, January 2024, addresses the use of sniffer dogs to detect human COVID-19 infections. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer, though one of the most common cancers affecting women globally, holds immense potential for prevention through screening. Therefore, we conducted this meta-analysis to assess the rate of cervical cancer screening in Arab countries and identify barriers among those who did not participate., Methods: A comprehensive search was conducted from January 1st to June 1st,2024, including all observational studies that reported cervical cancer screening uptake in any Arab country. A meta-analysis was performed using a random-effects model to estimate the pooled prevalence, and sensitivity analyses were conducted to test the robustness of the findings. The study followed PRISMA guidelines., Results: This meta-analysis, covering 55 studies and 204,940 Arab women, found an overall cervical cancer screening uptake rate of 18.2% (95% CI: 13.9-23.6), with sensitivity analysis confirming the reliability of this estimate. Country disparities were evident, with Bahrain having the highest uptake at 44.1%, while Somalia had the lowest at 8.9%. Among women who underwent screening, the majority were ever-married (94.7%) and held positive attitudes towards screening (91.0%). Barriers to screening were common among women who did not participate, with the most frequent reasons being a lack of information (25.1%), the misconception of feeling healthy (24.5%), fear of the procedure (19.3%), and feelings of embarrassment (13.2%). Additionally, women who were screened had lower perceived barrier scores (SMD = -0.466) and higher perceived benefits scores (SMD = 0.379) than those who were not (p < 0.05)., Conclusion: This meta-analysis reveals a low overall cervical cancer screening uptake (18.2%) among Arab women. Key barriers such as lack of information, fear, the misconception of feeling healthy, and embarrassment hinder uptake. This alarmingly low rate underscores the urgent need for targeted interventions to address these barriers and promote awareness of early detection's life-saving potential., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Breast cancer is the most common cancer among females. Assessing self-screening practices for breast cancer patients is vital for developing targeted interventions. The current study aimed to assess self-screening practices for breast cancer and associated factors via the theory of planned behavior constructs among female students in Ethiopian universities., Methods: A cross-sectional study design was conducted using the theory of planned behavior constructs. The data were collected from January 30, 2022, to February 30, 2022, in Ethiopia. A structured, self-administered questionnaire was used. The validity and reliability tests were checked to use the questionnaire in the main study through a pilot test. The data were collected through online Google Forms by distributing them to university students via Telegram groups, Imo, emails, and Facebook. The collected data were exported to SPSS version 26 for analysis. Bivariate analysis was used to identify the candidate variables for multiple logistic regression (P value < 0.02). Those variables with a P value less than 0.05 were considered significant predictors of breast cancer screening practices., Results: A total of 418 female students participated in the study. The respondents were aged between 18 and 37 years. In the current study, 318 (76.1%; 95% CI: 72.0, 80.4) university students had good screening practices for breast cancer. Nonhealth-related departments (AOR = 1.95; 95% CI: 1.11, 3.44), having training in breast cancer self-examination (AOR = 1.87; 95% CI: 1.04, 3.35), having a good attitude (AOR = 1.96; 95% CI: 1.11, 3.47), having good behavioral control (AOR = 4.1; 95% CI: 2.18, 7.71), and having good behavioral intentions (AOR = 1.88; 95% CI: 1.09, 3.24) were associated with self-screening practices for breast cancer patients., Conclusion: Designing a theory of planned behavior-based educational interventions improve self-screening practices for breast cancer among university female students. These insights could guide the development of future breast cancer awareness and prevention programs in university settings, with the goal of increasing early detection rates and lowering the risk of breast cancer. The study also serves as foundational information for designing future research using more advanced study design methods., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the ethical review committee members of the School of Pharmacy, University of Gondar, with reference number SOP/45/2014. A statement confirming that all the experimental protocols were approved by a named institutional and/or licensing committee was signed by Mr. Abyot Endale, Mr. Zemene Demelash, Mr. Asmamaw Emagn, Mr. Nurahimed Seid, and Mr. Gizework Aleminew. Written informed consent was obtained from each study participant. All methods were carried out in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: The World Health Organization has set a global strategy to eliminate cervical cancer, emphasizing the need for cervical cancer screening coverage to reach 70%. In response, China has developed an action plan to accelerate the elimination of cervical cancer, with Hubei province implementing China's first provincial full-coverage screening program using an artificial intelligence (AI) and cloud-based diagnostic system., Objective: This study aimed to evaluate the performance of AI technology in this full-coverage screening program. The evaluation indicators included accessibility, screening efficiency, diagnostic quality, and program cost., Methods: Characteristics of 1,704,461 individuals screened from July 2022 to January 2023 were used to analyze accessibility and AI screening efficiency. A random sample of 220 individuals was used for external diagnostic quality control. The costs of different participating screening institutions were assessed., Results: Cervical cancer screening services were extended to all administrative districts, especially in rural areas. Rural women had the highest participation rate at 67.54% (1,147,839/1,699,591). Approximately 1.7 million individuals were screened, achieving a cumulative coverage of 13.45% in about 6 months. Full-coverage programs could be achieved by AI technology in approximately 1 year, which was 87.5 times more efficient than the manual reading of slides. The sample compliance rate was as high as 99.1%, and compliance rates for positive, negative, and pathology biopsy reviews exceeded 96%. The cost of this program was CN ¥49 (the average exchange rate in 2022 is as follows: US $1=CN ¥6.7261) per person, with the primary screening institution and the third-party testing institute receiving CN ¥19 and ¥27, respectively., Conclusions: AI-assisted diagnosis has proven to be accessible, efficient, reliable, and low cost, which could support the implementation of full-coverage screening programs, especially in areas with insufficient health resources. AI technology served as a crucial tool for rapidly and effectively increasing screening coverage, which would accelerate the achievement of the World Health Organization's goals of eliminating cervical cancer., (©Lu Ji, Yifan Yao, Dandan Yu, Wen Chen, Shanshan Yin, Yun Fu, Shangfeng Tang, Lan Yao. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 20.11.2024.)

Oral cancer is the second most prevalent cancer in India and 5% of all cancers in women is contributed by oral cancer. In spite of being a part of national programme, the screening coverage rates remain low. Studies have indicated that the societal status of women and their empowerment plays a role in screening coverage for cancer. The objective of the current study is to estimate the coverage of oral cancer screening among Indian women within reproductive age-group across Indian states and union territories (UTs), to explore the relationship of socioeconomic status (SES) and women empower status (WES) with oral cancer screening coverage across Indian states and union territories (UT). Data from the fifth round of the nationally representative cross-sectional survey (National Family Health Survey, NFHS-2019-2021) was used in the present study with 3,48,882 individuals being included in the final analysis. We have cross-tabulated SES and WES composite scores with the Dimension Index (DI) of screening and categorised states and UTs into low, middle and high. We have represented these values over the Indian map. The interaction among these was graphically represented by a bubble plot. Further, we estimated the association of each indicator of SES and WES with screening coverage using multivariable logistic regression. The national coverage of oral cancer screening among women of reproductive age was 0.77% with Andhra Pradesh (7%) and Andaman and Nicobar Islands (10%) recording the highest screening coverage. Despite having high SES and WES scores, Madhya Pradesh and Uttar Pradesh, the screening (DI) was low. States with both high women empowerment status and high socioeconomic status showed high oral cancer screening uptake but the trend was not universal. Still, there were variations in the association among the states. The increased screening was significantly associated with higher access to improved sanitary facility (76%) and clean fuel for cooking (44%). Socio-economic status is an important precursor for better oral cancer screening coverage but women empowerment status did not always translate into good cancer screening uptake. Deep-rooted socio-cultural constructs and stigma associated with cancer and its implications may play a role. Implementation research for better uptake of oral cancer screening coverage is required., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethics The NFHS-5 received ethical approval from the International Institute for Population Sciences (IIPS), Mumbai (2019–21) as per Helsinki declaration. It was also reviewed by the International Review Board (IRB), which approved it ethically. After receiving complete information about the goal and methodology of the survey, the respondents signed to confirm their agreement. Interviews were conducted only after receiving each participant’s informed consent. Being an anonymous dataset it is publicly available on the Demographic and Health Surveys (DHS) Programme website that cannot be used to identify survey respondents. The current study was a secondary data analysis from the available records., (© 2024. The Author(s).)

Background: Colonoscopy as a common screening practice to prevent colorectal cancer lacks strong evidence. NordICC, the first randomized trial of colonoscopy screening, reported no clear clinical benefit for colonoscopy in the intention-to-screen population with suggested benefit in the risk of colorectal incidence and cancer-specific mortality in the per-protocol analyses. However, although the study was designed to perform survival analysis, no survival outcomes were reported since the underlying assumption for hazard ratio was not valid. We aimed to assess whether colonoscopy screening is associated with improved survival outcomes compared with usual care., Methods: We reconstructed patient-level data from the Kaplan-Meier estimator of the primary endpoints reported in NordICC for the intention-to-screen and adjusted per-protocol populations. The restricted-mean survival time difference (RMST-D) and restricted-mean time loss ratio (RMTL-R), which are robust alternatives to the hazard ratio without specific model assumptions, were calculated for colorectal cancer incidence and death., Results: In this study, no significant difference in colorectal cancer incidence over 10 years was found in the intention-to-screen population (RMST-D: -0.68 days, 95% CI -3.9-2.6; RMTL-R: 1.04, 95% CI 0.88-1.22) or in the per-protocol analysis population (RMST-D: -2.9 days, 95% CI -6.5-0.67; RMTL-R: 1.15, 95% CI 0.97-1.35). In the intention-to-screen population, inviting individuals to colonoscopy did not improve colorectal-cancer death (RMST-D: -0.29 days, 95% CI -1.6-1.0; RMTL-R: 1.07, 95% CI 0.78-1.48). Over 10 years, in the per-protocol analysis, individuals who underwent colonoscopy survived an average of 1.1 more days free of colorectal cancer, but this difference was not statistically significant (RMST-D: 95% CI -0.13-2.3; RMTL-R: 0.72, 95% CI 0.49-1.07)., Conclusions: In this reanalysis of the NordICC data, no evidence of improvement in survival outcomes for participants invited to undergo colonoscopy compared to usual care was identified, even when assuming that all invited participants did undergo colonoscopy. Thus, our results do not support the use of colonoscopy as a population-wide screening test as a mean to decrease colorectal cancer incidence or death., Registry: Not applicable., Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Purpose: The impact of the components of survivorship care plans on adherence to cancer screening guidelines among cancer survivors is limited. We examined the association of receipt of treatment summaries, follow-up instructions, and type of doctor providing survivorship care with adherence to breast cancer screening (BCS) and cervical cancer screening (CCS) guidelines in female cancer survivors., Methods: A cross-sectional analysis using Behavioral Risk Factor Surveillance System (BRFSS) data from 2014, 2016 and 2018 was conducted. BCS and CCS-eligible women were aged 40-74 and 30-64, respectively. BCS adherence was defined as a mammogram within 2 years and CCS adherence as a pap smear within 3 years or HPV test within 5 years. Univariate analysis with chi-square and multivariable logistic regression are reported., Results: 5,001 BCS and 3,014 CCS-eligible survivors were identified. In the BCS group, recipients of treatment summaries and follow-up instructions were significantly more adherent with BCS (84.1% vs. 77.4%; 83.4% vs. 74%, respectively, p < 0.001). In the CCS group, recipients of follow-up instructions were significantly more adherent with CCS (78.1% vs. 67.7%, p < 0.001). In both groups, there was no significant difference in BCS or CCS based on type of physician providing care (p = 0.087). On multivariate analysis, receipt of follow-up instructions was the only factor significantly associated with BCS (OR:2.81; 95%CI:1.76-4.49) and CCS (OR:3.14; 95%CI:1.88-5.23)., Conclusions: Follow-up instructions, as part of survivorship care plans, have the strongest association with BCS and CCS among female cancer survivors. Additional research should focus on improving the distribution of survivorship care plans, particularly follow-up instructions, as a method to increase BCS and CCS among cancer survivors., Competing Interests: Declarations Ethics approval This is an observational study with publicly available de-identified individual data and did not require approval from the Rutgers University Institutional Board Review. Competing interests The authors declare no competing interests. Disclaimers This research was presented as a poster at the 2023 ASCO Annual Meeting, held in Chicago, IL, June 2 to 6, 2023, and published as an abstract from the meeting., (© 2024. The Author(s).)

Despite government efforts, the uptake of screening for breast and cervical cancers among Japanese women remains low. This study employs financial literacy and financial education as proxies for rational decision-making to explore their potential to enhance cancer screening practices in Japan. Using data from Osaka University's Preference Parameters Study, mean comparison tests and probit regression models are utilized to examine the association between breast and cervical cancer screening and financial literacy and financial education. The results of probit regression show that individuals with higher levels of financial education tend to participate in both breast and cervical cancer screening. In contrast, individuals with higher financial literacy are likely to participate in breast cancer screening, whereas no significant impact is observed for cervical cancer screening. Furthermore, our findings reveal that financial education positively influences both breast and cervical cancer screening. Factors such as employment, marriage, higher education, increased household income, and greater assets demonstrate robust positive relationships with breast and cervical cancer screening. Meanwhile, psychological factors including happiness, a myopic view of the future, anxiety about later life, and perceived health status have no significant associations, except for a positive association between anxiety about life and cervical cancer screening. Our study suggests the development of targeted educational programs that leverage financial literacy and financial education to raise awareness about the importance of breast and cervical cancer screening., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bawalle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The Prostate Specific Antigen (PSA) blood test is still the only screening tool for prostate cancer. It is recommended between the ages of 50 and 69 as part of a shared decision making process between a patient and his or her doctor using a decision aid, as the test carries a significant risk of overdiagnosis. If a patient wishes to be screened, either because he is at higher risk, or because he places greater importance on a modest reduction in cancer-related mortality, the frequency of screening depends on his age, family history, and whether he is part of a high-risk group. The use of multiparametric MRI after a positive PSA result can reduce the number of biopsies and, consequently, the risk of overdiagnosis., Competing Interests: Marie-Anne Durand a développé l’outil d’aide à la décision pour la décision médicale partagée « Option Grid »”, qui est sous licence auprès de la compagnie EBSCO Health. Elle est consultante pour EBSCO Health et reçoit des redevances. Les autres auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

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., (Published 2024. This article is a U.S. Government work and is in the public domain in the USA. Cancer Medicine published by John Wiley & Sons Ltd.)

Cancer screening is the most cost-effective prevention strategy that enables improved cancer morbidity and mortality rates. However, there was a significant decline in cancer screening during the COVID-19 pandemic worldwide. This study aimed to measure regional differences in cancer screening by comparing screening rates before and during COVID-19 and to examine factors explaining the regional difference in cancer screening. All variables including the differences in cancer screening rate before and during the COVID-19 pandemic were collected from 229 administrative subregions in South Korea and joined with each community in ArcGIS environment. Factors explaining regional difference in cancer screening were analyzed through descriptive statistics, correlation analysis, and interactive decision tree modeling. Cancer screening rates decreased in all regions during the COVID-19 pandemic in South Korea. The findings revealed that national health insurance premiums, the number of cancer screening facilities, livelihood benefit recipients, and the population aged 65+ could be classified as variables highly affecting the decrease in cancer screening rate. These findings highlight the efforts to appraise different barriers to cancer screening in each community. In addition, it is important to promote sustainable cancer screening strategies from regional perspectives based on regional vulnerabilities and their complex impact on cancer screening., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: Lung cancer is the most common cause of cancer death in Portugal. The Dutch-Belgian lung cancer screening (LCS) study (NELSON), the biggest European LCS study, showed a lung cancer mortality reduction in a high-risk population when being screened. In this study, the cost-effectiveness of LCS, based on the NELSON study protocol and outcomes, was evaluated compared with no screening in Portugal. Methods: The present study modified an established decision tree by incorporating a state-transition Markov model to evaluate the health-related advantages and economic implications of low-dose computed tomography (LDCT) LCS from the healthcare standpoint in Portugal. The analysis compared screening versus no screening for a high-risk population aged 50-75 with a smoking history. Various metrics, including clinical outcomes, costs, quality-adjusted life years (QALYs), life-years (LYs) and the incremental cost-effectiveness ratio (ICER), were calculated to measure the impact of LDCT LCS. Furthermore, scenario and sensitivity analyses were executed to assess the robustness of the obtained results. Results: Annual LCS with volume-based LDCT resulted in €558 million additional costs and 86,678 additional QALYs resulting in an ICER of €6440 per QALY for one screening group and a lifetime horizon. In total, 13,217 premature lung cancer deaths could be averted, leading to 1.41 additional QALYs gained per individual diagnosed with lung cancer. Results are robust based on the sensitivity analyses. Conclusion: This study showed that annual LDCT LCS for a high-risk population could be cost-effective in Portugal based on a willingness to pay a threshold of one-time the GDP (€19,290 per QALY gained).

Background: The Trans.IT database is a national gastrointestinal (GI) endoscopy database developed in 2012. It automatically collects anonymous data from GI endoscopy procedures in a centralized database. All endoscopists use a structured reporting tool for uniform data collection. In this study, we aim to provide an overview of the database and to evaluate its impact on data registration quality., Methods: We used all ERCPs, colonoscopies and colorectal cancer (CRC)-screening colonoscopies performed between 2016 and 2020. We excluded centers joining after 2016 and patients below age 18. Data registration quality for ERCPs included completeness of data for: intention of ERCP, Schutz score, ASA classification, papillary status (virgin or previous sphincterotomy), cannulation (success or failure to cannulate the desired duct) and procedural success. For colonoscopies: indication, ASA-classification, Boston Bowel Preparation Score (BBPS), cecal intubation, polyp detection rate (PDR). For CRC-screening colonoscopies, ASA-classification, BBPS, cecal intubation, PDR and adenoma detection rate (ADR)., Results: A total of 14,156 ERCPs, 150,962 colonoscopies and 37,199 colorectal cancer screening colonoscopies were included in our analysis. For ERCPs, registration of procedural intention, Schutz score, ASA classification, papillary status, cannulation and procedural success improved from 34.9%, 32.7%, 72.6%, 36.5%, 34.6%, 27.2% in 2016, to 86.4%, 84.6%, 97.4%, 86.4%, 82.1%, 84.0%, respectively, in 2020. For non-screening colonoscopies, registration of indication, ASA classification, BBPS, cecal intubation and PDR improved from 40.4%, 60.5%, 47.6%, 69.8% and 32.3% in 2016 to 90.3%, 88.9%, 59.8%, 79.1% and 39.1%, respectively, in 2020. For CRC-cancer screening colonoscopy registration equaled outcome, PDR and ADR changed from 74.7% to 63.6% in 2016 to 66.3% and 53.8% in 2020, respectively., Conclusions: The quality of endoscopy data registration has consistently improved over the years by using the Trans.IT database. This is most likely the result of feedback to performing endoscopists to review performance in real-time online and progressive awareness of quality of data registration., (© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)

Purpose: Increasing the perceived need for CRC screening can facilitate undertaking CRC screening. This study aims to identify factors associated with the need for CRC screening in rural populations., Design: A cross-sectional online survey., Setting: The survey was conducted in June - September 2022 in the rural areas of Alaska, Idaho, Oregon, and Washington, US., Subjects: The subjects of this study were 250 adults (completion rate: 65%) aged 45-75 residing in rural Alaska, Idaho, Oregon, and Washington., Measures: Perceived need for CRC screening, internet usage for health purposes, demographics, and intrapersonal, interpersonal, community, and environmental characteristics., Results: Perceived need for CRC screening were negatively associated with patient-provider miscommunication ( β = -.23, P < .001) and perceived discrimination ( β = -.21, P < .001), cancer fatalism (β = -.16, P < .05), individualism ( β = -.15, P < .05), and dependence on community ( β = -.11, P < .05), but positively with compliance with social norms ( β = .16, P < .05), trust in health care providers ( β = .16, P < .05), knowledge about colorectal cancer ( β = .12, P < .05)., Conclusions: Our study showed potential individual and situational characteristics that might help increase colorectal cancer screening. Future efforts might consider addressing discrimination in health care settings, improving patient-provider communication, and tailoring messaging to reflect the rural culture., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background and Objective: In Europe, prostate cancer (PCa) is the most common cancer in men. Screening may therefore be crucial to lower health care costs, morbidity, and mortality. This systematic review aimed to provide a contemporary overview of the costs and benefits of PCa screening programmes., Methods: A peer-reviewed literature search was conducted, using the PICO method. A detailed search strategy was developed in four databases based on the following key search terms: "PCa", "screening", and "cost effectiveness". Any type of economic evaluation was included. The search strategy was restricted to European countries, but no restrictions were set on the year of publication., Key Findings and Limitations: A total of 7484 studies were identified initially. Of these, 19 studies described the cost effectiveness of PCa screening in Europe. Among the studies using an initially healthy study population, most focussed on risk- and/or age- and/or magnetic resonance imaging (MRI)-based screening in addition to prostate-specific antigen (PSA) testing and compared this with no screening. Incremental cost ratios (ICERs) varied from €5872 per quality-adjusted life year (QALY) to €372 948/QALY, with a median of €56 487/QALY. Risk-based screening followed by MRI testing seemed to be a more cost-effective strategy than no screening., Conclusions and Clinical Implications: This systematic review indicates that screening programmes incorporating a risk-based approach and MRI have the potential to be cost effective., Patient Summary: In this review, we looked at the cost effectiveness of prostate cancer screening in Europe. We found that a risk-based approach and incorporation of magnetic resonance imaging has the potential to be cost effective. However, there remains a knowledge gap regarding cost effectiveness of prostate cancer screening. Therefore, determinants of cost effectiveness require further investigation., (Copyright © 2024. Published by Elsevier B.V.)

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/#/)., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Lung cancer (LC) is a leading cause of cancer-related mortality worldwide. Lung Cancer Screening (LCS) programs that use low-dose computed tomography (LDCT) have been shown to reduce LC mortality by up to 25 % and are considered cost-effective. The European Health Union has encouraged its Member States to explore the feasibility of LCS implementation in their respective countries. The task force conducted a comprehensive literature review and engaged in extensive discussions to provide recommendations. These recommendations encompass the essential components required to initiate pilot LCS programs following the guidelines established by the World Health Organization. They were tailored to align with the specific context of the Portuguese healthcare system. The document addresses critical aspects, including the eligible population, methods for issuing invitations, radiological prerequisites, procedures for reporting results, referral processes, diagnostic strategies, program implementation, and ongoing monitoring. Furthermore, the task force emphasized that pairing LCS with evidence-based smoking cessation should be the standard of care for a high-quality screening program. This document also identifies areas for further research. These recommendations aim to guarantee that the implementation of a Portuguese LCS program ensures high-quality standards, consistency, and uniformity across centres., Competing Interests: Declaration of competing interest The authors have no conflicts of interest., (Copyright © 2024 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)