Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy.

Women Breast Cancer: Knowledge, Attitudes, Practices and Factors Associated with Early Screening in the Municipality of Abomey-Calavi in Benin in 2018

Background: Breast cancer is the dominant cancer in women in both developed and developing countries. The objective of this study was to assess the knowledge, attitudes, practices and factors associated with early breast cancer screening among women in the Municipality of Abomey-Calavi in Benin. Methods: This was a cross-sectional, descriptive, analytical study with prospective data collection from October 1 to 8, 2018, involving 1740 women in the Municipality of Abomey-Calavi, aged 18 years or older and selected by WHO four-stage random cluster sampling. Consenting women who were mentally competent, 18 years of age or older at the time of the survey, and residing continuously in the Municipality of Abomey-Calavi for the last six months prior to the survey were included. On the other hand, women who belonged to a breast cancer prevention service, women in whom secondary screening was noted, or non-consenting women were not included. The initial minimum size was estimated by the Schwartz formula with a cluster effect of k = 2. Information was collected by questionnaire survey, entered with Epidata 3.1. Fr and analyzed with R Studio 3.5.1. software. Results: The mean age of the women surveyed was 32.0 ± 11.5 years with a range of 18 and 71 years. Regarding knowledge, the clinical manifestation known by the majority of women was the presence of a nodule (68.50%). In the series, 1308 (75.17%) declared having heard about breast cancer once before, either on the radio, television or from friends and 726 (55.50%) had heard about breast cancer screening. Five hundred and twelve (70.52%) of the 726 who had heard of breast cancer said they knew that breast cancer could be screened earlier. Breast self-examination was the most cited screening method (67.58%). The disease is of natural origin according to 37.84% of them. Regarding attitudes and practices, the prevalence of early breast cancer screening was 12.93%, of which 11.67% declared that they had checked themselves to know whether they were carriers of the disease or not. The main means of the early screening used was breast self-examination (85.78%). Factors associated with early breast cancer screening found in multivariate analysis were age (≤50 years), education level (increasingly higher), marital status (married/coupled), place of residence (downtown), and socioeconomic level (average/high). Conclusion: The frequency of early breast cancer screening among women is still low in the municipality of Abomey-Calavi, although they have a good knowledge of the disease. This raises the need to strengthen awareness of early breast cancer screening.

Epidemiology and early screening strategies for colorectal cancer in China

China ranks the first worldwide in the number of new colorectal cancer(CRC) cases and CRC-related deaths. The increasing incidence of early-onset CRC in recent years highlights the challenges related to CRC screening and prevention. High-quality colonoscopy is the universally used gold standard for CRC screening. Risk assessment combined with a two-step screening strategy based on colonoscopy and non-invasive examinations was proven to be highly effective. However, systematic use of well-established risk factors associated with CRC, beyond age, could better identify those who might harbor advanced colorectal neoplasia, improve the diagnostic yield of current screening modalities, and optimize the selection of individuals who might benefit most from preventive strategies.“Personalization” and “Standardization” are the future development directions of CRC screening, from the initiation of screening in those at high risk for CRC to follow-up after treatment, which are the key to ensure the screening efficiency.

Bioinformatics Analysis Raises Candidate Genes in Blood for Early Screening of Parkinson's Disease

Parkinson＇s disease （PD） is a typical degenerative disease, which is characterized by the most obvious symptoms of movement dysfunction, including shaking, rigidity, slowness of movement and difficulty in walking and gait. This disease can not be clearly identified through laboratory tests at present, thus application of high-throughput technique in studying the expression profiles of PD helps to find the genetic markers for its early diagnosis. Studies on expression profiles of neurodegenerative diseases have revealed the novel genes and pathways involved in the progress of illness. In this study, the expression profiles of PD in blood were compared, showing that 181 differentially expressed genes （DEG） exhibit a similar expression trend both in patients and in normal controls.

Early screening of lung cancers:an effort arduous but worthwhile

Cancers are a concerning health catastrophe worldwide that may become the end of lifetime for many of us--they overwhelmingly exhaust medical resources, lead to huge economic burdens, and separate people from their beloved ones. Fewer and fewer insurance agencies are willing to include primary cancers on their general health insurance plan, just because cancers have been so flummoxingly usual in our daily life that many primary cancer claims would give rise to much less profits.

Application Value of Transvaginal Ultrasound on Early Screening for Ectopic Pregnancy

Objective:To explore the effect and value of transvaginal ultrasound in screening early ectopic pregnancy.Methods:A total of 146 patients with ectopic pregnancy in our hospital were selected.The patients1 entry time was from May 2018 to December 2020.146 patients were divided into two groups.The control group was screened by abdominal ultrasound with 73 cases,and the experimental group was screened by vaginal ultrasound with 73 cases.The uterine adnexal mass,pelvic effusion,peritoneal effusion and diagnostic accuracy were detected.Results:The positive number of abdominal ultrasound was significantly higher than that of vaginal ultrasound;In the detection process of abdominal ultrasound,54 cases of ectopic pregnancy,19 cases of non-ectopic pregnancy,the detection rate was 73.97%,26 cases of ectopic pregnancy,47 cases of non-ectopic pregnancy,the detection rate was 32.62%.Conclusion:The accuracy of transvaginal ultrasound is relatively high,and the accuracy of ectopic pregnancy examined by transvaginal ultrasound is higher,which is more friendly to patients,less traumatic and high operability.It can provide more accurate reports for patients and relieve the psychological pressure of patients,which is worthy of application in actual screening.

A Comprehensive Study on the digestive Endoscopic Technique and Narrow-Band Imaging for Early Gastric Cancer Screening

Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Methods:During the period from March 2023 to August 2023,312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected,and they underwent both conventional gastroscopy and endoscopic NBI,with clinicopathological tissue biopsy serving as the gold standard.The application value for early screening of gastric cancer was observed and analyzed.Results:The scoring data showed that the clarity of gastric mucosal glandular tube structure,microvascular structure clarity,and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology(P<0.05).The screening rate of pathological biopsy in 312 patients was 18.59%(58 cases).Conventional gastroscopy showed a screening rate of 11.53%(36 cases),while NBI technology examined a screening rate of 17.63%(55 cases),and the two-by-two comparison of the screening rate data of the three groups was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology(P<0.05).Conclusion:In the early screening of gastric cancer,endoscopic NBI technology can be applied to patients.Compared with conventional gastroscopy,it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure,with a certain screening rate.Additionally,its sensitivity,specificity,accuracy,positive predictive value,and negative predictive value are higher,demonstrating outstanding effectiveness.

An early screening model of pulse detection technology for hepatic steatosis

Background The increasing prevalence of hepatic steatosis presents a considerable challenge to public health.There is a critical need for the development of novel preventive and screening strategies for this condition.Thisstudy evaluated the potential applications of wrist pulse detection technology for the early detection of liverdiseases.The pulse time-domain features of a medical exam population with and without hepatic steatosis wereassessed to develop a screening model for this disease.Methods Participants were consecutively recruited from March 2021 to March 2022 in the medical examinationcenters of the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine and the Shanghai Municipal Hospital of Traditional Chinese Medicine.Clinical data from 255 participants,including general information(sex,age,and body mass index),and data related to glucose and blood lipids(fasting plasma glucose,triglyceride,total cholesterol,high-density lipoprotein,and low-density lipoprotein levels)were collected.Wrist pulse signalswere acquired using a pulse detection device,and the pulse time-domain features,including t_(1),t_(4),t_(5),T,w_(1),w_(2),h_(2)/h_(1),h_(3)/h_(1),and h5/h_(1) were extracted.Participants were assigned to hepatic steatosis and non-hepatic steatosisgroups according to their abdominal ultrasound examination results.Their clinical data and pulse time-domainfeatures were compared using chi-square and parametric or non-parametric statistical methods.Three datasetswere used to construct screening models for hepatic steatosis based on the random forest algorithm.The datasetsfor modeling were defined as Dataset 1,containing blood glucose and lipid data and general information;Dataset2,containing time-domain features and general information;Dataset 3,containing time-domain features,bloodglucose and lipid data,and general information.The evaluation metrics,accuracy,precision,recall,F1-score,andareas under the receiver operating characteristic curve(AUC)were compared for each model.Results The time-domain features of the two groups differed significantly.The t_(1),t_(4),t_(5),T,h_(2)/h_(1),h_(3)/h_(1),w_(1),and w_(2) features were higher in the hepatic steatosis group than in the non-hepatic steatosis group(P<0.05),while the h5/h_(1) features were lower in the hepatic steatosis group than in the non-hepatic steatosis group(P<0.05).The screening models for hepatic steatosis based on both time-domain features and blood glucose andlipid data outperformed those based on time-domain features or blood markers alone.The accuracy,precision,recall,F1-score,and AUC of the combined model were 81.18%,80.56%,76.32%,79%,and 87.79%,respectively.These proportions were 1.57%,1.86%,1.76%,2%,and 3.54%higher,respectively,than those of the model basedon time-domain features alone and 3.14%,4.2%,2.64%,4%,and 6.47%higher,respectively,than those of themodel based on blood glucose and lipid alone.Conclusion The early screening model for hepatic steatosis using datasets that included pulse time-domainfeatures achieved better performance.The findings suggest that pulse detection technology could be used toinform the development of a mobile medical device or remote home monitoring system to test for hepatitissteatosis.

Early screening and diagnosis strategies of pancreatic cancer:a comprehensive review

Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics and lack of typical early symptoms.Thus,an early diagnosis of pancreatic cancer is crucial for improving its prognosis.Currently,screening is often applied in high-risk individuals to achieve the early diagnosis of pancreatic cancer.Fully understanding the risk factors of pancreatic cancer and pathogenesis could help us identify the high-risk population and achieve early diagnosis and timely treatment of pancreatic cancer.Notably,accumulating studies have been undertaken to improve the detection rate of different imaging methods and the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)which is the golden standard for pancreatic cancer diagnosis.In addition,there are currently no biomarkers with sufficient sensitivity and specificity for the diagnosis ofpancreatic cancer to be applied in the clinic. As the only serum biomarkerapproved by the United States Food and Drug Administration, carbohydrateantigen 19-9 (CA19-9) is not recommended to be used in the early screeningof pancreatic cancer because of its limited specificity. Recently, increasingnumbers of studies focused on the discovering of novel serum biomarkersand exploring their combination with CA19-9 in the detection of pancreaticcancer. Besides, the application of liquid biopsy involving circulating tumor cells(CTCs), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomesin blood and biomarkers in urine, and saliva in pancreatic cancer diagnosis aredrawing more and more attention. Furthermore, many innovative technologiessuch as artificial intelligence, computer-aided diagnosis system, metabolomicstechnology, ion mobility spectrometry (IMS) associated technologies, and novelnanomaterials have been tested for the early diagnosis of pancreatic cancer andhave shown promising prospects. Hence, this review aims to summarize therecent progress in the development of early screening and diagnostic methods,including imaging, pathological examination, serological examination, liquidbiopsy, as well as other potential diagnostic strategies for pancreatic cancer.

Screening of Epstein-Barr Virus Early Antigen Expression Inducers from Chinese Medicinal Herbs and Plants

Ether extrilcls of 1693 Chinesc medicinal herbs and plilnts from 268 families werestudied for the induction of Epstcin-Barr viral (EBV ) early antigcn (EA ) expression in theRaji cell line. Fifty-two from 18 families were found to have inducing activity. Twenty-fiveand seven of them were from Euphorbiaccae and Thymclaeaceae, respectively. Some ofthem, such as Croton tiglium, Euphorbia kansui, Daphnc genkwa, Wikstrocmia chamacdaphen, Wikstroemia indica, Prunus mandshurica Koehne and Achyranthes bidentata arecommonly used drugs. The significance of these herbs in the activation of EBV in vivo andtheir relation to the development of nasopharyngeal carcinoma were discussed.

A new Screening Tool for Detecting Early Atheroslerosis

In a study published in the current issue of the Journal of Geriatric Cardiology, Ang and co-investigators used the highresolution 64-slice CT coronary angiography to detect coronary lesions in a group of patients with atypical angina.1 The clinical data of these patients were also used to calculate their risk according the Framingham and PROCAM scoring system.2,3 As the cohort is composed with a majority of low risk patients with atypical angina, only a small minority of the patients were classified as having medium and high risk. The results showed that MDCT uncovered 18% either significant lesions (＞50% stenosis) or calcifications (＞400Agatston units)in the low risk patients and 33% in the medium and high risk subgroups.……

The application of ultra-wide-field fundus autofluorescence in early metastatic choroidal tumor screening

I am Dr.Ke Yao,from Eye Center,the Second Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.I write to present three cases with metastatic choroidal tumor using an ultra-wide-field scanning laser ophthalmoscope.

Glucagon-like peptide-1 receptor agonists as a possible intervention to delay the onset of type 1 diabetes:A new horizon

Type 1 diabetes(T1D)is a chronic autoimmune condition that destroys insulinproducing beta cells in the pancreas,leading to insulin deficiency and hyperglycemia.The management of T1D primarily focuses on exogenous insulin replacement to control blood glucose levels.However,this approach does not address the underlying autoimmune process or prevent the progressive loss of beta cells.Recent research has explored the potential of glucagon-like peptide-1 receptor agonists(GLP-1RAs)as a novel intervention to modify the disease course and delay the onset of T1D.GLP-1RAs are medications initially developed for treating type 2 diabetes.They exert their effects by enhancing glucose-dependent insulin secretion,suppressing glucagon secretion,and slowing gastric emptying.Emerging evidence suggests that GLP-1RAs may also benefit the treatment of newly diagnosed patients with T1D.This article aims to highlight the potential of GLP-1RAs as an intervention to delay the onset of T1D,possibly through their potential immunomodulatory and anti-inflammatory effects and preservation of beta-cells.This article aims to explore the potential of shifting the paradigm of T1D management from reactive insulin replacement to proactive disease modification,which should open new avenues for preventing and treating T1D,improving the quality of life and long-term outcomes for individuals at risk of T1D.

Early Childhood Development (0 - 6 Years Old) from Healthy to Pathologic: A Review of the Literature

Early childhood development involves an appropriate global intervention concerning the different areas of development such as: physical, cognitive, language and socio-emotional [1]. Especially during the first six years of life in an adequate environment rich in exchange and interaction. We will present in this article a review of the literature concerning normal early childhood development, focus firstly in normal development’s steps, the importance of first experiences and first aid with a stable and caring attachment figure. second, we will describe the various developmental disorders, occurring during this age group which extends from birth to 6 years and based on the DSM5 classification, namely that developmental delay may concern only one aspect of development (e.g. language delay or motor delay specifically) or concern the different aspects of development (overall development delay). The dynamics of development is also important to clarify because schematically we contrast the pathologies fixed to progressive pathologies (where we find the concepts of stagnation or regression in the development of the child). We will discuss in the third chapter, the interest of early detection as well as the multiple clinical and psychometric diagnostic tools, which aim to detect any delay or disorder in order to initiate appropriate care and minimize the long-term consequences.

Novel multiplex stool-based assay for the detection of early-stage colon cancer in a Chinese population

BACKGROUND Stool DNA(sDNA)methylation analysis is a promising,noninvasive approach for colorectal cancer screening;however,reliable biomarkers for detecting early-stage colon cancer(ECC)are lacking,particularly in the Chinese population.AIM To identify a novel stool-based assay that can improve the effectiveness of ECC screening.METHODS A blinded case-control study was performed using archived stool samples from 125 ECC patients,and 125 control subjects with normal colonoscopy.The cohort was randomly divided into training and test sets at a 1.5:1 ratio.Targeted bisulfite sequencing(TBSeq)was conducted on five pairs of preoperative and postoperative sDNA samples from ECC patients to identify DNA methylation biomarkers,which were validated using pyrosequencing.By logistic regression analysis,a multiplex stool-based assay was developed in the training set,and the detection performance was further assessed in the test set and combined set.Theχ^(2)test was used to investigate the association of detection sensitivity with clinico-pathological features.RESULTS Following TBSeq,three hypermethylated cytosine-guanine sites were selected as biomarkers,including paired box 8,Ras-association domain family 1 and secreted frizzled-related protein 2,which differed between the groups and were involved in important cancer pathways.An sDNA panel containing the three biomarkers was constructed with a logistic model.Receiver operating characteristic(ROC)analysis revealed that this panel was superior to the fecal immunochemical test(FIT)or serum carcinoembryonic antigen for the detection of ECC.We further found that the combination of the sDNA panel with FIT could improve the screening effectiveness.In the combined set,the sensitivity,specificity and area under the ROC curve for this multiplex assay were 80.0%,93.6%and 0.918,respectively,and the performance remained excellent in the subgroup analysis by tumor stage.In addition,the detection sensitivity did not differ with tumor site,tumor stage,histological differentiation,age or sex,but was significantly higher in T4 than in T1-3 stage tumors(P=0.041).CONCLUSION We identified a novel multiplex stool-based assay combining sDNA methylation biomarkers and FIT,which could detect ECC with high sensitivity and specificity throughout the colon,showing a promising application perspective.

Sensitive Detection of Multiple Tumor Markers for Early Tumor Diagnosis

Tumor markers have a wide clinical applications for early tumor screening and diagnosis.In the study,the combined detection of serum tumor markers(SCC-Ag,CYFRA21-1,CEA,CA125,NSE)was used to explore the correlation and diagnostic efficacy of oral squamous cell carcinoma(OSCC).First,60 cases of OSCC patients,60 cases of patients with non-OSCC malignant tumors,and 60 cases of patients with healthy physical condition were collected as the control group in the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2015 to January 2018.Each experimental subject were draw 2 mL of fasting peripheral blood,and the tumor markers of SCC-Ag,CYFRA21-1,CEA,CA125,and NSE concentration were detected in the blood respectively.The results showed that the levels of the 5 of serum tumor markers of OSCC patients were different with those of the non-OSCC malignant tumor group.Compared with the control group,there was a significant difference(P<0.05).And the results showed that the sensitivity,specificity,accuracy,and positive predictive values of CEA,CA125,SCC-Ag,CYFRA21-1,and NSE were significantly improved after combined detection.Therefore,the combined detection of the 5 tumor markers can be used for the early diagnosis of OSCC.

Early detection of pancreatic cancer

Pancreatic adenocarcinoma is a low-incident but highly mortal disease. It accounts for only 3% of estimated new cancer cases each year but is currently the fourth common cause of cancer mortality. By 2030, it is expected to be the 2nd leading cause of cancer death. There is a clear need to diagnose and classify pancreatic cancer at earlier stages in order to give patients the best chance at a definitive cure through surgery. Three precursor lesions that distinctly lead to pancreatic adenocarcinoma have been identified, and we have increasing understanding the non-genetic and genetic risk factors for the disease. With increased understanding about the risk factors, the familial patters, and associated accumulation of genetic mutations involved in pancreatic cancer, we know that there are mutations that occur early in the development of pancreatic cancer and that improved genetic risk-based strategies in screening for pancreatic cancer may be possible and successful at saving or prolonging lives. The remaining challenge is that current standards for diagnosing pancreatic cancer remain too invasive and too costly for widespread screening for pancreatic cancer. Furthermore, the promises of noninvasive methods of detection such as blood, saliva, and stool remain underdeveloped or lack robust testing. However, significant progress has been made, and we are drawing closer to a strategy for the screening and early detection of pancreatic cancer.

Screening for Oral Cancer 2018

In Hungary, the incidence and mortality from oral cancer is so high, that in the past decades it has attracted international attention. The mortality rates are the highest in Europe. As risk factors, smoking and alcohol drinking have a multiplicative role;in addition, a number of dental factors also play a role. Premalignant conditions and lesions are well known. They should be targeted for early detection and early treatment. The screening tool is simple: inspection and palpation. The physician-patient encounters provide opportunity for screening. This paper looks for the answer to the long debated question: who is responsible for oral screening?

Sarcopenia affects the treatment and prognosis of colorectal cancer

Sarcopenia is a common complication of malnutrition.Patients with colorectal cancer are prone to secondary sarcopenia due to nutrient absorption,intestinal obstruction,metabolic disorders and other reasons.Nutritional status not only participates in the body’s normal function but also has an important impact on anti-tumor treatment.More and more evidence shows that sarcopenia has a negative effect on the treatment and prognosis of colorectal cancer.This article summarizes the related research,such as the influence of sarcopenia on the treatment of colorectal cancer.To evaluate the clinical value of sarcopenia in treating colorectal cancer and provide new ideas for the comprehensive treatment of sarcopenia in patients with colorectal cancer.

Expert consensus on the role of hematological markers in the earlyclinical screening of hepatocellular carcinoma

The disease burden of hepatocellular carcinoma (HCC) in China is heavy, and the prognosis is stillunfavourable. Therefore, early screening of high-risk groups of HCC through simple methods is the key toachieving early diagnosis and treatment and improving survival. At present, alpha-fetoprotein and otherhematological tests are still the main methods in the early screening of HCC, but the sensitivity andspecificity are limited, and the risk of missed diagnosis is high. In recent years, with the continuousdevelopment of science and technology, the improvement of traditional detection methods and theemergence of novel markers such as methylated deoxyribonucleic acid and microRNA have brought hopefor further improving the sensitivity and specificity of early HCC screening. This consensus summarizesthe research progress of traditional and new hematological test methods and puts forward expertguidance on the role of hematological markers in the early screening of HCC to provide a basis forimproving the prevention and control level in China.