Screening and early detection of pancreatic cancer in high risk population

Pancreatic cancer is a serious growing health issue in developed countries.For patients diagnosed with pancreatic cancer,the five year survival rate is below 5%.One major important reason leads to the poor survival rate is lack of early detection of pancreatic cancer.Over 80% of the patients are diagnosed in advanced disease stages.Screening for pancreatic cancer is a desirable option for high risk individuals to allow early detection and treatment of curable pancreatic neoplasms at a pre-invasive stage.This article highlights the need,endpoint,population,method,diagnostic yield,and the problems of current screening programs.

ESTABLISHMENT OF HIGH RISK POPULATION AND PRECANCEROUS LESION OF NASOPHARYNGEAL CARCINOMA(NPC)

A prospective study was done by the examination of nasopharyngoscope, reaction of EB virus's antigens and antibodies, nasopharyngofibroscope, pathological and EB virus's DNA, EBERs, etc. of about 100000 persons in high risk area of NPC in Guangdong Province, China from 1986 to 1995. If any one of the following four conditions is present in some persons, i.e., (1) EBV VCA/IgA titer>1:80, (2) EBV EDAb>60%, (3) Dual or triple positiveness in VCA/IgA, EA/IgA and EDAb, (4) Any one of VCA/IgA, EA/IgA and EDAb keeps high titer or going up, they should be regarded as in precancerosis of NPC. The moderate or severe heteroplasia and heterometaplasia of nasopharyngeal mucosa are the precancerous lesions of NPC. Some individual who is in precancerosis or with precancerous lesion should be regarded as the high risk population of NPC. The results are of important scientific basis for screening and second degree prevention of NPC.

A STUDY OF PRECANCEROUS GASTRIC LESIONS IN A HIGH RISK POPULATION

A study of precancerous gastric lesion was conducted in a randomly selected high risk population in Linqu, Shandong Province of China. 849 subjects aged from 30-64 were examined bioptically. There were 8 cases of gastric cancer, the prevalence rate was 0.9%. 169 subjects were diagnosed to be dysplasia, the prevalence rate of dysplasia was increased significantly with age. The regression equation was Y=0.47X-0.25. The prevalence of CAG was found in 36 per cent of the studied subjects and both dysplasia and CAG were more serious in the antrum than the. fundus. The results showed a natural history of precancerous gastric lesions in a high risk population in a high risk area.

Liver cancer screening in China: practices and its extended questions

Screening for liver cancer(hepatocellular carcinoma)in China started in early 1970s with the application of alpha-fetoprotein(AFP)in high-incidence regions.It has been extended to nationwide areas,emerging from the concepts of conducting screening in populations at-risk with positive hepatitis B surface antigen to the practice programs in rural and urban areas,and finally to the development of recommendations to guide medical practice for health care providers.The implementation of screening for liver cancer has resulted in earlier detection and hence the early curable treatment for patients who have gained short-or long-term survival,and even reduction in mortality rates,although these outcomes are more anecdotal than rigorously evidence-based.AFP or ultrasound examination has been considered as sensitive and specific methods for early detection but are with limitations.The combined use of these two modalities for screening populations at-risk every six months seems to have been reached consensus.The feasibility of screening for liver cancer is still debated because of differing opinions and even opposition to the choice of targeted sub-populations,the intrinsic necessity,and the contributions of the main risk factors among Western countries and China/Asian areas.Yet,the over 51%of global burden of liver cancer is in China,the solution to the early detection and treatment of liver cancer should fully consider the actual situation in China.The effectiveness of screening for liver cancer is worthy of anticipation.

Stroke screening and health-related physical fitness testing in medical staff members in Urumqi, China

Objective: Stroke is the leading cause of death and disability, and is closely related to a lack of exercise. Currently, most Chinese medical staff members lack exercise and may be at risk for stroke. We sought to determine the risk factors for stroke and study the significance of health-related physical fitness testing in stroke prevention among Chinese medical staff members. Methods: A total of 627 subjects from Urumqi, Xinjiang, China, were included in the study and a survey was conducted from 1st January 2016 to 1st February 2016. Stroke screening and health-related physical fitness testing were completed according to the standard protocol, and the related data were analyzed. Results: Based on the screening, 27.6%(n=173) of the subjects were at high risk for stroke. The top risk factors for stroke in these subjects were dyslipidemia, lack of exercise or mild physical activity, being overweight or obese, and high blood pressure. Body weight, body mass index, body fat, visceral fat area, body fat percentage, and basal metabolic rate were significantly higher (P<0.01) in subjects at high risk for stroke than in subjects who were not at high risk. Lung capacity, step index, grip test, vertical jump, and sit-up/push-up index were significantly lower (P<0.01) in subjects at high risk for stroke than in subjects who were not at high risk. Conclusions: A large proportion of China's on-the-job medical personnel is at high risk for stroke. This may be related to the nature of the profession and warrants more attention from the society. The health-related physical fitness measurement parameters in subjects at high risk for stroke were significantly different from those in subjects who were not at high risk. Screening and health-related physical fitness testing in medical staff members may contribute to stroke prevention. More rigorous controlled clinical trials will be needed in the future.