Colorectal cancer screening: Modalities and adherence

In the last decade,several studies have explored various modalities and strategies for colorectal cancer(CRC)screening,taking into account epidemiological data,individual characteristics,and socioeconomic factors.In this editorial,we comment further on a retrospective study by Agatsuma et al published in the recent issue of the World Journal of Gastroenterology.Our focus is on screening trends,particularly in relation to efforts to improve the currently suboptimal uptake among the general population worldwide,aiming to enhance early diagnosis rates of CRC.There is a need to raise awareness through health edu-cation programs and to consider the use of readily available,non-invasive screening methods.These strategies are crucial for attracting screen-eligible populations to participate in first-line screening,especially those in high-or average-risk groups and in regions with limited resources.Liquid biopsies and biomarkers represent rapidly evolving trends in screening and diagnosis;however,their clinical relevance has yet to be standardized.

Cost estimation and control of colorectal cancer screening

Objective:The aim of our study was to estimate the cost of colorectal cancer screening and to provide evidence for the cost control of colorectal cancer screening among general population in rural area of China.Methods:We determined the net cost for colorectal cancer mass-screening in Jiashan County,and evaluated the cost-benefit and cost effectiveness.Results:The compliance rate of primary screening and intensive screening were 84.6% and 78.7%,respectively.In primary screening,the average cost for each individual was 27.2 yuan,and the average cost for identifying one high-risk individual was 180.5 yuan.The mean cost to diagnose one colorectal cancer patient was 42963.3 yuan.As for identification of adenoma,the average cost for each case was 4384.0 yuan.Based on the calculation,the average cost of reducing one colorectal cancer patient was 12768 yuan by conducting the mass-screening protocol.Conclusion:It was beneficial to do the cost-benefit analysis of colorectal cancer screening in area of high incidence.Based on the results of cost-benefit analysis,more efforts should be made to reduce the cost and to improve the efficiency of the colorectal cancer screening.

Strategies for early detection of resectable pancreatic cancer

Pancreatic cancer is difficult to diagnose at an early stage and generally has a poor prognosis. Surgical resection is the only potentially curative treatment for pancreatic carcinoma. To improve the prognosis of this disease, it is essential to detect tumors at early stages, when they are resectable. The optimal approach to screening for early pancreatic neoplasia has not been established. The International Cancer of the Pancreas Screening Consortium has recently finalized several recommendations regarding the management of patients who are at an increased risk of familial pancreatic cancer. In addition, there have been notable advances in research on serum markers, tissue markers, gene signatures, and genomic targets of pancreatic cancer. To date, however, no biomarkers have been established in the clinical setting. Advancements in imaging modalities touch all aspects of the clinical management of pancreatic diseases, including the early detection of pancreatic masses, their characterization, and evaluations of tumor resectability. This article reviews strategies for screening high-risk groups, biomarkers, and current advances in imaging modalities for the early detection of resectable pancreatic cancer.

社区肺癌高危人群低剂量螺旋CT筛查结果分析

目的 :探讨对社区40岁及以上肺癌高危人群进行低剂量螺旋CT(LDCT)的筛查效果。方法 :从本社区肺癌高危人群数据库中登记的898例肺癌高危人群进行LDCT筛查。以发现至少1个≥4 mm非钙化结节为LDCT筛查阳性结果。结果 :检出阳性结节者共137名(15.3%),其中男性结节阳性检出率14.6%,女性检出率15.7%,差别无统计学意义(P>0.05)。各年龄段阳性结节检出率差异无统计学意义(P>0.05)。共筛查出肺癌3例,肺癌检出率为0.33%,占结节阳性者的2.2%。其中有1例是早期肺癌,肺癌早期诊断率33.33%,3例肺癌年龄都在60岁以上。结论 :LDCT在肺癌高危人群筛查应用,有助于提高肺癌的早期诊断率和非钙化结节的检出率,60岁以上高危人群的肺癌筛查应该引起高度关注。

低剂量螺旋CT技术在肺癌筛查中的应用价值研究

目的:探究低剂量螺旋CT技术在肺癌筛查中的应用价值。方法:将2015年2月-2018年8月在本院进行健康体检,结果符合肺癌高危人群的400例受检者纳为本次的研究对象。所有受检者均接受低剂量螺旋CT扫描与常规剂量螺旋CT扫描,对比两组的筛查结果及辐射情况、图像质量、肺结节形态学方面的差异。结果:低剂量螺旋CT检出受检者中有210例(52.50%)存在肺部病变,发现结节56个(14.00%),其中13个疑似恶性结节。经病理证实5例为肺癌,其中4例为早期肺癌,肺癌类型:腺癌1例、鳞癌3例、小细胞癌1例。常规剂量螺旋CT检出受检者中有193例(48.25%)存在肺部病变,发现结节49个(12.25%),其中13个疑似恶性结节。对比两组的辐射情况可知:低剂量螺旋CT扫描的辐射剂量及DLP均明显低于常规剂量螺旋CT扫描(辐射剂量:0.84±0.29mSv<14.51±3.49mSv;DLP:53.92±15.03mGy/cm<1105.06±261.02mGy/cm)(P<0.05),两种方法的图像质量并无明显差异(优良率:低剂量螺旋CT=99.75%vs常规剂量螺旋CT=100.00%)(P>0.05)。肺结节形态学方面,低剂量螺旋CT扫描结果显示:伴毛刺征21例(37.50%)、胸膜凹陷征13例(23.21%)、分叶征16例(28.57%)、血管聚集征6例(10.71%);常规剂量螺旋CT扫描结果显示:伴毛刺征18例(36.73%)、胸膜凹陷征12例(24.49%)、分叶征15例(30.61%)、血管聚集征4例(8.16%),两组经对比分析,形态学特征无明显差异(P>0.05)。结论:低剂量螺旋CT不会影响肺癌筛查的检出率,还能有效的降低受检者的辐射剂量并保证图像的优良率,值得进行推广。

低剂量CT对无症状肺癌高危人群的筛查价值

目的:探讨低剂量CT在无症状肺癌高危人群早期筛查中作用与意义。方法:随机选取2017年3月~2018年3月在我院参加'城市癌症早诊早治项目'筛查的244例肺癌高危人群作为观察对象。采用随机数字表法将研究对象分为观察组和对照组,每组各122例。观察组采用低剂量CT扫描;对照组采用常规剂量CT扫描。记录主机自动生成的CTDIvol、DLP、总扫描时间,并计算相应的ED。对比两组肺结节检出率和图像质量评分。结果:两组平均图像质量评分对比,差异无统计学意义(P>0.05)。两组高危人群肺结节和早期肺癌检出率对比,差异均无统计学意义(P>0.05)。观察组CTDIvol、DLP、ED均明显低于对照组,总扫描时间也明显较对照组减少,差异有统计学意义(P<0.05)。结论:低剂量CT检查可以在较低剂量暴露条件下,保证图像质量以满足无症状肺癌高危人群的筛查要求。

高危人群肺癌筛查—肺部实性及非实性结节的处理

目的:探讨高危人群肺癌筛查方法及肺部实性、非实性结节的临床处理。材料与方法:采用不同方法进行高危人群肺癌筛查,并与病理诊断结果进行比较。观察高危人群肺癌筛查出的肺部有实性结节和非实性结节的患者的HRCT征象,并观察预后状况。结果:病理诊断结果显示共30例为肺癌患者,采用胸部X线共筛查出肺癌21例,明显少于低剂量螺旋CT筛查的28例。共筛查出35例患者存在结节,包括30例肺癌患者,其中22例为非实性结节,13例为实性结节,共26例患者行手术治疗,其中3例患者术后2个月内死亡,其余24例患者预后良好。结论:低剂量螺旋CT在高危人群肺癌筛查中的应用优势更为明显,肺部实性及非实性结节转变为恶性病灶的可能性极大,临床应高度警惕。

低剂量螺旋CT对7496名社区肺癌高危人群的筛查研究

[目的]探讨低剂量螺旋CT（LDCT）对社区肺癌高危人群的筛查效果。[方法]在社区招募7496名肺癌高危人群进行LDCT筛查。肺癌高危人群定义为年龄40岁以上,并且具有下列任何一项者：20包年以上的吸烟史、肺癌家族史、肺部既往病史（慢性阻塞性肺病、肺结核）、职业接触史（石棉、氡、砷、铬、镍接触史）。以发现至少一个≥4 mm非钙化结节为LDCT筛查的阳性结果。[结果]7496名肺癌高危人群进行LDCT肺癌筛查,非钙化结节≥4 mm者共1057名（14.1%）。年龄≥55岁的高危人群结节阳性率显著高于年龄〈55岁者（14.9%vs9.7%;χ2=22.27,P〈0.001）。筛查出肺癌33例,占结节阳性者的3.1%,肺癌检出率为0.44%。共确诊21例非小细胞肺癌,其中0-Ⅰ期11例,早期诊断率为52.4%。[结论]LDCT肺癌筛查有助于提高肺癌的早期诊断率和非钙化结节的检出率,尤以55岁以上人群值得推广。

肺癌筛查高危人群非药物戒烟干预方法的研究进展

吸烟是肺癌筛查高危人群患肺癌的高危因素,患肺癌的相对风险随着吸烟时间和强度的增加而增加。戒烟可以降低患肺癌的风险,推迟肺癌的发病时间。加强对肺癌筛查高危人群的戒烟干预,提高戒烟成功率,可以降低肺癌的发病率与死亡率。我们综述了戒烟行为对肺癌筛查高危人群的影响及非药物戒烟的干预方法,旨在了解目前非药物戒烟干预实施的现状和效果,为医护人员帮助肺癌筛查高危人群戒烟提供方法和思路。