Ability of community-based prostate cancer screening to target an appropriate and underserved population

Screening is not universally beneficial due to over-and under-diagnosis,and false positives that beget additionaltesting and associated adverse events and expense.We examined data from all men who participated in a mass community prostate cancer screening between May 2009 and September 2010.The data contained information regarding patient demographics,family history of prostate cancer,lower urinary tract symptoms,prior history of prostate cancer,most recent digital rectal examination,and the presence of an established relationship with a physician.Current American Urological Association screening recommendations were then applied to determine the appropriateness of our outreach effort.A total of 438 men(mean age 66.5 years) underwent screening.A total of 106(24.2%) patients in our study met contemporary criteria for screening.Of these men,the vast majority was well educated,well insured,and well informed about the need for prostate cancer screening.Based on these data,mass community-based prostate cancer screening does not appear to identify and screen at-risk men.Future efforts at mass screening should more carefully target men most likely to benefit.

Interactions between pork consumption,CagA status and IL-1B-31 genotypes in gastric cancer

AIM: To explore potential interactions among Helicobacter pylori(H. pylori), CagA status, interleukin(IL)-1B-31 genotypes, and non-cardiac gastric cancer(GC) risk.METHODS: A case-control study of non-cardia GCwas performed at 3 hospitals located in Xi'an, China, between September 2008 and July 2010. We included 171 patients with histologically diagnosed primary noncardia GC and 367 population based controls(matched by sex, age and city of residence). A standardized questionnaire was used to obtain information regarding potential risk factors, including pork consumption. H. pylori CagA status was assessed by enzyme-linked immunosorbent assay, and IL-1B-31 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. Multivariate unconditional logistic regression was used to explore potential interactions among the factors.RESULTS: The CagA appeared to confer an increased risk of GC(OR = 1.81, 95%CI: 1.25-2.61). The main associations with IL-1B-31C allele here were 0.98(95%CI: 0.59-1.63) for CC vs TT and 0.99(95%CI: 0.64-1.51) for C Carriers vs TT. However, no associations were observed for CagA or IL-1B-31 genotype status among subjects who reported low pork consumption(P for interaction = 0.11). In contrast, high pork consumption and IL-1B-31C genotypes appeared to synergistically increase GC risk(P for interaction = 0.048) after adjusting for confounding factors, particularly among subjects with CagA(OR = 3.07, 95%CI: 1.17-10.79). We did not observe effect modification of pork consumption by H. pylori CagA status, or between H. pylori CagA status and IL-1B-31 genotypes after adjustment for pork consumption and other factors.CONCLUSION: These interaction relationships among CagA, IL-1B-31 and pork consumption may have implications for development of the preventive strategies for the early detection of non-cardiac GC.