Risultati per: Screening e la diagnosi del cancro al seno

Sacituzumab govitecan per carcinoma HR+/HER- e triplo negativo

Objectives
To explore husbands’ views on breast cancer screening, risk-based screening and their role in influencing their wives’ health-seeking behaviours.

Design
Qualitative focus group discussion (FGD) supplemented by quantitative data from a cohort study using a structured questionnaire.

Setting
This study was conducted in a community-based setting, with participants recruited online through non-profit organisations via social media and email.

Participants
Nineteen husbands of women without breast cancer history participated. The questionnaire data were completed by 3395 women with no breast cancer history.

Interventions
Not applicable.

Primary and secondary outcome measures
Not applicable.

Results
Six key themes emerged from FGDs regarding husbands’ attitudes towards women’s breast cancer screening practices: awareness, priorities, social support structures, fears, incentives and attitudes towards risk-based screening. These themes were supported by the questionnaire data, which also identified additional concerns not raised in FGDs, suggesting a gap in the husband’s awareness and limited health-related communication between spouses. While husbands expressed interest in their wives’ health and provided support in making screening appointments, their influence may be limited by these communication gaps. Most husbands were receptive to risk-based screening but raised concerns around the testing frequency and result interpretation.

Conclusions
This study highlights the need to actively engage husbands in breast cancer screening discussions and develop support strategies that enhance their involvement. Strengthening spousal communication on breast health may increase screening uptake among women.

Un confronto fra esperti nella Breast Unit del Gemelli

Asp Ambito 9 a Jesi per prevenzione malattie neurodegenerative

Introduction
Hepatocellular carcinoma (HCC) is expected to become the third most common cause of cancer death worldwide by 2030. The increase in HCC is in large part due to the rising prevalence of risk factors such as type 2 diabetes mellitus (T2DM). Up to 1 in 20 people living with T2DM have liver cirrhosis, and they have a 1% to 2% incidence of HCC per year. Patients with cirrhosis enter surveillance for HCC to identify early-stage, curable tumours. A diagnosis of T2DM does not mandate testing to identify patients with cirrhosis, with testing restricted to those with additional risks. There has never been a trial and nested cost-effectiveness evaluation comparing screening all patients with T2DM for cirrhosis against usual care.

Methods and analysis
The study will use a multi-centre, unblinded individual randomised controlled trial design. The aim will be to determine the effectiveness and cost-effectiveness of screening all adults with T2DM to identify those at high risk of HCC. The recruitment strategy has been supported by patient and public involvement (PPI). Participants will be identified via an automated search of primary care records and invited to participate via text. 320 participants will be randomised for screening. The screening will include measurement of bio-markers for liver fibrosis (ELF and Fib-4) and vibration-controlled transient elastography. Another 320 participants will be randomised to standard care. Demographic and medical history data will be collected at baseline from all participants. Outcome data will be collected remotely from healthcare records. The primary outcome is the proportion of participants in each arm who are referred to HCC surveillance following testing for liver disease within 12 months of randomisation. The results will be used to calculate the incremental cost-effectiveness ratio of screening via a Markov model.

Ethics and dissemination
The results of this study will be presented directly to National Health Service England. Additional dissemination via conference proceedings and publication will be supported by our PPI team. Ethical approval was granted by the West of Scotland Research Ethics Service on 2 August 2023, REC reference 23/WS/0102.

Trial registration number
ISRCTN17017677.

Oltre 38mila casi l’anno in Italia. Molecola funziona nella malattia metastatica, studio sulla fase precoce

Colonoscopy, a crucial procedure for detecting and removing colorectal polyps, has seen transformative advancements through the integration of Artificial Intelligence (AI), specifically in Computer-Aided Detection (CADe) and Diagnosis (CADx). These tools enhance real-time detection and characterization of lesions, potentially reducing human error, and standardizing the quality of colonoscopy across endoscopists. CADe has proven effective in increasing adenoma detection rate, potentially reducing long-term colorectal cancer incidence.

In Reply In response to the Letters regarding our recent article, we agree with Dr Shiratori and colleagues that our study requires a longer follow-up period, as was also noted by Drs Kumar and Bretthauer and by Dr Liu and colleagues. In our pragmatic trial, factors such as nonadherence to invitation, difference in participant characteristics, and limited treatment uptake have attenuated the potential benefits observed in earlier trials. To address this, we have provided the cumulative curve as requested and included a future projection based on the observed trends (Figure). In our trial, a nonsignificant 14% risk reduction was observed in 2020. However, with an extended follow-up to 2023, a significant 21% reduction would be expected after projection.

To the Editor A recent study shed light on the potential value of FIT combined with HPSA testing in gastric cancer screening, while also indirectly highlighting the potential link between H pylori infection and colorectal carcinogenesis. We would like to discuss aspects of the study that require careful interpretation and further exploration.

To the Editor In a recent trial, there were no differences in gastric cancer incidence or mortality between the 2 treatment groups at a median follow-up of 5.7 years (IQR, 4.9-6.5 years). The progression time from early asymptomatic to symptomatic gastric cancer is unknown and may be longer than the follow-up time of the trial. Presentation of cumulative incidence curves would be helpful to further gauge the effect of the intervention. Furthermore, the study excluded 4 patients with gastric cancer diagnosed on endoscopy after trial entry. While H pylori eradication may not have affected the development of cancer in these patients, excluding them creates bias because the control group was not exposed to gastroscopy with early detection of prevalent cancers. We suggest a recalculation of screening effects including the 4 patients who were excluded. Additionally, we are interested to know if more than 1 H pylori stool test was offered (for example, with subsequent FIT), which would provide information about reinfection and subsequent cancer risk.

This trial compares the effect of electronic sepsis screening vs no screening on mortality among hospitalized patients.

To the Editor Dr Lee and colleagues conducted a randomized, population-based trial in Taiwan to assess whether the addition of the Helicobacter pylori stool antigen (HPSA) test to the standard fecal immunochemical test (FIT) could reduce gastric cancer incidence and mortality. The study reported no significant differences between the 2 groups in gastric cancer incidence (0.032% vs 0.037%; P = .23) or mortality (0.015% vs 0.013%; P = .57). Several points merit further discussion.

To the Editor A recent randomized trial involving residents of Changhua County, Taiwan, offered valuable insights into the effectiveness of HPSA testing combined with FIT for colorectal cancer screening. While the study provides robust data, several key findings warrant further reflection.

Iniziativa all’Università Politecnica delle Marche

Radiologi: ‘E’ più difficile vedere un tumore, serve fare anche la risonanza’