Promising cancer clinical trials results involving the disruption of early stages of cancer with intervention agents such as tamoxifen or retinoids have led to significant new research interest in developing preventat...
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Promising cancer clinical trials results involving the disruption of early stages of cancer with intervention agents such as tamoxifen or retinoids have led to significant new research interest in developing preventative strategy for the control of epithelial cancers. Key to the efficient progress in this field is a clear understanding of the complex biology of the early stages of cancerization that proceed on the epithelial surface. Systematic analysis of the biology of strategic targets such as growth factors is one approach to this problem. Gastrin-releasing peptide is an autocrine growth factor for certain types of lung cancer cells. Mechanisms involved in the production and activation of this peptide are discussed as an example of how rational approaches to neutralization of cancer promotion biology can be achieved. The tools to monitor the success of this type of intervention also emerge from the understanding of the biology of growth factors, and intermediate end point markers that determine the presence or effects of a growth factor are attractive candidates for evaluation. Additional biologic tools reflecting the early stages of the cancer process need to be validated for use in serially evaluating the status of the relevant epithelium so that the ongoing success of a cancer intervention procedure can be established. Through this type of translational research, important applications of molecular biology may greatly improve the success of preventative strategies for cancercontrol.
There is now considerable concern that universal access to health care within realistic resource constraints requires some sort of cost-effectiveness analysis of given medical procedures and interventions. One such in...
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There is now considerable concern that universal access to health care within realistic resource constraints requires some sort of cost-effectiveness analysis of given medical procedures and interventions. One such intervention is routine mammographic screening for breast cancer. Here, we report preliminary results from an ongoing project to conduct a systematic and comprehensive review and comparison of the published cost-effectiveness analyses of screening for the early detection of breast cancer. We examine 16 such studies, and compare two studies in detail to explain how differences in assumptions and in consideration of down-stream effects have caused the published results for apparently comparable breast cancer screening programs to span a broad range.
Background: Reports to date have provided widely divergent estimates of the risk of second malignant neoplasms in patients with chronic lymphocytic leukemia (CLL), ranging from cancer deficits to excesses of twofold t...
Background: Reports to date have provided widely divergent estimates of the risk of second malignant neoplasms in patients with chronic lymphocytic leukemia (CLL), ranging from cancer deficits to excesses of twofold to threefold. Purpose: Our purpose was to estimate the risk of second primary cancers following CLL, utilizing population-based tumor registries, and to determine whether site-specific excesses might be associated with type of initial treatment for CLL. Methods: We analyzed data for 9456 patients diagnosed with CLL as a first primary cancer between 1973 and 1988, who were reported to one of nine tumor registries participating in the National cancer Institute's Surveillance, Epidemiology, and End Results(SEER) program and who survived 2 or more months. SEER files malignancies that developed at least 2 moths after the initial CLL diagnosis. Results: Compared with the general population, CCL patients demonstrated a significantly in creased risk of developing all second cancers (840 observed;observed-to-expected ratio[O/E]=1.28;95% confidence interval [CI]=1.19-1.37). Significant excesses were noted for cancers of the lung (O/E=1.90), brain(O/E=1.98), and eye (interaocular melanoma) (O/E=3.97) as well as malignant melanoma (O/E=2.79) and Hodgkin's disease (O/E=7.69).cancer risk, which did not vary according to initial treatment category was also constant across all time intervals after CLL diagnosis. Conclusion: CLL patients are at a significantly increased risk of developing a second malignant neoplasm. The patern of cancer excesses suggests a susceptibility state permitting the development of selected second malignancies in patients with CLL, perhaps because of shared etiologic factors, immunologic impairmentm, and /or other influences. Although our results fo not suggest a strong treatment effect, more detailed studies of second tumors in CLL are needed to investigate the role of radiation therapy and chemotherapy. [J Natl cancer Inst 84: 1422-1427, 1922]
Although it cannot be said that "everything causes cancer," our environment will never be carcinogen-free. As a result, there are many substances we come in contact with daily that could be potentially harmf...
To promote the inclusion of quality of life (QOL) end-points in clinical research on cancer, the National cancer Institute (USA) sponsored a workshop on QOL assessment in cancer clinical trials in July, 1990. Experts ...
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Breast cancer incidence in the United States has been rising dramatically since 1982, as shown in data collected by the Surveillance, Epidemiology, and End Results (SEER) program. In women aged 50 and older, incidence...
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Breast cancer incidence in the United States has been rising dramatically since 1982, as shown in data collected by the Surveillance, Epidemiology, and End Results (SEER) program. In women aged 50 and older, incidence rates for in situ and localized invasive tumors have increased over the period 1982-86, while rates for regional and distant tumors have remained stable. The incidence of localized tumors < 1.0 cm, 1.0-1.9 cm, and 2.0-2.9 cm in size has increased more rapidly than that of tumors 3.0 cm or more in size among women over age 50. Survival rates also have improved among cases diagnosed over this time period. These data suggest that early detection may be playing a role in the recent increase in female breast cancer incidence, though other factors cannot be ruled out. Conclusions regarding improved cancercontrol await confirmation by reduced breast cancer mortality.
Findings from the new American cancer Society prospective study of 1.2 million men and women indicate that mortality risks among smokers have increased substantially for most of the eight major cancer sites causally a...
Findings from the new American cancer Society prospective study of 1.2 million men and women indicate that mortality risks among smokers have increased substantially for most of the eight major cancer sites causally associated with cigarette smoking. Lung cancer risk for male smokers doubled, while the risk for females increased more than fourfold. On the basis of the new American cancer Society relative risks, we project that cigarette smoking alone will contribute to slightly more than 157 000 of the 514 000 total cancer deaths expected to occur in the United States in 1991. Overall, smoking directly contributes to 21.5% of all cancer deaths in women but 45% of all cancer deaths in men. It would also appear that lung cancer has now displaced coronary heart disease as the single leading cause of excess mortality among smokers in the United States.
This Consensus Statement reviews the findings, conclusions, and recommendations of a panel of experts convened by the American cancer Society Task Force on Children and cancer to discuss the potential value of mass sc...
This Consensus Statement reviews the findings, conclusions, and recommendations of a panel of experts convened by the American cancer Society Task Force on Children and cancer to discuss the potential value of mass screening of children for neuroblastoma.
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