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Hot Topics of the Day are picked by experts to capture the latest information and publications on public health genomics and precision health for various diseases and health topics. Sources include published scientific literature, reviews, blogs and popular press articles.

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79 hot topic(s) found with the query "Cancer prevention"

Challenges and opportunities for Lynch syndrome cascade testing in the United States.
Lauren E Passero et al. Fam Cancer 2024 3 (Posted: Apr 02, 2024 10AM)

From the abstract: " Lynch syndrome is an underdiagnosed genetic condition that increases lifetime colorectal, endometrial, and other cancer risk. Cascade testing in relatives is recommended to increase diagnoses and enable access to cancer prevention services, yet uptake is limited due to documented multi-level barriers. Individual barriers such as feelings of fear, guilt, and anxiety and limited knowledge about Lynch syndrome as well as interpersonal barriers including complex family dynamics and language barriers limit family communication about Lynch syndrome and prevent uptake of genetic screening for relatives. Organizational and environmental barriers including a shortage of genetics professionals, high costs, and fears of discrimination also reduce cascade testing. These multi-level barriers may disproportionately impact underserved populations in the United States,"

Cost-Effectiveness of Population-Based Multigene Testing for Breast and Ovarian Cancer Prevention.
Fangjian Guo et al. JAMA Netw Open 2024 2 (2) e2356078 (Posted: Feb 15, 2024 9AM)

From the abstract: "Is a population-wide genetic testing strategy more cost-effective than the current family history–based testing strategy for breast and ovarian cancer prevention? This economic evaluation found that population-based BRCA1, BRCA2, and PALB2 testing among unselected women was cost-effective for the prevention of breast and ovarian cancer and remained cost-effective in extensive 1-way sensitivity analyses. Population-wide genetic testing was 100% cost-effective for all the simulations in probabilistic sensitivity analyses; it became cost-inefficient only when the cost of the test exceeded a certain threshold ($825). The findings support the need for a shift toward more comprehensive genetic testing strategies to identify pathogenic variant carriers and enable informed decision-making for personalized risk management. "

A population-level digital histologic biomarker for enhanced prognosis of invasive breast cancer.
Mohamed Amgad et al. Nat Med 2023 11 (Posted: Nov 29, 2023 9AM)

From the abstract: " Here we present the Histomic Prognostic Signature (HiPS), a comprehensive, interpretable scoring of the survival risk incurred by breast tumor microenvironment morphology. HiPS uses deep learning to accurately map cellular and tissue structures to measure epithelial, stromal, immune, and spatial interaction features. It was developed using a population-level cohort from the Cancer Prevention Study-II and validated using data from three independent cohorts."

Communicating risk and the landscape of cancer prevention - an exploratory study that examines perceptions of cancer-related genetic counseling and testing among African Americans and Latinos in the Midwest.
Crystal Y Lumpkins et al. Journal of community genetics 2023 3 1-13 (Posted: Mar 20, 2023 7AM)

Six focus groups were held with a pilot sample of African Americans and Latinos who self-reported to be at-risk for cancer (N?=?53). Themes that emerged included (1) the lack of knowledge about cancer-related genetic counseling and testing; (2) cancer is feared often; (3) cancer-related genetic testing was perceived as something that could help but was also perceived as unnecessary testing that exposed individuals to medical harm; and (4) benefits to test were perceived as favorable for medical personnel but not for the patient.

Emergence of nutrigenomics and dietary components as a complementary therapy in cancer prevention.
Shambhavi Srivastava et al. Environmental science and pollution research international 2022 11 (60) 89853-89873 (Posted: Mar 02, 2023 10AM)

A Piece of a Puzzle – The All of Us Research Program and Cancer
K Littrell et al, CDC Blog Post, February 27, 2023 Brand (Posted: Feb 27, 2023 9AM)

The All of Us research program has vast potential for making an impact on population health using the new tools of precision medicine. Pairing genomic data with family health history will be critical for clinical utility. The genetic and environmental data that the All of Us research program promises are all important pieces of the puzzle in the progress towards cancer prevention and control.

Breast Cancer Awareness Month 2022 Digital Media Toolkit
CDC, October 5, 2022 Brand (Posted: Oct 11, 2022 2PM)

In support of the national Breast Cancer Awareness Month October 2022 observance, the CDC Division of Cancer Prevention and Control will focus messaging and activities on finding cancer early, when it’s easiest to treat. Content and activities will be structured to empower people to take the steps needed to find breast cancer early, when it’s easiest to treat by: Knowing your risk for breast cancer; Knowing how you can lower your risk of breast cancer Knowing your family history; Knowing when to get a breast cancer screening; Knowing where to get a breast cancer screening

The oral microbiome and lung cancer risk: An analysis of 3 prospective cohort studies
E Vogtman et al, JNCI, August 5, 2022 (Posted: Aug 06, 2022 6AM)

Previous studies suggested associations between the oral microbiome and lung cancer, but studies were predominantly cross-sectional and underpowered. Multiple oral microbial measures were prospectively associated with lung cancer risk in three US cohort studies with associations varying by smoking history and histologic subtype. The oral microbiome may offer new opportunities for lung cancer prevention.

Can breast cancer prevention strategies be tailored to biologic subtype and unique reproductive windows?
Schedin Pepper et al. Journal of the National Cancer Institute 2022 6 (Posted: Jul 03, 2022 8AM)

CDC Awards $215 Million in Funding to Advance National Cancer Prevention and Control toward Cancer Moonshot Goals
CDC, June 8, 2022 Brand (Posted: Jun 09, 2022 10AM)

This funding builds on investments CDC has made in a comprehensive, coordinated cancer prevention and control portfolio for more than 30 years. Funded programs will demonstrate how proven strategies advance health equity and build capacity in cancer prevention and control. Outcomes include improving the provision of clinical preventive services; facilitating planning among partners to promote evidence-based strategies in communities; and improving cancer surveillance.

Redefining precision cancer prevention to promote health equity.
Butler Eboneé N et al. Trends in cancer 2022 2 (Posted: Feb 23, 2022 8AM)

Precision cancer prevention as it is currently envisioned is a targeted, molecular-based approach to intercept carcinogenesis before cancer develops or before it becomes untreatable. Unfortunately, due to systemic biases, current precision cancer prevention interventions might not be effective in all populations, especially in minoritized communities. In addition, not all cancer risk is attributable to genetic or even biological factors, but includes social determinants of health (SDH). Here, we propose a broader framework for precision cancer prevention, anchored in optimizing the benefits to harms for all people.

Index case identification and outcomes of cascade testing in high-risk breast and colorectal cancer predisposition genes
M Abedalthagafi, EJHG, January 22, 2022 (Posted: Jan 24, 2022 2PM)

Identification of a cancer pathogenic variant variant in an index-case facilitates management strategies such as decisions around the extent of surgical management or targeted therapeutic strategies. It also defines the cancer prevention and early detection strategies in at-risk family members. Cascade screening also reassures non-carrier relatives, excluding them from intensive surveillance and at the same time, contributing to the cost-effectiveness of genetic testing for a wider population.

Polygenic risk modeling for prediction of epithelial ovarian cancer risk
EO Daring et al, EJHG. January 14, 2022 (Posted: Jan 17, 2022 7AM)

The model with the strongest association for non-mucinous EOC risk derived from the OCAC model development data was the S4 model (27,240 SNPs) with odds ratios (OR) of 1.38 (95% CI: 1.28–1.48, AUC: 0.588) per unit standard deviation, in women of European ancestries; 1.14 (95% CI: 1.08–1.19, AUC: 0.538) in women of East Asian ancestries; 1.38 (95% CI: 1.21–1.58, AUC: 0.593) in women of African ancestries; hazard ratios of 1.36 (95% CI: 1.29–1.43, AUC: 0.592) in BRCA1 pathogenic variant carriers and 1.49 (95% CI: 1.35–1.64, AUC: 0.624) in BRCA2 pathogenic variant carriers. Incorporation of the S4 PRS in risk prediction models for ovarian cancer may have clinical utility in ovarian cancer prevention programs.

Prospective Statewide Study of Universal Screening for Hereditary Colorectal Cancer: The Ohio Colorectal Cancer Prevention Initiative.
Pearlman Rachel et al. JCO precision oncology 2021 7 (Posted: Jul 14, 2021 6AM)

Three thousand three hundred ten unselected adults who underwent surgical resection for primary invasive CRC were prospectively accrued from 51 hospitals across Ohio between January 1, 2013, and December 31, 2016. Universal Tumor screening (UTS) for mismatch repair (MMR) deficiency was performed for all. UTS alone is insufficient for identifying a large proportion of CRC patients with hereditary syndromes, including some with LS. At a minimum, 7.1% of individuals with CRC have a PGV and pan-cancer MGPT should be considered for all patients with CRC.

The Million-Dollar Question: Can Empowerment Help People Take Steps to Prevent, Conquer, and Control Cancer?
L Richardson, CDC Cancer Blog, February 2021 (Posted: Feb 13, 2021 11AM)

As we enter a new year, it’s important for people to feel empowered to seek the care they need and to take actions to stay healthy. That’s why I’m excited about a new program from the Centers for Disease Control and Prevention (CDC) and the CDC Foundation, EmPOWERed Health. The program was inspired by the question: Could the number of cancer deaths be lowered by helping people take a more active role in their health and health care?

The role of genomics in global cancer prevention
O Ginsburg et al, Nature Rev Clin Oncology, September 2020 (Posted: Sep 29, 2020 8AM)

In this Review, we present the relevant history and emerging frontiers of cancer genetics and genomics from the perspective of global cancer prevention. We highlight the importance of local context in the adoption of new technologies and emergent evidence, with illustrative examples from worldwide.

Cancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study: a double-blind, randomised, placebo-controlled trial
J Burn et al, The Lancet June 13, 2020 (Posted: Jun 13, 2020 7AM)

In the double-blind, randomized CAPP2 trial, 861 patients from 43 international centres worldwide (707 [82%] from Europe, 112 [13%] from Australasia, 38 [4%] from Africa, and four [<1%] from The Americas) with Lynch syndrome were randomly assigned to receive 600 mg aspirin daily or placebo. Cancer outcomes were monitored for at least 10 years from recruitment.

Key steps for effective breast cancer prevention
KL Britt et al, Nat Rev Cancer, June 11, 2020 (Posted: Jun 13, 2020 7AM)

We can estimate a woman’s breast cancer risk using validated risk assessment models. Models are likely to improve over time, particularly with inclusion of polygenic risk and mammographic density. Evidence-based risk-reducing medications are recommended by professional health bodies; however, widespread implementation of these has proven challenging.

Cancer in sub-Saharan Africa.
Rebbeck Timothy R et al. Science (New York, N.Y.) 2020 01 (6473) 27-28 (Posted: Jan 13, 2020 9AM)

The World Economic Forum has initiated a “Leapfrogging with Precision Medicine” initiative that will advance the use of genetics and genomics in cancer prevention and treatment. These and many other institutions and activities have the potential to develop the knowledge and sustainable resources needed to address the cancer burden in Sub Saharan Africa.

Low rates of cascade genetic testing among families with hereditary gynecologic cancer: An opportunity to improve cancer prevention.
Griffin Natalie E et al. Gynecologic oncology 2019 Nov (Posted: Dec 04, 2019 10AM)

Cascade genetic testing (CGT) of hereditary breast and ovarian cancer (HBOC) or Lynch Syndrome (LS) patients' relatives offers opportunities to prevent cancer, but CGT rates are not well described. We aimed to measure reported disclosure of genetic testing results and CGT rates in these families and evaluate patients' views of educational media.

Prospective Evaluation of a Breast Cancer Risk Model Integrating Classical Risk Factors and Polygenic Risk in 15 Cohorts from Six Countries
AN Wilcox et al., MedXRIV, November 5, 2019 (Posted: Nov 06, 2019 8AM)

Evaluation across multiple prospective cohorts demonstrates that integrating a 313-SNP PRS into a risk model substantially improves its ability to stratify women of European ancestry for applying current breast cancer prevention guidelines.

25 Years of BRCA: How a Cancer Milestone Has Changed the Field
J Infanti, Penn Medicine Blog, October 2019 (Posted: Oct 29, 2019 9AM)

It’s been 25 years since the BRCA1 gene was first cloned — a discovery that accelerated cancer research and opened a new path for exploration in cancer prevention and treatment. The tremendous amount of research and innovation over the past 25 years has led us to a better understanding of the steps we can take to detect cancers early or prevent them altogether.

BRCA testing in unaffected young women in the United States, 2006-2017.
Guo Fangjian et al. Cancer 2019 Sep (Posted: Oct 09, 2019 8AM)

Over the past decade, there was increased use of BRCA testing for cancer prevention. Additional efforts are needed to maximize the early detection of women with BRCA pathogenic variants so that these cancers may be prevented.

For women Lynch syndrome is about more than colon cancer.
Parker Wendy M et al. Cancer prevention research (Philadelphia, Pa.) 2019 Sep (Posted: Oct 02, 2019 8AM)

We had the chance to listen to women with LS, in their own words, discuss their health care experiences as they relate to gynecologic cancer risk and identified several important themes. They describe feeling confused about their screening and surveillance options while also being heavily reliant on their health care providers for guidance.

Validation of New High Throughput, Low Cost HPV Test for Cervical Cancer Prevention
NCI, August 6, 2019 Brand (Posted: Aug 08, 2019 8AM)

A next-generation sequencing assay for detection of 51 types of human papillomavirus (HPV)provides a high-throughput, low cost, and reliable method of detecting cervical precancer and estimating HPV vaccination efficacy.

New name for breast-cancer syndrome could help to save lives
CC Pritchard, Nature, July 3, 2019 (Posted: Jul 03, 2019 1PM)

People of all sexes can have risk genes that are often assumed to affect only women. Renaming the syndrome to King syndrome, should aid cancer prevention and treatment. It also recognizes the pioneering contributions of geneticist Mary-Claire King.

Cancer prevention and screening: the next step in the era of precision medicine.
Loomans-Kropp Holli A et al. NPJ precision oncology 2019 33 (Posted: Feb 06, 2019 11AM)

High prevalence of Hereditary Cancer Syndromes and Outcomes in Adults with Early-Onset Pancreatic Cancer.
Bannon Sarah A et al. Cancer prevention research (Philadelphia, Pa.) 2018 Oct (Posted: Oct 03, 2018 8AM)

Cancer prevention: Molecular and epidemiologic consensus
M Song et al, Science, September 27, 2018 (Posted: Sep 28, 2018 11AM)

Population based germline testing for primary cancer prevention.
Manchanda Ranjit et al. Oncotarget 2018 Sep 9(69) 33062-33063 (Posted: Sep 26, 2018 10AM)

The Cost of Ovarian Cancer Prevention- Seven years ago, I was diagnosed with Lynch syndrome, a hereditary cancer condition which significantly increases my chances of developing early-onset cancer.
G Hurst, Cure Magazine, September 24, 2018 (Posted: Sep 26, 2018 9AM)

Skin Cancer Prevention Progress Report
CDC, 2018 Brand (Posted: Jul 06, 2018 10AM)

Cancer prevention by aspirin in children with Constitutional Mismatch Repair Deficiency (CMMRD).
Leenders Erika K S M et al. European journal of human genetics : EJHG 2018 Jun (Posted: Jun 20, 2018 9AM)

Colon Cancer Prevention Brings Father and Son Together
Dana Farber, May 2018 (Posted: May 28, 2018 10AM)

Breast Cancer Prevention (PDQ®)–Patient Version
Brand (Posted: May 03, 2018 8AM)

Significant SNPs Related to Telomere Length and Hepatocellular Carcinoma Risk in Chronic Hepatitis B Carriers
Mohamadkhani Ashraf et al. Asian Pacific journal of cancer prevention : APJCP 2018 Mar (3) 585-590 (Posted: May 01, 2018 11AM)

Inclusion of a Genetic Risk Score into a Validated Risk Prediction Model for Colorectal Cancer in Japanese Men Improves Performance.
Iwasaki Motoki et al. Cancer prevention research (Philadelphia, Pa.) 2017 Jul (Posted: Aug 23, 2017 9AM)

Prostate Cancer Prevention
Brand (Posted: Aug 22, 2017 0PM)

Utilization of colonoscopy and colonoscopic findings among individuals aged 40-54 years with a positive family history of colorectal cancer: a cross-sectional study in general practice.
Plath Jasper et al. European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) 2017 Jul (Posted: Jul 19, 2017 8AM)

Increasing awareness and knowledge of lifestyle recommendations for cancer prevention in Lynch Syndrome carriers: randomized controlled trial.
Vrieling Alina et al. Clinical genetics 2017 Jun (Posted: Jun 28, 2017 10AM)

Does personalised melanoma genomic risk information trigger conversations about skin cancer prevention and skin examination with family, friends and health professionals?
Smit A K et al. The British journal of dermatology 2017 Jun (Posted: Jun 21, 2017 8AM)

Realizing the Potential of Cancer Prevention — The Role of Implementation Science
KM Emmons et al, NEJM, March 8, 2017 (Posted: Mar 09, 2017 8AM)

Virtues and Weaknesses of DNA Methylation as a Test for Cervical Cancer Prevention.
Lorincz Attila T et al. Acta cytologica 2016 (6) 501-512 (Posted: Jan 24, 2017 0PM)

Clinical challenges associated with universal screening for Lynch Syndrome associated endometrial cancer.
Bruegl Amanda et al. Cancer prevention research (Philadelphia, Pa.) 2016 Dec (Posted: Dec 21, 2016 10AM)

Nutrigenomics at the Interface of Aging, Lifespan, and Cancer Prevention.
Riscuta Gabriela et al. The Journal of nutrition 2016 Oct (10) 1931-1939 (Posted: Oct 10, 2016 7PM)

Prostate Cancer Prevention (PDQ®)–Patient Version
NCI, September 8, 2016 (Posted: Sep 12, 2016 8AM)

Aspirin for Cancer Prevention- One Step Closer
E Vilar et al, JAMA Oncology, March 3, 2016 (Posted: Mar 03, 2016 3PM)

Cancer screening and genetics: a tale of two paradigms.
Hamilton Jada G et al. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2014 Jun (6) 909-16 (Posted: Jan 12, 2016 8AM)

Targeted Cancer Screening in Average-Risk Individuals.
Marcus Pamela M et al. American journal of preventive medicine 2015 Nov (5) 765-71 (Posted: Jan 12, 2016 8AM)

What is the Latest in Preventing Cancer?
SM Lipman, AACR Blog, January 7, 2016 (Posted: Jan 08, 2016 0PM)

Cancer prevention as part of precision medicine: "plenty to be done".
Stewart Bernard W et al. Carcinogenesis 2015 Nov (Posted: Nov 24, 2015 10AM)

Genomics of Cancer and a New Era for Cancer Prevention
P Brennan et al, PLOS Genetics, November 2015 (Posted: Nov 16, 2015 7AM)

Do Health Professionals Need Additional Competencies for Stratified Cancer Prevention Based on Genetic Risk Profiling?
S Chowdhury et al. P Pers Med June 2015 (Posted: Jul 24, 2015 11AM)

Breast cancer prevention in the era of precision medicine.
Narod Steven A et al. J. Natl. Cancer Inst. 2015 May (5) (Posted: Apr 11, 2015 9PM)

Molecular Pathways: Aspirin and Wnt Signaling-A Molecularly Targeted Approach to Cancer Prevention and Treatment.
Gala Manish K et al. Clin. Cancer Res. 2014 Dec 11. (Posted: Mar 24, 2015 10AM)

Can Aspirin and Cancer Prevention be Ageless Companions?
Farag Mohamed et al. J Clin Diagn Res 2015 Jan (1) XE01-XE03 (Posted: Mar 24, 2015 10AM)

Renewed Focus on Preventing Gastric Cancer
Jenks S, J Natl Cancer Inst (2015) 107(1):dju501 (Posted: Mar 04, 2015 10AM)

Genomic landscape and genetic heterogeneity in gastric adenocarcinoma revealed by whole-genome sequencing.
Wong Swee Seong et al. Nat Commun 2014 5477 (Posted: Mar 04, 2015 10AM)

Glutathione S-transferase gene GSTM1, gene-gene interaction, and gastric cancer susceptibility: evidence from an updated meta-analysis.
Lao Xianjun et al. Cancer Cell Int. 2014 (1) 127 (Posted: Mar 04, 2015 10AM)

Genetic polymorphisms of ADH1B, ADH1C and ALDH2, alcohol consumption, and the risk of gastric cancer: the Japan Public Health Center-based prospective study.
Hidaka Akihisa et al. Carcinogenesis 2015 Feb (2) 223-31 (Posted: Mar 04, 2015 10AM)

Genetic polymorphisms of DNA repair pathways influence the response to chemotherapy and overall survival of gastric cancer.
Zhou Jing et al. Tumour Biol. 2014 Dec 28. (Posted: Mar 04, 2015 10AM)

Mutational landscape of gastric adenocarcinoma in Chinese: Implications for prognosis and therapy.
Chen Kexin et al. Proc. Natl. Acad. Sci. U.S.A. 2015 Jan 27. (4) 1107-12 (Posted: Mar 04, 2015 10AM)

Familial gastric cancer: genetic susceptibility, pathology, and implications for management.
Oliveira Carla et al. Lancet Oncol. 2015 Feb (2) e60-e70 (Posted: Mar 04, 2015 10AM)

Polymorphism of the XRCC3 gene and risk of gastric cancer in a Kashmiri population: a case-control study.
Bashir Haamid et al. Eur. J. Cancer Prev. 2015 Jan 30. (Posted: Mar 04, 2015 10AM)

Exome sequencing identifies ATP4A gene as responsible of an atypical familial type I gastric neuroendocrine tumor.
Calvete Oriol et al. Hum. Mol. Genet. 2015 Feb 11. (Posted: Mar 04, 2015 10AM)

Genetic variation and gastric cancer risk: a field synopsis and meta-analysis.
Mocellin Simone et al. Gut 2015 Mar 2. (Posted: Mar 04, 2015 10AM)

Genetic disorders and tests associated with gastric cancer
From the NIH Genetic Testing Registry Brand (Posted: Mar 04, 2015 10AM)

What are the risk factors for gastric cancer
from the American Cancer Society (Posted: Mar 04, 2015 10AM)

What is hereditary diffuse gastric cancer?
from the NIH Genetics Home Reference Brand (Posted: Mar 04, 2015 10AM)

NCI Information: Stomach (Gastric) Cancer Prevention
Family history and genetic factors increase risk of gastric cancer (Posted: Mar 04, 2015 10AM)

CDC Information: Skin Cancer Prevention
Traveling for spring break? Don't forget to pack, protect yourself from the sun, and go! Brand (Posted: Feb 25, 2015 0PM)

CDC Information: Cancer Prevention Starts in Childhood
Brand (Posted: Feb 25, 2015 0PM)

Cancer prevention and control
Brand (Posted: Feb 25, 2015 0PM)

National Cancer Institute Information-Head and Neck Cancer: Prevention, Genetics, Causes
(Posted: Feb 13, 2015 11AM)

Aspirin to Reduce Cancer Risk
Brand (Posted: Jan 11, 2014 11AM)

In the United States, tens of millions of adults take aspirin to reduce their risk of heart attack or stroke. But studies over the last two decades have suggested that regular use of aspirin may have another important benefit: decreasing the risk of developing or dying from some types of cancer. Results from some of these studies, in fact, formed the basis for guidance released in April 2016Exit Disclaimer by an influential federal advisory panel on disease prevention. The panel, the U.S. Preventive Services Task Force (USPSTF), recommended that, for some people, aspirin can be used to help reduce their risk of cardiovascular disease and colorectal cancer. Several researchers who conducted some of the seminal studies on which the USPSTF based its guidance stressed the importance of the panel?s actions. Writing in Nature Reviews Cancer, Andrew Chan, M.D., of Harvard Medical School, and several colleagues called the recommendation a "crucial first step in realizing a potential broader population-wide impact of aspirin use" for cancer prevention. The USPSTF recommendations are far from sweeping, however. And researchers are continuing to investigate critical questions, including just how aspirin may reduce colorectal cancer risk and what other cancers, if any, regular use of this century-old drug may help to prevent. The findings from these studies should help to fill an important informational void. At least one study suggests that, even before the USPSTF made its recommendations, Americans were buying in to the idea of aspirin's anticancer potential; in that 2015 study, 18% of Americans who were taking aspirin regularly said they were doing so to help prevent cancer.

Stomach (Gastric) Cancer Prevention (PDQ®)–Health Professional Version
Brand (Posted: Jan 11, 2014 11AM)

Overview Note: Separate PDQ summaries on Stomach (Gastric) Cancer Screening, Gastric Cancer Treatment, and Levels of Evidence for Cancer Screening and Prevention Studies are also available. Who Is at Risk? People at elevated risk for gastric cancer include elderly patients with atrophic gastritis or pernicious anemia, patients with sporadic gastric adenomas,[1] familial adenomatous polyposis,[2] or hereditary nonpolyposis colon cancer,[3] and immigrant ethnic populations from countries with high rates of gastric carcinoma.[4,5] Workers in the rubber and coal industries are also at increased risk.[6] Risk factors for gastric cancer include the presence of precursor conditions such as chronic atrophic gastritis and intestinal metaplasia, pernicious anemia, and gastric adenomatous polyps. Genetic factors include a family history of gastric cancer, Li Fraumeni syndrome, and Type A blood type.[6] Environmental factors include low consumption of fruits and vegetables; consumption of salted, smoked, or poorly preserved foods; cigarette smoking; and radiation exposure.[6-8] There is consistent evidence that Helicobacter pylori infection, also known as H. pylori infection, of the stomach is strongly associated with both the initiation and promotion of carcinoma of the gastric body and antrum and of gastric lymphoma.[9-11] The International Agency for Research on Cancer classifies H. pylori infection as a cause of noncardia gastric carcinoma and gastric low-grade B-cell mucosa-associated lymphoid tissue or MALT lymphoma (i.e., a Group 1 human carcinogen).[12,13] Compared with the general population, people with duodenal ulcer disease may have a lower risk of gastric cancer.[14] Interventions for Reduction of Stomach (Gastric) Cancer Risk Smoking cessation Based on solid evidence, smoking is associated with an increased risk of stomach cancer.[15-17] The 2004 Surgeon General?s report identifies cigarette smoking as a cause of stomach cancer, with an average relative risk (RR) in former smokers of 1.2 and in current smokers of 1.6.[18] Compared with persistent smokers, the risk of stomach cancer decreases among former smokers with time since cessation. This pattern of observations makes it reasonable to infer that cigarette smoking prevention or cessation would result in a decreased risk of gastric cancer. Magnitude of Effect: A systematic review and meta-analysis showed a 60% increase in gastric cancer in male smokers and a 20% increase in gastric cancer in female smokers compared with nonsmokers.[15] Study Design: Evidence obtained from case-control and cohort studies. Internal Validity: Good. Consistency: Good. External Validity: Good. H. Pylori infection eradication Based on solid evidence, H. pylori infection is associated with an increased risk of gastric cancer. A meta-analysis of seven randomized studies, all conducted in areas of high-risk gastric cancer and all but one conducted in Asia, suggests that treatment of H. pylori may reduce gastric cancer risk (from 1.7% to 1.1%; RR = 0.65; 95% confidence interval, 0.43?0.98).[19] Only two studies assessed gastric cancer incidence as the primary study outcome, and two different studies were double blinded. It is unclear how generalizable the results may be to the North American population. In the initial report from a clinical trial, 3,365 randomized subjects were followed in an intention-to-treat analysis; it was shown that short-term treatment with amoxicillin and omeprazole reduced the incidence of gastric cancer by 39% during a period of 15 years following randomization, with similar but not statistically significant reductions for gastric cancer mortality.[20] Magnitude of Effect: Risk of cancer may be reduced; effect on cancer mortality is not known. Study Design: Randomized controlled trials of H. pylori eradication. Internal Validity: Good. Consistency: Good. External Validity: Good. Interventions With Inadequate Evidence as to Whether They Reduce the Risk of Stomach (Gastric) Cancer Diet Based on fair evidence, excessive salt intake and deficient dietary consumption of fresh fruits and vegetables are associated with an increased risk of gastric cancer. Dietary intake of vitamin C contained in vegetables, fruits, and other foods of plant origin is associated with a reduced risk of gastric cancer. Diets high in whole-grain cereals, carotenoids, allium compounds, and green tea are also associated with a reduced risk of this cancer. However, it is uncertain if changing one's diet to include more vegetables, fruits, and whole grains would reduce the risk of gastric cancer. Magnitude of Effect: Small, difficult to determine. Study Design: Cohort or case-control studies. Internal Validity: Good. Consistency: Small number of studies. External Validity: Fair (populations vary greatly in their underlying nutritional status). Cancer

Using Gene Expression to Diagnose Lung Cancer More Accurately
Brand (Posted: Jan 11, 2014 11AM)

Assessing gene expression in normal cells from the upper airways of current and former smokers with suspected lung cancer may be useful in improving the diagnostic accuracy of bronchoscopy, potentially reducing the need for invasive biopsies, according to a new study published in the New England Journal of Medicine (NEJM). When potentially cancerous lesions in the lung are identified by CT scan, clinicians often use bronchoscopy to evaluate these lesions more closely. Although this procedure is relatively safe, it often fails to produce a definitive diagnosis because the scope cannot reach some areas of the lung. In such cases, an invasive biopsy (surgical or needle) may be required. But these procedures carry the risk of complications, and some investigators have reported more than one quarter of people who undergo a lung biopsy turn out to have benign lesions. In an effort to help address this problem, the researchers tested the normal bronchial cells in the upper airway, taking advantage of the ?field of injury? concept, explained the study?s lead investigator, Avrum Spira, M.D., of the Boston University School of Medicine. When a person smokes, all the cells in their respiratory airways are exposed to tobacco smoke, which causes DNA damage. A distinct pattern of DNA damage can be observed in the epithelial cells of smokers who go on to develop lung cancer, Dr. Spira and his colleagues showed in a 2007 study. The patterns of DNA damage in normal cells from the upper respiratory tract are ?like the canary in the coal mine,? he explained in an interview. Based on differences in the pattern of DNA damage, the researchers developed a gene expression signature?a genomic classifier?that could be used to test normal cells from the bronchial airway obtained during bronchoscopy for the presence of tumors inside the lungs. In the NEJM study, they applied the findings of the earlier study and showed that ?the classifier works in a real-world, clinical setting,? said Dr. Spira. The study, which was funded in part by NCI?s Early Detection Research Network, enrolled 639 adult current and former smokers who were participating in two clinical trials, AEGIS 1 and AEGIS 2. All participants underwent a bronchoscopy for suspected lung cancer, and a brush was used to collect epithelial cells from the mainstem bronchus of the airway during bronchoscopy. The gene expression patterns in the epithelial cells were analyzed and patients were followed until a diagnosis was made or for 12 months after bronchoscopy. A total of 487 patients were found to have lung cancer. No diagnosis could be made in 272 patients based on a bronchoscopy alone, they found. Of these patients with a nondiagnostic bronchoscopy, 170 underwent a further invasive procedure to secure a diagnosis (including surgery in 76 patients), 52 of whom were eventually diagnosed with benign lung lesions. They also assessed the sensitivity and specificity of bronchoscopy plus the classifier, because an accurate diagnostic test not only detects most of the cancers that are present (sensitivity) but it also has a low chance of incorrectly indicating cancer in someone who does not have it (specificity). Overall, the sensitivity of bronchoscopy plus the classifier was 97 percent compared with 75 percent for bronchoscopy alone. The sensitivity of the combination test was consistently high across nodule size, location, cancer stage, or type, they reported. The genomic classifier incorrectly suggested cancer in 53 percent of people who did not have lung cancer. Although the test has a high rate of false positives, when both the bronchoscopy and the classifier were negative, the probability that the patient had cancer was reduced. A negative test result can inform clinical management and eliminate unnecessary invasive biopsies that carry the risk of complications as well as costs to the health care system, Dr. Spira said. ?A negative test gives you peace of mind,? he explained. One limitation of the study is that it was evaluated only in patients who were already strongly suspected of having cancer, said Barry Kramer, M.D., M.P.H., director of NCI?s Division of Cancer Prevention. "The paper doesn?t tell us how this would perform in a true screening setting," Dr. Kramer continued. "The prevalence of cancer in the two cohorts is 74 percent and 75 percent, much higher than in a general population of screened cigarette smokers or former smokers, even with abnormalities on low-dose chest CT." This is the first time a genomic classifier for lung cancer has been developed and validated in high-risk cohorts, explained Sudhir Srivastava, Ph.D., M.P.H., chief of the cancer biomarkers research group in NCI?s Division of Cancer Prevention. The study, he continued, "lends further support for developing a similar approach for lung cancer screening in an asymptomatic population." Initially, the test?known commercially as the Percepta Bronchial Genomic Classifier?will be available to 30 to 40 medical centers as part of an early access program before becoming more widely available, according to Veracyte, which manufactures the test. Cancer

Cancer Moonshot Blue Ribbon Panel Report
Brand (Posted: Jan 11, 2014 11AM)

The Blue Ribbon Panel report describes 10 transformative research recommendations for achieving the Cancer MoonshotSM's ambitious goal of making a decade's worth of progress in cancer prevention, diagnosis, and treatment in just 5 years.

Approaches to Blue Ribbon Panel Recommendations: The Case of Lynch Syndrome
Brand (Posted: Jan 11, 2014 11AM)

The National Cancer Institute (NCI) convened a Workshop on February 22?23, 2017, in Rockville, Maryland, to discuss issues related to cancer genetic testing approaches, current practices, and resources for case and family ascertainment in hereditary cancers, using Lynch syndrome as an example. Lynch syndrome is a genetically inherited disorder that increases the risk of colorectal and endometrial cancers and several other malignancies. It is estimated that in the United States, up to 1 million people live with Lynch syndrome, but many are unaware of it. One approach recommended by the Cancer MoonshotSM Blue Ribbon Panel for identifying those with Lynch syndrome is testing of colorectal and endometrial cancers for specific markers. When the tumor test is abnormal, additional genetic testing and counseling is indicated to determine whether an individual has Lynch syndrome. If Lynch syndrome is diagnosed, then other family members could be tested. During the Workshop, the Cancer MoonshotSM Blue Ribbon Panel Report recommendations on cancer prevention and early detection in individuals at high risk for cancer were reviewed, and discussion topics included health care delivery, gaps in current knowledge, and identification of resources needed to inform implementation.


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