Importance: In 2018, only half of US women obtained all evidence-based cancer screenings. This proportion may have declined during the COVID-19 pandemic because of social distancing, high-risk factors, and fear.
Objective: To evaluate optimal screening strategies in women who obtain some, but not all, US Preventive Services Task Force (USPSTF)-recommended cancer screenings.
Design, Setting, And Participants: This modeling study was conducted from January 31, 2017, to July 20, 2020, and used 4 validated mathematical models from the National Cancer Institute's Cancer Intervention and Surveillance Modeling Network using data from 20 million simulated women born in 1965 in the US.
Interventions: Forty-five screening strategies were modeled that combined breast, cervical, colorectal, and/or lung cancer (LC) screenings; restricted to 1, 2, 3 or 4 screenings per year; or all eligible screenings once every 5 years.
Main Outcomes And Measures: Modeled life-years gained from restricted cancer screenings as a fraction of those attainable from full compliance with USPSTF recommendations (maximum benefits). Results were stratified by LC screening eligibility (LC-eligible/ineligible). We repeated the analysis with 2018 adherence rates, evaluating the increase in adherence required for restricted screenings to have the same population benefit as USPSTF recommendations.
Results: This modeling study of 20 million simulated US women found that it was possible to reduce screening intensity to 1 carefully chosen test per year in women who were ineligible for LC screening and 2 tests per year in eligible women while maintaining 94% or more of the maximum benefits. Highly ranked strategies screened for various cancers, but less often than recommended by the USPSTF. For example, among LC-ineligible women who obtained just 1 screening per year, the optimal strategy frequently delayed breast and cervical cancer screenings by 1 year and skipped 3 mammograms entirely. Among LC-eligible women, LC screening was essential; strategies omitting it provided 25% or less of the maximum benefits. The top-ranked strategy restricted to 2 screenings per year was annual LC screening and alternating fecal immunochemical test with mammography (skipping mammograms when due for cervical cancer screening, 97% of maximum benefits). If adherence in a population of LC-eligible women obtaining 2 screenings per year were to increase by 1% to 2% (depending on the screening test), this model suggests that it would achieve the same benefit as USPSTF recommendations at 2018 adherence rates.
Conclusions And Relevance: This modeling study of 45 cancer screening strategies suggests that women who are noncompliant with cancer screening guidelines may be able to reduce USPSTF-recommended screening intensity with minimal reduction in overall benefits.
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http://dx.doi.org/10.1001/jamaoncol.2021.0952 | DOI Listing |
Acta Pharmacol Sin
January 2025
State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin, 300350, China.
Histone lysine-specific demethylase 1 (LSD1) is overexpressed in various solid and hematological tumors, suggesting its potential as a therapeutic target, but there are currently no LSD1 inhibitors available on the market. In this study we employed a computer-guided approach to identify novel LSD1/EGFR dual inhibitors as a potential therapeutic agent for non-small cell lung cancer. Through a multi-stage virtual screening approach, we found L-1 and L-6, two compounds with unique scaffolds that effectively inhibit LSD1 with IC values of 6.
View Article and Find Full Text PDFSci Rep
January 2025
Department of MRI, Zhongshan City People's Hospital, No. 2, Sunwen East Road, Shiqi District, Zhongshan, 528403, Guangdong, China.
To investigate the potential of an MRI-based radiomic model in distinguishing malignant prostate cancer (PCa) nodules from benign prostatic hyperplasia (BPH)-, as well as determining the incremental value of radiomic features to clinical variables, such as prostate-specific antigen (PSA) level and Prostate Imaging Reporting and Data System (PI-RADS) score. A restrospective analysis was performed on a total of 251 patients (training cohort, n = 119; internal validation cohort, n = 52; and external validation cohort, n = 80) with prostatic nodules who underwent biparametric MRI at two hospitals between January 2018 and December 2020. A total of 1130 radiomic features were extracted from each MRI sequence, including shape-based features, gray-level histogram-based features, texture features, and wavelet features.
View Article and Find Full Text PDFCommun Med (Lond)
January 2025
International Research Center for Neurointelligence, The University of Tokyo, Tokyo, Japan.
Background: In-person interaction offers invaluable benefits to people. To guarantee safe in-person activities during a COVID-19 outbreak, effective identification of infectious individuals is essential. In this study, we aim to analyze the impact of screening with antigen tests in schools and workplaces on identifying COVID-19 infections.
View Article and Find Full Text PDFPharmacoeconomics
January 2025
Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK.
Background: Testing high-risk populations for non-visible haematuria may enable earlier detection of bladder cancer, potentially decreasing mortality. This research aimed to assess the cost-effectiveness of urine dipstick screening for bladder cancer in high-risk populations in England.
Methods: A microsimulation model developed in R software was calibrated to national incidence data by age, sex and stage, and validated against mortality data.
Nat Rev Clin Oncol
January 2025
Department of Obstetrics and Gynecology, University of California, Irvine, Irvine, CA, USA.
Cervical cancer is preventable with screening and vaccination approaches; however, access to these preventative measures is limited both nationally and globally and thus many women will still develop cervical cancer. Novel treatments and practice-changing research have improved cervical cancer outcomes over the past few decades. In this Review, we discuss clinical trials that have refined or redefined the treatment of cervical cancers across the early stage, locally advanced, persistent, recurrent and/or metastatic disease settings.
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