ASPO Abstracts
Life expectancy is normal if neoplasia is early detected: One stop screening for multiple cancer types: 11 year experience of an integrated cancer prevention center
Category: Early Detection & Risk Prediction, Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2018
Abstract Body:
BACKGROUND: Cancer is the leading cause of mortality worldwide. METHODS: Screening of healthy individuals (age 20-80 years) at the ICPC included 11 most common cancer types that are responsible for 80% of cancer mortality. Extensive clinical and epidemiological data was obtained. Peripheral blood DNA was and genotyped for APC I1307K and E1317Q. Subjects were examined by specialists in internal medicine, surgery, plastic surgery, OBGYN, urology, oncology, oral surgery, gastroenterology, and others when indicated. Women (all ages) underwent vaginal US and pap smear and (40 yr) mammography and US/MRI with a clinical indication. PSA and free PSA for Men (>40 yr). LDCT for heavy smokers. Colonoscopy was recommended to all subjects (>40 yr). RESULTS: 7067 (49.4%) men and 7240 (50.6%) women began screening at a mean age of 46.69±11.5 years. 647 new lesions were detected among 602 (4.21%). Over half of them were malignant (366, 56.6%). Skin (105, 0.73%), breast (44, 0.31%), prostate (35, 0.24%), thyroid (31, 0.22%), colorectal (24, 0.17%), ovarian (19, 0.13%), urinary (17, 0.12%), lung (15, 0.10%), hematology (15, 0.10%), cervical (14, 0.10%) and oropharynx (11, 0.08%). Patients with newly diagnosed cancers began screening at a significantly older age (55±13 years, P<0.0001). In 23 patients (0.16%) more than one cancer was detected. Among all patients with cancer (1150) 69 (6.0%) died after 33±26 months at a mean age of 69±13 years. The survival rate of both groups (newly diagnosed and cured) was not significantly different. The APC I1307K and E1317Q variants were detected in 572 (4.8%) and 182 (1.5%) subjects respectively. First-degree family member with cancer (OR = 1.8), I1307K carrier ship (OR = 1.36), female gender (OR = 1.31) and advanced age (OR = 1.06) were all associated with statistically significant (P<0.05) increased cancer risk. Advanced age and first degree family history were also associated with detection of more than one cancer types. CONCLUSIONS: One stop shop screening for 11 common cancers is feasible. Screening in this setting can significantly improve morbidity and mortality. The I1307K APC carries an overall increase cancer risk. The life expectancy of cancer patients diagnosed at the ICPC is similar to the general population.
Keywords: Screening, Early detection, Prevention, Cancer, Mortality