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NCCN Policy Summit: Reducing the Cancer Burden Through Prevention and Early Detection

Lindsey Bandini, Alyssa Schatz, Victoria Hood, Nikia Clark, Michael J. Hall, and Robert W. Carlson

Reducing the Cancer Burden Through Prevention and Early Detection Cancer prevention, screening, and early detection play an integral role in cancer incidence and outcomes. It is estimated that 30% to 50% of cancers worldwide are preventable

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Counterpoint: Prostate-Specific Antigen Velocity Is Not of Value for Early Detection of Cancer

Andrew J. Vickers

, including those related to early detection. Even an article concluding that there was “little justification” for the use of PSA velocity reported that PSA velocity was a statistically significant ( P <.001) predictor in a multivariable model. 1 However

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Prostate Early Detection Clinical Practice Guidelines in Oncology

Prostate cancer is the most commonly diagnosed cancer in American men and the second leading cause of cancer deaths. In 2004, nearly 20 million men in the United States will be confronted with important decisions regarding early detection for prostate cancer. In brief, the dilemma is that because not all men with prostate cancer die of the disease, treatment is not necessary for some patients. However, an estimated 29,900 patients will die of prostate cancer in 2004. Therefore, differentiating between patients whose cancer is clinically insignificant and those whose disease will progress is a challenge. The NCCN Prostate Cancer Early Detection Clinical Practice Guidelines in Oncology provide a set of sequential recommendations detailing a screening and subsequent work-up strategy for maximizing the detection of prostate cancer in an organ-confined state while attempting to minimize unnecessary procedures.

For the most recent version of the guidelines, please visit NCCN.org

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Prostate Cancer

James Mohler, Robert R. Bahnson, Barry Boston, J. Erik Busby, Anthony D'Amico, James A. Eastham, Charles A. Enke, Daniel George, Eric Mark Horwitz, Robert P. Huben, Philip Kantoff, Mark Kawachi, Michael Kuettel, Paul H. Lange, Gary MacVicar, Elizabeth R. Plimack, Julio M. Pow-Sang, Mack Roach III, Eric Rohren, Bruce J. Roth, Dennis C. Shrieve, Matthew R. Smith, Sandy Srinivas, Przemyslaw Twardowski, and Patrick C. Walsh

low death rate suggests that, unless prostate cancer is becoming biologically less aggressive, increased public awareness with earlier detection and treatment of prostate cancer has begun to affect mortality from this prevalent cancer. However, early

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Role of Complexed PSA in the Early Detection of Prostate Cancer

Yoshio Naya and Koji Okihara

hyperplasia on elevated serum prostatic specific antigen levels . J Urol 1995 ; 154 : 407 – 413 . 5 Djavan B Zlotta AR Byttebier G . Prostate specific antigen density of the transition zone for early detection of prostate cancer . J Urol 1998

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HSR22-140: Patient Preferences for Multi-Cancer Early Detection Tests: A Discrete Choice Experiment (DCE)

Heather Gelhorn, Melissa Ross, Anuraag R Kansal, Eric T Fung, Michael Seiden, Nicolas Krucien, and Karen C Chung

OBJECTIVES : Early cancer detection can significantly improve patient outcomes and reduce mortality. Emerging blood-based multi-cancer early detection (MCED) tests can detect a variety of cancer types across stages with a range of sensitivity

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HSR23-100: The Potential Clinical Impact of a Multi-Cancer Early Detection Test for Individuals With Missing Cancer Stage Information

Ali Tafazzoli, Alissa Shaul, Weicheng Ye, Anuraag R. Kansal, and A. Mark Fendrick

comorbidities. Cancer stage is prognostic and vital for estimating the clinical impact of prevention strategies such as multi cancer early detection (MCED) tests. This study investigated different imputation approaches for missing stage data and the resulting

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Potential Cost-Effectiveness of Risk-Based Pancreatic Cancer Screening in Patients With New-Onset Diabetes

Naomi R.M. Schwartz, Lynn M. Matrisian, Eva E. Shrader, Ziding Feng, Suresh Chari, and Joshua A. Roth

unresectable stage IV disease (4.8-month median cancer-specific survival). 3 These large differences in survival motivate the need for effective PAC early-detection strategies that can identify cases before disease spread. The primary challenge surrounding

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Computed Tomography Screening for the Early Detection of Lung Cancer

Rebecca P. Petersen and David H. Harpole Jr.

Although lung cancer is the leading cause of cancer-related death in the world and has an increased chance of cure if detected at an earlier stage, routine lung cancer screening is currently not recommended in the United States. Unfortunately, most patients with lung cancer present only after the onset of symptoms and have advanced disease that cannot be surgically resected. The overall 5-year survival rate for all patients with lung cancer is only 15%. When the cancer is detected at its earliest stage (pathologic stage IA), however, the 5-year survival rate is more than 70%. Although past randomized screening trials evaluating the use of standard chest radiography or sputum cytology have not resulted in lower mortality, recent studies suggest that computed tomography (CT) may have promise as a screening tool. This article summarizes experience over the past decade of using low-dose spiral CT imaging as a screening tool to detect early lung cancers in asymptomatic, high-risk individuals.

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Use of Nomograms for Early Detection in Prostate Cancer

Devon C. Snow and Eric A. Klein

Since the first introduction of prostate-specific antigen (PSA) as a screening tool in the 1980s, the accurate diagnoses of clinically significant prostate cancer remains a challenge. Analysis of a correlation between PSA levels and prostate biopsies of men with PSA 3 ng/mL or less in the placebo group of the Prostate Cancer Prevention Trial suggested that no “normal” PSA level exists. With the acknowledgement that PSA level is considered a continuum rather than a dichotomous marker, accurately diagnosing clinically significant prostate cancer is even more challenging. Nomograms are increasingly being used as tools in the clinical setting to address this challenge. Through incorporating multiple clinical factors, such as PSA, digital rectal examination, age, race, prostate volume, family history, and previous negative biopsy, risk calculators can improve sensitivity of diagnosis over using a PSA cutoff alone. This article discusses the rational for the use of nomograms and the advantages and limitations for the most commonly used nomograms.