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Continuation of Annual Screening Mammography and Breast Cancer Mortality in Women Older Than 70 Years. Randomized trials have shown that initiating breast cancer screening between ages 50 and 69 years and continuing it for 10 years decreases breast cancer mortality. However, no trials have studied whether or when women can safely stop screening mammography. An estimated 52% of women aged 75 years or older undergo screening mammography in the United States.To estimate the effect of breast cancer (...) screening on breast cancer mortality in Medicare beneficiaries aged 70 to 84 years.Large-scale, population-based, observational study of 2 screening strategies: continuing annual mammography, and stopping screening.U.S. Medicare program, 2000 to 2008.1 058 013 beneficiaries aged 70 to 84 years who had a life expectancy of at least 10 years, had no previous breast cancer diagnosis, and underwent screening mammography.Eight-year breast cancer mortality, incidence, and treatments, plus the positive
Association of Aspirin with Hepatocellular Carcinoma and Liver-Related Mortality. More information is needed about the long-term effects of low-dose aspirin (≤160 mg) on incident hepatocellular carcinoma, liver-related mortality, and gastrointestinal bleeding in persons with chronic hepatitis B or hepatitis C virus infection.Using nationwide Swedish registries, we identified all adults who received a diagnosis of chronic hepatitis B or hepatitis C from 2005 through 2015 and who did not have (...) a history of aspirin use (50,275 patients). Patients who were starting to take low-dose aspirin (14,205 patients) were identified by their first filled prescriptions for 90 or more consecutive doses of aspirin. We constructed a propensity score and applied inverse probability of treatment weighting to balance baseline characteristics between groups. Using Cox proportional-hazards regression modeling, we estimated the risk of hepatocellular carcinoma and liver-related mortality, accounting for competing
Cyclin-dependent kinase 4 and 6 inhibitors for hormone receptor-positive breast cancer: past, present, and future. The development and approval of cyclin-dependent kinase (CDK) 4 and 6 inhibitors for hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer represents a major milestone in cancer therapeutics. Three different oral CDK4/6 inhibitors, palbociclib, ribociclib, and abemaciclib, have significantly improved progression-free
outcome was cancer detection according to grade group (i.e., a clustering of Gleason grades). Grade group 1 refers to clinically insignificant disease; grade group 2 or higher, cancer with favorable intermediate risk or worse; and grade group 3 or higher, cancer with unfavorable intermediate risk or worse. Among the men who underwent subsequent radical prostatectomy, upgrading and downgrading of grade group from biopsy to whole-mount histopathological analysis of surgical specimens were recorded (...) was associated with the fewest upgrades to grade group 3 or higher on histopathological analysis of surgical specimens (3.5%), as compared with MRI-targeted biopsy (8.7%) and systematic biopsy (16.8%).Among patients with MRI-visible lesions, combined biopsy led to more detection of all prostate cancers. However, MRI-targeted biopsy alone underestimated the histologic grade of some tumors. After radical prostatectomy, upgrades to grade group 3 or higher on histopathological analysis were substantially lower
May 2019. 8. Proposed intervention’s place in clinical management The most recent version of the World Health Organization classification of tumours of the central nervous system defines the morphological subtypes of this group of cancers and their genetically distinct variants. By virtue of their place in the WHO Guidelines, the proposed genetic tests have documented known significance in each of the diseases specified; there are no tests proposed in the application with variations of unknown (...) with clinical or laboratory evidence, including morphological features, of glial neoplasm with probable oligodendroglial component, as requested by a specialist or consultant physician, for the detection of chromosome 1p/19q co-deletion. Maximum one test per lifetime Fee: $340 XXXXX-09 Analysis of tumour tissue from a patient with clinical or laboratory evidence, including morphological features, of glial neoplasm, as requested by a specialist or consultant physician, for the identification of IDH1/2
edition) 2018. Elsevier. ISBN978-0-323-52357-8 9 Jacob, J et al. Rare breast cancer: 246 invasive secretory carcinomas from the National Cancer Data Base. Journal of surgical Oncology. 2016; 113(7): 721-5 11 rearranged, which confers a worse prognosis, is 1%. 10 However, the applicant states that approximately 10% of the incident population would require the proposed test. Table 3: Estimated disease incidence and number of tests to be performed annually Genetic test(s) Tumour type Estimated number (...) , and gene mutations which develop in cells after the egg is fertilised are called “somatic mutations”. Somatic tumour testing is where a piece of a tumour is tested to look at the somatic mutations in the cancer cells. These tests can help provide patients with appropriate, targeted treatment, or advice about the outcome of their disease. Applications 1526, 1527 and 1528 are for somatic tumour testing for rare cancers. They have been grouped together because the numbers of patients with each
intervention’s place in clinical management The most recent version of the World Health Organization classification of lymphoid neoplasms defines the morphological subtypes of this group of cancers and their genetically distinct variants. By virtue of their place in the WHO Guidelines, the proposed genetic tests have documented known significance in each of the diseases specified; there are no tests proposed in the application with variations of unknown significance. The clinical utility of each test (...) spanned three applications: • Application No. 1526 – Somatic gene testing of haematological malignancies • Application No. 1527 – Somatic gene testing of central nervous system tumours and sarcomas • Application No. 1528 – Somatic gene testing of hydatidiform mole, granulosa cell tumour of the ovary, midline squamous cell carcinoma, salivary gland carcinoma, secretory carcinoma of the breast and renal cell carcinoma. 4 MSAC noted that there has been a long history of meetings for these applications
MBS items to cover the urological component and radiation oncology component of LDR-BT for use as a boost to EBRT in patients with high- intermediate and high-risk prostate cancer. The proposed MBS item descriptors are summarised in Table 1. 4 Table 1 Applicant proposed MBS item descriptor Category 3 – Therapeutic procedures PROSTATE, radioactive seed implantation (radiation oncology component), using transrectal ultrasound guidance, for localised (non-metastatic) prostatic malignancy classified (...) (urological component), using transrectal ultrasound guidance, for localised (non-metastatic) prostatic malignancy classified as high-intermediate risk (defined as having a prostate specific antigen (PSA) of 10-20 ng/ml and a Gleason score of 7 and a tumour classified as T2b-c) or high risk (defined as having a PSA of greater than 20 ng/ml and/or a Gleason score of 8-10 and/or a tumour classified as T3). It is recommended the procedure only be performed as ‘boost’ treatment, in addition to external beam
: about 60% of NSCLCs are adenocarcinoma. Former or current smoking is often a causal factor in all forms of lung cancer. However, nonsmokers with lung cancer frequently have adenocarcinoma. This type of cancer is usually found on the outer parts of the lung. People with adenocarcinoma tend to have better survival than people with other types of lung cancer • Squamous cell (epidermoid) carcinoma: 25% to 30% of all NSCLCs are squamous cell carcinomas. Squamous cells are flat cells that line the inside (...) • Other subtypes: Less common NSCLC subtypes include adenosquamous carcinoma and sarcomatoid carcinoma The progression of cancer is divided into four stages; a higher number signifies more extensive disease. In stage 1, the cancer is confined to the original site within the lung and there is no sign of spread to lymph nodes (N0) or elsewhere (M0). In stage 2, the cancer has spread to lymph nodes within the lung (N1). In stage 3, the cancer has spread to lymph nodes in the middle of the chest
-expression-profiling-tests-for-early-stage-invasive-breast-cancer March 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 10, pp. 1–234, March 2020 3 ABSTRACT Background Breast cancer is a disease in which cells in the breast grow out of control. They often form a tumour that may be seen on an x-ray or felt as a lump. Gene expression profiling (GEP) tests are intended to help predict the risk of metastasis (spread of the cancer to other parts of the body) and to identify people who will most (...) and the experiences, preferences, and values of people with early-stage invasive breast cancer. BACKGROUND Health Condition Breast cancer is a disease in which cells in the breast grow out of control, eventually forming a tumour. Environmental, lifestyle, and genetic factors influence a person’s risk of developing breast cancer. These risk factors may include obesity, physical inactivity, alcohol consumption, age, hormone replacement therapy, dense breasts, genetic mutation, and a personal and/or family history
Cinacalcet hydrochloride (Mimpara) - Secondary hyperparathyroidism (HPT) or Parathyroid carcinoma and primary HPT in adults Published 9 March 2020 www.scottishmedicines.org.uk Statement of advice SMC2275 cinacalcet hydrochloride 1mg, 2.5mg and 5mg granules in capsules for opening (Mimpara®) Amgen Ltd 7 February 2020 Advice context: No part of this advice may be used without the whole of the advice being quoted in full. This advice represents the view of the Scottish Medicines Consortium (...) or carer. Vice Chairman Scottish Medicines Consortium ADVICE: in the absence of a submission from the holder of the marketing authorisation cinacalcet hydrochloride granules in capsules for opening (Mimpara®) is not recommended for use within NHSScotland. Indication under review: Secondary hyperparathyroidism (HPT) ? Treatment of secondary HPT in adult patients with end-stage renal disease (ESRD) on maintenance dialysis therapy. ? Treatment of secondary HPT in children aged 3 years and older with ESRD
(Lorviqua ® ) is accepted for use within NHSScotland on an interim basis subject to ongoing evaluation and future reassessment. Indication under review: as monotherapy for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) whose disease has progressed after: ? alectinib or ceritinib as the first ALK tyrosine kinase inhibitor (TKI) therapy; or ? crizotinib and at least one other ALK TKI In the relevant subgroup of a non-comparative (...) Scottish Medicines Consortium www.scottishmedicines.org.uk 2 Indication As monotherapy for the treatment of adult patients with anaplastic lymphoma kinase (ALK)- positive advanced non-small cell lung cancer (NSCLC) whose disease has progressed after: 1 ? alectinib or ceritinib as the first ALK tyrosine kinase inhibitor (TKI) therapy; or ? crizotinib and at least one other ALK TKI Dosing Information The recommended dose is 100mg lorlatinib taken orally once daily. Treatment with lorlatinib
the penultimate dose) and had received at least two prior platinum-based chemotherapy regimens. Response to chemotherapy could be either complete or partial as defined by Response Evaluation Criteria In Solid Tumours (RECIST) version 1.1 or a serological response according to Gynaecologic Cancer InterGroup (GCIG) cancer antigen 125 (CA 125) criteria. There was no restriction on residual carcinoma size for those defined as having a partial response. Patients who had persistent lesions of >2cm were defined (...) The recommended dose is 600mg twice daily, equivalent to a total daily dose of 1200mg, until disease progression or unacceptable toxicity. For the maintenance treatment, patients should start the maintenance treatment with rucaparib no later than eight weeks after completion of their final dose of platinum containing regimen. There is no requirement for BRCA testing prior to using rucaparib for the maintenance treatment of adult patients with relapsed high-grade epithelial ovarian cancer, fallopian tube
because of palliative treatment and new biological treatments for advanced disease. BetterunderstandingofthenaturalhistoryofGIcancershas shown that most of them are preceded by slowly progressing precancerous conditions or lesions, as well as by early invasive stages, therefore providing opportunities for effective inter- ventions. Beyond the classic adenoma–carcinoma sequence for colorectal carcinogenesis, similar pathways based on metaplasia–dysplasia–cancer progression have been shown for upper GI (...) ,colorectalcancer,andpancreaticcancer)werecon- sidered. 3 For esophageal and pancreatic cancer, endoscopic screening may be considered only in high-risk individuals: – For squamous cell carcinoma, in those with a personal history of head/neck cancer, achalasia, or previous caustic injury; – For Barrett’s esophagus (BE)-associated adenocarci- noma,inthosewithlong-standinggastroesophagealreflux disease symptoms (i.e.,>5 years) and multiple risk factors (age=50 years, white race, male sex, obesity, first-degree
cell carcinoma a The following Table replaces Table 7. Therapy Pembrolizumab in combination with axitinib Disease setting Previously untreated advanced renal cell carcinoma Trial Study to evaluate the efficacy and safety of pembrolizumab in combination with axitinib versus sunitinib monotherapy in participants with renal cell carcinoma (KEYNOTE-426)  NCT02853331 Phase Phase III Control Sunitinib PFS 11.1 months 12 months survival 78% Absolute survival gain PFS gain 4 months 12 months survival (...) gain: 12% HR (95% CI) PFS HR 0.69 (0.57-0.84) OS HR: 0.53 (0.38-0.74) c significant QoL/toxicity - ESMO-MCBS score b 4 (Form 2b) Therapy Nivolumab, a PD-1 checkpoint inhibitor Disease setting Advanced clear cell renal cell carcinoma previously treated with one or two regimens of anti-angiogenic therapy Trial Study of nivolumab vs. everolimus in pre-treated advanced or metastatic clear-cell renal cell carcinoma (CheckMate 025)  NCT01668784 Phase Phase III Control Everolimus Median OS: 19.6 months
, Marco Cura, MD, Ahmed Kamel Abdel Aal, MD, PhD, Jason W. Mitchell, MD, MPH, MBA, Sreekumar Madassery, MD, Sasan Partovi, MD, Timothy D. McClure, MD, Alda L. Tam, MD, MBA, and Sheena Patel, MPH ABBREVIATIONS AUA¼ American Urological Association, CI¼ con?dence interval, CSS¼ cancer-speci?c survival, EAU¼ European Association of Urology, HR ¼ hazard ratio, MW ¼ microwave, NCCN ¼ National Comprehensive Cancer Network, PA ¼ percutaneous ablation, PN ¼ partial nephrectomy, RCC ¼ renal cell carcinoma, RCT (...) ¼ randomized controlled trial, RF ¼ radiofrequency, RN ¼ radical nephrectomy, SEER¼ Survival, Epidemiology, and End Results, WMD¼ weighted mean difference BACKGROUND It is estimated that, in 2019, 73,820 new cases of kidney cancer will be diagnosedintheUnitedStates,resultingin14,770newdeaths(1).Renalcell carcinoma(RCC)isthemostcommontypeofkidneycancer,accountingfor approximately9outof10kidneycancers(2).Owingtotheincreasinguseof cross-sectionalimagingandimprovinglifeexpectancies,theincidencerates
Shared follow-up and survivorship care for low-risk endometrial cancer: A guide for women canceraustralia.gov.au SHARED FOLLOW-UP AND SURVIVORSHIP CARE FOR LOW-RISK ENDOMETRIAL CANCER A guide for women on shared follow-up and survivorship care Why is follow-up and survivorship care important? After treatment for low-risk endometrial cancer, it is important to have follow-up visits to: check whether the cancer has come back monitor and address any side effects of treatment receive practical (...) and emotional support. Follow-up care involves your primary care team (General Practitioner (GP) and primary health care nurse) and the specialist multidisciplinary gynaecological cancer team (specialist team). What is shared follow-up and survivorship care? When your follow-up care is shared between your specialist team and your primary care team, this is known as shared follow-up and survivorship care. Allied health professionals, such as dietitians, psychologists and others, may also be involved in your
Shared follow-up and survivorship care for low-risk endometrial cancer: Roles and responsibilities for the delivery of care canceraustralia.gov.au Roles and Responsibilities for the delivery of care This resource is for all members of the multidisciplinary team. It provides an overview of key roles and responsibilities of the specialist multidisciplinary gynaecological cancer team (specialist team) and primary care team in the commencement and delivery of shared follow-up care for low-risk (...) endometrial cancer. Shared follow-up and survivorship care for low-risk endometrial cancer is designed for women who have completed active treatment for low-risk endometrial cancer. Shared care involves the joint participation of primary and specialist teams in the planned delivery of patient care. Shared care can provide women with the benefits of care by a specialist team combined with continuity of care and ongoing management from primary care providers. Establishing agreed shared care arrangements