bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of breast cancer risk in BRCA carriers with ovarian cancer: Evaluation of data from longitudinal observation.
Authors: Safra Tamar , Waissengrin Barliz , Gerber Deanna , Bernstein Molho Rinat , Amit Amnon , Salman Lina , Josephy Dana , Chen-Shtoyerman Rakefet , Bruchim Ilan , Frey Melissa Kristen , Pothuri Bhavana , Muggia Franco 
Published: May 2019

e13062 Background: To confirm data from older studies reporting reduced risks of breast cancer (BC) in BRCA mutated (BRCA+) ovarian cancer (OC) patients and to re-evaluate BC surveillance and/or prophylactic mastectomy in OC patients. Methods: Data on 430 BRCA+ mutation carriers diagnosed with OC between 2000 and 2017 in 6 medical centers (one in the USA and five in Israel) were analyzed. Data included demographics, breast surveillance type, family history, BRCA mutation types, timing of BC diagnosis (before or after OC diagnosis) and family history of cancer. Results: Median age at diagnosis of OC was 55.4 years (range, 31.3-90) and median follow-up was 4.6 years. Most patients were BRCA1 (66.6%), and 35.7% had 185delAG. Most patients (68.4%) were Ashkenazi Jews, 27.4% had a family history of BC and 16.5% were diagnosed with BC before OC. Five percent developed BC following OC diagnosis with a median time to BC diagnosis of 68 months (range, 11-210). Of those diagnosed with BC, 50% had triple-negative BC, 40% had luminal B ER+, PR-, Her2-neg and 10% had luminal A -ER+, PR+, her2-neg. There was a non-significant increase in BC after OC, and in BC prior to OC diagnosis; there was no correlation of BC with family history. No definite deaths from BC were recorded. Conclusions: The incidence of BC after OC diagnosis in the BRCA+ population at a median follow-up of 4.6 years is consistent with prior series. Prophylactic bilateral Surveillance measures should be re-evaluated in this population and may only be needed in long-term disease-free survivors and/or subpopulations to be identified. Clinical trial information: 07-146.
HPV test self collection versus CO-testing (2015-2018): New experience in a screening program in a northern province of Argentina, Tucumán.
Authors: Zarba Juan Jose , Holgado Silvia Victoria , Cinto Conrado Oscar , Ali Veronica , Arrieta Maria Fernanda , Gonzalez Adriana Beatriz , Abete Claudia Veronica 
Published: May 2019

e13063 Background: The benefits of population screening under the program in women at risk of uterine cervical cancer both methodsof detection, the search of lesions by gynecological cytology or the search for infection by oncogenic virus of the VPH family is widely demonstrated. Each of them has considerations to favor and others against. In Tucuman the two are applied since December 2014. Objective:to analyze partial results of the first stage of application of two methods under population screening program in women at risk of cervical cancer in Tucumán, Argentina. Methods: We analized the period December 2014 December 2018 of the files of the national register (SITAM: Sistema de Información de tamizaje- It is an on-line information system that allows the nominalized registration of women who access studies, diagnoses and treatments for the prevention of cervical cancer).49337samples from non-pregnant, aged 30 and older women without health insurance were included. 2 collection methods were applied: "Co-testing" (CT), cytological for PAP test and biological sampling for HPV Test ((T-HPV) and "Self-collected sampling" (SC) biological material for T-HPV. In cytology, Pap smear were stained with Papanicolaou and for the biological material, T-HPV Hybrid Capture was applied to detect 13 oncogenic HPV types. Bethesda System was used for cytological diagnosis. Results: until 2019 January, 49337 samples were processed, 7352 (14,8%) womenhave HPV oncogenic. Conclusions: the application of T-HPV to SC samples showed a interesting positivity,demonstrating once again T-HPV is an important strategy in the cervical cáncer prevention program.[Table: see text]
Demographic characteristics of smoldering multiple myeloma patients: A hospital-based study including 11,643 patients.
Authors: Chamoun Kamal , Kyasaram Ravi Kumar , Metheny Leland L. , Gallogly Molly , Caimi Paolo Fabrizio , Gerson Stanton L. , De Lima Marcos J.G. , Malek Ehsan 
Published: May 2019

e13064 Background: SMM is the requisite asymptomatic phase that precedes Multiple Myeloma (MM). Observation until progression to MM has been the standard of care. However, the improvement in risk assessment and utility of chemoprevention strategies stemmed from large trials (e.g. QUIREDEX and E3A06) is beginning to shift the paradigm toward early detection of SMM by implementing screening strategies (e.g., PROMIS study). Lack of specific ICD code for SMM has been a major problem in epidemiologic studies aiming at characterizing the demographics and temporal dynamics of SMM. Here, we used the National Cancer Data Base (NCDB), which covers more than 70% of cancer pts in the USA, for this purpose. Methods: NCDB data from year 2010 to 2014 was analyzed. We defined SMM as pts with ICD-O 9732 that were placed on active surveillance or did not receive any therapy in the first 3 months (m) after diagnosis (Ravindran et al. Blood Cancer J. 2016). Institution size was categorized as small, medium and large if they reported < 10, 10-50, and > 50 cases per year, respectively. Results: Out of a total of 68234 MM pts, we identified 11643 (17%) with SMM. Median follow up was 32 m (0 - 85). Median age was 65 years (26 - 90), 52% were males, 71% were white and 24% were black. Median survival was 77.7 and 49.8 m for pts with SMM and MM, respectively ( p= 0.001). Median age at diagnosis of SMM was 62 and 66 years in blacks and whites, respectively ( p= 0.01). Over 87% of pts were diagnosed in small and medium size institutions (38% and 49%, respectively). Medicare was the main insurance payer (57%), followed by private insurance (32%) and Medicaid (5%), and 3% were not insured. The majority of pts (59.5%) lived in areas where the median income is less than $46K/year. Median distance traveled to treatment facility was 8.5 miles. During the first two years from diagnosis 18% needed treatment which is compatible with known estimated 10% per year risk of progression from SMM to MM. Conclusions: This large study of over 11,000 SMM pts highlights the national demographics of SMM diagnosed between years 2010 and 2014. Our results indicate that targeting small and medium size facilities should be an essential part of SMM screening strategies.
Protamine sulfate may prevent infections by pathogens that require heparan sulfate proteoglycan interactions, including high- and low-risk Human Papillomaviruses and Chlamydia trachomatis..
Authors: Gomez Ricardo , Young Jesse , Ozbun Michelle 
Published: May 2019

e13065 Background: Human papillomaviruses (HPVs) are the most common pathogens of the reproductive tract with 80% of the population acquiring an infection at least once in their lifetime. Globally, high-risk (oncogenic) HPVs cause 630,000 new cancer cases per year and are responsible for 99% of cervical cancers. Regardless of available screening and preventive measures, cervical cancer is the fourth most common malignancy in women worldwide causing more than 445,000 new cases and 270,000 deaths annually. Like many pathogens of the reproductive tract, initiation of HPV infections require attachment to negatively-charged heparan sulfate proteoglycans (HSPG) present in the extracellular matrix and plasma membrane of host cells. To better define the role of HSPGs in HPV infections, we used protamine sulfate (PrS), a polycationic peptide that is FDA approved to neutralize heparin. Structural similarities between HSPGs and heparin allow PrS to bind HSPGs preventing HPV-HSPG interactions and infection. In order to further evaluate proof of concept for PrS we expanded our investigation to Chlamydia trachomatis, another genital tract pathogen whose mechanism of infection has been reported to rely on HSPGs. Methods: High and low risk HPV viruses were used in prophylactic and post exposure cell-based assays and a preclinical prophylactic mouse vaginal challenge model to evaluate the effects of PrS on infection. Chlamydia trachomatis serovar L2 was also used in prophylactic cell-based assays to evaluate the effects of PrS on infection. Results: A single dose prophylactic application of PrS reduced infection by high- and low-risk HPV genotypes by up to 95% in vitro (p-value < 0.001) in a dose response manner and 60% in vivo (p-value 0.05). In addition, post-HPV exposure PrS treatment significantly decreased infection. PrS showed the greatest effectiveness in the first two hours after HPV exposure. In line with our data on HPV, Chlamydia trachomatis infection showed a statistically significant decrease in cells pretreated with PrS (p-value 0.05). Conclusions: Inhibition of attachment by PrS presents a unique opportunity to provide a new cheap prophylactic modality for HPV infection, which would reduce cervical cancer global burden.
Data from an integrated cancer prevention center screening for multiple cancer types.
Authors: Bernstein Ezra , Isakov Ofer , Galazan Lior , Leshno Ari , Shaked Meital , Liberman Eliezer , Gur Eyal , Elran Hanoch , Sror Miri , Harlap-Gat Amira , Kleinman Shlomi , Steiner Moran , Aviram Galit , Blachar Arye , Kessler Ada , Golan Orit , Shapira Shiran , Geva Ravit , Wolf Ido , Arber Nadir 
Published: May 2019

e13069 Background: Cancer is the second leading cause of death globally, and was responsible for ~9.6 million deaths in 2018. Importantly, between 30–50% of cancers can be prevented by avoiding risk factors and implementing existing evidence-based prevention strategies. Methods: We present the results of 15758 adults who came to our clinic between 2006 and 2018. Patients were counseled on reducing risk factors and screened for early detection of 11 of the most common cancer types. Patients were examined by specialists in internal medicine, surgery, plastic surgery, OBGYN, urology, oncology, oral surgery, gastroenterology, and others. Women underwent vaginal US, pap smear, mammography (40yr) and US/MRI of the breast with a clinical indication. Men underwent PSA/free PSA ( > 40yr). LDCT for moderate smokers. Colonoscopy was recommended to all subjects ( > 40yr). Results: A total of 7900 (50.1%) men and 7857 women (49.9%) mean age 46.9±11.3 years were screened. A total of 418 (2.7%) malignant lesions were detected in patients who had been screened, 245 (1.6%) of which were detected through our screening: skin 66 (0.4%), prostate 30 (0.2%), thyroid 28 (0.2%), breast 28 (0.2%), colorectal 19 (0.1%), urinary 13 (0.08%), lung 11 (0.07%), cervical 11 (0.07%), other/unknown 9 (0.06%), hematologic 8 (0.05%), ovarian 5 (0.03%), uterine 5 (0.03%), pancreas 3 (0.02%), testicular 3 (0.02%), oropharyngeal 2 (0.01%), hepatobiliary 2 (0.01%), stomach 1 (0.01%), larynx 1 (0.01%). A total of 17 (0.1%) malignant lesions were missed: breast 3 (0.02%), colorectal 3 (0.02%), skin 2 (0.01%), thyroid 2 (0.01%), hematologic 2 (0.01%), pancreas 2 (0.01%), kidney 1 (0.01%), lung 1 (0.01%), brain 1 (0.01%). A total of 147 (0.9%) malignant lesions developed > 1year after a visit. Only forty-nine of the cancer patients (12.5%) died after 18.9±17.8 months at a mean age of 66.5±12.2 years. Significantly, better than the expected cancer mortality in general. First-degree family member with cancer (HR = 1.46) and advanced age (HR = 21.8) was associated with increased cancer risk (P < 0.05). Conclusions: One stop shop cancer screening, in the setting of a multidisciplinary outpatient clinic is feasible, can detect cancer at an early stage, and can significantly improve survival.
Risk of colonic adenoma in patients with non–colorectal cancers.
Authors: Abu-Sbeih Hamzah , Ali Faisal , Qiao Wei , Lum Phillip , Shafi Mehnaz , Bresalier Robert , Hawk Ernest , Gottumukkala Raju S. , Wang Yinghong 
Published: May 2019

e13070 Background: In the last two decades, the incidence of colorectal cancer (CRC) has decreased dramatically after the implementation of CRC screening in the United States. Several risk factors for colonic adenoma (CA), the main precursor for CRC, have been found. Whether personal history of non-colorectal cancer (NCRC) is a risk factor for CA has not been studied. Here, we assess the risk of CA in patients with NCRCs. Methods: We conducted a retrospective study of cancer patients who underwent colonoscopy after cancer diagnosis between 2009 and 2018. We included patients without history of NCRC as a control group. Multivariate logistic regression was used to assess independent risk factors for CA (Table 1). Results: Total of 9408 patients with NCRC were included; CA was detected in 4503 (48%). Histology revealed tubulovillous features in 611 (14%) patients and villous in 51 (1%). High grade dysplasia was detected in 1,317 (29%) patients and adenocarcinoma in 388 (9%). The rate of adenocarcinoma was the highest in patients with multiple myeloma (14%). Adenoma detection rate (ADR) was 30% in patients younger than 40 years ( n= 1621), 32% in patients between 40 and 50 years ( n= 812), 47% in patients between 50 and 60 years ( n= 2892), and 55% in patients older than 60 years ( n= 4493). Multivariate analysis revealed an increased risk of CA with old age, male sex, family history of CRC, and high body mass index ( P< 0.05). The median time from NCRC diagnosis to CA detection was 3 years (IQR 1-8). Conclusions: ADR in patients with a personal history of NCRC is higher than the ADR of patients without NCRC. CRC screening should be performed after the diagnosis of NCRC is made, even if it was before the standard threshold of CRC screening age of 50 years.[Table: see text]
Development of a plasma cell-free DNA chromosome instabilities assay for early cancer detection and treatment response monitoring of multiple tumor types.
Authors: Yang Yang , Yin Wei , Li Nan , Xu Wensheng , Ma Fei , Chen Xiaosong , Cao Wen-Ming , Yan Wangjun , Wang Jiandong , Nai Dongxing , Qin Chenjie , Ziliang Qian 
Published: May 2019

e13072 Background: Tumor cells keep shedding DNA into blood stream. Here we present a retrospective study to investigate the potential of CIN in plasma cell-free DNA (cfDNA) as a minimal-invasive biomarker for early cancer detection and cancer treatment responses monitoring. Methods: To characterization cfDNA CIN, 160 plasma samples from non-cancer individuals and 569 from cancer patients, including tumors from the brain, respiratory tract, gastrointestinal tract, urinary tract, liver, gallbladder, female reproductive system, prostate, breast and sarcoma. cfDNA was extracted and sent to low-coverage whole genome sequencing by the Illumina X10, followed by CIN analyses by a customized workflow Ultrasensitive Chromosomal Instability Detector (UCAD). Results: In non-cancer individuals, increased CIN in cfDNA was found associated with active EBV infections(P<0.01) and HBV infection (P=0.042). No statistical significances were found for the other parameters, including age, hypertension, diabetes, chronic kidney diseases, family history of cancer and etc. cfDNA CIN increased along with the development of lung cancer lesions, from adenocarcinoma in-situ, minimal invasive adenocarcinoma, invasive adenocarcinoma (P=0.034) to relapsed cancer (P<0.01). The sensitivity of early lung cancer detection was 30.7%, 37.5%, 45.5%, 50.0% and 98.1% for AIS, MIA, IAC, SCC and relapsed lung cancer, at a specificity of 75%. cfDNA CIN levels did not show statistical differences regarding metastases sites. cfDNA CIN were further increased in relapsed breast cancer (P<0.01). The sensitivity of relapsed breast cancer detection was 73.3%, 94.4%, 89.6% and 80.0% for HER2+, Luminal A, Luminal B and triple negative breast cancer, at a specificity of 90%. In primary liver cancer, cfDNA CIN decreased after curative therapies, including R0 resections and liver transplant. R0 resections showed similar performance as compared to liver transplant (P=0.35) in terms of cfDNA CIN decreasing. Furthermore, cfDNA CIN was higher in patients after R0 resections (P=0.003) and liver transplant (P=0.03) than that of HBV-positive cancer-free patients, indicating the potential risk of disease relapses. For advanced stage patients, continuously increasing cfDNA CIN level was found associated with worse survival, and a decreasing trend predicting better prognosis vice versa. Conclusions: Plasma cfDNA CIN analysis might be a useful tool for cancer management.
Community-based lung cancer screening program: A five-year comprehensive review.
Authors: Hakimian Ari , Joob Axel , Aversano Jennifer , Vercillo Michael , Oconnor Michael , Liu Yangyang 
Published: May 2019

e13080 Background: Low-dose chest CT for lung cancer screening has been shown to have a significant impact on the early diagnosis of lung cancer. Initial trials have shown an approximate 20% decrease in overall lung cancer mortality (NLST, 2011). This study incorporates all patients who were evaluated by the Center for Thoracic Disease in a community-based lung cancer screening program from 2013 to 2018. Over the course of the study, thoracic surgeons have evaluated these patients with subsequent interval-based scans to monitor the progression of suspicious nodules. Methods: Eligibility criteria for the program included patients within the age range of 55-80, with a > 30 pack year smoking history, and that were current smokers or quit tobacco less than 15 years ago. Individuals between 50-55 years old were also included if they had > 20 pack year smoking history and at least one additional lung cancer risk factor. All patients included in this analysis completed an initial lung cancer screening consultation and recommended follow-up evaluations with thoracic surgeons from March 2013 to December 2018. All patients with suggestive abnormalities were discussed at a multidisciplinary conference prior to embarking on any invasive procedures. Patient data was collected on REDCap. Descriptive statistics for all continuous (mean ± SD) and categorical [N (%)] variables were calculated on patients. Results: 470 patients were included in the final analysis. The majority of the patients were males (56.4%), mean age was 64 years old (range: 50-81), and 55.3% were current smokers. The average smoking history was 42.3 pack years. 223 (47.6%) patients had a family history of cancer and 70 (14.5%) patients had a personal history of cancer. 25 patients (5.3%) had a diagnosis of primary lung cancer, among whom, 16 patients (64%) had early stage lung cancer (stage 1 and stage 2), 5 patients (20%) had stage 3, and 4 patients (16%) had stage 4 lung cancer. The cancer distribution included 17 adenocarcinomas (68%), 3 squamous cell carcinomas (12%), 3 small cell cancers (12%), 1 large cell cancer (4%) and 1 carcinoid tumor (4%). Conclusions: This study has demonstrated the value of enrolling patients in a community-based lung cancer screening program. Our results have reiterated the prevalence of discovering early staged lung cancer in high risk patients. This comprehensive five-year review indicates the importance of physician coordinated follow-up and evaluation in lung cancer screening patients.
Characteristics, treatment patterns, and survival from three cohorts of advanced or metastatic cancer patients using healthcare claims data in the United States.
Authors: Lamy Francois-Xavier , Beachler Daniel C , Russo Leo J , Lanes Stephan , Dinh Jade , Taylor Devon H , Yin Ruihua , Jamal-Allial Aziza , Verpillat Patrice 
Published: May 2019

e13082 Background: Our main objective was to identify, in healthcare claims data, patients with advanced or metastatic: urothelial carcinoma (amUC), gastric cancer (amGC) and non-small cell lung cancer (amNSCLC) and to report on their characteristics, treatments, and survival rates using contemporaneous real-world data. Methods: This cohort study was conducted in the HealthCore Integrated Research Database (HIRD), from January 2010 to January 2018, which contains healthcare claims data from commercial health plans across the US (60 million lives). We applied algorithms, previously validated on registry data, to the HIRD to define 3 cohorts of advanced stage cancer. Cohort characteristics and treatment patterns were described. Patient vital status was captured through probabilistic linkage with the National Death Index (NDI) and survival was assessed using the Kaplan-Meier method. Results: Algorithms to predict advanced stage cancer resulted in the following cohorts: 1,501 amUC, 6,253 amGC and 38,451 amNSCLC cases. Most patients in each cohort were de novo advanced or metastatic, but subsets were diagnosed at early stage and progressed to advanced stage (ranging from 15.1% for amNSCLC to 23.1% for amUC). Patient characteristics, treatments and survival outcomes are described in Table. Not all received systemic treatment; Immune Checkpoint inhibitors (ICI) were used in 5.3%, 2.2% and 10.8% of treated amUC, amGC and amNSCLC patients, respectively. Conclusions: In these cohorts of advanced or metastatic cancer patients, median survival time was limited despite most receiving treatment: radiation, systemic therapy or surgery. Treatment with ICI was low despite recent data in amUC and amNSCLC. Characteristics, treatments, and survival from estimated advanced stage date. [Table: see text]
Association of leisure time physical activity with breast cancer risk and breast cancer sub-types in Nigerian women.
Authors: Bigman Galya , Adebamowo Sally Nneoma , Jedy-Agba Elima Enaji , Achusi Izuchukwu Benerdin , Adebamowo Clement Adebayo 
Published: May 2019

e13085 Background: The association between physical activity and breast cancer has not been studied among Nigerian women and in particular by breast cancer sub-types. Therefore are studies aims are to examine the association between leisure time physical activity (LTPA) and breast cancer in Nigerian women and to examine the association between LTPA and estrogen receptor positive (ER+), triple negative breast cancer (TNBC+), Luminal A breast cancer in Nigerian women. Methods: We enrolled 739 newly diagnosed primary invasive breast cancer and 739 age-matched controls in Nigeria from 01/2014 to 07/2016. This analysis is restricted to the 40% of cases for whom we have complete ER, TNBC and Luminal-A data and their matched controls. We derived the average amount of time per week spent on LTPA over the past one year using a modified Nurses’ Health Study II PA questionnaire. LTPA was calculated from the total metabolic equivalent (METs) assigned for each reported physical activity hour/week (i.e. walking, cycling, and dancing). We examined LTPA by comparing participants who attained the WHO physical activity recommendations of at least 150 minutes of moderate-intensity or/and 75 minutes of vigorous-intensity aerobic activity weekly with those who did not. We used conditional logistic regression to estimate the adjusted Odds Ratio (OR) of LTPA and overall as well as subtypes of breast cancer. Results: The mean (SD) age of cases was 41.6 (9.1) and controls was 43.9 (11.8) years. Women who attained the WHO physical activity recommendations had 43% decreased risk of breast cancer (OR = 0.57 95% CI:0.42-0.77) compared with those who did not, after controlling for demographic, anthropometric and fertility related factors. LTPA was also associated with reduced risk of breast cancer subtypes by 41% for ER+, 59% for TNBC+ and 59% for Luminal A. Conclusions: Physical activity is associated with reduced risk of breast cancer overall and by subtypes in Nigerian women.