Medical Integrity Up in Smoke? Conflicts of Interest and the Lung Cancer Screening Controversy

Journal author conflicts of interest are discussed in relation to the recent controversy over tobacco company funding of lung cancer screening studies.     

Decline in Cancer Screening in Vulnerable Populations? Results of the EDIFICE Surveys

Background

We studied cancer screening over time and social vulnerability via surveys of representative populations.

Methods

Individuals aged 50–75 years with no personal history of cancer were questioned about lifetime participation in screening tests, compliance (adherence to recommended intervals [colorectal, breast and cervical cancer]) and opportunistic screening (prostate and lung cancer).

Results

The proportion of vulnerable/non-vulnerable individuals remained stable between 2011 and 2016. In 2011, social vulnerability had no impact on screening participation, nor on compliance. In 2014, however, vulnerability was correlated with less frequent uptake of colorectal screening (despite an organised programme) and prostate cancer screening (opportunistic), and also with reduced compliance with recommended intervals (breast and cervical cancer screening). In 2016, the trends observed in 2014 were substantiated and even extended to breast, colorectal and cervical cancer screening uptakes. Social vulnerability has an increasingly negative impact on cancer screening attendance. The phenomenon was identified in 2014 and had expanded by 2016.

Conclusion

Although organised programmes have been shown to ensure equitable access to cancer screening, this remains a precarious achievement requiring regular monitoring. Further studies should focus on attitudes of vulnerable populations and on ways to improve cancer awareness campaigns.

     

Training and Validating a Portable Electronic Nose for Lung Cancer Screening

Introduction

Profiling volatile organic compounds in exhaled breath enables the diagnosis of several types of cancer. In this study we investigated whether a portable point-of-care version of an electronic nose (e-nose) (Aeonose, [eNose Company, Zutphen, the Netherlands]) is able to discriminate between patients with lung cancer and healthy controls on the basis of their volatile organic compound pattern.

Risk of Second Lung Cancer in Patients with Previously Treated Lung Cancer: Analysis of Surveillance,Epidemiology, and End Results (SEER) Data

Introduction

The risk for development of a second primary lung cancer (SPLC) after treatment of an initial primary lung cancer (IPLC) is around 1% to 2% per patient per year. The present screening and surveillance guidelines do not adequately address this particular patient population.

Lung Cancer in Never Smokers-Different Disease

Lung cancer is the number one cause of cancer deaths in the world (approximately 1.2 million deaths per year). While smoking is undoubtedly the major cause of lung cancer, cancers arising in lifetime never smokers     

Lung Cancer Epidemiology in Mainland China

Lung cancer incidence has increased rapidly in China over the last 20 years, especially in females. Among the 183 registered worldwide populations, lung cancer incidence in males was ranked as the 73rd, 74th, 127th and 23rd respectively for Shanghai, Tianjin, Qidong and Hong Kong, and in females the 52nd, 13th, 102nd and 23rd. The sex ratio (M/F) ranged from 1.5 to 3.5 for most areas. The ratio of squamous/ adenocarcinoma was 2.01 in males and 0.67 in females in Tianjin, 0.97 and 0.28 in Hong Kong, 1.00 and 0.61 in the US white population and 1.18 and 0.49 in US blacks. Much research on risk factors have been conducted and documented including the following: genetic predisposition/polymorphism, smoking/coal soot and DMA adduct, cytochrome P450-1A1 (CYP1A1), glutathione S-transferase-M (GST-M), viral infection /HPV infection, high background radiation, family history, tobacco consumption, mental health, prior lung diseases, coal soot indoor air pollution, cooking fume indoor air pollution, hormones, diet, occupational exposure, outdoor air pollution, socioeconomic level/education, alcohol consumption and their interactions(addition/synergy). Based on current information we should carefully devise a plan to control lung cancer that can be put into practice.     

Erythrocyte Catalase and Carbonic Anhydrase Activities in Lung Cancer

Aim: To study the relationship between the pathogenesis of lung cancer and antioxidant status and acidicmedia by measuring the activities of erythrocyte catalase (CAT) and carbonic anhydrase (CA). Methods: A totalof 26 patients with lung cancer and 15 healthy individuals were included in the study. The CAT and CA activitiesof erythrocytes were defined. The catalase (CAT) activity of erythrocytes was measured using Aebi`s method.Carbonic anhydrase (CA) activity was analyzed by CO2 hydration. Results: It was found that erythrocyte CAand CAT activities were significantly lower in patients with lung cancer compared to controls (p<0.05). Of the 26patients with lung cancer, seven (26.9%) had metastasis, and the CA and CAT levels in patients with metastasiswere significantly decreased (p=0,0001). Conclusions: Development of oxidative stress due to lung cancer maybe related to the balance between prooxidant and antioxidant reactions. Catalase may have a preventive effectfor malignant lung cancers and the gene of the antioxidant enzymes may be one of the anti-oncogenes, andinactivation of one of these genes in the process of carcinogenesis may lead to tumor development. This maybe an explanation for the very low levels of antioxidant CAT in patients with lung cancer compared to healthyindividuals. Carbonic anhydrase (CA) in tumor cells may be an indicator of the acid-base balance in lung cancer.Decreased levels of CA in patients with lung cancer may provide a convenient media for tumor development,growth and metastasis by creating an acidic media.     

Expression of Coxsackie and Adenovirums and its Significance in Human Lung Cancer

OBJECTIVE To study the relationship between the coxsackie and adenovirus receptor （CAR） and the development of human lung cancer. To optimize adenovirus vector-based gene therapy. METHODS The expression of CAR in 112 cases of lung cancer was examined using immunohistochemistry. At the same time, the relationship between CAR expression and clinicopathologic characteristics was analyzed, RESULTS ：lhere is a little expression of CAR in normal lung tissue. Compared with paraneoplastic epithelial tissue of the lung, the expression of CAR is generally up-regulated in tumor tissues showing a significant dif- ference （P〈0.01）. The positive rate of CAR expression in squamous cell carcinoma was 43.1%, and in adenocarcinoma 70.2%, with the difference between the two rates being statistically significant （P〈0.01）. Compared to the paraneoplastic tissues, the difference in CAR positive expression was 35.4% for squamous cell carcinoma and 38.3% for adenocarcinoma. But the difference in different stages of squamous cell carcinoma had no statistical significance （P〉0.05）. However, the expression of CAR was at a high level in the bronchioalveolar carcinomas as 80.4% were CAR positive. This research showed that there was a specially high expression of CAR in adenocarcinomas. CONCLUSION CAR is expressed in human lungs at a low level and up-regulated in the tumor tissues, suggesting that there is a relationship between adenocarcinoma and CAR. This research provides a basis for planning a regimen of gene therapy using an adenovirus vector,     

Prevalence And Impact of Medical Comorbidities in A Real‐World Lung Cancer Screening Population

BackgroundLung cancer screening trials generally enroll motivated, relatively healthy, and adherent populations. We therefore evaluated the prevalence and effects of comorbidities in a real-world population undergoing low-dose computed tomography (LDCT) scans.Patients and MethodsWe calculated the Charlson Comorbidity Index (CCI) of patients for whom an initial low-dose computed tomography (LDCT) for lung cancer screening was ordered between February 2017 and February 2019 in an integrated safety-net healthcare system. We examined the association between CCI and initial LDCT completion using multivariable logistic regression, assessed the association between specific medical comorbidity and LDCT completion using Chi-square test or Fisher's exact test as appropriate, and examined the association between CCI and LDCT Lung-RADS results using Fisher's exact test.ResultsA total of 1358 patients were included in the analysis. Mean age was 63 years, 57% were women, and 50% were Black. Patients had moderate comorbidity burden (median CCI 3) with chronic pulmonary disease the most common comorbidity. Overall, 943 LDCT (70%) were completed. There was no difference in 30-day, 90-day, or 1-year completion rates of initial LDCT according to CCI. However, 30-day LDCT completion rates did increase over time (P < .001). Lung-RADS scores were not associated with CCI.ConclusionIn a real-world setting, patients undergoing lung cancer screening have moderate comorbidity burden. The degree and type of medical comorbidity are not associated with initial screening completion or results. Timeliness of LDCT completion may improve as program experience increases.