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Paper: Long-term risk of screen-detected and interval breast cancer after false-positive results at mammography screening: Joint analysis of three national cohorts
Corresponding author: Dr. Marta Roman
Author summary: Most European countries invite women ages 50 to 69 years for a screening mammography every two years with the goal to diagnose asymptomatic breast cancers in an early stage. It is known that one in every five women screened on a regular basis during this age range will be recalled for further assessments due to mammographic abnormalities where malignancy is finally ruled out, the so called false-positive screening result.
In our study, we found that women who experience a false-positive result have a two-fold risk of being diagnosed with a screen-detected cancer or interval breast cancer later in life. And most importantly, they remained at an elevated risk over a decade after the false-positive result. In addition, women who experienced a second false-positive result had a four-fold increase in risk.
Women with mammographic abnormalities leading to a false-positive result have a biological susceptibility to develop future breast cancer. This information should be considered to design personalized screening strategies based on individual risk.
Post embargo link: https://doi.org/10.1038/s41416-018-0358-5
Paper: Whole colon investigation versus flexible sigmoidoscopy for suspected colorectal cancer based on presenting symptoms and signs: a multicentre cohort study
Corresponding author: Dr. Amanda Cross
Contact: Imperial press office - Faculty of Medicine
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Author summary: A study of 7375 patients referred to hospital with suspected bowel cancer has shown that the type of diagnostic investigation may be decided by considering each patient's particular symptoms. Most patients with suspected bowel cancer are referred for colonoscopy, an examination of the inside of the entire bowel, placing enormous pressure on these NHS services. Flexible sigmoidoscopy is a quicker and safer examination of the inside of the lower part of the bowel only. This study revealed that patients with just rectal bleeding or increased stool frequency, but crucially, no anaemia or abdominal mass, had a low risk (0.4%) of having cancer in the upper part of the bowel; therefore, these patients could be examined safely by flexible sigmoidoscopy alone. If these criteria were incorporated into guidelines, the burden of colonoscopy on patients and the NHS would be alleviated and the risk of missing cancers in the upper part of the bowel minimised.
Post embargo link: https://doi.org/10.1038/s41416-018-0335-z
Paper: Molecular characterisation of aromatase inhibitor-resistant advanced breast cancer: the phenotypic effect of ESR1 mutations
Corresponding author: Professor Mitch Dowsett
Contact: Ben Kolbington, ICR media office
Telephone: 020 7153 5380
Author summary: Breast cancers (BCs) containing oestrogen receptor (ER) are diagnosed in >45,000 women per year in UK. Growth of most is driven by oestrogen such that recurrence and mortality from the disease is reduced by about 50% and 40%, respectively, by aromatase inhibitors (AIs) that stop oestrogen production. Nonetheless about 9,000 women with ER+ disease recur each year. To identify mechanisms of AI-resistance we assessed the genetic make up of BCs recurring in 41 AI-treated patients who had become resistant to an AI. While many genetic changes occurred at recurrence we found that each change was present in only a few patients which means that the genetic make-up of individual tumours needs to be characterised to allow fully personalised therapy. Mutation of the ER itself was the most frequent change; for the first time we showed the way in which this mutated-ER stimulated the tumour in the absence of oestrogen.
Post embargo link: https://doi.org/10.1038/s41416-018-0345-x
Paper: Kidney stones and the risk of renal cell carcinoma and upper tract urothelial carcinoma: the Netherlands Cohort Study
Corresponding author: Jeroen van de Pol, Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University
Telephone: +31 43 3883423
Author summary: Kidney stones linked to developing kidney cancer and cancer of the upper urinary tract. In this study, participants with a history of kidney stones were approximately 1.5 times more likely to develop kidney cancer and cancer of the upper urinary tract, compared to participants without kidney stones. By assessing the relationship between kidney stones and kidney cancer in more detail, the researchers found that participants with kidney stones were three times more likely to develop a less common kidney cancer subtype, called papillary renal cell carcinoma. This study was performed in the Netherlands Cohort Study in which over 120,000 participants with the age of 55-69 years were followed over a period of more than 20 years. In total, 608 participants developed kidney cancer and 152 participants developed cancer of the upper urinary tract. The findings of this research hint that a lifestyle, which may lead to the formation of kidney stones, may also play a crucial role in the development of specific cancer subtypes.
Post embargo link: https://doi.org/10.1038/s41416-018-0356-7
The British Journal of Cancer is editorially independent of Cancer Research UK. The BJC is one of the most-cited general cancer journals, publishing significant advances in translational and clinical cancer research. It also publishes high-quality reviews and thought-provoking comment on all aspects of cancer prevention, diagnosis and treatment. The BJC is owned by Cancer Research UK and published by Springer Nature.
British Journal of Cancer