Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

https://www.pure.ed.ac.uk/ws/files/8378925/The_benefits_and_harms_of_breast_cancer_screening.pdf

The benefits and harms of breast cancer screening: an independent review

Screening mammography aims to identify breast cancer at earlier stages of the disease, when treatment can be more successful1. Despite the existence of screening programmes worldwide, the interpretation of mammograms is affected by high rates of false positives and false negatives2. Here we present an artificial intelligence (AI) system that is capable of surpassing human experts in breast cancer prediction. To assess its performance in the clinical setting, we curated a large representative dataset from the UK and a large enriched dataset from the USA. We show an absolute reduction of 5.7% and 1.2% (USA and UK) in false positives and 9.4% and 2.7% in false negatives. We provide evidence of the ability of the system to generalize from the UK to the USA. In an independent study of six radiologists, the AI system outperformed all of the human readers: the area under the receiver operating characteristic curve (AUC-ROC) for the AI system was greater than the AUC-ROC for the average radiologist by an absolute margin of 11.5%. We ran a simulation in which the AI system participated in the double-reading process that is used in the UK, and found that the AI system maintained non-inferior performance and reduced the workload of the second reader by 88%. This robust assessment of the AI system paves the way for clinical trials to improve the accuracy and efficiency of breast cancer screening. An artificial intelligence (AI) system performs as well as or better than radiologists at detecting breast cancer from mammograms, and using a combination of AI and human inputs could help to improve screening efficiency.

/pdf/international-evaluation-of-an-ai-system-for-breast-cancer-4c1yg7x284.pdf

International evaluation of an AI system for breast cancer screening.

This guideline from the USPSTF is based on current evidence on mammography, digital breast tomography, and supplemental screening for breast cancer. The recommendations apply to asymptomatic women ...

/pdf/screening-for-breast-cancer-u-s-preventive-services-task-4hi5mt179k.pdf

Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement

Colorectal cancer (CRC) ranks third among the most commonly diagnosed cancers worldwide, with wide geographical variation in incidence and mortality across the world. Despite proof that screening can decrease CRC incidence and mortality, CRC screening is only offered to a small proportion of the target population worldwide. Throughout the world there are widespread differences in CRC screening implementation status and strategy. Differences can be attributed to geographical variation in CRC incidence, economic resources, healthcare structure and infrastructure to support screening such as the ability to identify the target population at risk and cancer registry availability. This review highlights issues to consider when implementing a CRC screening programme and gives a worldwide overview of CRC burden and the current status of screening programmes, with focus on international differences.

https://gut.bmj.com/content/gutjnl/64/10/1637.full.pdf

Colorectal cancer screening: a global overview of existing programmes

Sa1568 The Efficiency of Colonic Capsule Endoscopy in Detection of Colorectal Polyps and Cancers Compared to Colonoscopy - Final Results of Multicenter, Prospective, Cross-Over Study

Background & Aims: Adequate bowel preparation is essential for successful and effective colonoscopy. Several types of cleansing agents are currently available including low-volume solutions. The aim of this study was to compare the efficacy of four different bowel cleansing agents. Methods: A single-center, prospective, randomized, and single-blind study was performed. Consecutive patients referred for colonoscopy were enrolled and randomized into one of the following types of laxatives: polyethylenglycol 4L (PEG), oral sulfate solution (OSS), 2L polyethylenglycol + ascorbate (2L-PEG/Asc), or magnesium citrate + sodium picosulfate (MCSP). The primary outcome was quality of bowel cleansing evaluated according to the Boston Bowel Preparation Scale (BBPS). Secondary outcomes were polyp detection rate (PDR) and tolerability. Results: Final analysis was performed on 431 patients. The number of patients with adequate bowel preparation (BBPS total scores >= 6 and sub scores >= 2 in each segment) was not significantly different throughout all groups (95.4% PEG; 94.6% OSS; 96.3% 2L-PEG/Asc; 96.2% MCSP; p=0.955). Excellent bowel preparation (BBPS total scores >= 8) was associated with younger age (p=0.007). The groups did not have significantly different PDRs (49.5% PEG; 49.1% OSS; 38% 2L-PEG/Asc; 40.4% MCSP; p=0.201). The strongest predictors of pathology identification were age and male gender. The best-tolerated solution was MCSP (palatability: p<0.001; nausea: p=0.024). Conclusion: All tested laxatives provided comparable efficacy in terms of bowel cleansing quality and PDR. The low-volume agent MCSP was the best tolerated.

/pdf/comparison-of-four-bowel-cleansing-agents-for-colonoscopy-19gpo65ke1.pdf

Comparison of Four Bowel Cleansing Agents for Colonoscopy and the Factors Affecting their Efficacy. A Prospective, Randomized Study.

In the Czech Republic, the first COVID-19 cases were confirmed on 1 March 2020; early population interventions were adopted in the following weeks. A simple epidemiological model was developed to help decision-makers understand the course of the epidemic and perform short-term predictions. In this paper, we present the use of the model and estimated changes in the reproduction number (decrease from > 2.00 to

/pdf/modelling-the-first-wave-of-the-covid-19-epidemic-in-the-4wkefnfg32.pdf

Modelling the first wave of the COVID-19 epidemic in the Czech Republic and the role of government interventions

The adenoma detection rate (ADR) is the primary quality indicator for colonoscopies. The polyp detection rate (PDR) is available from administrative data and does not depend on histology verification. The correlation between PDR and ADR and the ADR/PDR conversion factor in preventive colonoscopies were evaluated. In the prospective study, asymptomatic individuals aged 45-75 years with preventive colonoscopy in 2012-2016 were included. Spearman's correlation coefficient was used to assess PDR/ADR for each endoscopist. Conversion factor predicting ADR from PDR was obtained by linear regression and subsequently compared with adenoma to polyp detection rate quotient. One thousand six hundred fourteen preventive colonoscopies performed by 16 endoscopists in 8 screening colonoscopy centres in the Czech Republic were analysed. Correlation between PDR and ADR in all preventive colonoscopies was high and statistically significant (Rs 0.82;P< 0.001). There was a strong correlation between PDR and ADR in men (Rs 0.74;P= 0.002) and in screening colonoscopies (Rs 0.85;P< 0.001). The conversion factor to convert ADR from PDR was 0.72 in all preventive colonoscopies, 0.76 in FOBT+ colonoscopies and 0.67 in screening colonoscopies. ADR may be replaced by PDR in the assessment of colonoscopy quality. The value of the conversion factor varies according to colonoscopy indication and gender of examined individuals; in this Czech study, it was 0.72 in all preventive colonoscopies. The minimum requested ADR of 25 % corresponds to a PDR of 35 %, when converted with the appropriate conversion factor.

The conversion factor for predicting adenoma detection rate from polyp detection rate varies according to colonoscopy indication and patient sex

Mo1576 The Efficiency of Colonic Capsule Endoscopy in Detection of Colorectal Polyps and Cancers Comparing to Colonoscopy: Multicenter, Prospective Crosses Over Study

Ondrej Majek

Papers

Sa1568 The Efficiency of Colonic Capsule Endoscopy in Detection of Colorectal Polyps and Cancers Compared to Colonoscopy - Final Results of Multicenter, Prospective, Cross-Over Study

Comparison of Four Bowel Cleansing Agents for Colonoscopy and the Factors Affecting their Efficacy. A Prospective, Randomized Study.

Modelling the first wave of the COVID-19 epidemic in the Czech Republic and the role of government interventions

The conversion factor for predicting adenoma detection rate from polyp detection rate varies according to colonoscopy indication and patient sex

Mo1576 The Efficiency of Colonic Capsule Endoscopy in Detection of Colorectal Polyps and Cancers Comparing to Colonoscopy: Multicenter, Prospective Crosses Over Study