This simple, validated model effectively stratifies short-term PC risk using routine data, potentially facilitating targeted surveillance in the general population.
Abstract
Background/Objectives: Early detection of pancreatic cancer (PC) remains challenging due to the lack of effective screening tools. We aimed to develop a clinically applicable model to identify individuals at high risk of PC using routine health check-up data. Methods: In a 1:4 matched case–control study (111 cases and 439 controls) using data collected between 2010 and 2018, PC cases were defined as individuals diagnosed with PC within 2 years of a health check-up. A model was developed using conditional logistic regression and validated in an independent cohort of 52,043 individuals (40 PC cases; 2019–2021). Results: Five risk factors were identified: carbohydrate antigen 19-9 ≥ 39 U/mL, hemoglobin A1c ≥ 6.5%, alkaline phosphatase > 110 IU/L, weight loss ≥ 5%, and dyspepsia. A 12-point risk scoring system was constructed, with an area under the curve of 0.784 in the development and 0.841 in the validation cohort. At a threshold of ≥5, the high-risk group had a significantly higher 2-year incidence of PC than the low-risk group (2.56% vs. 0.047%; p < 0.001), a 54.76-fold risk enrichment, with a negative predictive value of 99.95% and a number-needed-to-follow of 39. Conclusions: This simple, validated model effectively stratifies short-term PC risk using routine data, potentially facilitating targeted surveillance in the general population.
Pancreatic ductal adenocarcinoma (PDAC) remains a significant global health burden, projected to become the second leading cause of cancer-related mortality in the Western world by 2030. Due to the lack of effective population-wide screening methods, targeted surveillance of high-risk individuals-those with a lifetime risk exceeding 5-10% based on family history or pathogenic germline variants-represents the most viable strategy for early detection. Current surveillance protocols utilize endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) to identify potentially curable T1N0M0 tumors or high-grade precursor lesions. Clinical evidence demonstrates that these programs significantly improve outcomes, increasing the detection of stage I tumors and raising 5-year overall survival rates from 9% to 50%. This editorial emphasizes that the future effectiveness of PDAC prevention lies in refined risk stratification through universal germline testing, the integration of polygenic and environmental data, and the provision of comprehensive psychosocial support to manage the emotional impact of surveillance.
D. Campa, C. Rizzato, A. Kataki et al.· Revista Espanola de Enfermed...· 0 citations
Background: Prostate cancer is the third most frequently diagnosed cancer worldwide with a significant public health burden. Objective: To investigate the effect of prostate-specific antigen (PSA) testing in the early detection of prostate cancer and to highlight age and body mass index as the associated risk factors in a screening program at Hiwa Cancer Hospital in Sulaymaniyah City in Iraq. Methods: This was a population-based screening study that enrolled 958 men aged between 30 and 75 years. A questionnaire was designed to collect demographic data, and serum PSA concentrations were measured for all participants. Results: PSA values exceeding 4.0ng/mL were referred for further urological evaluation. Most of the participants (94.6%) exhibited PSA levels within the normal range (≤4 ng/mL), whereas 52(5.42%) of them demonstrated PSA levels exceeding 4.0ng/mL. Among those with abnormal PSA levels, 41(4.3%) participants had PSA values ranging from 4.1 to 10ng/mL, while 11(1.1%) participants had levels above 10 ng/mL. Prostate cancer was confirmed in five individuals, which accounts for 9.61% of participants with elevated PSA levels (>4.0 ng/ml). Patients diagnosed with prostate cancer showed a substantially higher PSA level (median: 43ng/mL) compared with non-cancer participants (median: 5.5ng/mL). No statistically significant associations were observed between PSA levels and either body mass index or age, although PSA demonstrated a moderate positive correlation with increasing age. Conclusions: The study indicates a low prevalence of prostate cancer within the screened population while emphasizing the importance of PSA screening programs for early detection.
S. Nidhamalddin, R. A. Mohammed, B. Marouf et al.· Al-Rafidain Journal of Medic...· 0 citations
BACKGROUND & AIMS
The rising prevalence of cirrhosis, driven by non-viral etiologies, strains healthcare systems and necessitates personalized hepatocellular carcinoma (HCC) surveillance. We conducted a head-to-head comparison of the Toronto HCC risk index (THRI) and aMAP score within an etiology-diverse Western population to evaluate their performance in identifying low-risk patients.
METHODS
We included adults with cirrhosis from 3 sites in the Netherlands. The exclusion criteria were follow-up <6 months, missing risk score data, or prior HCC. THRI and aMAP were calculated as previously reported. Performance was assessed using time-dependent AUC analysis and cumulative HCC incidence using Kaplan-Meier analysis.
RESULTS
In a cohort of 1531 patients, the median age was 53 years (IQR: 44-61), 63% were male, the median CTP was 5 (IQR: 5-7). The etiology of liver disease was non-viral in 60% of patients, with the majority having steatotic liver disease (SLD: 453, 30%). Over a median follow-up of 5.4 years (IQR: 3.0-9.1), 196 patients developed HCC. Overall 5-year cumulative HCC incidence was 7.2% (95%CI: 5.7-8.7). THRI offered superior discrimination over aMAP at 3 years (AUC 0.74 vs 0.64) and at 5 years (0.73 versus 0.70). Patients identified by THRI as low-risk (n = 269, 18%) had a lower 5-year risk of HCC (0.5%) than those identified as low risk by aMAP (2.9%). Among the patients considered low-risk by aMAP (n = 437), two-thirds were assigned a higher risk category by THRI and had a substantially higher 5-year HCC incidence than low-risk THRI and low-risk aMAP (4.3%vs. 0%, p = 0.009).
CONCLUSION
THRI appears more effective than aMAP in identifying patients with negligible 5-year HCC risk and may inform personalized HCC surveillance strategies, particularly in supporting deferral decisions in low-risk patients.
Mohamed Moussa, K. de Wit, L. Baak et al.· Digestive and Liver Disease· 0 citations
OBJECTIVE
Breast cancer method of detection (MOD) describes how a cancer is first identified: through screening or non-screening (symptomatic/incidental) presentation. We examined associations between MOD and patient demographics, tumor characteristics, treatment patterns, and survival.
METHODS
This retrospective cohort study included women ≥40 years diagnosed with breast cancer between 1/2019 and 12/2021, follow-up through 7/2026. MOD was classified as screen-detected or non-screen-detected. Logistic regression and chi-square tests evaluated associations with patient, tumor, and treatment variables. Kaplan-Meier and multivariable Cox regression assessed all-cause survival.
RESULTS
Among 1,023 women (mean age 63.5 ± 12.1 years), screen-detected cancers (n=710, 69.4%) had more favorable characteristics: earlier T stage (T0: 26.3% vs. 5.4%, p<0.001), negative lymph nodes (N0: 85.5% vs. 59.1%, p<0.001), fewer metastases (M0: 98.6% vs. 82.4%, p<0.001), and lower grade (grade 1: 18.6% vs. 7.4%, p<0.001). More received lumpectomy (72.1% vs. 50.2%, p<0.001) and fewer received neoadjuvant chemotherapy (5.2% vs. 22.5%, p<0.001). Non-screen-detected cancers were more common among the unemployed (21.0% vs. 14.0%, p=0.001), uninsured (3.8% vs. 1.7%, p=0.026), and women ≥75 years (23.3% vs. 16.1%, p=0.019). Within non-screen-detected cancers, tumor stage worsened with time since last negative screen (p<0.001). Screen-detected cancers showed superior all-cause survival (5-year: 92.9% vs. 73.6%, p<0.001). After adjustment, screen-detection was independently associated with 43% lower mortality (HR=0.57, p=0.003). Significant survival benefit persisted in women ≥75 years (HR=0.44, p=0.014).
DISCUSSION
Screen-detected breast cancers were associated with favorable biology, less aggressive treatment, and improved survival. These findings can inform screening guidelines and underscore the importance of incorporating MOD into cancer registries.
Babita Panigrahi, Alexandra DiTommaso, N. Ghuman et al.· Journal of the American Coll...· 0 citations
This population-based study suggests that several initial cancers are associated with elevated risk of CCA, and the increased risk may be due to shared genetic or environmental etiological factors between these malignancies.
M. Kai, Wen Jiang, Jieqiong Liu et al.· 0 citations
PURPOSE
To determine the prevalence of actionable incidental findings (AIFs) in a high-risk lung cancer screening cohort within a universal healthcare setting and identify potential opportunities in system-level quality improvement for AIF detection and management.
METHODS
This retrospective cohort study identified all individuals that presented for a baseline lung cancer screening exam between August 2019 and September 2025. Structured computed tomography (CT) report text was extracted and included an affirmation of whether an AIF was present, a description of the AIF, and a management recommendation. AIF type and prevalence were compared to guideline literature to identify areas of lower-than-expected reporting. Comparisons were performed using t-tests or chi-square tests.
RESULTS
There were 3169 unique individuals with eligible CT reports (37.2% female, 64.0 ± 5.2 years of age) with 424 AIFs identified in 370 (11.7%) individuals. AIFs were associated with higher body mass index, active smoking, Lung-RADS score, and less common with a personal history of cancer (P < .05). Moderate or severe coronary artery calcification (n = 106, 3.3%), thyroid lesions (n = 43, 1.4%), and interstitial lung abnormalities (n = 41, 1.3%) were most common. Bone mineral density (0%), vertebral fractures (0.1%), and indeterminate adrenal lesions (0.1%) were infrequently reported despite guidelines suggesting clinical relevance. Management recommendations were generally aligned with provincial program-specific guidance.
CONCLUSION
AIFs were common, but prevalence was relatively low for several key, potentially significant findings. Standardized reporting of AIFs and program-specific guidance is required considering the downstream costs associated with systematic identification of these AIFs.
Adam Gaisinsky, Lara Gabrielle Lim, Hussain Alshimali et al.· Canadian Association of Radi...· 0 citations
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