- MeSH
- analýza dat MeSH
- časná detekce nádoru metody statistika a číselné údaje MeSH
- lidé MeSH
- lidské papilomaviry * patogenita MeSH
- nádory děložního čípku * diagnóza prevence a kontrola MeSH
- Papanicolaouův test metody statistika a číselné údaje MeSH
- plošný screening metody statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- antagonisté androgenů farmakologie terapeutické užití MeSH
- časná detekce nádoru metody MeSH
- farmakoterapie metody MeSH
- lidé MeSH
- nádory prostaty rezistentní na kastraci diagnóza farmakoterapie MeSH
- nádory prostaty * diagnóza epidemiologie farmakoterapie sekundární MeSH
- PARP inhibitory farmakologie terapeutické užití MeSH
- prostatický specifický antigen analýza MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- časná detekce nádoru metody MeSH
- dospělí MeSH
- lidé MeSH
- management nemoci MeSH
- papilární karcinom štítné žlázy * chirurgie dietoterapie epidemiologie farmakoterapie MeSH
- plošný screening metody MeSH
- štítná žláza diagnostické zobrazování metabolismus patologie MeSH
- těhotenství metabolismus MeSH
- těhotné ženy * MeSH
- thyreotropin krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství metabolismus MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- Klíčová slova
- systém Genius,
- MeSH
- časná detekce nádoru metody přístrojové vybavení MeSH
- digitální technologie klasifikace metody MeSH
- lidé MeSH
- nádory děložního čípku diagnostické zobrazování diagnóza prevence a kontrola MeSH
- Papanicolaouův test * metody přístrojové vybavení MeSH
- počítačové zpracování obrazu metody přístrojové vybavení MeSH
- umělá inteligence * MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
- Klíčová slova
- studie Lipidica, lipidotomický test,
- MeSH
- časná detekce nádoru metody MeSH
- hematologické testy MeSH
- klinická studie jako téma MeSH
- krevní plazma MeSH
- lidé MeSH
- lipidy krev MeSH
- multicentrické studie jako téma MeSH
- nádorové biomarkery MeSH
- nádory slinivky břišní * diagnóza prevence a kontrola MeSH
- primární zdravotní péče MeSH
- Check Tag
- lidé MeSH
Prostate cancer (PCa) poses a significant global health threat, with high incidence and mortality rates. In 2022, the Council of the European Union (EU) updated its screening recommendations, prioritizing PCa screening. This signals a crucial step towards establishing new early detection programmes in EU member states. This study investigates the role of policy makers and governance in cancer screening to inform the development of PCa screening. We had a mixed-method study design. First, a rapid review was conducted on policy making and governance in EU-funded cancer screening initiatives. Second, a focus group discussion reviewed study concepts and methods. Third, a systematic literature review was performed and, fourth, a series of in-depth interviews with actors involved in PCa screening pilots was conducted. Data were analysed thematically and the findings are used to propose 10 recommendations for policy makers. The results of the rapid review and focus group discussion framed the study in the context of existing cancer screening programmes across the EU, and highlighted what already exists in terms of governance tools and methodology. The literature review and in-depth interviews presented key learnings from the literature and real-life settings. These findings are reported using a pre-existing conceptional framework for effective health system governance. The study underscores the critical importance of governance in effective cancer screening programmes. Ten recommendations are proposed, including: defining cancer screening governance, allocating budgets and defining common approaches and key performance indicators for evaluation, establishing methods to enhance citizen participation, and reinforcing network governance.
- MeSH
- časná detekce nádoru * metody MeSH
- Evropská unie MeSH
- lidé MeSH
- nádory prostaty * diagnóza MeSH
- plošný screening * organizace a řízení MeSH
- správní úředníci * MeSH
- vytváření politiky * MeSH
- zdravotní politika * MeSH
- zjišťování skupinových postojů MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
At a population level, the European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter and Microbiota Study Group (EHMSG), and the European Society of Pathology (ESP) suggest endoscopic screening for gastric cancer (and precancerous conditions) in high-risk regions (age-standardized rate [ASR] > 20 per 100 000 person-years) every 2 to 3 years or, if cost-effectiveness has been proven, in intermediate risk regions (ASR 10-20 per 100 000 person-years) every 5 years, but not in low-risk regions (ASR < 10).ESGE/EHMSG/ESP recommend that irrespective of country of origin, individual gastric risk assessment and stratification of precancerous conditions is recommended for first-time gastroscopy. ESGE/EHMSG/ESP suggest that gastric cancer screening or surveillance in asymptomatic individuals over 80 should be discontinued or not started, and that patients' comorbidities should be considered when treatment of superficial lesions is planned.ESGE/EHMSG/ESP recommend that a high quality endoscopy including the use of virtual chromoendoscopy (VCE), after proper training, is performed for screening, diagnosis, and staging of precancerous conditions (atrophy and intestinal metaplasia) and lesions (dysplasia or cancer), as well as after endoscopic therapy. VCE should be used to guide the sampling site for biopsies in the case of suspected neoplastic lesions as well as to guide biopsies for diagnosis and staging of gastric precancerous conditions, with random biopsies to be taken in the absence of endoscopically suspected changes. When there is a suspected early gastric neoplastic lesion, it should be properly described (location, size, Paris classification, vascular and mucosal pattern), photodocumented, and two targeted biopsies taken.ESGE/EHMSG/ESP do not recommend routine performance of endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)-CT prior to endoscopic resection unless there are signs of deep submucosal invasion or if the lesion is not considered suitable for endoscopic resection.ESGE/EHMSG/ESP recommend endoscopic submucosal dissection (ESD) for differentiated gastric lesions clinically staged as dysplastic (low grade and high grade) or as intramucosal carcinoma (of any size if not ulcerated or ≤ 30 mm if ulcerated), with EMR being an alternative for Paris 0-IIa lesions of size ≤ 10 mm with low likelihood of malignancy.ESGE/EHMSG/ESP suggest that a decision about ESD can be considered for malignant lesions clinically staged as having minimal submucosal invasion if differentiated and ≤ 30 mm; or for malignant lesions clinically staged as intramucosal, undifferentiated and ≤ 20 mm; and in both cases with no ulcerative findings.ESGE/EHMSG/ESP recommends patient management based on the following histological risk after endoscopic resection: Curative/very low-risk resection (lymph node metastasis [LNM] risk < 0.5 %-1 %): en bloc R0 resection; dysplastic/pT1a, differentiated lesion, no lymphovascular invasion, independent of size if no ulceration and ≤ 30 mm if ulcerated. No further staging procedure or treatment is recommended.Curative/low-risk resection (LNM risk < 3 %): en bloc R0 resection; lesion with no lymphovascular invasion and: a) pT1b, invasion ≤ 500 μm, differentiated, size ≤ 30 mm; or b) pT1a, undifferentiated, size ≤ 20 mm and no ulceration. Staging should be completed, and further treatment is generally not necessary, but a multidisciplinary discussion is required. Local-risk resection (very low risk of LNM but increased risk of local persistence/recurrence): Piecemeal resection or tumor-positive horizontal margin of a lesion otherwise meeting curative/very low-risk criteria (or meeting low-risk criteria provided that there is no submucosal invasive tumor at the resection margin in the case of piecemeal resection or tumor-positive horizontal margin for pT1b lesions [invasion ≤ 500 μm; well-differentiated; size ≤ 30 mm, and VM0]). Endoscopic surveillance/re-treatment is recommended rather than other additional treatment. High-risk resection (noncurative): Any lesion with any of the following: (a) a positive vertical margin (if carcinoma) or lymphovascular invasion or deep submucosal invasion (> 500 μm from the muscularis mucosae); (b) poorly differentiated lesions if ulceration or size > 20 mm; (c) pT1b differentiated lesions with submucosal invasion ≤ 500 μm with size > 30 mm; or (d) intramucosal ulcerative lesion with size > 30 mm. Complete staging and strong consideration for additional treatments (surgery) in multidisciplinary discussion.ESGE/EHMSG/ESP suggest the use of validated endoscopic classifications of atrophy (e. g. Kimura-Takemoto) or intestinal metaplasia (e. g. endoscopic grading of gastric intestinal metaplasia [EGGIM]) to endoscopically stage precancerous conditions and stratify the risk for gastric cancer.ESGE/EHMSG/ESP recommend that biopsies should be taken from at least two topographic sites (2 biopsies from the antrum/incisura and 2 from the corpus, guided by VCE) in two separate, clearly labeled vials. Additional biopsy from the incisura is optional.ESGE/EHMSG/ESP recommend that patients with extensive endoscopic changes (Kimura C3 + or EGGIM 5 +) or advanced histological stages of atrophic gastritis (severe atrophic changes or intestinal metaplasia, or changes in both antrum and corpus, operative link on gastritis assessment/operative link on gastric intestinal metaplasia [OLGA/OLGIM] III/IV) should be followed up with high quality endoscopy every 3 years, irrespective of the individual's country of origin.ESGE/EHMSG/ESP recommend that no surveillance is proposed for patients with mild to moderate atrophy or intestinal metaplasia restricted to the antrum, in the absence of endoscopic signs of extensive lesions or other risk factors (family history, incomplete intestinal metaplasia, persistent H. pylori infection). This group constitutes most individuals found in clinical practice.ESGE/EHMSG/ESP recommend H. pylori eradication for patients with precancerous conditions and after endoscopic or surgical therapy.ESGE/EHMSG/ESP recommend that patients should be advised to stop smoking and low-dose daily aspirin use may be considered for the prevention of gastric cancer in selected individuals with high risk for cardiovascular events.
- MeSH
- biopsie MeSH
- časná detekce nádoru * metody normy MeSH
- gastroskopie * normy MeSH
- hodnocení rizik MeSH
- infekce vyvolané Helicobacter pylori komplikace MeSH
- lidé MeSH
- nádory žaludku * patologie diagnóza terapie MeSH
- prekancerózy * patologie diagnóza terapie MeSH
- společnosti lékařské MeSH
- žaludeční sliznice patologie diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- směrnice pro lékařskou praxi MeSH
- Geografické názvy
- Evropa MeSH
Úvod: Incidence věkově předčasného kolorektálního karcinomu (KRK) celosvětově stoupá. V České republice je aktuálně věková hranice pro celopopulační screening KRK 50 let. Zvažuje se snížení věkové hranice, ale to v praxi naráží na omezenou kapacitu endoskopických pracovišť. Cílem práce bylo zhodnotit riziko nálezu neoplastické léze dle věkových skupin a pohlaví. Metodika: Jedná se o retrospektivní observační studii provedenou v Beskydském gastrocentru v Nemocnici ve Frýdku-Místku v letech 2017–2023. V tomto období byla sledována incidence neoplastických lézí ve věkových skupinách 30–34 let, 35–39 let, 40–44 let, 45–49 let, 50–54 let, 55–59 let, zvlášť pro muže a ženy. K porovnání dvou kategorických proměnných byl použit Chí kvadrát test; p < 0,05 bylo považováno za signifikantní. Výsledky: Za sledované období bylo provedeno celkem 13 352 koloskopií, 7 094 u mužů, 6 258 u žen, 2 678 u pacientů < 50 let, 10 674 u pacientů ≥ 50 let. Charakteristiky pacientů a incidence neoplastických lézí v jednotlivých pětiletých věkových skupinách jsou zobrazeny v tabulkách níže v tomto textu. Incidence neoplastických lézí v každé pětileté věkové skupině byla vždy významně vyšší než v předcházející mladší věkové skupině. Pokud jako referenční skupinu s nejnižším výskytem neoplastických lézí, u které je v současnosti v ČR doporučen screening KRK, bereme ženy 50–54 let, mají statisticky srovnatelné riziko jak muži 45–49 let (p = 0,304), tak muži 40–44 let (p = 0,086). Ženy 45–49 let (p = 0,001) mají statisticky signifikantně nižší riziko než ženy 50–54 let. Závěry: Pokud bychom měli snižovat věkovou hranici pro screening KRK v ČR postupně tak, abychom nezahltili kapacitu endoskopických center, jsou v nejvyšším riziku muži 45–49 let, poté muži 40–44 let a až poté ženy 45–49 let. Samozřejmostí je surveillance osob s rodinným rizikem KRK a časný termín endoskopického vyšetření pro symptomatické pacienty.
Background: Early onset colorectal cancer (CRC; cancer in a person younger than 50 years) has increasing incidence in the last few years. Current age limit for population screening in Czech Republic is 50 years of age. Lowering the age limit is necessary, but this collides with limited capacity of endoscopy units. The aim of our study was to evaluate the risk of neoplastic lesions according to age and gender. Methods: It was an observational retrospective study conducted in a non-university hospital Frýdek-Místek between 2017 and 2023. The incidence of all neoplastic lesions was evaluated in age groups 30–34, 35–39, 40–44, 45–49, 50–54, and 55–59 years separately for men and women. Two dichotomous variables were compared using the Chi square test, where P <0.05 was considered significant. Results: During the study period, 13,352 colonoscopies were done in total (7,094 men, 6,258 women); 2,678 in patients <50 years of age, and 10,674 in patients ≥50 years. The incidence of all neoplastic lesions in each age group was always significantly higher than in the previous age group, the results are shown in the tables below in this text. As we determined the reference group of women 50–54 years of age as the group with the lowest risk of neoplastic lesions currently involved in population screening, the comparable risk of all neoplastic lesions was observed for men 45–49 years of age (P = 0.304) and also for men 40–44 years of age (P = 0.086). Women 45–49 years of age (P = 0.001) have a significantly lower risk of advanced neoplastic lesions than women 50–54 years of age. Conclusions: If we do not want to overload the capacity of endoscopy units, we should lower the age limit for population screening by age and gender groups. According to our retrospective data, the highest risk of neoplastic lesions is found in men 45–49 years of age, and after them men 40–44 years of age. Women 45–49 years of age have a significantly lower risk of CRC.
- MeSH
- časná detekce nádoru metody statistika a číselné údaje MeSH
- dospělí MeSH
- kolorektální nádory * diagnóza etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- rizikové faktory * MeSH
- sexuální faktory MeSH
- služby preventivní péče metody MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Pancreatic ductal adenocarcinoma (PDAC) is frequently diagnosed in its late stages when treatment options are limited. Unlike other common cancers, there are no population-wide screening programmes for PDAC. Thus, early disease detection, although urgently needed, remains elusive. Individuals in certain high-risk groups are, however, offered screening or surveillance. Here we explore advances in understanding high-risk groups for PDAC and efforts to implement biomarker-driven detection of PDAC in these groups. We review current approaches to early detection biomarker development and the use of artificial intelligence as applied to electronic health records (EHRs) and social media. Finally, we address the cost-effectiveness of applying biomarker strategies for early detection of PDAC.
- MeSH
- časná detekce nádoru * metody MeSH
- duktální karcinom slinivky břišní diagnóza genetika MeSH
- genomika metody MeSH
- lidé MeSH
- nádorové biomarkery * MeSH
- nádory slinivky břišní * diagnóza genetika MeSH
- umělá inteligence * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH