Dépistage, diagnostic et pronostic

Découverte de technologies et de biomarqueurs

Menée sur des échantillons sanguins prélevés sur 2 512 patients atteints de mélanome et 471 témoins sains, cette étude analyse les caractéristiques des cellules tumorales circulantes en association avec le stade de la maladie

Circulating Tumor Cells in Melanoma Patients
• PLoS ONE, Vol. 7 (7), pp. e41052, 2012 (article en libre accès)

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Menée sur des échantillons sanguins prélevés sur 2 512 patients atteints de mélanome et 471 témoins sains, cette étude analyse les caractéristiques des cellules tumorales circulantes en association avec le stade de la maladie

“Circulating Tumor Cells in Melanoma Patients”

• Clawson, Gary A.;Kimchi, Eric;Patrick, Susan D.;Xin, Ping;Harouaka, Ramdane;Zheng, Siyang;Berg, Arthur;Schell, Todd;Staveley-O’Carroll, Kevin F.;Neves, Rogerio I.;Mosca, Paul J.;Thiboutot, Diane

Circulating tumor cells (CTCs) are of recognized importance for diagnosis and prognosis of cancer patients. With melanoma, most studies do not show any clear relationship between CTC levels and stage of disease. Here, CTCs were enriched ( 400X) from blood of melanoma patients using a simple centrifugation device (OncoQuick), and 4 melanocyte target RNAs (TYR, MLANA, MITF, and MIF) were quantified using QPCR. Approximately one-third of melanoma patients had elevated MIF and MLANA transcripts (p<0.0001 and p<0.001, respectively) compared with healthy controls. In contrast, healthy controls had uniformly higher levels of TYR and MITF than melanoma patients (p<0.0001). There was a marked shift of leukocytes into the CTC-enriched fractions (a 430% increase in RNA recovery, p<0.001), and no relationship between CTC levels and stage of disease was found. CTCs were captured on microfabricated filters and cultured. Captured melanoma CTCs were large cells, and consisted of 2 subpopulations, ...

Mots clés : Mélanome; Dépistage, diagnostic et pronostic (Découverte de technologies et de biomarqueurs)

Menée in vitro et in vivo, cette étude évalue les performances d'une méthode d'imagerie basée sur la mesure de la durée de vie de la fluorescence pour suivre en temps réel les effets d'un anticorps monoclonal sur les cellules tumorales

Real-time monitoring of in vivo acute necrotic cancer cell death induced by near infrared photoimmunotherapy using fluorescence lifetime imaging
• Cancer Research, sous presse, 2012 (résumé)

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Menée in vitro et in vivo, cette étude évalue les performances d'une méthode d'imagerie basée sur la mesure de la durée de vie de la fluorescence pour suivre en temps réel les effets d'un anticorps monoclonal sur les cellules tumorales

“Real-time monitoring of in vivo acute necrotic cancer cell death induced by near infrared photoimmunotherapy using fluorescence lifetime imaging”

• Nakajima, Takahito;Sano, Kohei;Mitsunaga, Makoto;Choyke, Peter L;Kobayashi, Hisataka

A new type of monoclonal antibody (mAb)-based, highly specific phototherapy (photoimmunotherapy; PIT) that utilizes a near infrared (NIR) phthalocyanine dye, IRDye700DX (IR700) conjugated with a mAb, has recently been described. NIR light exposure leads to immediate, target-selective necrotic cell death in vitro. Detecting immediate in vivo cell death is more difficult because it takes at least 3 days for the tumor to begin to shrink in size. In this study, fluorescence lifetime (FLT) was evaluated before and after PIT for monitoring the immediate cytotoxic effects of NIR mediated mAb-IR700 PIT. Anti-EGFR panitumumab-IR700 was used for targeting EGFR-expressing A431 tumor cells. PIT with various doses of NIR light was performed in cell pellets in vitro and in subcutaneously xenografted tumors in mice in vivo. FLT measurements were obtained before and 0, 6, 24 and 48 h after PIT. In vitro, PIT at higher doses of NIR light immediately led to FLT shortening in A431 cells. In vivo PIT ...

Mots clés : Cancer (général); Dépistage, diagnostic et pronostic (Découverte de technologies et de biomarqueurs)

Evaluation des technologies et des biomarqueurs

Menée sur des cellules tumorales circulantes de mélanome, cette étude évalue les performances d'une méthode appelée Smart-Seq pour déterminer des profils d'expression de gènes à partir de cellules uniques

Full-length mRNA-Seq from single-cell levels of RNA and individual circulating tumor cells
• Nature Biotechnology, sous presse, 2012 (résumé)

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Menée sur des cellules tumorales circulantes de mélanome, cette étude évalue les performances d'une méthode appelée Smart-Seq pour déterminer des profils d'expression de gènes à partir de cellules uniques

“Full-length mRNA-Seq from single-cell levels of RNA and individual circulating tumor cells”

• Ramskold, Daniel;Luo, Shujun;Wang, Yu-Chieh;Li, Robin;Deng, Qiaolin;Faridani, Omid R.;Daniels, Gregory A.;Khrebtukova, Irina;Loring, Jeanne F.;Laurent, Louise C.;Schroth, Gary P.;Sandberg, Rickard

Genome-wide transcriptome analyses are routinely used to monitor tissue-, disease- and cell type–specific gene expression, but it has been technically challenging to generate expression profiles from single cells. Here we describe a robust mRNA-Seq protocol (Smart-Seq) that is applicable down to single cell levels. Compared with existing methods, Smart-Seq has improved read coverage across transcripts, which enhances detailed analyses of alternative transcript isoforms and identification of single-nucleotide polymorphisms. We determined the sensitivity and quantitative accuracy of Smart-Seq for single-cell transcriptomics by evaluating it on total RNA dilution series. We found that although gene expression estimates from single cells have increased noise, hundreds of differentially expressed genes could be identified using few cells per cell type. Applying Smart-Seq to circulating tumor cells from melanomas, we identified distinct gene expression patterns, including candidate ...

Mots clés : Mélanome; Dépistage, diagnostic et pronostic (Evaluation des technologies et des biomarqueurs)

Menée sur 210 patients allemands atteints d'une leucémie myéloïde aiguë sans anomalie cytogénétique, cette étude évalue l'association entre l'expression du facteur LEF-1 et le pronostic de la maladie

High expression of lymphoid enhancer-binding factor-1 (LEF1) is a novel favorable prognostic factor in cytogenetically normal acute myeloid leukemia
• Blood, sous presse, 2012 (résumé)

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Menée sur 210 patients allemands atteints d'une leucémie myéloïde aiguë sans anomalie cytogénétique, cette étude évalue l'association entre l'expression du facteur LEF-1 et le pronostic de la maladie

“High expression of lymphoid enhancer-binding factor-1 (LEF1) is a novel favorable prognostic factor in cytogenetically normal acute myeloid leukemia”

• Metzeler, Klaus H.;Heilmeier, Bernhard;Edmaier, Katrin E.;Rawat, Vijay P.S.;Dufour, Annika;Döhner, Konstanze;Feuring-Buske, Michaela;Braess, Jan;Spiekermann, Karsten;Büchner, Thomas;Sauerland, Maria C.;Döhner, Hartmut;Hiddemann, Wolfgang;Bohlander, Stefan K.;Schlenk, Richard F.;Bullinger, Lars;Buske, Christian

Lymphoid enhancer-binding factor-1 (LEF1) is a key transcription factor of Wnt signaling. We recently showed that aberrant LEF1 expression induces acute myeloid leukemia (AML) in mice, and found high LEF1 expression in a subset of cytogenetically normal (CN-)AML patients. Whether LEF1 expression associates with clinical and molecular patient characteristics and treatment outcomes remained unknown. We therefore studied LEF1 expression in 210 adults with CN-AML treated on German AML Cooperative Group trials using microarrays. High LEF1 expression (LEF1high) associated with significantly better relapse-free (RFS; P<.001), overall (OS; P<.001) and event-free (EFS; P<.001) survival. In multivariable analyses adjusting for established prognosticators, LEF1high status remained associated with prolonged RFS (P=.007), OS (P=.01) and EFS (P=.002). In an independent validation cohort of 196 CN-AML patients provided by the German-Austrian AML Study Group, LEF1high patients had significantly ...

Mots clés : Leucémie; Dépistage, diagnostic et pronostic (Evaluation des technologies et des biomarqueurs)

Menée sur 50 patients atteints d'un cancer colorectal métastatique, cette étude évalue les performances d'une technologie, la fusion à haute résolution, pour identifier des tumeurs présentant une mutation du gène KRAS en assocation avec la réponse au cetuximab

KRAS mutation detection by high-resolution melting analysis significantly predicts clinical benefit of cetuximab in metastatic colorectal cancer
• British Journal of Cancer, sous presse, 2012 (résumé)

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Menée sur 50 patients atteints d'un cancer colorectal métastatique, cette étude évalue les performances d'une technologie, la fusion à haute résolution, pour identifier des tumeurs présentant une mutation du gène KRAS en assocation avec la réponse au cetuximab

“KRAS mutation detection by high-resolution melting analysis significantly predicts clinical benefit of cetuximab in metastatic colorectal cancer”

• Malapelle, U.;Carlomagno, C.;Salatiello, M.;De Stefano, A.;De Luca, C.;Bianco, R.;Marciano, R.;Cimminiello, C.;Bellevicine, C.;De Placido, S.;Troncone, G.

Background: Anti-epidermal growth factor receptor (EGFR) monoclonal antibodies are restricted to KRAS wild-type (WT) metastatic colorectal cancers (mCRCs), usually identified by direct sequencing, that may yield false negative results because of genetic heterogeneity within the tumour. We evaluated the efficiency of high-resolution melting analysis (HRMA) in identifying KRAS-mutant (MUT) tumours. Methods: We considered 50 mCRC patients scored as KRAS-WT by direct sequencing and treated with cetuximab-containing chemotherapy, and tested the correlations between HRMA findings and response rate (RR), progression-free (PFS) and overall survival (OS). Results: Aberrant melting curves were detected in four (8%) cases; gene cloning confirmed these mutations. Response rate (RR) of HRMA KRAS-WT patients was 28.3%. There was no response in HRMA KRAS-MUT patients. Disease control rate (responsive plus stable disease) was 58.7% in HRMA KRAS-WT patients and 25% in HRMA KRAS-MUT patients. There was ...

Mots clés : Colon-rectum; Dépistage, diagnostic et pronostic (Evaluation des technologies et des biomarqueurs)

Essais de technologies et de biomarqueurs dans un contexte clinique

Menée sur 381 patients atteints d'un carcinome urothélial de la vessie traité par cystectomie radicale et lymphadénectomie sans chimiothérapie ou radiothérapie préopératoire (durée médiane de suivi : 41 mois), cette étude identifie les facteurs clinicopathologiques associés à la survie spécifique des patients n'ayant présenté qu'une seule métastase ganglionnaire au moment de l'opération

Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy
• BJU International, sous presse, 2012 (résumé)

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Menée sur 381 patients atteints d'un carcinome urothélial de la vessie traité par cystectomie radicale et lymphadénectomie sans chimiothérapie ou radiothérapie préopératoire (durée médiane de suivi : 41 mois), cette étude identifie les facteurs clinicopathologiques associés à la survie spécifique des patients n'ayant présenté qu'une seule métastase ganglionnaire au moment de l'opération

“Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy”

• Rink, Michael;Hansen, Jens;Cha, Eugene K.;Green, David A.;Babjuk, Marko;Svatek, Robert S.;Xylinas, Evanguelos;Tagawa, Scott T.;Faison, Talia;Novara, Giacomo;Karakiewicz, Pierre I.;Daneshmand, Siamak;Lotan, Yair;Kassouf, Wassim;Fritsche, Hans-Martin;Pycha, Armin;Comploj, Evi;Tilki, Derya;Bastian, Patrick J.;Chun, Felix K.;Dahlem, Roland;Scherr, Douglas S.;Shariat, Shahrokh F.

Study Type – Therapy (outcomes)Level of Evidence 2bWhat's known on the subject? and What does the study add?Lymph node (LN) metastasis is a critical predictor for disease recurrence and cancer-specific survival in patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy. Patients with a low LN disease burden (pN1) might be cured by surgery alone, while patients with a high LN disease burden (stage ≥ pN2) might benefit most from adjuvant chemotherapy.We found that outcomes of patients with pN1 UCB are significantly affected by pathological stage and soft tissue surgical margin status. Our nomogram may help to improve outcomes prediction in patients with pN1 UCB. An accurate prediction of the individual risk of outcomes may help risk stratifying patients with pN1 UCB to help improve clinical decision-making. OBJECTIVES * •To identify clinicopathological factors that predict outcomes in patients with a single lymph node (LN) metastasis (pN1) treated ...

Mots clés : Vessie; Dépistage, diagnostic et pronostic (Essais de technologies et de biomarqueurs dans un contexte clinique)

Menée sur 25 327 patientes atteintes d'un carcinome lobulaire ou canalaire invasif du sein, cette étude néerlandaise montre que le type histologique des tumeurs n'est pas associé de manière indépendante au risque de récidive

Histological type is not an independent prognostic factor for the risk pattern of breast cancer recurrences
• Breast Cancer Research and Treatment, sous presse, 2012 (résumé)

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Menée sur 25 327 patientes atteintes d'un carcinome lobulaire ou canalaire invasif du sein, cette étude néerlandaise montre que le type histologique des tumeurs n'est pas associé de manière indépendante au risque de récidive

“Histological type is not an independent prognostic factor for the risk pattern of breast cancer recurrences”

• Kwast, Annemiek;Groothuis-Oudshoorn, Karin;Grandjean, Ilse;Ho, Vincent;Voogd, Adri;Menke-Pluymers, Marian;van der Sangen, Maurice;Tjan-Heijnen, Vivianne;Kiemeney, Lambertus;Siesling, Sabine

Invasive lobular breast cancer (ILC) is less common than invasive ductal breast cancer (IDC) and appears to have a distinct biology. Inconsistent findings regarding disease-free survival (DFS) are probably due to the fact that histologic type is related to hormone receptor status. This study aims to determine whether the type of the primary breast cancer histology is an independent prognostic factor for DFS, the risk pattern of loco-regional recurrences and distant metastases (DM), and whether it is a prognostic factor for the site of DM. All Dutch women diagnosed between 2003 and 2005 with ILC ( n = 2,949) or IDC ( n = 22,378) were selected from the Netherlands Cancer Registry. DFS was assessed using proportional hazard regression analysis. Compared to patients with IDC, those with ILC were significantly older and more likely to have more than three positive lymph nodes and have larger, better differentiated, more multifocal, and hormone receptor positive tumors (all P < 0.001). ...

Mots clés : Sein; Dépistage, diagnostic et pronostic (Essais de technologies et de biomarqueurs dans un contexte clinique)

Menée sur 44 patientes ménopausées atteintes d'un cancer du sein ER+ de stade précoce et recevant un traitement à base d'inhibiteurs d'aromatase, cette étude montre une association entre la suppression des estrogènes plasmatiques par le létrozole et l'anastrozole et l'indice de masse corporelle

Suppression of Plasma Estrogen Levels by Letrozole and Anastrozole Is Related to Body Mass Index in Patients With Breast Cancer
• Journal of Clinical Oncology, sous presse, 2012 (résumé)

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Menée sur 44 patientes ménopausées atteintes d'un cancer du sein ER+ de stade précoce et recevant un traitement à base d'inhibiteurs d'aromatase, cette étude montre une association entre la suppression des estrogènes plasmatiques par le létrozole et l'anastrozole et l'indice de masse corporelle

“Suppression of Plasma Estrogen Levels by Letrozole and Anastrozole Is Related to Body Mass Index in Patients With Breast Cancer”

• Folkerd, Elizabeth J.;Dixon, J. Michael;Renshaw, Lorna;A'Hern, Roger P.;Dowsett, Mitch

Purpose To investigate whether suppression of plasma estradiol and estrone sulfate levels by the aromatase inhibitors (AIs) anastrozole and letrozole is related to body mass index (BMI) in postmenopausal women with early estrogen receptor (ER) –positive breast cancer. Recent studies have reported that the AI anastrozole has lower effectiveness than tamoxifen in women with high BMI. This effect with high BMI might hypothetically be a result of reduced inhibition of aromatase and suppression of plasma estrogen levels and might be overcome by the use of an increased dose of anastrozole or, alternatively, the use of a more potent AI such as letrozole.Patients and Methods Plasma estradiol and estrone sulfate levels from a highly sensitive radioimmunoassay were available for 44 postmenopausal patients who received anastrozole (1 mg per day) for 3 months followed by letrozole (2.5 mg per day) for 3 months or the opposite sequence. Correlations between the estrogen suppression by each AI ...

Mots clés : Sein; Dépistage, diagnostic et pronostic (Essais de technologies et de biomarqueurs dans un contexte clinique)

A partir d'échantillons sériques prélevés sur 193 patients atteints d'un cancer du poumon non à petites cellules, cette étude montre que le niveau d'expression du microARN-125b circulant peut permettre de détecter la maladie et qu'un niveau élevé d'expression est associé à un pronostic défavorable

Circulating miR-125b is a novel biomarker for screening non-small-cell lung cancer and predicts poor prognosis
• Journal of Cancer Research and Clinical Oncology, sous presse, 2012 (résumé)

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A partir d'échantillons sériques prélevés sur 193 patients atteints d'un cancer du poumon non à petites cellules, cette étude montre que le niveau d'expression du microARN-125b circulant peut permettre de détecter la maladie et qu'un niveau élevé d'expression est associé à un pronostic défavorable

“Circulating miR-125b is a novel biomarker for screening non-small-cell lung cancer and predicts poor prognosis”

• Yuxia, Ma;Zhennan, Tian;Wei, Zhang

Purpose MicroRNAs are small, non-coding RNAs that are critical regulators of various diseases including cancer, and may represent a novel class of cancer biomarkers. Recent reports have highlighted the oncogenic aspects of miR - 125b . However, the level and clinical relevance of circulating miR - 125b transcripts in human serum of non-small-cell lung cancer (NSCLC) patients are unclear. The purpose of this study was to identify circulating miR - 125b transcripts in human serum for use as a biomarker for stratification and prediction of prognosis in NSCLC. Methods We analyzed serum levels of miR - 125b in 193 patients with different stages of NSCLC. Blood samples were collected before surgery and therapy. Quantitative reverse transcription–polymerase chain reaction of circulating miR - 125b transcripts was performed directly in serum to improve the efficiency of miRNA assessment. Receiver operating characteristic analysis was used to evaluate the sensitivity and specificity of serum ...

Mots clés : Poumon; Dépistage, diagnostic et pronostic (Essais de technologies et de biomarqueurs dans un contexte clinique)

Menée sur 53 patients atteints d'un adénocarcinome du pancréas traité par résection chirurgicale, cette étude évalue l'association entre la présence d'une lymphopénie induite par une chimioradiothérapie adjuvante et la survie des patients

The Association Between Treatment-Related Lymphopenia and Survival in Newly Diagnosed Patients With Resected Adenocarcinoma of the Pancreas
• Cancer Investigation, sous presse, 2012 (résumé)

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Menée sur 53 patients atteints d'un adénocarcinome du pancréas traité par résection chirurgicale, cette étude évalue l'association entre la présence d'une lymphopénie induite par une chimioradiothérapie adjuvante et la survie des patients

“The Association Between Treatment-Related Lymphopenia and Survival in Newly Diagnosed Patients With Resected Adenocarcinoma of the Pancreas”

• Balmanoukian, Ani;Ye, Xiaobu;Herman, Joseph;Laheru, Daniel;Grossman, Stuart A.

Fifty-three patients with resected pancreatic adenocarcinoma were studied to determine if adjuvant chemo-radiation causes severe lymphopenia and if this is associated with adverse outcomes. Total lymphocyte counts (TLC) were normal in 91% before adjuvant chemo-radiation. Two months later, TLC fell by 63% (p < .0001) with 45% of patients having TLC < 500 cells/mm3. Median survival in patients with low TLC was 14 versus 20 months (p = .048). Multivariate analysis revealed a significant association between treatment related lymphopenia and survival (HR 2.2, p = .014). Adjuvant chemo-radiation induced lymphopenia is frequent, severe, and an independent predictor for survival in patients with resected pancreatic adenocarcinoma.

Mots clés : Pancréas; Dépistage, diagnostic et pronostic (Essais de technologies et de biomarqueurs dans un contexte clinique)

Politiques et programmes de dépistage

A partir des données du "Swedish Board of Health and Welfare" sur la période 1960 - 2009, cette étude évalue l'intérêt d'un programme de dépistage de cancer du sein par mammographie chez les femmes âgées de plus de 40 ans pour réduire le taux de mortalité spécifique (1 286 000 femmes ; durée de suivi :18 ans)

Mammography Screening and Breast Cancer Mortality in Sweden
• Journal of the National Cancer Institute, sous presse, 2012 (résumé)

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A partir des données du "Swedish Board of Health and Welfare" sur la période 1960 - 2009, cette étude évalue l'intérêt d'un programme de dépistage de cancer du sein par mammographie chez les femmes âgées de plus de 40 ans pour réduire le taux de mortalité spécifique (1 286 000 femmes ; durée de suivi :18 ans)

“Mammography Screening and Breast Cancer Mortality in Sweden”

• Autier, P.;Koechlin, A.;Smans, M.;Vatten, L.;Boniol, M.

Background Swedish women aged 40–69 years were gradually offered regular mammography screening since 1974, and nationwide coverage was achieved in 1997. We hypothesized that this gradual implementation of breast cancer screening would be reflected in county-specific mortality patterns during the last 20 years.Methods Using data from the Swedish Board of Health and Welfare from 1960 to 2009, we used joinpoint regression to analyze breast cancer mortality trends in women aged 40 years and older (1286 000 women in 1995–1996). Poisson regression models were used to compare observed mortality trends with expected trends if screening had resulted in breast cancer mortality reductions of 10%, 20%, or 30% among women screened during 18 years of follow-up after the introduction of screening. All statistical tests were two-sided.Results From 1972 to 2009, breast cancer mortality rates in Swedish women aged 40 years and older declined by 0.98% annually, from 68.4 to 42.8 per 100 000, and ...
Screening Mammography: What Good Is It and How Can We Know If It Works?
• Journal of the National Cancer Institute, sous presse, 2012 (éditorial en libre accès)

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A partir des données du "Swedish Board of Health and Welfare" sur la période 1960 - 2009, cette étude évalue l'intérêt d'un programme de dépistage de cancer du sein par mammographie chez les femmes âgées de plus de 40 ans pour réduire le taux de mortalité spécifique (1 286 000 femmes ; durée de suivi :18 ans)

“Screening Mammography: What Good Is It and How Can We Know If It Works?”

• Vannier, Michael W.
Is the Breast Cancer Mortality Decrease in Sweden Due to Screening or Treatment? Not the Right Question
• Journal of the National Cancer Institute, sous presse, 2012 (éditorial en libre accès)

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A partir des données du "Swedish Board of Health and Welfare" sur la période 1960 - 2009, cette étude évalue l'intérêt d'un programme de dépistage de cancer du sein par mammographie chez les femmes âgées de plus de 40 ans pour réduire le taux de mortalité spécifique (1 286 000 femmes ; durée de suivi :18 ans)

“Is the Breast Cancer Mortality Decrease in Sweden Due to Screening or Treatment? Not the Right Question”

• Segnan, Nereo ; Rosso, Stefano ; Ponti, Antonio
Mammography Screening Shows Limited Effect on Breast Cancer Mortality in Sweden
• Journal of the National Cancer Institute, sous presse, 2012 (communiqué de presse)

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A partir des données du "Swedish Board of Health and Welfare" sur la période 1960 - 2009, cette étude évalue l'intérêt d'un programme de dépistage de cancer du sein par mammographie chez les femmes âgées de plus de 40 ans pour réduire le taux de mortalité spécifique (1 286 000 femmes ; durée de suivi :18 ans)

“Mammography Screening Shows Limited Effect on Breast Cancer Mortality in Sweden”

Mots clés : Sein; Dépistage, diagnostic et pronostic (Politiques et programmes de dépistage)

Cet article livre un regard critique sur les travaux récents en défaveur des programmes de dépistage du cancer du sein

Do not jump too quickly to conclusions
• Breast Cancer Research, Vol. 14 (4), pp. 108, 2012 (éditorial en libre accès)

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Cet article livre un regard critique sur les travaux récents en défaveur des programmes de dépistage du cancer du sein

“Do not jump too quickly to conclusions”

• Kopans, Daniel

A great deal of misinformation has been promulgated about mammography screening. For example, there is no biological or scientific support for the us of the age of 50 as a threshold for screening. Mammography screening does not result in the massive amounts of overdiagnosis that a small group has suggested by using faulty methodology, and screening can still reduce deaths even if the rate of advanced cancers is not decreased. The results in this Netherlands study may be due to the screening interval and thresholds for intervention, but they do not show that screening is ineffective.

Mots clés : Sein; Dépistage, diagnostic et pronostic (Politiques et programmes de dépistage)

A partir de données issues des registres américains des cancers, cette étude analyse l'évolution de l'incidence du cancer de la prostate aux Etats-Unis après la publication, en 2008, des recommandations d'un groupe d'experts en défaveur de l'usage d'un dépistage à l'aide du PSA pour les hommes âgés de plus de 75 ans

Declines in prostate cancer incidence after changes in screening recommendations
• Archives of Internal Medicine, sous presse, 2012 (article en libre accès)

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A partir de données issues des registres américains des cancers, cette étude analyse l'évolution de l'incidence du cancer de la prostate aux Etats-Unis après la publication, en 2008, des recommandations d'un groupe d'experts en défaveur de l'usage d'un dépistage à l'aide du PSA pour les hommes âgés de plus de 75 ans

“Declines in prostate cancer incidence after changes in screening recommendations”

• Howard, D. H.

On August 5, 2008, the US Preventive Services Task Force (USPSTF) recommended against screening men 75 years or older for prostate cancer.1 For men younger than 75 years, the USPSTF maintained its previous recommendation: “ . . . the evidence is insufficient to recommend for or against routine screening for prostate cancer. . . ”2 (p915) (although this recommendation was changed to “do not screen” younger men in the 2011 guidelines). This study evaluates trends in prostate cancer incidence following the release of the 2008 USPSTF recommendation. If the revised recommendation led to a decline in prostate cancer screening rates, there should be a corresponding decline in the incidence of early-stage tumors among men 75 and older relative to trends in the incidence of late-stage tumors and early-stage tumors in younger men.
Time to stop screening for prostate cancer: Comment on “declines in prostate cancer incidence after changes in screening recommendations”
• Archives of Internal Medicine, sous presse, 2012 (commentaire)

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A partir de données issues des registres américains des cancers, cette étude analyse l'évolution de l'incidence du cancer de la prostate aux Etats-Unis après la publication, en 2008, des recommandations d'un groupe d'experts en défaveur de l'usage d'un dépistage à l'aide du PSA pour les hommes âgés de plus de 75 ans

“Time to stop screening for prostate cancer: Comment on “declines in prostate cancer incidence after changes in screening recommendations””

• Katz, M. H.

Over the last decade, the evidence that screening for prostate cancer causes more harm than good has grown so much that the US Preventive Services Task Force recommended in 2008 against screening for prostate cancer in men 75 years or older, and more recently, recommended against screening men of any age. The data in the Research Letter by Howard suggest that many physicians agree with the recommendation not to screen older men. Given that the harms of screening (eg, false-positive results, increased worry, treatment-related morbidities such as incontinence and erectile dysfunction) outweigh the benefits for younger men as well, we hope to see a similar decrease in early prostate cancer incidence in young men.

Mots clés : Prostate; Dépistage, diagnostic et pronostic (Politiques et programmes de dépistage)

A partir d'entretiens et de données administratives, cette étude allemande évalue, en fonction de l'intervalle de surveillance, le risque de cancer colorectal après coloscopie et résection d'adénomes (2 582 cas et 1 798 témoins), puis identifie les facteurs associés

Risk of Colorectal Cancer After Detection and Removal of Adenomas at Colonoscopy: Population-Based Case-Control Study
• Journal of Clinical Oncology, sous presse, 2012 (résumé)

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A partir d'entretiens et de données administratives, cette étude allemande évalue, en fonction de l'intervalle de surveillance, le risque de cancer colorectal après coloscopie et résection d'adénomes (2 582 cas et 1 798 témoins), puis identifie les facteurs associés

“Risk of Colorectal Cancer After Detection and Removal of Adenomas at Colonoscopy: Population-Based Case-Control Study”

• Brenner, Hermann;Chang-Claude, Jenny;Rickert, Alexander;Seiler, Christoph M.;Hoffmeister, Michael

Purpose Empirical evidence for recommendations of surveillance intervals after detection and removal of adenomas at colonoscopy is still sparse and mostly based on observations of adenoma recurrence. We aimed to assess risk of colorectal cancer (CRC) according to time since polypectomy and factors that might be relevant for risk stratification.Methods In a population-based case-control study conducted in Germany, detailed history and results of previous large-bowel endoscopies were obtained by interview and from medical records. Risk of CRC among participants with detection of at least one adenoma at a preceding colonoscopy compared with participants without previous large-bowel endoscopy was assessed according to time since polypectomy among 2,582 cases with CRC and 1,798 matched controls.Results Adjusted odds ratios (95% CIs) of CRC for participants with polypectomy less than 3, 3 to 5, and 6 to 10 years ago (using participants without previous endoscopy as reference group) were 0.2 ...

Mots clés : Colon-rectum; Dépistage, diagnostic et pronostic (Politiques et programmes de dépistage)

Ressources et infrastructures (Dépistage)

Cette étude présente un modèle permettant à un homme d'évaluer les risques et les bénéfices d'un éventuel dépistage du cancer de la prostate à l'aide du PSA

To be screened or not to be screened? Modeling the consequences of PSA screening for the individual
• British Journal of Cancer, sous presse, 2012 (résumé)

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Cette étude présente un modèle permettant à un homme d'évaluer les risques et les bénéfices d'un éventuel dépistage du cancer de la prostate à l'aide du PSA

“To be screened or not to be screened? Modeling the consequences of PSA screening for the individual”

• Wever, E. M.;Hugosson, J.;Heijnsdijk, E. A. M.;Bangma, C. H.;Draisma, G.;de Koning, H. J.

Background: Screening with prostate-specific antigen (PSA) can reduce prostate cancer mortality, but may advance diagnosis and treatment in time and lead to overdetection and overtreatment. We estimated benefits and adverse effects of PSA screening for individuals who are deciding whether or not to be screened. Methods: Using a microsimulation model, we estimated lifetime probabilities of prostate cancer diagnosis and death, overall life expectancy and expected time to diagnosis, both with and without screening. We calculated anticipated loss in quality of life due to prostate cancer diagnosis and treatment that would be acceptable to decide in favour of screening. Results: Men who were screened had a gain in life expectancy of 0.08 years but their expected time to diagnosis decreased by 1.53 life-years. Of the screened men, 0.99% gained on average 8.08 life-years and for 17.43% expected time to diagnosis decreased by 8.78 life-years. These figures imply that the anticipated loss in ...