INTRODUCTIONColorectal cancer (CRC) is one of the most frequently di-agnosed malignancies worldwide, in both men and women. The highest incidence rates were registered in West European countries (up to 51.2/100,000), Australia/New Zealand (36.9/100,000), and North America (31.5/100,000). 1 However, according to the International Agency for Research on Cancer (IARC), in some Asian countries (e.g., Republic of Korea, Japan, Singapore), the incidence rate might be as high as that in Western Europe. 2 In addition, a mortality rate of 17.3 cases per 100,000 people is reported in Asia, which is higher than those in North America (10.1/100,000) and Australia (10.9/100,000). High mortality rates have been reported even in some Asian countries with relatively low incidences of CRC (
Objectives: The aim of this study was to present the baseline results of a pilot project conducted to evaluate the effectiveness of lung cancer screening using low-dose chest computed tomography (CT) in regions with excessive radon levels in the Republic of Kazakhstan.Methods: In total, 3671 participants were screened by low-dose chest CT. Current, former, and never-smokers who resided in regions with elevated levels of radon in drinking water sources and indoor air, aged between 40 and 75 with no history of any cancer, and weighing less than 140 kg were included in the study. All lung nodules were categorized according to the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS 1.0).Results: Overall, 614 (16.7%) participants had positive baseline CT findings (Lung-RADS categories 3 and 4). Seventy-four cancers were detected, yielding an overall cancer detection rate of 2.0%, with 10.8% (8/74) stage I and a predominance of stage III (59.4%; 44/74). Women never-smokers and men current smokers had the highest cancer detection rates, at 2.9% (12/412) and 6.1% (12/196), respectively. Compared to never-smokers, higher odds ratios (ORs) of lung cancer detection were found in smokers (OR,2.48; 95% confidence interval [CI], 1.52 to 4.05, <i>p</i><0.001) and former smokers (OR, 2.32; 95% CI, 1.06 to 5.06, <i>p</i>=0.003). The most common histologic type of cancer was adenocarcinoma (58.1%).Conclusions: Implementation of low-dose CT screening for lung cancer in regions with elevated radon levels is an effective method for both smokers and never-smokers.
Relevance: Breast cancer is the most common malignant neoplasm among wom-en in our country. Mammography is currently the method of choice in breast can-cer diagnostics. However, it has limitations associated with the imposition of breast tissue layers, which makes it difficult to identify lesions and leads to a mis-diagnosis. Breast tomosynthesis is a tomographic technique in which the effect of tissue superimposition is significantly reduced due to layer-by-layer scanning. The purpose of this study was to review the capacity of tomosynthesis in the di-agnosis of breast cancer. Results: The combination of tomosynthesis with a synthesized image is the best technology for screening because it offers the best combination of efficiency and radiation dose. Advantages include greater diagnostic accuracy due to both in-creased sensitivity and specificity, and a significantly less need for additional mammography projections (targeted mammography, targeted mammography with magnification). Conclusions: Tomosynthesis as a diagnostic method significantly exceeds the method of mammography. The higher informative value of the results provided by tomosynthesis reduces the frequency of false-negative and false-positive radio-logical conclusions.
Relevance: Multiparametric MRI (mpMRI) is one of the main methods for diagnosing prostate cancer (PCa). Although mpMRI has been adopted into routine urological and oncological practice in a few short years, there are conflicting views on the timing of mpMRI. The purpose was to study the diagnostic value and role of mpMRI at the stages of diagnosis of prostate cancer. Methods: The article reviews the literature on the use of mpMRI in diagnosing prostate cancer in the framework of traditional clinical approaches. Results: current national guidelines in Europe emphasize the value of mpMRI in diagnosing patients with suspected PCa. The rationale for using mpMRI in selecting patients with suspected PCa who should and should not be biopsied and selecting areas of the prostate for biopsy is compelling. The evidence base, including level 1 studies, is overwhelming, as are arguments for patient benefit in avoiding biopsy or overdiagnosis of clinically insignificant cancer. Conclusion: Patients considering biopsy start to realize that mpMRI imaging can avoid biopsy in some cases and make it more targeted in others. For obvious reasons, these patients will seek to avoid the risk of biopsy or minimize the risk with fewer biopsy specimens. Switching from “standard” SB to TB judiciously and selectively augmented with BD using a two-stage risk assessment offers the best compromise to reduce biopsy rates and reduce overdiagnosis of cnPCa while minimizing the chances of missing clinically significant cancer. Evidence that it is possible to avoid SB altogether, even in the era of mpMRI before biopsy, is weak. This provides grounds for searching for new methods for diagnosing clinically significant cancer using mpMRI
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