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Use of azathioprine for graft-vs-host disease is the major risk for development of secondary malignancies after haematopoietic stem cell transplantation: a nationwide population-based study.

BackgroundAs more patients are treated by haematopoietic stem cell transplantation (HSCT), development of secondary malignancy (SM) becomes an increasingly common issue in long-term survivors.MethodsWe conducted a nationwide population-based study of the Taiwanese population to analyse patients who received HSCT between January 1997 and December 2010. Standardised incidence ratios (SIRs) were used to compare the risk of SM in HSCT patients and the general population. Multivariate analysis was performed to identify independent predictors of SM.ResultsPatients receiving HSCT had a significantly

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… Public health surveillance with electronic medical records: at risk of surveillance bias and overdiagnosis. Eur J Public Health. 2013;23 (3:350–351. doi: 10.1093/eurpub/ckt044. Curtis RE, Metayer C, Rizzo JD, Socié G, Sobocinski KA, Flowers MED, Travis WD, Travis LB, Horowitz MM, Deeg HJ. …

Supplemental Screening as an Adjunct to Mammography for Breast Cancer Screening in People With Dense Breasts: A Health Technology Assessment.

BACKGROUND: Screening with mammography aims to detect breast cancer before clinical symptoms appear. Among people with dense breasts, some c … that the main harms of supplemental screening for people with dense breasts are false-positives and overdiagnosis, both of which lead to unnecessary and burdensome health care treatments. Screening programs raise inherent tensions between individual- and population-level interests; they may yield population-level benefit, but are statistically of very little be …

One Giant Step for Giant Cell Arteritis: Updates in Diagnosis and Treatment.

Purpose of reviewGiant cell arteritis (GCA), a medium and large vessel vasculitis occurring in the aged, remains a formidable disease, capable of taking both vision and life, through a multitude of vascular complications. Our understanding of the spectrum of its manifestations has grown over the years, to include limb claudication, aortitis, and cardiac disease, in addition to the more classic visual complications resulting from of ischemia to branches of the external and internal carotid arteries. While a clinical presentation of headache, jaw claudication, scalp tenderness, fever and other s

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… Diagnostic evaluation Aside from the protean manifestations of GCA, the dilemma in patients with symptomatology concerning for GCA is overdiagnosis and exposure to high dose glucocorticoids in this vulnerable population, which has its own complications—hypertension, diabetes, osteopenia, and fractures … To address the limitations of TAB, timely diagnostic imaging modalities have therefore been increasing employed to expediate treatment and prevent overdiagnosis and treatment complications. …

Представление результатов анализа диабетических осложнений с головы до ног: всеобъемлющий радиологический обзор.

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… A significant diagnostic pitfall is the overdiagnosis of bowel ischemia. The absence of reduced mural enhancement, mesenteric vessel occlusion, or severe clinical symptoms indicates a benign etiology, allowing conservative management in selected patients. …

Monoclonal gammopathy of increasing significance: time to screen?

Monoclonal gammopathy (MG) is a frequently detected clonal B-cell or plasma-cell disorder. Importantly, every multiple myeloma (MM) case is preceded by MG. Although clinical algorithms now allow earlier treatment of patients with biomarkers of malignancy before MM-induced tissue damage (CRAB) occurs, most patients are still diagnosed late. It is important to revisit how MG should be managed in clinical practice and whether screening is required. As the prevalence of MG and other medical co-morbidities both rise with increasing age, the degree of contribution of MG to disease states other than

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… Overdiagnosis: how cancer screening can turn indolent pathology into illness. APMIS. 2014;122(8):683-689. 86. Heaney JLJ, Richter A, Bowcock S, et al. Excluding myeloma diagnosis using revised thresholds for serum free light chain ratios and M-protein levels. …

Increased Risk of Site-Specific Cancer in People with Type 2 Diabetes: A National Cohort Study.

A retrospective cohort design was used with the objective to evaluate cancer risk among people with type 2 diabetes mellitus (T2DM) in Lithuania. The cohort was established by identifying all patients with the first diagnosis of T2DM in the National Health Insurance Fund database during 2000-2012. Cancer cases were identified by record linkage with the Lithuanian Cancer Registry. Standardized incidence ratios (SIRs) were calculated. Of the 127,290 people that were included, 5959 cases of cancer in men and 6661 cancer cases in women with T2DM were observed. A statistically significant increase

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… The use of PSA testing as an early detection tool may cause overdiagnosis or detection of indolent tumors [ 27 ]. We found a lower risk of lung, tracheal, oesophageal, mouth, and laryngeal cancer in diabetic men. …

Полуструктурированный клинический интервью для оценки компульсивного сексуального поведения (SSCI-CSB): Развитие, надежность и валидность.

Цели Оценка компульсивного сексуального поведения (КСП) требует тонких подходов к оценке, идеально через клинические интервью. Однако ни одно из нескольких доступных клинических интервью для КСП не продемонстрировало сильные психометрические свойства. Чтобы решить эту проблему, мы разработали Semi-Structured Clinical Interview for the assessment of CSB (SSCI-CSB), интервью, которое собирает информацию о проявлениях, симптомах и клиническом течении КСП. Цель этого исследования состояла в том, чтобы проанализировать его надежность и обоснованность в выборке пациентов, нуждающихся в лечении некон

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… Diagnostic performance of a given instrument depends on the prevalence of the target condition: when the prevalence of the target condition is low (as is the case of CSB [Walton et al.  2017 ]), the proportion of false positives tend to be high (Streiner  2003 ), leading to its overdiagnosis. …

Регулирование глюкозы как движущая сила аутоиммунной мимикрии, воспаления и психиатрических Симптомов: обзор наизусть.

Происхождение глицемии влияет на широкий спектр психических и физиологических симптомов. Многие психические заболевания связаны с плохим регулированием глюкозы. Антиядерные антитела (АНА), широко используемые для выявления аутоиммунных заболеваний, могут иногда отражать переходную метаболическую активацию иммунной системы, а не хроническую патологию. Имеющиеся данные свидетельствуют о том, что регулирование глюкозы, включая глицемическую изменчивость, реактивную гипогликемию и постприндиальные шипы, может вызвать системное воспаление, нейропсихиатрические симптомы и временное производство авто

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… By accounting for metabolic drivers earlier in evaluation, clinicians may reduce overdiagnosis, minimize unnecessary immunosuppression, and improve patient outcomes through individualized, targeted management. …

Cancer diagnosis and prognosis after initiation of hemodialysis: multicenter Japan CANcer and DialYsis (J-CANDY) study.

BackgroundCancer is a leading cause of death among patients on hemodialysis; however, the data on its diagnosis, treatment and prognosis are limited. Here we analyzed the surgical practice patterns and outcomes of patients on hemodialysis with cancer and compared them with those of general cancer patients from the National Cancer Center database.MethodsThis nationwide registry enrolled hemodialysis patients who were subsequently diagnosed with primary cancers of the kidney, colorectum, stomach, lung, liver, bladder, pancreas and breast in 20 hospitals in Japan between 2010 and 2012. The primar

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… However, we should be cautious about this conclusion because lead time bias, length bias and overdiagnosis could be factors [ 43 ]. In addition, the efficacy of screening tests for dialysis patients is controversial. …

Development, efficacy and side effects of antibody‑drug conjugates for cancer therapy (Review).

Antibody-drug conjugates (ADCs) are anticancer drugs that combine cytotoxic small-molecule drugs (payloads) with monoclonal antibodies through a chemical linker and that transfer toxic payloads to tumor cells expressing target antigens. All ADCs are based on human IgG. In 2009, the Food and Drug Administration (FDA) approved gemtuzumab ozogamicin as the initial first-generation ADC. Since then, at least 100 ADC-related projects have been initiated, and 14 ADCs are currently being tested in clinical trials. The limited success of gemtuzumab ozogamicin has led to the development of optimization

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… Breast cancer screening trials: Endpoints and overdiagnosis. J Natl Cancer Inst. 2021;113:1131–1135. doi: 10.1093/jnci/djaa140. 46. Hamilton E, Shastry M, Shiller SM, Ren R. Targeting HER2 heterogeneity in breast cancer. Cancer Treat Rev. 2021;100(102286) doi: 10.1016/j.ctrv.2021.102286. 47. …

Ultra-Hypofractionated Stereotactic Body Radiotherapy for Localized Prostate Cancer: Clinical Outcomes, Patterns of Recurrence, Feasibility of Definitive Salvage Treatment, and Competing Oncological Risk.

A cohort of 650 patients treated for localized prostate cancer (PCa) with CyberKnifeTM ultra-hypofractionated radiotherapy between 2011 and 2018 was retrospectively analyzed in terms of survival, patterns of failure, and outcomes of second-line definitive salvage therapies. The analysis was performed using survival analysis including the Kaplan-Meier method and Cox regression analysis. At a median follow-up of 49.4 months, the main pattern of failure was local-regional failure (7.4% in low-, and 13% in intermediate/high-risk group at five years), followed by distant metastases (3.6% in low-, a

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… Discussion Despite the uncontested impact of PCa on overall mortality, it should be appreciated that overdiagnosis and overtreatment can also be detrimental to public health. …

Keyword Index for Volume 109

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… oral health 1367 oral squamous cell carcinoma 1859 oropharyngeal cancer 2904 OSNA 1693 OSSN 1981 osteoporosis/drug therapy 795 osteosarcoma 1579, 2142, 2228, 2607 outreach 1549 ovarian cancer 452, 462, 603, 610, 751, 769, 965, 1072, 1786, 2368, 2744 overall survival 121, 318, 1093, 1760 overdiagnosis …

Cancer in the Oldest-Old Population in the MENA Region: Epidemiology and Temporal Trends Based on GBD 2021.

IntroductionCancer among the oldest-old (aged ≥85) is an escalating public health concern, particularly in the Middle East and North Africa (MENA), where demographic aging is advancing rapidly.MethodsWe analyzed cancer incidence and mortality trends among the oldest-old in MENA from 1990 to 2021 using Global Burden of Disease (GBD) 2021 data, and compared these trends to global patterns.ResultsCancer incidence and mortality among the oldest-old in MENA increased substantially, surpassing global trends. Between 1990 and 2021, incidence rose by 54.2% in MENA vs 25.3% globally, while mortality in

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… MENA. 32 , 50 Screening and Early Detection: Benefits, Limitations, and Gaps In the oldest-old, reduced screening contributes to frequent late-stage diagnoses. 51 However, routine screening is often discouraged in this age group because of comorbidities, limited life expectancy, and the risks of overdiagnosis … Major guidelines—including those of the American Cancer Society (ACS), the United States Preventive Services Task Force (USPSTF), and the American Geriatrics Society—converge on the principle that screening eligibility should weigh life expectancy, the risk of overdiagnosis, and the burden of treatment …

Burning Issues/Hot Topics: The Charcot Foot.

Charcot neuro-osteoarthropathy remains one of the most serious complications of diabetic neuropathy, with the potential for rapid progression to deformity, ulceration and limb-threatening outcomes. The earliest signs and symptoms are often subtle and easily missed, yet early recognition provides a narrow window of opportunity to prevent irreversible structural change. Contemporary diagnostic pathways are underpinned by close clinical observation and correlation of bedside findings with detailed imaging analysis, enabling earlier identification of active disease before collapse occurs. This art

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… The Group agrees that the risk of overdiagnosis outweighs the risk of misdiagnosis and delayed institution of treatment. Thus, at present, in cases with a clinically suspected CNO, the person should be treated as the diagnosis has been confirmed until proven otherwise. …

Analyzing Comorbidity Patterns in Patients With Thyroid Disease Using Large-Scale Electronic Medical Records: Network-Based Retrospective Observational Study.

BackgroundThyroid disease (TD) is a prominent endocrine disorder that raises global health concerns; however, its comorbidity patterns remain unclear.ObjectiveThis study aims to apply a network-based method to comprehensively analyze the comorbidity patterns of TD using large-scale real-world health data.MethodsIn this retrospective observational study, we extracted the comorbidities of adult patients with TD from both private and public data sets. All comorbidities were identified using ICD-10 (International Classification of Diseases, 10th Revision) codes at the 3-digit level, and those with

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… Additionally, some diagnoses may be subject to overdiagnosis or underdiagnosis due to the complexity of clinical issues. Certain diseases may not be frequently coded, and broad categorization may obscure differences among heterogeneous conditions. …

Cumulative burden of 144 conditions, critical care hospitalisation and premature mortality across 26 adult cancers.

A comprehensive evaluation of the total burden of morbidity endured by cancer survivors remains unavailable. This study quantified the burden of 144 health conditions and critical care admissions across 26 adult cancers and treatment modalities in 243,767 adults. By age 60, top conditions ranked by fold difference (cumulative burden in survivors divided by cumulative burden in controls) were haematology, immunology/infection and pulmonary conditions. Patients who had all three forms of treatment (chemotherapy, radiotherapy and surgery) experienced a high cumulative burden of late morbidities c

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… There is evidence that over-screening in cancer survivors might lead to more harm due to overdiagnosis 7 , thus, our results may inform survivorship screening guidelines to limit screening to patients whose prognosis could benefit from early detection and to promote adherence to screening in patients …

Adherence to cancer screening guidelines in Australian survivors of allogeneic blood and marrow transplantation (BMT).

Allogeneic Blood and Marrow Transplant (BMT) survivors are at high risk of secondary cancers. Although current guidelines endorse survivors following Country-specific general population screening recommendations to mitigate this risk, little is known about cancer screening adherence in Australian BMT survivors. We conducted a cross-sectional survey of 441 BMT survivors who were >1 year post transplant, to explore rates of screening for secondary cancers and to identify barriers to cancer screening recommendations. Survey instruments included the Sydney Post-BMT Survey, FACT-BMT, DASS 21, The C

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… Although this is reassuring to those involved in post transplant care, it runs counter to recent literature that suggests that cancer screening can increase anxiety and overdiagnosis 33 , 35 . …

Состояние и тенденции распространения рака в раннем возрасте и связанные с ним факторы риска в Китае: демографическое исследование.

ИСТОРИЯ ВОПРОСА: Данное исследование было направлено на оценку масштабов распространения рака в раннем возрасте в Китае и тенденций изменения связанных с ним факторов риска на основе последних статистических данных о раке. МЕТОДЫ: Мы интегрировали и проанализировали данные 34 в Китае от глобального бремени болезней 2021 Исследование и Глобальная обсерватория по раковым заболеваниям 2022 проект. Первичные результаты включают в себя стандартизованные по возрасту показатели заболеваемости (АСИР), смертность (СЗМС) и скорректированные на инвалидность показатели продолжительности жизни (ССО) и сред

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… Therefore, caution should be exercised when interpreting these increases solely as overdiagnosis, and efforts should focus on refining diagnostic thresholds and promoting risk-based screening strategies to ensure appropriate management. …

Killing me softly--future challenges in apoptosis research.

The induction of apoptosis, a highly regulated and clearly defined mode of cell dying, is a vital tenet of modern cancer therapy. In this review we focus on three aspects of apoptosis research which we believe are the most crucial and most exciting areas currently investigated and that will need to be better understood in order to enhance the efficacy of therapeutic measures. First, we discuss which target to select for cancer therapy and argue that not the cancer cell as such, but its interaction with the microenvironment is a more promising and genetically stable site of attack. Second, the

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… Overdiagnosis and overtreatment in cancer: An opportunity for improvement. JAMA. 2013;310:797–798. doi: 10.1001/jama.2013.108415. 110. Wen P.Y., Kesari S. Malignant gliomas in adults. N. Engl. J. Med. 2008;359:492–507. doi: 10.1056/NEJMra0708126. …

Immunosenescence and cancer predisposition in pediatric transplant recipients: An emerging paradigm.

Pediatric solid organ and hematopoietic stem cell transplant recipients paradoxically experience accelerated immune aging despite chronological youth, establishing a paradigm with profound implications for cancer risk and long-term outcomes. This comprehensive review synthesizes current evidence demonstrating how transplantation-related factors, anti-thymocyte globulin-mediated T cell depletion, cytomegalovirus reactivation, chronic immunosuppression, and thymic dysfunction, induce premature immunosenescent phenotypes. These processes converge to generate T cell populations exhibiting CD28 los

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… Yanik et al [ 7 ] noted that although thyroid cancer SIR was elevated 6-fold post-transplant, mortality from thyroid cancer was not increased, suggesting detection of indolent cancers that would not have caused clinical harm, classic overdiagnosis. … Adjustment strategies: Calculating cancer-specific mortality in addition to incidence helps distinguish true increased risk from overdiagnosis[ 75 ], as aggressive cancers drive mortality, whereas indolent overdiagnosed cancers do not[ 7 ]. …