First report of screening an asymptomatic population for cancer: the yield of an integrated cancer prevention center.
BACKGROUND
Cancer is a leading cause of mortality worldwide. The most effective way to combat cancer is by prevention and early detection.


OBJECTIVE
To evaluate the outcome of screening an asymptomatic population for the presence of benign and neoplastic lesions.


METHODS
Routine screening tests for prevention and/or early detection of 11 common cancers were conducted in 300 consecutive asymptomatic apparently healthy adults aged 25-77 years. Other tests were performed as indicated.


RESULTS
Malignant and benign lesions were found in 3.3% and 5% of the screenees, respectively, compared to 1.7% in the general population. The most common lesions were in the gastrointestinal tract followed by skin, urogenital tract and breast. Advanced age and a family history of a malignancy were associated with increased risk for cancer with an odds ratio of 9 and 3.5, respectively (95% confidence interval 1.1-71 and 0.9-13, respectively). Moreover, high serum C-reactive protein levels and polymorphisms in the APC and CD24 genes indicated high cancer risk. When two of the polymorphisms existed in an individual, the risk for a malignant lesion was extremely high (23.1%; OR 14, 95% CI 2.5-78).


CONCLUSIONS
Screening asymptomatic subjects identifies a significant number of neoplastic lesions at an early stage. Incorporating data on genetic polymorphisms in the APC and CD24 genes can further identify individuals who are at increased risk for cancer. Cancer can be prevented and/or diagnosed at an early stage using the screening facilities of a multidisciplinary outpatient clinic.
Boursi
Ben
B
Department of Medicine B, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Guzner-Gur
Hanan
H
Mashich
Yaquv
Y
Miler
Udi
U
Gur
Eyal
E
Inbar
Roy
R
Blachar
Arye
A
Sperber
Fanny
F
Kleiman
Shlomi
S
Yafo
Ariel
A
Elran
Hanoch
H
Sella
Tal
T
Naumov
Inna
I
Kazanov
Diana
D
Kraus
Sarah
S
Galazan
Lior
L
Reshef
Netta
N
Sion-Tadmor
Tali
T
Rozen
Miri
M
Liberman
Eliezer
E
Moshkowitz
Menachem
M
Arber
Nadir
N
D000328:Adult; D000367:Age Factors; D000368:Aged; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D055088:Early Detection of Cancer; D005260:Female; D005820:Genetic Testing; D006801:Humans; D007557:Israel; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors