Percentage of U.S. residents with up-to-date screening for colorectal cancer remains at 60% - what options, other than colonoscopy, do we have?

From the NEJM:

The percentage of U.S. residents with up-to-date screening for colorectal cancer has not increased appreciably since 2010 and remains at approximately 60%. To achieve the highest level of adherence to colorectal cancer screening, it may be best to provide participants a choice, because the “best” strategy is the one that they will adhere to consistently.

The NEJM reviews all the options in this table:

http://blogs.nejm.org/now/wp-content/uploads/sites/6/2017/01/nejmcp1512286_t2.jpeg

Full article is here:

Screening for Colorectal Neoplasia - Now@NEJM http://buff.ly/2ikfKA0

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Myeloma Patients Have New Hope Thanks to New Treatments - WSJ video

Medical scientists have made major advances in treating different types of cancer in the past decade, but perhaps none more so than the blood cancer known as myeloma. WSJ's Ron Winslow explains on Lunch Break with Tanya Rivero:

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"Bio-detection" dogs in trial to be used for prostate cancer sniffing

Many urologists agree that the PSA test for detecting prostate cancer is often unreliable, but it remains widely used because there are no other relatively inexpensive tests. Researchers in Britain say this method may soon be replaced with dogs trained to sniff out the type of cancer that, according to the American Cancer Society, affects one in every 7 men. VOA’s George Putic reports:



It takes 6 months to train a dog to detect prostate cancer. According to the report, trained dogs can detect prostate tumors in urine in 93 percent of cases.

"These dogs have the ability to screen hundreds of samples in a day; it's something they find very easy, they enjoy their work. To them it's a hunt game - they find the cancer."

The alternative, "electronic nose" sensitivity is well below the one of a dog. A dog can find 1 part per trillion. An electronic nose is unable to find anything below 1 per million.

References:

Cancer sniffing dogs to aid British doctors. Reuters. http://buff.ly/1PWNrOL

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Most cancers caused by "bad luck" in cell division and "poor repair" of the defect

Researchers at Johns Hopkins University studied 31 different cancers. Of those, just 9 were found to be linked to bad genetics or unhealthy lifestyle choices. However, researchers excluded two of the most common cancers from their study, breast cancer and prostate cancer (published in the journal Science).

The most common cause of the production of most cancerous cells occurs when one chemical letter in DNA is incorrectly swapped for another during stem cell division. Scientists found that cancer rates were higher in parts of the body where cells are quickest to regenerate, thereby creating more random mutations.

Genetic mutations that randomly crop up as our stem cells divide are “the major contributors to cancer overall, often more important than either hereditary or external environmental factors.”



BBC: New research suggests most types of cancer are the result of bad luck, rather than unhealthy lifestyles, diet or even inherited genes.

References:

Study concludes that many cancers caused by bad luck in cell division | Fox News http://buff.ly/1xebIsy
Besides Lifestyle and Inherited Genes, Cancer Risk Also Tied to Bad Luck - WSJ http://buff.ly/1xebVMw

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Myelodysplastic Syndromes / Myeloproliferative Disorders

What are myelodysplastic syndromes?

Myelodysplastic syndromes are clonal marrow stem-cell disorders, characterized by ineffective hemopoiesis leading to blood cytopenias, and by progression to acute myeloid leukemia in a third of patients.

Who is affected?

15% of cases occur after chemotherapy or radiotherapy for a previous cancer. The syndromes are most common in elderly people.

What is the cause?

The pathophysiology involves cytogenetic changes with or without gene mutations and widespread gene hypermethylation at advanced stages.

What are the symptoms?

Clinical manifestations result from cytopenias (anemia, infection, and bleeding).

How to make the diagnosis?

Diagnosis is based on examination of blood and bone marrow showing blood cytopenias and hypercellular marrow with dysplasia, with or without excess of blasts. Prognosis depends largely on the marrow blast percentage, number and extent of cytopenias, and cytogenetic abnormalities.

What is the treatment?

Treatment of patients with lower-risk myelodysplastic syndromes, especially for anaemia, includes growth factors, lenalidomide, and transfusions.

Treatment of higher-risk patients is with hypomethylating agents and, whenever possible, allogeneic stem-cell transplantation.

In this first video in the series, Myeloproliferative Neoplasms 2015 - Mayo Clinic, Ruben Mesa, M.D., professor and hematologist at Mayo Clinic in Arizona, discusses the treatment and management of myeloproliferative neoplasms as well as shares highlights from the 56th Annual American Society of Hematology (ASH) meeting in San Francisco, December 2014.



Here is the complete playlist:

https://www.youtube.com/playlist?list=PLSWR1ylG_6JZKr0ChD4N_8MJ3g3FnF08S

References:

Myelodysplastic syndromes : The Lancet http://buff.ly/VwiRor

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