Cancer Screening Protocol Improves Morbidity and Mortality

Between 2006 and 2016, the researchers enrolled healthy individuals 20–80 years old and collected extensive clinical and epidemiologic data. Patients were examined by specialists in internal medicine, surgery, plastic surgery, obstetrics and gynecology, urology, oncology, oral surgery, gastroenterology, and others, and screening included:

• DNA was extracted and genotyped for APC I1307K and E1317Q.
• Women underwent vaginal ultrasound and Pap tests, as well ultrasound and magnetic resonance imaging with a clinical indication.
• Women older than 40 years underwent mammography.
• Men older than 40 years had prostate-specific antigen (PSA) and free PSA screening.
• Low-dose computed tomography was examined in patients who were heavy smokers.
• Patients older than 40 years were recommended to receive a colonoscopy.

A total of 6,258 women (49%) and 6,461 men (51%) with a mean age of 47 (± 11.5) years were screened.

New malignant lesions were detected in 389 individuals (1.75%), the most common of which were skin (n = 74; 0.6%), prostate (n = 62; 0.5%), thyroid (n = 51; 0.4%), breast (n = 36; 0.3%), colorectal (n = 22; 0.2%), ovarian (n = 19; 0.1%), uterine (n = 14; 0.1%), testicular (n = 12; 0.09%), lung (n = 10; 0.08%), and urinary (n = 9; 0.07%) cancers.

In addition, 28 patients (0.22%) had more than one cancer detected. Patients at advanced age and with a first-degree family history were more likely to have more than one cancer detected.

Twenty-eight patients with cancer (7.2%) died after 32.4 (± 28.1) months at a mean age of 69.4 (± 14.2) years, which the researchers noted was “significantly better than the expected cancer mortality.”

The APC I1307K variant was detected in 572 patients (4.8%), whereas the E1317Q variant was detected in 182 patients (1.5%). “Impressively, the APC I1307K carries an overall increased cancer risk,” the authors commented.

The following characteristics were statistically significantly associated with an increased risk for cancer (p < 0.05 for all):

• First degree family member with cancer (odds ratio [OR] = 2.02)
• I1307K carrier (OR = 1.53)
• Female gender (OR = 1.23)
• Advanced age (OR = 1.06).

“One-stop-shop screening, in the setting of a multidisciplinary outpatient clinic, is feasible and can prevent and detect cancer at an early stage,” the authors concluded. “It significantly improved morbidity and mortality.”