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One-stop screening of CRC, breast and prostate cancer shows promising early results

Christina Lau
15 Oct 2020
From left: Prof Simon Ng, Dr Polly Cheung, a patient diagnosed with early breast cancer through the programme, Prof Joseph Sung, Mr Leong Cheung, Prof Samuel Wong, Prof Anthony Ng

A programme that offers one-stop screening of colorectal cancer (CRC), breast cancer and prostate cancer is effective with a high level of acceptance among asymptomatic individuals in Hong Kong, researchers from the Chinese University of Hong Kong (CUHK) have reported.

The CUHK Jockey Club Multi-Cancer Prevention Programme, a 5-year programme launched in 2018, aims to provide free cancer screening to asymptomatic Hong Kong residents aged 40–75 years, and to raise public awareness about screening of obesity-related cancers.

With a target recruitment of 10,000, a total of 3,446 individuals (male, 44.7 percent; overweight or obese, 87.6 percent) had been enrolled into the programme between 6 August 2018 and 18 August 2020.

Among 3,230 participants eligible for faecal occult blood test, 367 (11.4 percent) had a positive result and were offered colonoscopy. As of 18 August 2020, colonoscopy results were available for 347 of the participants, of whom 151 (43.5 percent) were found to have 1–3 adenomas, while 95 (27.4 percent) had advanced adenoma and 10 (2.9 percent; 0.3 percent of those eligible for faecal occult blood test) had CRC.

Most participants (n=3,146) were also eligible for breast (n=1,717) or prostate (n=1,429) cancer screening. A majority of these individuals (1,703 women and all men) were willing to undergo breast or prostate cancer screening following CRC screening.

Including those who were not eligible for CRC screening, a total of 1,846 female participants and 1,516 male participants were eligible for screening mammography and evaluation of prostate-specific antigen (PSA) level with or without Prostate Health Index (PHI), respectively.

Among 1,828 female participants with mammography reports available, 45 (2.4 percent) had a positive result (ie, Breast Imaging Reporting and Data System [BI-RADS] 4 or 5) and were offered breast ultrasound as well as biopsy. Breast cancer was diagnosed on biopsy in 15 women (0.8 percent of those eligible for mammography).

Of the 1,516 male participants who underwent prostate cancer screening, 98 were offered prostate ultrasound and biopsy. Prostate cancer was diagnosed on biopsy in 37 men (2.4 percent of those eligible for PSA test).

Screening for metabolic syndrome was also offered to the participants, with 50 new cases of diabetes diagnosed through the programme. These diabetes patients were referred for further management, while overweight or obese participants were given classes on exercise and diet to facilitate weight management and reduce cancer risk.

According to the researchers, these results demonstrate the feasibility and effectiveness of one-stop screening for CRC, breast cancer and prostate cancer among asymptomatic individuals.

Overweight or obesity is associated with an increased risk of CRC, breast cancer and prostate cancer. [Gut 2014;63:1130-1136; Obesity Reviews 2003;4:157-173; Recent Results Cancer Res 2016;208:137-153]

“The programme aims to raise awareness of colorectal health and overweight or obesity among Hong Kong residents aged 40–75 years. Recruitment has been ongoing,” said Professor Joseph Sung, programme director and Mok Hing Yiu Professor of Medicine, CUHK.

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Most Read Articles
Prof. Corinne Faivre-Finn, 30 Nov 2020
Consolidation therapy with the PD-L1 inhibitor durvalumab (Imfinzi®, AstraZeneca) following chemoradiation therapy (CRT) has become the standard of care in patients with unresectable stage III non-small-cell lung cancer (NSCLC), based on primary results of the PACIFIC study. The 4-year update of the study, presented recently at the European Society for Medical Oncology Virtual Congress 2020 (ESMO 2020), demonstrated durable and sustained survival benefits that were consistent with those reported in the primary analyses.
Dr. Roy Herbst, Dr. David Spigel, 09 Jul 2020
The third-generation EGFR-tyrosine kinase inhibitor (EGFR-TKI) osimertinib is a standard of care in patients with EGFR-positive advanced non-small-cell lung cancer (NSCLC). Results of the ADAURA study, presented at the American Society of Clinical Oncology 2020 Virtual Scientific Programme (ASCO 2020), support earlier use of osimertinib in the adjuvant setting, with superior disease-free survival (DFS) in patients who underwent complete resection of stage IB/II/IIIA EGFR-positive NSCLC. 
Prof. Mark Shackleton, 01 Apr 2020
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Dr. Keith Wong, 30 Nov 2020
The B-cell lymphoma-2 (BCL-2) inhibitor, venetoclax, has demonstrated promising efficacy in relapsed/refractory chronic lymphocytic leukaemia (CLL). However, the associated risk of tumour lysis syndrome (TLS) in certain patients necessitates prophylactic measures and close monitoring. In an interview with MIMS Oncology, Dr Keith Wong from the haematology department of a public hospital in Hong Kong discussed important treatment considerations for patients with CLL, and highlighted prophylactic and supportive measures established at his hospital to mitigate the risk of TLS complications associated with venetoclax-based therapy.