Cancer screening articles within Nature Reviews Clinical Oncology

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  • News & Views |

    A recent study reported the development and validation of the Liver Artificial Intelligence Diagnosis System (LiAIDS), a fully automated system that integrates deep learning for the diagnosis of liver lesions on the basis of contrast-enhanced CT scans and clinical information. This tool improved diagnostic precision, surpassed the accuracy of junior radiologists (and equalled that of senior radiologists) and streamlined patient triage. These advances underscore the potential of artificial intelligence to enhance hepatology care, although challenges to widespread clinical implementation remain.

    • Jeong Min Lee
    •  & Jae Seok Bae
  • News & Views |

    The benefits and potential harms of mammography-based screening for breast cancer are often a matter of debate. Here, I discuss the promises and limitations of a recent study that tested an artificial intelligence-based tool for the detection of breast cancer in digital mammograms in a large, prospective screening setting.

    • Despina Kontos
  • Review Article |

    Hepatocellular carcinoma (HCC) is among the most common causes of cancer-related death globally, and despite improvements in prevention and treatment strategies, continued increases in HCC incidence and mortality are predicted. Cirrhosis remains the major risk factor for HCC, although the underlying aetiology is shifting from virus-related to non-viral liver diseases. In this Review, the authors discuss the changing trends in HCC epidemiology and their implications for screening, prevention and therapy, including opportunities to further improve the management of patients with, or at high risk of, HCC.

    • Amit G. Singal
    • , Fasiha Kanwal
    •  & Josep M. Llovet
  • News & Views |

    Epstein–Barr virus (EBV)-based biomarkers are used for nasopharyngeal carcinoma (NPC) screening in endemic regions. A recent prospective study describes the use of a new serological biomarker, antibodies targeting the EBV protein BNLF2b, for NPC screening in >20,000 participants. This biomarker yielded both higher sensitivity and specificity for NPC detection in the screening cohort compared with the conventionally used antibodies. Herein, we highlight the key findings of this study and discuss the implications of these results.

    • W. K. Jacky Lam
    •  & Anthony T. C. Chan
  • Perspective |

    The authors of this Perspective propose that, with further improvement in detection efficiency, circulating tumour cells (CTCs), which are released early during cancer development, have the potential to be used for the early detection of clinically relevant, aggressive cancers. Thus, use of CTCs as diagnostic biomarkers might improve outcomes by enabling the identification of cancers at a stage at which they are more amenable to treatment while avoiding overtreatment of patients with indolent tumours.

    • Rachel Lawrence
    • , Melissa Watters
    •  & Yong-Jie Lu
  • Review Article |

    Globally, gastric cancer is a common and highly fatal cancer with two anatomical subtypes, non-cardia and cardia gastric cancer. Helicobacter pylori causes almost 90% of distal gastric cancers worldwide. The authors of this Review summarize the current epidemiology of gastric cancer and the evidence and implications of primary and secondary prevention efforts.

    • Aaron P. Thrift
    • , Theresa Nguyen Wenker
    •  & Hashem B. El-Serag
  • Review Article |

    Bladder cancer is among the ten most common cancers worldwide and therefore constitutes a substantial health-care burden. This Review summarizes the global trends in bladder cancer incidence and mortality, and describes the main risk factors associated with bladder cancer occurrence and outcomes. The implications, challenges and opportunities of these epidemiological trends for public health and clinical practice are also discussed.

    • Lisa M. C. van Hoogstraten
    • , Alina Vrieling
    •  & Lambertus A. Kiemeney
  • Review Article |

    Despite a considerable increase in research output over the past decades, the translation of radiomic research into clinically useful tests has been limited. In this Review, the authors provide 16 key criteria to guide the clinical translation of radiomics with the hope of accelerating the use of this technology to improve patient outcomes.

    • Erich P. Huang
    • , James P. B. O’Connor
    •  & Lalitha K. Shankar
  • News & Views |

    Tracking circulating tumour DNA (ctDNA) after surgery holds promise for patient management and therapeutic intervention in non-small-cell lung cancer (NSCLC). A study published by Zhang and colleagues tracks ctDNA from 261 patients with stages I–III NSCLC and suggests that the likelihood of disease relapse decreases for high-risk stage II/III patients after 18 months without ctDNA detection.

    • Alexander Frankell
    •  & Mariam Jamal-Hanjani
  • Perspective |

    Liquid biopsy assays of diverse cancer-associated molecular alterations in blood, including genomic, epigenomic, transcriptomic, proteomic and metabolomics changes, offer considerable opportunities for early detection of cancer as well as improved management of the disease. In this Perspective, the authors review key advances in liquid biopsy-based multi-omics approaches for biomarker discovery. They also introduce the ‘nano-omics’ paradigm, whereby nanotechnology tools are used to capture and enrich various cancer-derived analytes from biofluids for subsequent omics analyses, with the aim of developing novel biomarker panels for early cancer detection.

    • Lois Gardner
    • , Kostas Kostarelos
    •  & Marilena Hadjidemetriou
  • News & Views |

    Over the past decade, iterative improvements to models predicting breast cancer risk have primarily come from new information about genetic risk factors and improvements to mammogram-based risk scores. Epigenetic risk factors offer some potential to further improve risk stratification. However, the recently developed DNA methylation score (the WID-BC index) is not yet convincing for predicting breast cancer risk.

    • Melissa C. Southey
    •  & Pierre-Antoine Dugué
  • Review Article |

    Photoacoustic imaging is a novel imaging technique that provides scalably high levels of spatial resolution at rapid acquisition speed, without the need for radiation or exogenous contrast agents. In this Review, the authors describe the emerging role of this technology in the screening, diagnosis and management of patients with cancer, and provide an overview of the future implementation of this technology.

    • Li Lin
    •  & Lihong V. Wang
  • News & Views |

    The Kerala Oral Cancer Screening Trial did not demonstrate an overall cancer-related mortality benefit. Herein, we discuss the important lessons learnt from a recent reanalysis of data from this trial in an attempt to demonstrate the advantages of using a novel risk-based approach to cancer screening.

    • Anil K. D’Cruz
    •  & Richa Vaish
  • Perspective |

    Liquid biopsy assays have the potential to revolutionize the diagnosis and management of cancer, and rapid progress is being made in the clinical translation of such assays. This Perspective outlines notable advances in the use of liquid biopsy technologies in the management of solid tumours, as well as future research avenues, clinical trial methodologies and implementation logistics for the eventual integration of liquid biopsy into the clinical workflow.

    • Michail Ignatiadis
    • , George W. Sledge
    •  & Stefanie S. Jeffrey
  • Review Article |

    Despite the introduction of novel therapies, lung cancer remains the leading cause of cancer-related mortality worldwide. Randomized controlled trials of low-dose CT-based lung cancer screening in high-risk populations have shown a reduction in mortality. The authors of this Review discuss these studies and present the Screening Planning and Implementation RAtionale for Lung cancer (SPIRAL), a framework to define the scope of future implementation research on lung cancer screening.

    • Matthijs Oudkerk
    • , ShiYuan Liu
    •  & John K. Field
  • News & Views |

    Measuring the methylation status of cell-free DNA (cfDNA) in plasma holds great potential for the early, noninvasive detection of cancer. Two recent papers published in Nature Medicine showcase the successful application of cfDNA methylation-based cancer detection to two highly challenging scenarios.

    • Wenyuan Li
    •  & Xianghong Jasmine Zhou
  • Consensus Statement
    | Open Access

    Risk-adapted approaches to breast cancer prevention and screening could potentially be more effective than universal approaches, which have important limitations. In this Consensus Statement, representatives of the European Collaborative on Personalized Early Detection and Prevention of Breast Cancer (ENVISION) discuss the current state of breast cancer risk prediction, risk-stratified prevention and early detection strategies, and their implementation. They also present the ENVISION recommendations on priorities for future research in each of these areas with the aim of stimulating and guiding risk-adapted breast cancer prevention and screening programmes.

    • Nora Pashayan
    • , Antonis C. Antoniou
    •  & Martin Widschwendter
  • News & Views |

    Cell-free DNA and proteins are secreted into the bloodstream by multiple types of cancer. In a recently published prospective study involving 10,006 women, such markers were used in a cancer screening approach that incorporated PET–CT as a confirmatory test. Herein, we discuss the implications of these results.

    • Y. M. Dennis Lo
    •  & W. K. Jacky Lam
  • News & Views |

    Lung cancer screening is currently based only on low-dose CT scans; however, novel, more accessible methods that might improve uptake and adherence are eagerly awaited. New liquid biopsy approaches promise to revolutionize cancer screening. Herein, we discuss the opportunities and challenges associated with two such novel assays.

    • Christian Rolfo
    •  & Alessandro Russo
  • News & Views |

    The identification of individuals carrying cancer susceptibility genetic variants could be improved by peridiagnostic cancer genetic testing and cascade testing of the relatives of patients diagnosed with cancer. Herein we discuss two studies that highlight the importance of active involvement of the medical team, both in informing the relatives and offering pre-test telephone genetic counselling.

    • Nora Pashayan
    •  & Clare Turnbull
  • Perspective |

    Advances in imaging and biomarker discovery have led to a revolution in prostate cancer diagnosis, and nontargeted prostate biopsies should become obsolete. The authors of this Perspective article describe the current diagnostic pathway and discuss how advances in prebiopsy multiparametric MRI and the discovery of novel tumour markers should lead to a new diagnostic pathway.

    • Derek J. Lomas
    •  & Hashim U. Ahmed
  • News & Views |

    Interval invasive breast cancers diagnosed after a normal mammogram but before the next screening examination have a different tumour biology from that of screen-detected breast cancers, and thus are not detected on mammography. Understanding the genetics and biology of interval invasive cancers could inform better approaches to detection.

    • Yiwey Shieh
    • , Elad Ziv
    •  & Karla Kerlikowske
  • Perspective |

    A systems biology-based approach incorporating multiscale, longitudinal measurements (from single-cell analyses to whole-body monitoring) would help to decipher the complexity of cancer and would facilitate the development of personalized therapies. The authors of this Perspective discuss how systems biology-based approaches can provide data for early detection of disease transitions, prediction of therapeutic responses and clinical outcomes, and for the design of personalized treatments.

    • James T. Yurkovich
    • , Qiang Tian
    •  & Leroy Hood
  • Consensus Statement
    | Open Access

    Attempts to incorporate additional criteria into the traditional tumour-node-metastasis staging classification have often resulted in inaccuracy and confusion in the use of terminology. In this Position paper, the authors provide guidance on the consistent use of the terminology relating to cancer staging.

    • James Brierley
    • , Brian O’Sullivan
    •  & Mary Gospodarowicz
  • News & Views |

    Researchers from Google AI have presented results obtained using a deep learning model for the detection of lung cancer in screening CT images. The authors report a level of performance similar to, or better than, that of radiologists. However, these claims are currently too strong. The model is promising but needs further validation and could only be implemented if screening guidelines were adjusted to accept recommendations from black-box proprietary AI systems.

    • Colin Jacobs
    •  & Bram van Ginneken
  • News & Views |

    In a landmark analysis, investigators of the Multicentric Italian Lung Detection (MILD) trial have confirmed 10-year mortality reductions with lung cancer screening using low-dose helical CT (LDCT). These data complement the reduced lung cancer-specific mortality reported in the National Lung Screening Trial and reinforce the rationale for broad implementation of LDCT screening in high-risk populations.

    • Matthew B. Schabath
    •  & Denise R. Aberle
  • Review Article |

    CRISPR systems have enabled important advances in cancer research by accelerating the development of study models or as a tool in genetic screening studies to discover and validate therapeutic targets. The authors of this Review discuss these applications and new potential uses, such as cancer detection and development of anticancer therapies.

    • Hao Yin
    • , Wen Xue
    •  & Daniel G. Anderson
  • News & Views |

    Population-based mammographic screening is widely accepted as an intervention to reduce overall mortality from breast cancer, but at the cost of morbidity due to false positives and substantial overdiagnosis and overtreatment of ultra-low-risk disease, as well as personal and health-economic burdens. Recent data from a modelling study strengthen the rationale for personalized, risk-based screening approaches, now being tested in multiple clinical trials.

    • Laura J. Esserman
    •  & Andrea Z. LaCroix
  • News & Views |

    PapSEEK, a novel liquid-based cytology test, enabled the highly specific detection of endometrial and ovarian cancer in a retrospective study. Herein, I discuss potential applications of this tool, both for cancer screening of asymptomatic populations and for the early diagnosis of cancer in symptomatic women.

    • Usha Menon
  • Comment |

    A call for action has been made for the establishment of a global fund for cancer control, but potential donors have not reacted yet, possibly because this task would require an annual expenditure of billions of dollars. Herein, I suggest a less onerous starting point: targeting childhood cancer in Africa guided by well-designed national cancer control plans.

    • Cristina Stefan
  • Review Article |

    After curative treatment, 30% of patients with stage I–III and up to 65% of patients with stage IV colorectal cancer (CRC) develop recurrent disease. Thus, surveillance for disease recurrence is clearly needed in these patients, but controversy surrounds the optimal follow-up approaches. Herein, the current evidence relating to surveillance strategies for patients with CRC is comprehensively reviewed, and the future development of patient-centred programmes is discussed.

    • Eric P. van der Stok
    • , Manon C. W. Spaander
    •  & Ernst J. Kuipers
  • Review Article |

    Patients diagnosed with cancer through an emergency presentation have worse outcomes compared with those in whom cancer is diagnosed through other routes; therefore, reducing the number of patients presenting as an emergency with cancer will improve patients' outcomes. In this Review, the authors describe the available evidence in this area, and provide recommendations for future research, clinical practice and public health policy.

    • Yin Zhou
    • , Gary A. Abel
    •  & Georgios Lyratzopoulos
  • News & Views |

    Annual thoracic CT screening is currently recommended for individuals deemed to be at high risk of developing lung cancer; however, Patz and co-workers now raise the very important question of choosing the optimal interval between screening exams, in order to balance the potential benefits and harms associated with each round of CT. Herein, we present important considerations for determining such intervals.

    • David Yankelevitz
    •  & Claudia Henschke
  • News & Views |

    We believe that current controversies surrounding screening might be better approached by shifting the question from 'does screening work?' to 'for whom does screening work?' We propose a 'rule-out/rule-in' principle as an intellectual basis and starting point for screening. Finally, we advocate the 'equal management of equal risks' principle as an unifying framework for developing simplified and consistent screening guidelines and practice.

    • Philip E. Castle
    •  & Hormuzd A. Katki