Colorectal cancer after a negative Haemoccult II® test and programme sensitivity after a first round of screening: the experience of the Department of Calvados (France)

Colorectal cancers emerging after a negative Haemoccult II® are described in the context of a first round of mass screening in the Department of Calvados (France), from April 1991 to the end of December 1994. People with a cancer occurring after a negative test until 31 December 1995 were identified by a local cancer registry. Incidence was calculated and the programme sensitivity was estimated. The incidence of cancer emerging after a negative test was 57.7 per 100 000, i.e. half of the calculated incidence in the reference group (141.6 per 100 000). These cancers did not differ from those of either the non-responder or reference groups, in particular for the stage of extension. The programme sensitivity was globally higher than that estimated in European trials: 77.2, 66.3 and 55.9%, 1, 2 and 3 years after the test respectively. Programme sensitivity was higher for distal colon cancer 1 year after the test, which is probably due to the relatively slow growth of this subsite. © 1999 Cancer Research Campaig

The impact of population-based faecal occult blood test screening on colorectal cancer mortality:a matched cohort study

BACKGROUND: Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme. METHODS: Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000–2007) before the roll out of a national programme. All residents (50–69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier. RESULTS: There were 379 655 people in each group (median age 55.6 years, 51.6% male). Participation was 60.6%. There were 961 (0.25%) CRC deaths in invitees, 1056 (0.28%) in controls, rate ratio (RR) 0.90 (95% confidence interval (CI) 0.83–0.99) overall and 0.73 (95% CI 0.65–0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95% CI 1.06–1.38). CONCLUSION: There was a 10% relative reduction in CRC mortality in a routine screening programme, rising to 27% in participants

Temporal trends in mode, site and stage of presentation with the introduction of colorectal cancer screening: a decade of experience from the West of Scotland

background:  Population colorectal cancer screening programmes have been introduced to reduce cancer-specific mortality through the detection of early-stage disease. The present study aimed to examine the impact of screening introduction in the West of Scotland. methods:  Data on all patients with a diagnosis of colorectal cancer between January 2003 and December 2012 were extracted from a prospectively maintained regional audit database. Changes in mode, site and stage of presentation before, during and after screening introduction were examined. results:  In a population of 2.4 million, over a 10-year period, 14 487 incident cases of colorectal cancer were noted. Of these, 7827 (54%) were males and 7727 (53%) were socioeconomically deprived. In the postscreening era, 18% were diagnosed via the screening programme. There was a reduction in both emergency presentation (20% prescreening vs 13% postscreening, P0.001) and the proportion of rectal cancers (34% prescreening vs 31% pos-screening, P0.001) over the timeframe. Within non-metastatic disease, an increase in the proportion of stage I tumours at diagnosis was noted (17% prescreening vs 28% postscreening, P0.001). conclusions:  Within non-metastatic disease, a shift towards earlier stage at diagnosis has accompanied the introduction of a national screening programme. Such a change should lead to improved outcomes in patients with colorectal cancer

The Supernova Legacy Survey 3-year sample: Type Ia Supernovae photometric distances and cosmological constraints

We present photometric properties and distance measurements of 252 high redshift Type Ia supernovae (0.15 < z < 1.1) discovered during the first three years of the Supernova Legacy Survey (SNLS). These events were detected and their multi-colour light curves measured using the MegaPrime/MegaCam instrument at the Canada-France-Hawaii Telescope (CFHT), by repeatedly imaging four one-square degree fields in four bands. Follow-up spectroscopy was performed at the VLT, Gemini and Keck telescopes to confirm the nature of the supernovae and to measure their redshifts. Systematic uncertainties arising from light curve modeling are studied, making use of two techniques to derive the peak magnitude, shape and colour of the supernovae, and taking advantage of a precise calibration of the SNLS fields. A flat LambdaCDM cosmological fit to 231 SNLS high redshift Type Ia supernovae alone gives Omega_M = 0.211 +/- 0.034(stat) +/- 0.069(sys). The dominant systematic uncertainty comes from uncertainties in the photometric calibration. Systematic uncertainties from light curve fitters come next with a total contribution of +/- 0.026 on Omega_M. No clear evidence is found for a possible evolution of the slope (beta) of the colour-luminosity relation with redshift.Comment: (The SNLS Collaboration) 40 pages, 32 figures, Accepted in A&

Mesorectal radiotherapy for early stage rectal cancer: A novel target volume

With the introduction of population-based bowel cancer screening, rectal cancer is diagnosed at earlier stages, yet standard treatment still requires the same extensive surgery that is used for more advanced stages. Organ preserving treatment is rapidly developing and is subject of investigation in numerous clinical trials. The STAR-TREC trial is an international, multi-centre randomised trial investigating organ preservation using (chemo)radiotherapy. Patients with small mrT1-3bN0V0M0 tumours are randomized between three arms: standard TME, organ preservation with SCRT or with CRT. In this trial, the clinical target volume has been tailored to the early staged disease of the included patients. This mesorectal irradiation volume includes the mesorectum and pre-sacral lymph nodes at the level of the tumour, two centimetres below and cranially up to the S2-3 interspace level. In contrast to conventional irradiation volumes, the lateral lymph nodes and the nodes along the superior rectal artery are excluded. As a result, the dose to the bowel, bladder, anal sphincter and the neurovascular plexus in the lower pelvis is substantially decreased, especially when combined with modern irradiation techniques, such as dynamic arc therapy. These lower doses are expected to lead to decreasing acute and late toxicity and beneficial functional outcomes. The implementation of this novel target volume will be accompanied by an extensive quality assurance program in the STAR-TREC trial. We describe the rationale behind the novel, mesorectal only radiotherapy treatment used in the STAR-TREC trial specifically tailored for early stage disease, with the goal of organ preservation

An ongoing case-control study to evaluate the NHS Bowel Cancer Screening Programme

© 2014 Massat et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

Stable oxygen isotope variability in two contrasting glacier river catchments in Greenland

Analysis of stable oxygen isotope (δ18O) characteristics is a useful tool to investigate water provenance in glacier river systems. In order to attain knowledge on the diversity of δ18O variations in Greenlandic rivers, we examined two contrasting glacierised catchments disconnected from the Greenland Ice Sheet (GrIS). At the Mittivakkat Gletscher river, a small river draining a local temperate glacier in southeast Greenland, diurnal oscillations in δ18O occurred with a 3 h time lag to the diurnal oscillations in run-off. The mean annual δ18O was −14.68 ± 0.18 ‰ during the peak flow period. A hydrograph separation analysis revealed that the ice melt component constituted 82 ± 5 % of the total run-off and dominated the observed variations during peak flow in August 2004. The snowmelt component peaked between 10:00 and 13:00 local time, reflecting the long travel time and an inefficient distributed subglacial drainage network in the upper part of the glacier. At the Kuannersuit Glacier river on the island Qeqertarsuaq in west Greenland, the δ18O characteristics were examined after the major 1995–1998 glacier surge event. The mean annual δ18O was −19.47 ± 0.55 ‰. Despite large spatial variations in the δ18O values of glacier ice on the newly formed glacier tongue, there were no diurnal oscillations in the bulk meltwater emanating from the glacier in the post-surge years. This is likely a consequence of a tortuous subglacial drainage system consisting of linked cavities, which formed during the surge event. Overall, a comparison of the δ18O compositions from glacial river water in Greenland shows distinct differences between water draining local glaciers and ice caps (between −23.0 and −13.7 ‰) and the GrIS (between −29.9 and −23.2 ‰). This study demonstrates that water isotope analyses can be used to obtain important information on water sources and the subglacial drainage system structure that is highly desired for understanding glacier hydrology

Constraining dark matter halo properties using lensed SNLS supernovae

This paper exploits the gravitational magnification of SNe Ia to measure properties of dark matter haloes. The magnification of individual SNe Ia can be computed using observed properties of foreground galaxies and dark matter halo models. We model the dark matter haloes of the galaxies as truncated singular isothermal spheres with velocity dispersion and truncation radius obeying luminosity dependent scaling laws. A homogeneously selected sample of 175 SNe Ia from the first 3-years of the Supernova Legacy Survey (SNLS) in the redshift range 0.2 < z < 1 is used to constrain models of the dark matter haloes associated with foreground galaxies. The best-fitting velocity dispersion scaling law agrees well with galaxy-galaxy lensing measurements. We further find that the normalisation of the velocity dispersion of passive and star forming galaxies are consistent with empirical Faber-Jackson and Tully-Fisher relations, respectively. If we make no assumption on the normalisation of these relations, we find that the data prefer gravitational lensing at the 92 per cent confidence level. Using recent models of dust extinction we deduce that the impact of this effect on our results is very small. We also investigate the brightness scatter of SNe Ia due to gravitational lensing. The gravitational lensing scatter is approximately proportional to the SN Ia redshift. We find the constant of proportionality to be B = 0.055 +0.039 -0.041 mag (B < 0.12 mag at the 95 per cent confidence level). If this model is correct, the contribution from lensing to the intrinsic brightness scatter of SNe Ia is small for the SNLS sample.Comment: 11 pages, 7 figures, accepted for publication in MNRA

Characteristics of patients receiving allergy vaccination: to which extent do socio-economic factors play a role?

Background: Little is known about characteristics of patients receiving allergen-specific immunotherapy. Identifying obstacles to appropriate treatment according to guidelines may facilitate the development of strategies aiming at improved treatment of patients with allergic respiratory diseases. The objective of this study was to investigate differences in disease severity, demographic and socioeconomic status between allergic rhinitis patients receiving allergen-specific immunotherapy and allergic rhinitis patients not receiving allergen-specific immunotherapy. Methods: A total of 366 patients were studied of whom 210 were going to receive subcutaneously administrated immunotherapy (SIT) against grass pollen and/or house dust mite allergy. The severity of rhino-conjunctivitis (hay fever) and/or asthma was classified according to international guidelines. The questionnaires included an EQ-5D visual analogue scale instrument and some socio-economic questions. Results: Severity of disease, young age, high level of education as well as greater perceived impairment of health-related quality of life due to allergic symptoms were significantly associated with use of SIT. Somewhat unexpectedly, household income was not associated with use of SIT. Conclusion: Use of SIT was associated with both disease severity measures and educational level, but not income level. These results suggest social inequality as reflected by lower use of SIT among patients with lower educational level may represent an obstacle to treatment with SIT

A long postreproductive life span is a shared trait among genetically distinct killer whale populations.

The extended female postreproductive life span found in humans and some toothed whales remains an evolutionary puzzle. Theory predicts demographic patterns resulting in increased female relatedness with age (kinship dynamics) can select for a prolonged postreproductive life span due to the combined costs of intergenerational reproductive conflict and benefits of late-life helping. Here, we test this prediction using >40 years of longitudinal demographic data from the sympatric yet genetically distinct killer whale ecotypes: resident and Bigg's killer whales. The female relatedness with age is predicted to increase in both ecotypes, but with a less steep increase in Bigg's due to their different social structure. Here, we show that there is a significant postreproductive life span in both ecotypes with >30% of adult female years being lived as postreproductive, supporting the general prediction that an increase in local relatedness with age predisposes the evolution of a postreproductive life span. Differences in the magnitude of kinship dynamics however did not influence the timing or duration of the postreproductive life span with females in both ecotypes terminating reproduction before their mid-40s followed by an expected postreproductive period of about 20 years. Our results highlight the important role of kinship dynamics in the evolution of a long postreproductive life span in long-lived mammals, while further implying that the timing of menopause may be a robust trait that is persistent despite substantial variation in demographic patterns among populations