Early detection of cancer.
Early detection of cancer.
Early detection of cancer greatly increases the chances for successful treatment. There are two major components of early detection of cancer: education to promote early diagnosis and screening.
Screening is the presumptive identification of unrecognized disease or defects by means of tests, examinations, or other procedures that can be applied rapidly. The success of screening depends on having sufficient numbers of personnel to perform the screening tests and on the availability of facilities that can undertake subsequent diagnosis, treatment, and follow-up.
The success of screening programmes depends on a number of fundamental principles:
- The target disease should be a common form of cancer, with high associated morbidity or mortality;
- Effective treatment, capable of reducing morbidity and mortality, should be available;
- Test procedures should be acceptable, safe, and relatively inexpensive.
Special offers to our patients!
Serological markers for detection of cancer and family doctor consultation only 399 Lt/115,56 Eur.
Serologic markers have been studied extensively in immunology and have also been widely used in the study, clinical diagnosis, and prognosis of cancer. Prostate-specific antigen (PSA) in serum has been studied widely and used in early detection and management of prostate cancer. Several monoclonal and polyclonal antibodies have been developed for the detection of PSA, and about 25 to 75 percent of patients with the disease have PSA in their sera. Even with the potential problem of lack of specificity of the test, PSA is the most widely used tumor-associated antigen.
The most commonly used markers for diagnosis and management of epithelial ovarian cancer is CA 125, which is an antigenic determinant, part of a glycoprotein present in the sera of approximately 80 percent of patients with epithelial ovarian cancer. It is found elevated in about 40 percent of patients with Stage I ovarian cancers and about 20 percent of patients with mucinous malignancies. In addition, approximately 60 percent of pancreatic carcinomas express CA 125, as do 25 percent of all other solid tumors. However, CA 125 is not only a marker for cancer, but is also elevated in a number of benign gynecologic conditions, including pelvic inflammatory disease, endometriosis, uterine leiomyoma, and early pregnancy. This nonspecificity has limited the use of CA 125 as a tumor maker in screening and diagnosis.
Carcinoembryonic antigen (CEA), alphafetoprotein (AFP), and altered carbohydrate antigen 19–9 (CA19–9) have been studied in the past decade for early diagnosis of human pancreatic adenocarcinoma and gastrointestinal malignancies. The utility of CEA as a serum marker in the detection of tumors has been limited due to the finding that CEA levels are affected by a variety of factors, including liver function, biliary obstruction, and subclinical hepatitis, and because the interlaboratory variation in CEA measurements could run as high as 36 percent.
AFP was first described as a tumor marker for hepatoma in the 1960s. It is most frequently elevated among patients with hepatoma and yolk sac (endodermal sinus) tumors. AFP-positive tumors can be found throughout the gastrointestinal tract.
CA 19–9 is frequently elevated in pancreatic cancer, but is also elevated in cancers of the biliary tract, and less frequently in colorectal and gastric cancers. Studies have shown that CA 19–9 can identify, with reasonable accuracy, the majority of patients with pancreatic cancer in a highly select patient population. The utility of other markers, such as pancreatic oncofetal antigen (POA) and tumor-associated trypsin inhibitor (TATI), is still being studied.
Serological markers have great potential to be used in clinical practice, including early detection of cancer, because these markers are differently expressed—qualitatively or quantitatively, and because they vary between either people who are healthy and those that have certain diseases.
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