K Hemminki1, H Liu2, A Heminki3, J Sundquist4. 1. Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany; Center for Primary Health Care Research, Lund University, Malmö, Sweden. Electronic address: k.hemminki@dkfz.de. 2. Division of Molecular Genetic Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany. 3. Cancer Gene Therapy Group, Molecular Cancer Biology Program, Transplantation Laboratory, Haartman Institute, Finnish Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland. 4. Center for Primary Health Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, USA.
Abstract
BACKGROUND: Cancer of unknown primary (CUP) is diagnosed at a metastatic stage but no diagnostic effort is spared to find the primary cancers because these will guide the treatment. Consequently, the diagnostic work-up for CUP is more comprehensive than for any other cancer, resulting in detection of second cancers unrelated to CUP. We want to use the detection rate of second cancers as a measure of efficacy of the diagnostic modalities in finding tumors, assuming that the detection rates have increased with modern technologies. PATIENTS AND METHODS: The number of CUP patients identified in the nation-wide Swedish Database was 28,574 and relative risks (RRs) for second cancers were recorded in three periods from 1980 through 2008. The first 5 months after CUP were considered critical for second cancers to be diagnosed during the intense work-up for CUP. RESULTS: Among second cancers, diagnosable by computed tomography or magnetic resonance imaging, there was a large 6.80-fold increase in RR immediately following CUP diagnosis from the period 1980-1989 to 2000-2008. Over the same periods, the increase in in situ tumors was 7.16-fold. CONCLUSION: These data suggest that improvements in the resolution and availability of powerful imaging techniques result in increasingly sensitive detection of tumors.
BACKGROUND:Cancer of unknown primary (CUP) is diagnosed at a metastatic stage but no diagnostic effort is spared to find the primary cancers because these will guide the treatment. Consequently, the diagnostic work-up for CUP is more comprehensive than for any other cancer, resulting in detection of second cancers unrelated to CUP. We want to use the detection rate of second cancers as a measure of efficacy of the diagnostic modalities in finding tumors, assuming that the detection rates have increased with modern technologies. PATIENTS AND METHODS: The number of CUP patients identified in the nation-wide Swedish Database was 28,574 and relative risks (RRs) for second cancers were recorded in three periods from 1980 through 2008. The first 5 months after CUP were considered critical for second cancers to be diagnosed during the intense work-up for CUP. RESULTS: Among second cancers, diagnosable by computed tomography or magnetic resonance imaging, there was a large 6.80-fold increase in RR immediately following CUP diagnosis from the period 1980-1989 to 2000-2008. Over the same periods, the increase in in situ tumors was 7.16-fold. CONCLUSION: These data suggest that improvements in the resolution and availability of powerful imaging techniques result in increasingly sensitive detection of tumors.
Authors: M B Hannouf; E Winquist; S M Mahmud; M Brackstone; S Sarma; G Rodrigues; P Rogan; J S Hoch; G S Zaric Journal: Pharmacogenomics J Date: 2016-03-29 Impact factor: 3.550
Authors: Kari Hemminki; Otto Hemminki; Anni I M Koskinen; Asta Försti; Kristina Sundquist; Jan Sundquist; Xinjun Li Journal: BMC Nephrol Date: 2018-07-03 Impact factor: 2.388