Cancer Screening in U.S. Primary Care Practices
Yabroff et al. Page 2471
In the United States, primary care physicians play a central role in implementing cancer screening guidelines because many cancer screens require a referral to a specialist. Yabroff and colleagues assessed primary care physicians' use of system strategies in cancer screening, including screening reminders, screening rate performance reports, and implementation of practice guidelines. They found that only 10% of primary care physicians in the United States used systems strategies to support breast, cervical, and colorectal cancer screening. This is the case despite extensive evidence on the effectiveness of these strategies to improve patient care. This report highlights the need for more primary care practices to implement systems strategies to improve the use and quality of cancer screening.
Ovarian Cancer Biomarkers
Bandiera et al. Page 2496
The Risk for Ovarian Malignancy Algorithm (ROMA) is a tool that uses serum levels of human epididymis protein 4 (HE4) and CA125 to determine the risk of epithelial ovarian cancer (EOC) in patients with a pelvic mass. In this study, Bandiera and colleagues analyzed the diagnostic and prognostic value of HE4 and CA125 alone or combination (ROMA) to evaluate EOC risks. In both pre- and postmenopausal women, the high specificity of HE4 helped discriminate benign cysts from EOC, and the high sensitivity of CA125 was important for detecting EOC. Elevated HE4 and ROMA were both independent prognostic factors for shorter overall survival. Future multicenter studies will be necessary for further assessment of HE4, CA125, and ROMA to monitor EOC.
Cataracts and Ovarian Cancer
Lurie et al. Page 2507
Although solar UV radiation is a risk factor for cataract formation, the major health benefit of UV radiation exposure is the production of vitamin D, which is implicated in protection against several cancers. In this population-based case–control study, Lurie and colleagues examined the association of ovarian cancer risk with cataract formation as an indicator of high long-term UV radiation exposure. The authors report that a history of cataracts was significantly associated with reduced risk for ovarian cancer, adding indirect evidence to the hypothesis that lifetime vitamin D exposure may be inversely associated with the risk of ovarian cancer.
Toll-Like Receptor Gene Variants and the Risk of Gastric Cancer
Zeng et al. Page 2594
Genetic polymorphisms of Toll-like receptors (TLR) may influence the outcome of Helicobacter pylori infection and play roles in gastric cancer. Zeng and colleagues conducted a population-based study to screen the genetic variants of TLR2 and TLR5 and evaluate their associations with gastric cancer. The authors detected 9 genetic variants within the promoters and exons of TLR2 and TLR5 that either decreased or increased the risk of gastric cancer and/or H. pylori infection. These findings suggest that TLR2 and TLR5 gene variants may influence H. pylori–related gastric cancer carcinogenesis.