Latest news with #ofInternalMedicine
New York Post
19 hours ago
- Health
- New York Post
Appendix cancer has quadrupled in older millennials in the US
Researchers are reporting a startling spike in appendiceal adenocarcinoma (AA) — otherwise known as appendix cancer — in people born after 1945. Cases have more than tripled in Americans born between 1980 and 1985 and quadrupled in those born between 1985 and 1990, according to a new study out of Vanderbilt University Medical Center. 'I think it's alarming,' study author Andreana N. Holowatyj, an assistant professor of hematology and oncology, told The Post. Advertisement 3 A new study has identified an alarming spike in appendiceal adenocarcinoma (AA) — otherwise known as appendix cancer — in people born after 1945. top images – Appendix cancer is very rare, estimated to affect only about one or two people per 1 million per year, according to the National Cancer Institute. Indeed, Holowatyj's team identified only 4,858 people aged 20 and over who were diagnosed with AA between 1975 and 2019. Advertisement The findings, published Monday in the Annals of Internal Medicine, are nonetheless part of a troublesome trend. AA is yet another type of cancer that seems to be on the rise in younger adults — joining the ranks of colorectal, breast, uterine, kidney and pancreatic cancers. 'I think the fact that we're seeing birth cohort or generational effects across a plethora of cancer types is indeed alarming because it really stresses the need to understand what is underpinning this pattern in order for us to be able to actively reverse it,' Holowatyj said. 3 Experts point to lifestyle changes, such as more sedentary behavior, as a possible cause of the rise in cancer cases in younger people. StockPhotoPro – Advertisement As with other cancers, health experts aren't exactly sure what could be causing the jump in AA cases. 'I think it's going to be a constellation of factors that may be driving appendiceal cancer development,' Holowatyj said. 'One of the things we often think about is, what has changed across birth cohorts over time?' she said. Advertisement Holowatyj pointed to 'possibly the use of antibiotics, both in childhood and in the food chain, the industrialization of the food industry over time, the lifestyle patterns and the tripling of obesity since the 1970s, increasingly sedentary behavior, possibly environmental exposures that have changed across different parts of the country and over time.' Whatever the cause, she hopes this study encourages the public to be 'aware of this cancer, to know about the signs and symptoms of appendix cancers and know that we're seeing more cases diagnosed across generations.' 3 Most AA cases are diagnosed incidentally after someone has their appendix removed. Avocado_studio – Many of these symptoms can mimic appendicitis: Abdominal pain, often on the lower right side Bloating, diarrhea or constipation Feeling full after small meals Unexplained weight loss Nausea and vomiting Abdominal mass or swelling Holowatyj hopes that people with symptoms 'see a healthcare professional in a timely manner because it's truly critical to detect appendix cancer early.' There are no standardized screening tests for appendix cancers — most cases are diagnosed incidentally after someone has their appendix removed. 'I think it's important to understand that appendix cancer is actually diagnosed in younger ages more commonly than we see in other cancers,' she said, noting that one in three patients diagnosed with appendix cancer is under the age of 50, compared to one in eight for colon cancer.
Medscape
15-05-2025
- Health
- Medscape
Lower FIT Cutoffs Could Cut Costs of CRC Screening
Multitarget stool DNA tests — which are becoming more popular in the United States — have shown increased sensitivity over fecal immunochemical tests (FITs) for early colorectal cancer (CRC) screening, however FITs can be more cost-effective, according to the results of a new study. 'Although our study is not and does not claim to be a comprehensive cost-effectiveness analysis, our results indicate there would be much to gain if the current trends of decreasing FIT use rates and increasing [multitarget stool DNA test] use rates in the United States could be reversed,' wrote Hermann Brenner, MD, of Heidelberg University, Heidelberg, Germany, and colleagues. The main argument in favor of multitarget stool DNA test 'has been their higher sensitivity compared with FIT. However, as previously shown, essentially the same sensitivity and specificity could be achieved at no incremental cost by lowering the FIT positivity threshold,' the authors pointed out. In the study, recently published in the Annals of Internal Medicine , researchers compared screening test performance characteristics of a current multitarget stool DNA test (Cologuard, Exact Sciences) and a next-generation multitarget stool DNA test (Cologuard Plus, Exact Sciences) with a current FIT, using data from close to 170 patients. The sensitivity for CRC was 73.8% for FIT vs 92.3% for the current multitarget stool DNA test, and 67.3% vs 93.9% for FIT vs the next generation multitarget stool DNA test. The sensitivity for any advanced neoplasia was 27.7% vs 46.4% for FIT vs the current multitarget test, and 25.2% vs 45.6% for FIT vs the next generation multitarget test. However, specificities for no advanced neoplasia were higher for FIT at 94.9% and 94.8% compared with 86.6% for the current multitarget test and 90.6% for the next generation test. The researchers assumed a 60% uptake of colonoscopy after a positive result. Overall, the screening costs for each case of advanced neoplasia or early detected CRC were 7-9 times higher for the multitarget stool DNA tests than FIT-based screening tests, they reported. The costs per each additional early CRC case were more than $700,000 for both multitarget tests compared with FIT costs, they noted. The findings are limited by the observational design, but the results suggest value in the increased use of FIT if the positivity threshold was reduced, the researchers stated. 'The FIT cutoffs used in different countries vary widely, and the current practice in the United States that hinders use of quantitative information from FITs and flexibility in defining the positivity threshold should be reconsidered,' they concluded. Follow-up Is Essential to FIT Success The invasiveness of CRC screening tests remains a significant impediment to screening, said David A. Johnson, MD, professor of medicine and chief of Gastroenterology at Eastern Virginia School of Medicine, Norfolk, Virginia, in an interview. Stool-based testing can be done at home 'without the encumberments related to colonoscopy,' said Johnson, who was not involved in the study. However, stool-based testing, in particular FIT, is much less effective in detection of precancerous type polyps, and more of a colon cancer detection test. The goal of screening is cancer prevention rather than simply detection, but these tests are better than no screening, he added. The current study findings were not surprising, as the cost effectiveness of FIT in particular has been previously reported, albeit for the detection of CRC rather than precancerous polyps, Johnson told Medscape Medical News . As for the effectiveness, 'disparities for sensitivity trade off with specificity,' he said. This would mean earlier detection of lesions, as opposed to over-testing for lesions that are not really there. 'FIT testing has been extremely effective when done in well-directed programmatic and systematic testing,' Johnson told Medscape Medical News . 'Following up on noncompliance as well as colonoscopy for positive tests is critical to optimize outcomes for this approach or run the risks for adverse outcomes,' he said. The current study was limited by the potential impact of age and comorbidities on sensitivity testing, he noted. 'The assumptions for this present study would be subject to real world testing, which also might be subject to the demographic locations and insurance related factors for systematic testing and comprehensive follow-up.'
