Annual Meeting Proceedings Part 1 - American Society of Clinical ...

102s Cancer Prevention/Epidemiology
1567 General Poster Session (Board #5A), Sat, 1:15 PM-5:15 PM
Cancer screening: Source of information and level of trust. Presenting
Author: Jean F. Morere, Oncology Department, Hôpital Avicenne, Bobigny,
France
Background: Providing public information is critical for cancer control.
EDIFICE surveys were conducted to provide a better understanding of the
participation of the French population in cancer screening programs
(colorectal, breast) or individual cancer screening (prostate). To evaluate
sources of information in the general population and their level of trust,
specific questions were addressed in the EDIFICE 3 survey. Methods: This
third nationwide observational study, EDIFICE 3, was conducted by phone
interviews among a representative sample of 1603 subjects aged between
40 and 75 years old, using the quota method. Questions on the source of
information were: Concerning cancer screening, what are all your means of
information? What level of trust (quoted from 1 to 10) do you have on the
following media of information; your own general practitioner, physicians in
general, patient associations, national health insurance system, health
authorities, your close circle, radio and television, lay press, internet.
Results: In the overall population, the most frequently quoted means of
information for cancer screening were: radio and television (61%), general
practitioners (52%), lay press (33%), institutional letters (19%) and
internet (18%). People under 50 years old named significantly more often
radio and television (66% vs 58%) and internet (24% vs 15%), while older
people above 50 years old (target population for screening programs) more
frequently named institutional letters (26% vs 7%). In a trust scale from 0
to 10, the best level of trust was achieved by general practitioners (8.2),
patient associations (6.8), national health insurance system (6.6) and
health authorities (6.2). In contrast, radio and television (5.7), lay press
(5.2) and internet (4.6) were mistrusted. Overall, women and younger
subjects were more trustful. Conclusions: Radio and television are the most
frequently quoted source of information but paradoxically they are not
highly trusted. The general practitioner appears to be the best option
(trusted and used) for providing cancer screening information. As institutional
letters were frequently quoted and highly trusted, they might be
useful for informing the population even before the age of recommended
screening.
1569 General Poster Session (Board #5C), Sat, 1:15 PM-5:15 PM
Patient perceptions of stool-based DNA testing across racial groups.
Presenting Author: Lily Huang, Case Western Reserve University, Cleveland,
OH
Background: Despite the widespread acceptance of colonoscopy as the gold
standard for Colorectal Cancer (CRC) screening, compliance rates with
recommended CRC screening lag far behind screening for breast and
cervical cancers. Patients often delay or forgo screening colonoscopy due to
associated discomfort, inconvenience, anxiety, and high cost. In addition,
recent data have casted doubt on its effectiveness, especially in detecting
right-sided colon neoplasia. Stool-based DNA (sDNA) testing is an emerging
CRC screening tool that is convenient, noninvasive, and effective in
detecting both right and left sided colon cancer. The goal of this study was
to evaluate patient attitudes towards sDNA testing, identify preferences in
CRC screening tools, and assess racial differences in these attitudes and
preferences. Methods: In a colonoscopy-based case-control study, 100
patients of average CRC risk were asked to complete (1) sDNA testing
(LabCorp ColoSure test), (2) screening colonoscopy, and (3) a patient
satisfaction survey. Results: Eighty patients completed the study, including
55 (69%) White, 22 (27%) African American, and 3 (4%) Others. Overall,
patients rated sDNA testing favorably in all preparation and test related
features, except for perceived accuracy. Patients reporting a preferred
screening method favored sDNA testing (78%) to FOBT (12%) or colonoscopy
(10%), and 83% of all patients reported that they are likely to repeat
sDNA testing. Non-Caucasians rated sDNA testing less favorably than
Caucasians – reporting more discomfort (ANOVA, p�0.004), more anxiety
(ANOVA, p�0.001), and less suitability (Chi-Squared, p�0.0035). Of
those patients reporting a preferred screening test, 82% of Caucasians and
64% of non-Caucasians selected sDNA testing. Conclusions: Although
sDNA testing was ranked less favorably by non-Caucasians, it was well
received overall as the preferred CRC screening test, as compared to FOBT
and colonoscopy. The differences between racial groups may reflect the
generally lower uptake of CRC screening among non-Caucasians, regardless
of the test. In conclusion, sDNA testing may be an effective means to
increase CRC screening in African Americans, hence preventing CRC and
closing the racial disparity gap.
1568 General Poster Session (Board #5B), Sat, 1:15 PM-5:15 PM
Cancer screening in France: 3rd edition of the EDIFICE survey. Presenting
Author: Jérôme Viguier, CHRU Trousseau, Tours, France
Background: The EDIFICE survey program started in 2005 and was aimed at
providing a better understanding of the participation of the French
population in cancer screening programs and assess the evolution over
time. The EDIFICE 3 survey was conducted in 2011, following EDIFICE 1
(2005) and EDIFICE 2 (2008), and focused on colorectal, breast and
prostate cancer. Methods: This third nationwide observational study,
EDIFICE 3, was conducted by phone interviews among a representative
sample of 1603 subjects aged between 40 and 75 years, using the quota
method. The analysis focused on the target population of the national
screening programs for breast and colorectal cancer (50-74 years). The
same population was analysed for prostate cancer screening behaviours.
Results: For breast cancer, the rate of women attending at least one
screening test was 93%/94%/95% in 2005/2008/2011 respectively. A
mammography had been performed as recommended within the last two
years for 75%/83%/83% among them. We observed an increase in timing
compliance between 2005 and 2011, significant for women aged 65-74.
For colorectal cancer, the rate of subjects attending at least one screening
test was 25%/38%/59%. A fecal test or colonoscopy had been performed
according to the recommended timing for NA/30%/51% among them.
Colorectal cancer screening has increased significantly in all age groups,
especially between 65 and 69 years, and for both genders. For prostate
cancer, the rate of men having performed at least one screening test (PSA
and/or rectal examination) was 36%/49%/50%.This rate have significantly
decreased in men aged 50-59 between 2008 and 2011(44% vs 37%,
p�0.05). Conclusions: For National Programs, the attendance rate remains
high for breast cancer screening and is improving for colorectal cancer
screening. However, the European guideline objective rate of participation
for colorectal cancer screening has not yet been reached. Despite the
absence of recommendations, prostate cancer screening is frequently
carried out and stable overall.
1570 General Poster Session (Board #5D), Sat, 1:15 PM-5:15 PM
On-line breath analysis of volatile organic compounds as a method for
colorectal cancer detection. Presenting Author: Francisco Zambrana Tevar,
Department of Medical Oncology, Hospital Infanta Sofía, Madrid, Spain
Background: Analysis of exhaled volatile organic compounds (VOCs) in
breath is an emerging approach for cancer diagnosis, but little is known
about its potential use as a biomarker for colorectal cancer (CRC). We
investigated whether a combination of VOCs could distinct CRC patients
from healthy volunteers. Methods: In a pilot study, we prospectively
analyzed breath exhalations of 38 CRC patient and 43 healthy controls all
scheduled for colonoscopy, older than 50 in the average-risk category. The
samples were ionized and analyzed using a Secondary ElectroSpray
Ionization (SESI) coupled with a Time-of-Flight Mass Spectrometer (SESI-
MS). After a minimum of 2 hours fasting, volunteers deeply exhaled into the
system. Each test requires three soft exhalations and takes less than ten
minutes. No breath condensate or collection are required and VOCs masses
are detected in real time, also allowing for a spirometric profile to be
analyzed along with the VOCs. A new sampling system precludes ambient
air from entering the system, so background contamination is reduced by
an overall factor of ten. Potential confounding variables from the patient or
the environment that could interfere with results were analyzed. Results:
255 VOCs, with masses ranging from 30 to 431 Dalton have been identified
in the exhaled breath. Using a classification technique based on the ROC
curve for each VOC, a set of 9 biomarkers discriminating the presence of
CRC from healthy volunteers was obtained, showing an average recognition
rate of 81.94%, a sensitivity of 87.04% and specificity of 76.85%.
Conclusions: A combination of cualitative and cuantitative analysis of VOCs
in the exhaled breath could be a powerful diagnostic tool for average-risk
CRC population. These results should be taken with precaution, as many
endogenous or exogenous contaminants could interfere as confounding
variables. On-line analysis with SESI-MS is less time-consuming and
doesn’t need sample preparation. We are recruiting in a new pilot study
including breath cleaning procedures and spirometric analysis incorporated
into the postprocessing algorithms, to better control for confounding
variables.
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