Introduction: Early diagnosis of cancer


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Rebecca Fitzgerald
University of Cambridge, UK

Abstract

Invasive cancer is rapidly disseminated through the lymphovascular system and therefore most patients with a clinically apparent malignancy have a poor prognosis. Early diagnosis improves outcomes for cancer but there are a number of issues to consider when deciding on the optimal time to intervene in the natural history of disease which spans many years from the start of a premalignant lesion through to invasive cancer. In this session Professor Olesen, will consider early diagnosis from the primary care perspective. This is highly relevant since more than 90% of all cancers are diagnosed based on symptoms presented to the health care system, and more than 80% begin their cancer pathway in general practice. Professor Olesen will compare the data from the British and Danish Health care systems and discuss how outcomes might be improved through raising awareness and improving access to diagnostic services. Dr. Nick Coleman is a pathologist and cancer researcher who has extensive expertise in biomarkers. He will give an overview of the biology of minichromosome maintenance (MCM) proteins, with particular reference to their value as biomarkers for early cancer diagnosis. The most advanced clinical application of MCM detection is in improving cervical screening, although potential uses are also emerging in colorectal cancer screening and identifying lung cancer cells in sputum. Professor Matthijs Oudkerk will discuss the role of imaging in early diagnosis with particular reference to NELSON CT lung cancer screening trial. This session is likely to raise many issues around the science of early detection as well as the logistical, cost and psychological effects of screening programmes.