Category: Screening

Men, on the island of Ireland, experience a disproportionate burden of ill-health.

Ireland was the first country in the world to adopt a National Men’s Health Policy, and there were three underlying factors behind the rationale to develop this.

Firstly, there were particular concerns about differences in health outcomes between males and females, and between different groups of males. This led to a call for a specific policy focus on men’s health in Ireland’s National Health Strategy in 2001.

Secondly, there was a recognition of the need to develop a gendered approach to men’s health in order to more effectively engage men in services and programmes.

Thirdly, concerns within wider grass roots men’s health organisations about the state of men’s health, and the health status of specific population groups of men, contributed bottom-up momentum to policy development (Health Service Executive, 2016).

The Men’s Health Forum in Ireland recently launched three publications titled ‘Men’s Health in Numbers’.  These tell you everything that you ever wanted to know about the facts and figures on men’s health on the island of Ireland.  Download the reports at: https://www.mhfi.org/news/1096-men-s-health-in-numbers.html

NCCN: Genetic/Familial High-Risk Assessment: Colorectal (01.2023)

Click to access genetics_colon.pdf

NCCN⁩ expanding genetic testing to “Any Lynch related cancer” instead of colon and endometrial cancer as one of the testing criteria

thisisGO.ie is an online personalised resource for you and yours who have been impacted by a gynaecological cancer

The team at thisisGO.ie recognises the importance of having access to the latest scientific research.

See a sample of recent scientific papers pertinent to gynaecological cancers and summaries the key points from each of the papers referenced below.

If this is of interest to you, you can find lots more articles,  disease specific, when you “Create a Profile”. Once logged in just search ‘Decoding the Science’.

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Lynch syndrome: from detection to treatment

Lynch syndrome is encountered by many clinicians at some stage in their practice and yet remains under-diagnosed with historically limited success in risk stratification and management.

The PLSD(http://plsd.eu) international database continues to expand our knowledge of LS-associated cancer risk. However, we have yet to obtain international consensus on the optimal surveillance strategies, which will be essential among a population of patients who are living beyond their index cancer.

The advent of NGS(next generation sequencing) into clinical practice will undoubtably improve detection rates and allow for more effective, precise, and personalised management programmes for patients with LS.

Finally, over the next decade it will be exciting to see improvements in the preventative strategies that can be offered to patients in the form of aspirin, or even anti-cancer vaccines, as we continue to attempt to disrupt the natural history of this prevalent cancer predisposition syndrome.

https://www.frontiersin.org/articles/10.3389/fonc.2023.1166238/full?utm_source=S-TWT&utm_medium=SNET&utm_campaign=ECO_FONC_XXXXXXXX_auto-dlvrit

 National Strategy for Accelerating Genetic and Genomic Medicine in Ireland

The key strategic areas of focus for the development Ireland’s genetics and genomics service are:

  • Coordinating a national approach to genetics and genomics: A national office for genetics and genomics will be established to oversee all aspects of genetic and genomic clinical service and research activities, engage with key stakeholders to address policy and legislative gaps, and drive the implementation of this strategy.
  • Ensuring Patient and Public Involvement (PPI) and Partnerships: In alignment with Sláintecare, this National Strategy outlines our approach for developing a sustainable patient and family centred genetics and genomics service that can be accessed equitably across the country and across the lifespan of patients. The service is to be supported by strong governance, a skilled workforce, pioneering research and innovation, and trusted partnerships.
  • Building the genetics and genomics workforce for the future: A workforce plan will support recruitment, retention, education and career development of the current specialised workforce which includes genetic counsellors and clinical scientists. Staff will be supported and will develop specialised knowledge and skills in genetics and genomics.
  • Enhancing genetic and genomic clinical services: There is a need to continue the transition of genetics and genomics into routine service delivery and support the use of evidence-based genetic and genomic tests. This will enable the development of locally integrated, multidisciplinary, patient and family centred diagnostic and care pathways. 
  • Strengthening infrastructures to drive advances in genetics and genomics: Supporting infrastructure is needed to collect, test, store, process and analyse samples for both patient care and ongoing research applications. To strengthen data infrastructure, existing genetic and genomic data capacity and capability will be reviewed. Continued work on further infrastructure implementation will be carried out to support clinical service delivery.

Click to access national-strategy-for-accelerating-genetic-and-genomic-medicine-in-ireland.pdf

Patients’ satisfaction w/Lynch syndrome providers

This episode is the first in a series featuring former CGA-IGC research grant recipients.Features Dr. Allison Burton-Chase, MD from the Albany College of Pharmacy and Health Sciences. Dr. Burton-Chase was the first recipient of the CGA-IGC research grant in 2014 for her work entitled “Factors Impacting the Decision of an Individual with Lynch Syndrome to Terminate a Health Care Provider Relationship”.

The majority of patients who terminated their patient-provider relationships did so due to negative interactions, such as the provider having a lack of Lynch syndrome-specific knowledge or not being open to improving their knowledge on Lynch syndrome.

https://www.cgaigc.com/post/patients-satisfaction-w-lynch-syndrome-providers-interview-w-2014-cga-igc-research-grant-recipient

Performance of the Fecal Immunochemical Test(FIT) in Detecting Advanced Colorectal Neoplasms and Colorectal Cancers in People Aged 40–49 Years: 

Recently, the cases of colorectal cancers has been rising in younger age (<50) individuals. Although current guidelines recommend colorectal cancer screening should be initiated at age 45 instead of 50, the optimal approach of colorectal cancer screening is not clear.

This article investigates the efficacy of fecal immunochemical test (FIT), which detects occult blood in stool, in predicting advanced colorectal polyps and tumors among people aged 40–49.

The findings suggest FIT is useful to identify such people with high risk to have advanced colorectal lesions. Hence, FIT may be considered as the first-line screening tool for these people, and further comparative study between FIT and colonoscopy will be of great value.

The detection rate of ACRN(advanced) and CRC based on FITs in individuals aged 40–49 years is acceptable, and the yield of ACRN might be similar between individuals aged 45–49 and 50–59 years. Further comparative and cost-effective analysis of colonoscopies is mandatory to guide its use in EOCRC screening.

https://www.mdpi.com/2321922

How I Deal With My Lynch Syndrome Diagnosis

“Being proactive with my daily health has been important throughout my Lynch journey. Taking control of my health by exercising, maintaining my weight and eating well is essential and helps me feel like I can control some aspects of my life. “

“Living with Lynch syndrome can be challenging, but prioritising self-care, seeking professional support, connecting with others, and practicing mindfulness and stress reduction techniques have helped me manage the emotional impact of this condition.”

https://www.curetoday.com/view/how-i-deal-with-my-lynch-syndrome-diagnosis

Guidance on faecal immunochemical testing (FIT) to help diagnose colorectal cancer among symptomatic patients in primary care

A new guideline around faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC). NHS England has subsequently written to all GP practices in England recommending they implement this guideline ‘in full’.

Symptoms alone have a poor sensitivity for CRC, meaning a high volume of secondary care investigations are required to detect cases if symptom-based criteria alone guide referrals. Endoscopy services in the UK have been struggling to keep up with referral demands, and waiting times for a colonoscopy lengthened during the COVID-19 pandemic. It is in this context that the role of FIT has been recently evaluated, to determine whether it can safely triage referrals and better identify high-risk patients than symptoms and non-specific blood tests alone.

CONCLUSION

FIT offers a non-invasive, community-based opportunity to help improve triage of the large number of patients seen in primary care with lower GI symptoms. Patients with a negative FIT, particularly in the context of a normal examination and other investigations, are low risk and may be managed in primary care if symptoms resolve. However, CRC pathways must permit the referral of people with a negative FIT and persistent and concerning symptoms or rectal bleeding for urgent assessment.

https://bjgp.org/content/73/731/283

A Focused Clinical Review of Lynch Syndrome

The results of germline testing for LS can be complicated and the diagnostic pathway is not always clear. Furthermore, by testing only those with cancer for LS we fail to identify these individuals before they develop potentially fatal pathology.

Given the benefits to discovering that someone has LS, not just for the patient but for their immediate family members, it is expected that most people would welcome genetic testing for LS. In fact, there is good number of studies that suggest that hypothetically there is a high interest in finding out this information.By contrast, there are good reports that show that there is a high number of people that decline testing.

In summary, LS care has come a long way over the last twenty years. We now understand the individual cancer risk to inform consent, tests to accurately diagnoses LS and ways by which we can reduce cancer risk. However, more needs to be done to find those who are undiagnosed, develop less invasive cancer surveillance methods and develop new vaccinations and treatments.

https://www.dovepress.com/a-focused-clinical-review-of-lynch-syndrome-peer-reviewed-fulltext-article-CMAR