Lege Artis Medicinae

[Cancer Screening Recommendations in the United States]

JÓNÁS Eszter1

MARCH 01, 2000

Lege Artis Medicinae - 2000;10(03)

[At the Cancer Institute (NCI) in the summer of 1999, I attended a course on Tumor Prevention and Control, which focused on primary and secondary tumor prevention options. The course had 15 foreign and the same number of American students. All continents except Australia were represented in the international group. While foreign students were (with one exception) doctors, in the case of American participants, in addition to the 20% proportion of doctors, the rest came from nurses, biologists, chemists, sociologists, mathematicians working in the field of prevention. What was said was divided into eight topics. The first was titled Tumor and Statistics. In this module, we are introduced to the basic concepts of biostatistics as well as some health surveys that have been successful in America for decades. In the second part, we get a summary of the biometric methodology. The third topic was Genetics and Tumor Biology. Here we could hear about oncogenes and suppressor genes as well as hereditary tumors. The fourth working group dealt with the prevention and control of the most common and high-mortality tumors. In the fifth part, we heard about diet and chemoprevention. There has been talk of foods that promote the development of certain tumors or that inhibit this process. A separate lecture was given on the role of herbs in the prevention of tumor formation. The sixth topic was entitled Special Populations and the Environment. They pointed out the decisive role of the environment in the development of cancer. The seventh topic dealt with the possibilities of disseminating health protection and lifestyle reform. Not only were we able to learn about the theoretical possibilities of popularization, but we were also able to learn about some successful American programs. The final section provided information on ongoing tumor prevention and control research at NCI.]

AFFILIATIONS

  1. Semmelweis Egyetem Orvosi Népegészségtani Intézet, Budapest

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[Chromosomal mosaicism is defined as the presence of two or more cell lines having different chromosomal complements in the same individual. In the conceptus the extent of the mosaicism depends on the timing of chromosomal mutation occurance, the cell lineage affected, and the viability of the mutation. The resultant mosaicism can be either generalized, confined placental or confined embryonic. The process of the loss or removal of one of the three chromosomes from the trisomic conception, at least from the cells that will form the proper fetus is known as trisomic zygote rescue. As the result of this phenomenon, the embryo/fetus becomes disomic, while the placental compartment remains trisomic or mosaic. After losing a chromosome, the remaining pair might originate from the same parent. The presence of two chromosomes from one parent in a disomic cell line is termed uniparental disomy. Uniparental disomy is one form of aberrant origin for disomic cells, and the term „pseudodisomy" is also used. Uniparental disomy can involve homozygosity for the chromosome, and the term ,,isodisomy" has been suggested for this phenomenon. If the homozigosity for the chromosome is not complete, the term „heterodisomy" is used. Depending on the pathologic chromosome, the clinical consequences of the confined placental mosaicism and uniparental disomy can be intrauterine and/or postnatal growth restriction, spontaneous abortion. Increased perinatal morbidity and mortality, minor congenital malformations can result from the phenomena. Confined placental mosaicism and uniparental disomy are well known in syndromatology too. The connections of mosaic trisomy 7 and Silver-Russell syndrome, mosaic trisomy 15 and Angelman syndrome, mosaic trisomy 15 and Prader-Villi syndrome are described. Due to the presence of aneuploid cells in the placenta, confined placental mosaicism may cause placental dysfunction, hydropic degeneration of the placenta or „unexplained" highly increased serum hCG level. ]

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