One-stop-shop for cancer screening: A model for the future.

Authors

null

Ezra Bernstein

Integrated Cancer Prevention Center, Tel-Aviv Medical Center, Tel-Aviv, Israel

Ezra Bernstein , Shiran Shapira , Shahar Lev-Ari , Ari Leshno , Udi A. Sommer , Lior Galazan , Humaid O. Al-Shamsi , Ido Wolf , Meital Shaked , Mori Hay Levy , Miri Sror , Menachem Moshkowitz , Ori A. Segal , Eyal Gur , Alfred I. Neugut , Nadir Arber

Organizations

Integrated Cancer Prevention Center, Tel-Aviv Medical Center, Tel-Aviv, Israel, Health promotion and Integrated Cancer Prevention Center, Tel Aviv Medical Center, Tel Aviv, Israel, Integrated Cancer Prevention Center, Tel Aviv, Israel, Tel Aviv Sorasky Medical Center, Tel Aviv, Israel, Integrated Cancer Prevention Center, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel, Burjeel Cancer Institute, Sharjah, ON, United Arab Emirates, Tel Aviv Medical Center and Sackler School of Medicine, Tel Aviv, Israel, Integrated Cancer Prevention Center, Tel-Aviv Medical Center, Tel Aviv, Israel, Health Promotion and Integrated Cancer Prevention Center, Tel Aviv Medical Center, Tel Aviv, Israel, Tel Aviv University, Tel Aviv, Israel, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Columbia University Herbert Irving Comprehensive Caner Center, New York, NY, Health Promotion and Integrated Cancer Prevention Center, Tel Aviv, Israel

Research Funding

No funding received
None

Background: Cancer is the second leading cause of death globally. Early detection will often greatly reduce mortality for many cancers, increase treatment effectiveness, and improve the quality of life for cancer patients, and, by implementing evidence-based prevention strategies, 30–50% of cancers can be prevented. Screening for different cancer types separately is inefficient. A solution is the Integrated Cancer Prevention Center (ICPC), a program with specialists in each discipline who test for multiple cancers during one visit. Methods: This is a prospective cohort study of 17,104 self-referred, asymptomatic patients who visited the Integrative Cancer Prevention Center (ICPC) between January 1, 2006, and December 31, 2019. Clinical, laboratory, and epidemiological data were recorded by multiple specialists. Patients were given follow-up recommendations and diagnoses when appropriate. The primary measure was the detection and staging of new malignant lesions. Secondary measures included cost-benefit and mortality benefit. Results: We screened 8618 men and 8486 women with an average age of 47.11 ± 11.71 years. Of 259 cancers detected through the ICPC, 49 (18.9%) were stage 0, 115 (44.4%) were stage I, 31 (12%) were stage II, 25 (9.7%) were stage III, and 32 (12.4%) were stage IV. Seventeen cancers were missed, only six of which were within the scope of the ICPC, and 189 cancers developed > one year after the last visit to the ICPC. Compared to the stage of detection for cancers in the US, all cancers except for colon were detected at an earlier stage at the ICPC. Lung was the most significant with 86.7% of cancers detected at stage 0, I, or II at the ICPC compared to only 49.3% caught at those stages in the US. Conclusions: This is a proof of concept for a one-stop-shop approach to asymptomatic cancer screening in a multidisciplinary outpatient clinic. It offers evidence that this screening framework can and should be replicated in other healthcare settings and on a national policy level as it saves lives and money. The encouraging results presented here should further the conversation about the utility of screening and add momentum to the movement for increased screening.

Stages of detection for cancers detected by the ICPC.

Stage 0
Stage I
Stage II
Stage III
Stage IV
Bladder
1
0
0
0
0
Brain
0
0
0
0
0
Breast
10
12
7
11
0
Cervical
9
1
0
0
0
Colon
1
7
3
5
4
Hematological
0
0
0
1
12
Hepatobiliary
0
0
0
0
2
Laryngeal
0
1
1
0
0
Lung
0
11
2
1
1
Neuroendocrine
0
1
0
0
1
Oral
0
2
0
0
0
Other
1
0
0
0
2
Ovarian
0
2
0
1
2
Pancreatic
0
1
0
0
3
Prostate
0
23
10
1
2
Renal
0
8
4
0
1
Skin (BCC)
14
2
0
0
0
Skin (SCC)
4
3
0
0
0
Skin (Melanoma)
8
10
0
0
0
Soft Tissue
0
0
1
0
0
Testicular
0
5
0
0
0
Thyroid
0
22
0
5
0
Upper GI
0
0
1
0
1
Uterine
1
2
1
0
0
Total
49 (18.9%)
115 (44.4%)
31 (12%)
25 (9.7%)
32 (12.3%)

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Prevention, Risk Reduction, and Hereditary Cancer

Track

Prevention, Risk Reduction, and Genetics

Sub Track

Cancer Prevention

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 10554)

DOI

10.1200/JCO.2021.39.15_suppl.10554

Abstract #

10554

Poster Bd #

Online Only

Abstract Disclosures

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