There remains a need for objective and cost‐effective approaches capable of diagnosing early‐stage disease in point‐of‐care clinical settings. Given an increasingly ageing population resulting in a rising prevalence of chronic diseases, the need for screening to facilitate the personalising of therapies to prevent or slow down pathology development will increase. Such a tool needs to be robust but simple enough to be implemented into clinical practice. There is interest in extracting biomarkers from biofluids (e.g., plasma or serum); techniques based on vibrational spectroscopy provide an option. Sample preparation is minimal, techniques involved are relatively low‐cost, and data frameworks are available. This review explores the evidence supporting the applicability of vibrational spectroscopy to generate spectral biomarkers of disease in biofluids. We extend the inter‐disciplinary nature of this approach to hypothesise a microfluidic platform that could allow such measurements. With an appropriate lightsource, such engineering could revolutionize screening in the 21st century. (© 2014 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)

Biospectroscopy is an emerging field that harnesses the platform of physical sciences with computational analysis in order to shed novel insights on biological questions. An area where this approach seems to have potential is in screening or diagnostic clinical settings, where there is an urgent need for new approaches to objectively interrogate large numbers of samples in an objective fashion with acceptable levels of sensitivity and specificity. This review outlines the benefits of biospectroscopy in screening for precancer lesions of the cervix due to its ability to separate different grades of dysplasia. It evaluates the feasibility of introducing this technique into cervical screening programs on the basis of its ability to identify biomarkers of progression within derived spectra ('biochemical‑cell fingerprints').

Aims: Since surgical resection is the only chance for longterm survival, determining the resectability of a pancreatic tumor is a crucial step. Although centralization for surgical expertise has improved the resection rates of pancreatic cancer in recent years, diagnostic work-up for M0pancreatic cancer patients is not centralized in the Netherlands. The current study investigated whether the hospital of initial diagnosis influenced the chance of undergoing surgery and the effect on survival. Methods: All patients diagnosed with M0-pancreatic cancer between 2005 and 2012 in The Netherlands were included. Population-based data were obtained from the nationwide Netherlands Cancer Registry. All 97 hospitals were classified as either «pancreatic center» or «nonpancreatic center», based on high-volume (>15/year) pancreatoduodenectomies performed in 2012. Groups were compared using chi-square tests. The relationship between diagnostic center and the chance of undergoing surgery was analysed by multivariable logistic regression. The influence of hospital of diagnosis on overall survival was assessed using multivariable Cox regression analysis. Results: Nineteen hospitals were designated as a pancreatic center (19.6%). Of the 7276 included patients, 2657 (36.5%) underwent surgery with a curative intent. This proportion was 50.6% of patients diagnosed in pancreatic centers and 29.6% for non-pancreatic centers. Actual resection was done in 41.3% for pancreatic centers and 23.0% for non-pancreatic centers. In multivariable analysis, patients diagnosed in a pancreatic center were more likely to undergo surgery with a curative intent (OR 2.26 95%CI 2.02e2.53). Diagnosis in a pancreatic center was associated with improved survival compared to diagnosis in a non-pancreatic center (HR 0.93; 95%CI 0.88e0.98). Conclusions: In this nationwide analysis, patients diagnosed with M0-pancreatic cancer in a pancreatic center were more likely to undergo a potentially curative resection and had better survival. This suggests that patients with M0-pancreatic cancer who are not referred for resection should undergo assessment by a specialized team.

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