Validity of sonographic screening for the detection of abdominal cancers

Mizuma, Yoshihiro; Watanabe, Yoshiyuki; Ozasa, Kotaro; Hayashi, Kyohei; Kawai, Keiichi

doi:10.1002/jcu.10089

Cited by 13 publications

(13 citation statements)

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“…Complete diagnostic visualisation of kidneys by ultrasound occurs in 97.4% of cases, comparing favourably with 98.8% visualisation rates of the aorta in AAA screening [54, 55]. Mizuma et al and Filipas et al report an excellent sensitivity (82–83.3%) and specificity (98–99.3%) of ultrasound for detecting RCC in the general population as part of a screening intervention [56, 57]. The potential for false-negative results was not based on CT which is generally considered gold standard, but rather repeat ultrasound at a 1-year interval and follow-up via a registry and health records.…”

Section: Resultsmentioning

confidence: 99%

“…Several observational studies have been published on screening for RCC using ultrasound, however, none have been randomized in design, and all were published more than a decade ago [50, 56–61] (Table 3). Mihara et al screened 219,640 asymptomatic Japanese individuals selected from the general population (age range 29–70 years) over a 13-year period [60].…”

Section: Resultsmentioning

confidence: 99%

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Epidemiology and screening for renal cancer

et al. 2018

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PurposeThe widespread use of abdominal imaging has affected the epidemiology of renal cell carcinoma (RCC). Despite this, over 25% of individuals with RCC have evidence of metastases at presentation. Screening for RCC has the potential to downstage the disease.MethodsWe performed a literature review on the epidemiology of RCC and evidence base regarding screening. Furthermore, contemporary RCC epidemiology data was obtained for the United Kingdom and trends in age-standardised rates of incidence and mortality were analysed by annual percentage change statistics and joinpoint regression.ResultsThe incidence of RCC in the UK increased by 3.1% annually from 1993 through 2014. Urinary dipstick is an inadequate screening tool due to low sensitivity and specificity. It is unlikely that CT would be recommended for population screening due to cost, radiation dose and increased potential for other incidental findings. Screening ultrasound has a sensitivity and specificity of 82–83% and 98–99%, respectively; however, accuracy is dependent on tumour size. No clinically validated urinary nor serum biomarkers have been identified. Major barriers to population screening include the relatively low prevalence of the disease, the potential for false positives and over-diagnosis of slow-growing RCCs. Individual patient risk-stratification based on a combination of risk factors may improve screening efficiency and minimise harms by identifying a group at high risk of RCC.ConclusionThe incidence of RCC is increasing. The optimal screening modality and target population remain to be elucidated. An analysis of the benefits and harms of screening for patients and society is warranted.Electronic supplementary materialThe online version of this article (10.1007/s00345-018-2286-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Epidemiology and screening for renal cancer

et al. 2018

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“…None of the studies reported 95 per cent confidence intervals for point estimates of prevalence, despite the fact that this was an item on the quality assessment checklist (although this is readily calculable, given knowledge of the sample size). Three studies did not clearly state ultrasound criteria used to define a suspicious renal mass and three further studies included only solid (rather than complex cystic) masses in this definition. Five studies reported data on the prevalence of renal masses, but no histological data were available, so these studies were excluded from the analysis of the prevalence of histologically proven RCC.…”

Section: Resultsmentioning

confidence: 99%

“…It is anticipated that, in future, the development of non‐invasive modalities, such as measurement of urinary biomarkers, will allow improved discrimination between benign and malignant SRM (with further differentiation between indolent and aggressive RCC), enabling personalized treatment strategies and reducing overtreatment.These considerations may be offset further by the potential benefit derived from early detection of other malignancies within the renal fossa (including adrenal and upper urinary tract urothelial cell cancers, renal secondary metastases, renal carcinoid, sarcoma and lymphoma). Spouge and colleagues reported the prevalence of these combined malignancies as 0·2 per cent, whereas Mizuma et al , Malaeb and colleagues and Patel and co‐workers all reported a prevalence of 0·03 per cent. These rates vary considerably, and insufficient data were available for meta‐analysis.…”

Section: Discussionmentioning

confidence: 98%

Meta-analysis of the prevalence of renal cancer detected by abdominal ultrasonography

Rossi

Hsu

Blick

et al. 2017

British Journal of Surgery

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Background:The potential for an ultrasound-based screening programme for renal cell carcinoma (RCC) to improve survival through early detection has been the subject of much debate. The prevalence of ultrasound-detected asymptomatic RCC is an important first step to establishing whether a screening programme may be feasible.Methods: A systematic search of MEDLINE and Embase was performed up to March 2016 to identify studies reporting the prevalence of renal masses and RCC. Two populations of patients were chosen: asymptomatic individuals undergoing screening ultrasonography and patients undergoing ultrasonography for abdominal symptoms not related to RCC. A random-effects meta-analysis was performed. Study quality was evaluated using a validated eight-point checklist.

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“…Observational studies evaluating screening for RCC using ultrasound have been conducted. However, none were randomised, and all were published more than a decade ago [11][12][13][14][15][16][17][18]. Owing to the relatively low prevalence of RCC in unselected asymptomatic individuals, a randomised controlled trial (RCT) sufficiently powered to detect an impact on survival would need to recruit hundreds of thousands of participants [11].…”

Section: Introductionmentioning

confidence: 99%

A Decision Analysis Evaluating Screening for Kidney Cancer Using Focused Renal Ultrasound

Rossi

Klatte

Usher‐Smith

et al. 2021

European Urology Focus

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Background: Screening for renal cell carcinoma (RCC) has been identified as a key research priority; however, no randomised control trials have been performed. Value of information analysis can determine whether further research on this topic is of value. Objective: To determine (1) whether current evidence suggests that screening is potentially cost-effective and, if so, (2) in which age/sex groups, (3) identify evidence gaps, and (4) estimate the value of further research to close those gaps. Design, setting, and participants: A decision model was developed evaluating screening in asymptomatic individuals in the UK. A National Health Service perspective was adopted. Intervention: A single focused renal ultrasound scan compared with standard of care (no screening). Outcome measurements and statistical analysis: Expected lifetime costs, qualityadjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER), discounted at 3.5% per annum. Results and limitations: Given a prevalence of RCC of 0.34% (0.18-0.54%), screening 60yr-old men resulted in an ICER of £18 092/QALY (s22 843/QALY). Given a prevalence of RCC of 0.16% (0.08-0.25%), screening 60-yr-old women resulted in an ICER of £37 327/ QALY (s47 129/QALY). In the one-way sensitivity analysis, the ICER was <£30 000/QALY as long as the prevalence of RCC was !0.25% for men and !0.2% for women at age 60 yr. Given the willingness to pay a threshold of £30 000/QALY (s37 878/QALY), the population-expected values of perfect information were £194 million (s244 million) and £97 million (s123 million) for 60-yr-old men and women, respectively. The expected value y Joint senior authors.

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Validity of sonographic screening for the detection of abdominal cancers

Abstract: The sensitivity of screening sonography was relatively high and the specificity was sufficient among our asymptomatic population. The present study suggests that the target organ for sonographic screening to detect curable cancers should be the kidneys.

Cited by 13 publications

References 13 publications

Epidemiology and screening for renal cancer

Epidemiology and screening for renal cancer

Meta-analysis of the prevalence of renal cancer detected by abdominal ultrasonography

A Decision Analysis Evaluating Screening for Kidney Cancer Using Focused Renal Ultrasound

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