Drew Morse

October 2, 2014
BIOE 215 - Cancer Detection
Quiz Section AB

Question 1
Problem #1 Both the prognosis and the survival rate for pancreatic cancer are very
poor, and this stems from the insufficient screening methods used to detect the disease[1].
Creating-cost effective screening for pancreatic cancer is one of the biggest problems
because the only current method requires the use of Computed Tomography (CT) scans,
which can only be done with large and expensive pieces of equipment. There have been
no discoveries if there are any serologic markers for early pancreatic cancer, which would
allow for the creation of a much cheaper screening method[1]. Thus, the best course of
action aimed at improving the rate of early detection is required screening for the two
most high-risk groups, hereditary pancreatic cancer relatives and new-onset diabetes
patients.
Problem #2 The methods for detecting colorectal cancer while the disease is in its early
stages are both invasive and unpleasant, and often very costly. The most invasive and
expensive screening procedure that is widely accepted is the colonoscopy, which is the
method of choice for screening high-risk patients[2]. On the other hand, fecal
immunochemical tests (FITs) are both cheaper and fairly non-invasive. This screening
method could have a huge impact on the early diagnosis and/or prevention of colorectal
cancer, as in one study participants were almost twice as likely to complete the screening
if they were recommended FITs instead of colonoscopys[3]. Colorectal cancer results
from the malignant evolution of adenomatous polyps, but these polyps can be removed
90% of the time solely through colonoscopies[2]. If FITs were implemented on a general
basis for asymptomatic patients, and then positives were given a colonoscopy, both to
ensure the existence of the cancer and potentially to remove the polyp, mortality rates
would drastically improve.
Problem #3 The presence of limiting sociocultural factors among minority women in
their native, traditional countries or immigrant women in multicultural western societies
poses a major hindrance to both access and utilization of breast cancer screening.
Specifically focusing on Muslim cultures, womens actions are controlled by men, and
these men might either disapprove of breast cancer screening techniques or may not have
any knowledge of them[4]. Also, in societies dominated by males, women tend to base
their self worth on their ability to service the men, children, and elders in their homes;
therefore, women refuse to put themselves in a position (that position being potentially
diagnosed with breast cancer) that could greatly deteriorate their status. According to the
US 1987-88 National Health Interview survey, 23.4% of Black women and 20.5% of
Hispanic women received a clinical breast examination, compared to 35.2% of White
women[5]. This could be in large part due to economic disparities, as two-thirds of
uninsured or underinsured American women are of racial/ethnic minorities[4].

Confidence and Reliability

The source I am most confident about citing in my paper is The Challenge of
Early Breast Cancer Detection among Immigrant and Minority Women in Multicultural
Societies found in The Breast Journal, because not only is it written by a Ph.D and
found in a well circulated medical journal, but it has over 30 references listed. On top of
that, it has been cited in other publications over 38 times, which often denotes very high
reliability.
Screening for colorectal cancer also seems highly reliable, as it is found in the
British Medical Bulletin (which means it has been peer reviewed), it cites eight sources in
its references section, and has been cited by another scholarly article. Although I am not
quite as confident in it as my previously mentioned article, this still seems reliable
enough to cite with conviction.
The article, The Importance of Choosing Colorectal Cancer Screening Tests
seems almost, if not as reliable as the breast cancer article. The main reason for this is
that it was published in JAMA Internal Medicine, which is an expansive, but highly
renowned medical journal. For this to be published in JAMA, it would have had to
undergo many peer reviews. It also lists ten references, so I am fairly confident in its
validity.
Both Breast cancer screening among older racial/ethnic minorities and whites:
barriers to early detection and Detecting Early Pancreatic Cancer: Problems and
Prospects are my least reliable sources, mainly because I could not find that either of
them cited any references. Although, I am still fairly confident in their reliability mostly
because I found both on trusted scientific databases and they are both published in
scientific journals (Journal of Gerontology and Seminars on Oncology, respectively).

Question 2
Additional Sources
If I further studied problems 2 and 3, I think a source that could be very beneficial
would be an interview of a doctor (Gastroenterologist and Breast Cancer Specialist,
respectively). This would give some insight into the actual workings of our health care
system related to the screening methods for these two different types of cancer. For
question two, maybe the gastroenterologist could comment on his views of fecal
immunochemical tests and also give an estimate of how often they are used for patients
that are asymptomatic for colorectal cancer.
Another potential source could be the most recently reported governmental data
on mortality rates related to each respective type of cancer, survival rates after initial
screening catches the disease in its infancy, and other helpful numbers.
Another primary source, if I were in the position to undertake such a task, would
be to perform my own research in a lab, or to visit other high-level laboratories. This
could give insight on what measures are being taken to prevent these cancers from
proliferating in the public, or finding new screening methods that could decrease
mortality rates. For example, if a lab was working on finding as certain protein in our
genes that could determine whether we were prone to having pancreatic cancer, then a
cheap screening test for serologic markers could potentially be dispersed too much larger
portions of the population

Sources
1.
2.
3.
4.

5.

Chari, S.T., Detecting Early Pancreatic Cancer: Problems and Prospects.

Seminars in Oncology, 2007. 34(4): p. 284-294.
Scholefield, J.H., Screening for colorectal cancer. British Medical Bulletin, 2002.
64(1): p. 75-80.
Theodore R. Levin, M., The Importance of Choosing Colorectal Cancer
Screening Tests. JAMA Internal Medicine, 2012. 172(7): p. 582-583.
Remennick, L., The Challenge of Early Breast Cancer Detection among
Immigrant and Minority Women in Multicultural Societies. The Breast Journal,
2006. 12(Supplement S1): p. 103-110.
Caplan, L., Breast cancer screening among older racial/ethnic minorities and
whites: barriers to early detection. Journal of Gerontology, 1992. 47: p. 101-110.