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ICSN 2010 Call For Abstracts

Abstract submissions for the 2010 International Cancer Screening Network Biennial Meeting are closed. Abstracts were considered for the topics below.

New Technologies and Comparative Effectiveness

Abstracts were solicited on comparative effectiveness of breast, colorectal, and cervical cancer screening. Examples of comparative effectiveness studies include the following: (1) accuracy studies comparing detection rates, adverse events and cost of newer tests to older tests prior to introduction into population based screening; (2) assessments of better algorithms of triaging from screening test to diagnosis and intervention (such as cut points for lesion size on CT colonography or immunochemical fecal occult blood tests); or (3) randomized controlled trials comparing longer term endpoints of incidence and mortality.

Stoppage Rules in Older Populations

Effects of Screening Cessation

As cancer screening programs are developed on a population level, the age to stop screening should be considered for those who have had consistent negative screenings. The goal is to identify at what age the potential harm of screening outweighs the continued benefits of screening. Age is itself an important question given that age adjusted for comorbidity is more important than chronological age. Clinical trials have varied over the age groups considered.

We solicited abstracts that address new work on the risks and benefits of screening that contribute to an understanding of the appropriate age to stop screening. Such topics include studies of the effects of screening in older adults, modeling comorbidity and adjusted life years gained with screening, age to stop surveillance in those with prior neoplastic findings, age to stop screening in those who began screening at a later age than currently recommended, and complications of screening in older populations.

The presentations for this session will include the quantitative types of information on risks and benefits that a physician would convey to the patient.

Behavioral Aspects of Stopping Screening

Much of the work on screening communication over the last 20 years has focused on how to offer screening, communicate risk, and communicate benefit. While early work focused on promotion, more recent work has focused on shared and informed decision making about the choice to begin screening.

As screening programs and populations mature, the issue of when to stop screening has begun to emerge. In some countries recommendations have included an age to stop or to at least consider stopping. In this session, we are soliciting abstracts that present new work addressing how to communicate the issues relevant to stopping screening. We solicited abstracts addressing physician and/or patient behavior around the issues of cessation. Abstracts about how care providers (e.g., physicians) address cessation decisions, tests of methods to present cessation information, systematic reviews of how issues such as comorbidity affect patient decisions, tests of patient perception of messages about cessation, or attitudes about cessation were considered.

HPV Vaccination in Cervical Cancer Screening

Monitoring Effectiveness of HPV Vaccination

As HPV vaccination programs are disseminating into clinical practice, systems are being developed to monitor the effectiveness of vaccination in clinical practice, in both short- and
long-term outcomes. Topics include results from data systems or registries that are monitoring effectiveness of special vaccination programs as well as efforts to model effectiveness of vaccination with data from diverse sources.

Behavioral Aspects of HPV Vaccination

Existing research is examining whether HPV vaccinated girls will become screened women. In addition, questions remain about whether hard to reach groups are more likely to participate in vaccination or screening, about the influence of vaccinating the girls on the screening behavior of their mothers, and what factors determine likelihood of girls participating in HPV vaccination and women in cervical cancer screening. Abstracts that link screening and vaccination were of particular interest.

Can Overdiagnosis and/or Overtreatment Be Reduced by Individualized Screening?

Overdiagnosis

Overdiagnosis is commonly defined as "the detection by screening of cancer which would never have been diagnosed in the host’s lifetime if screening had not taken place," but not everyone agrees with that definition. Some say it is the diagnosis of a cancer that otherwise would not have affected the person’s life. Overdiagnosis by either definition is a serious negative side effect of cancer screening. It is therefore important to monitor overdiagnosis in screening programs, but due to the lead time this monitoring is a methodologically complicated task. Abstracts on definitions and methods for analysis of overdiagnosis were invited for this session.

Overtreatment

Overtreatment is a serious negative side effect of overdiagnosis. This problem is illustrated by a recent follow-up study of untreated CIN3 cases that showed only one-third of the women developed invasive cervical cancer over a period of 30 years. It is therefore important to monitor overtreatment in screening programs and evaluate its consequences. Work in this area is close to the problem of overdiagnosis, but in this session we are specifically interested in the morbidity introduced by treatment. Abstracts on definitions and methods for analysis of overtreatment were invited for this session.

Individualized Screening Schedules

With a drug response rate in cancer patients of only about 30%, the research on future cancer drugs has increasingly focused on personalized medicine. In cancer screening guidelines, age and certain identified familial cancer risks have so far been the only factors considered. These very general guidelines may have led to underscreening of certain population groups and overscreening of other groups. The prospects for development of personalized screening guidelines will be discussed during the session.

Information on risk factors and/or the application of novel biomarkers may allow screening strategies to be tailored to different risk groups in the population. Increasingly, we may be able to move from one-size-fits-all in terms of screening policies to more individualized screening approaches. This may, in turn, improve the balance between the benefits and harms of screening for breast cancer.

The prospects for development of personalized screening guidelines will be discussed during the session.

Pre-Meeting Workshop: Validation of Biomarker Research Utilizing Cancer Screening Programs as a Resource

Abstracts were solicited for posters and presentations from investigators from ICSN countries that have implemented specimen collection within the context of organized screening programs or affiliated research efforts. Based on the June 2007 ICSN meeting, it was recognized that ICSN countries participating in organized screening programs might have relevant data systems within the context of organized cancer screening programs that might serve as a resource for validation research of biomarkers that have been identified from much more selected and potentially biased samples of people. In this session, we solicited abstracts on any validation research that is occurring within ICSN countries that have utilized such resources.

Early Efforts to Establish Biomarker Collection via Cancer Screening Programs (Poster Only)

Posters that provide information on early efforts to set up biomarker collection to enable related research were also invited.

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