It is paramount that an accurate assessment of the impact of a cancer diagnosis is available with which to plan future resource allocation and to highlight the area to direct future policy initiatives. In the second chapter I take a modelling approach to estimate the economic burden of bladder cancer due occupational exposure. Using a multi-stage Markov model, I estimate direct, indirect, and intangible lifetime costs of bladder cancer starting in the year 2011. The results of this analysis indicate that there is a substantial economic burden associated with occupational bladder cancer. Of the three components that make up the total economic costs, intangible costs represent the largest proportion, followed by indirect and direct costs. In the third chapter, I use a data set created via a linkage of several administrative data resources to estimate the relationship between cancer diagnosis and annual labour market earnings. Using the Mahalanobis' distance and propensity score matching combined with a difference-in-difference regression, I isolate the impact of cancer diagnosis on labour market earnings of cancer survivors by comparison to their peers without cancer. There are two conclusions that can be derived from the results. First, I found that cancer survivors recover a fraction of their labour market earnings over time as they are further removed from the time of the cancer diagnosis. Secondly, I found the heterogeneous effects of cancer where most cancer survivors showed a persistent loss of labour market earnings except breast, cervix, and skin cancer survivors in the less-active age group. In the fourth chapter I examine the impact of cancer on health using three commonly used health indicators: life expectancy, Health Utility Index, and health-adjusted life expectancy. Specifically, I decomposed the differences between individuals with and without cancer in above-mentioned indicators by age and cancer type—considering all cancer types, then specifically breast, colorectal and prostate cancers. The results of the study indicate the heterogeneous effects of cancer on health outcomes and provide a repository of health outcome information that other researchers and policymakers can use. / Thesis / Doctor of Philosophy (PhD) / In 2017, there were approximately 206,200 new cancer diagnoses in Canada, and 1 in 2 Canadians are currently expected to develop cancer in their lifetime. The chances are that most Canadians may know someone—likely more than one person—who has been afflicted with cancer. As more Canadians are diagnosed with cancer and survive, researchers are increasingly trying to understand and describe the short- and longer-term impact of cancer on health and social role engagement (particularly paid work) of afflicted individual, with the intent of identifying ways to minimize adverse outcomes. The following chapters investigate the impact of a cancer diagnosis on annual labour market earnings, health, and the aggregation of these and other impacts on the societal economic burden. Chapter 1 sets the context for the entire thesis and draw out the overall objectives and motivations of the work. In Chapter 2 I conduct a comprehensive costing evaluation to estimate the economic burden of occupational cancer, taking a societal perspective, and provide a detailed breakdown of items that contribute to the economic burdens of cancer. In Chapter 3 I estimate the change in labour market earnings due to cancer diagnosis over a period of 5 years to uncover the heterogeneous effects of cancer type on labour market earnings. Finally, in Chapter 4 I estimate the impact of cancer on health using three different health indicators. In Chapter 5 I summarize the findings and contributions of each study.

MicroRNAs (miRNAs) may serve as diagnostic and predictive biomarkers for cancer. The aim of this study was to identify novel cancer biomarkers from miRNA datasets, in addition to those already known. Three published miRNA cancer datasets (liver, breast, and brain) were evaluated, and the performance of the entire feature set was compared to the performance of individual feature filters, an ensemble of those filters, and a support vector machine (SVM) wrapper. In addition to confirming many known biomarkers, the main contribution of this study is that seven miRNAs have been newly identified by our ensemble methodology as possible important biomarkers for hepatocellular carcinoma or breast cancer, pending wet lab confirmation. These biomarkers were identified from miRNA expression datasets by combining multiple feature selection techniques (i.e., creating an ensemble) or by the SVM-wrapper, and then classified by different learners. Generally speaking, creating a subset of features by selecting only the highest ranking features (miRNAs) improved upon results generated when using all the miRNAs, and the ensemble and SVM-wrapper approaches outperformed individual feature selection methods. Finally, an algorithm to determine the number of top-ranked features to include in the creation of feature subsets was developed. This algorithm takes into account the performance improvement gained by adding additional features compared to the cost of adding those features. / by Alex Kotlarchyk. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

Includes bibliographical references. / xiii, 260 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examins Fecal Occult Blood Test (FOBT) screening as a possible means of reducing mortality from colorectal cancer in Australia. Consists of an evaluation of a FOBT screening program in South Australia (in terms of numbers of cancers detected, accuracy of the test used, costs of the program and characteristics of participants) and surveys of the general population and of South Australian general practitioners, providing information on knowledge, attitudes and practices in relation to colorectal cancer and its prevention. / Thesis (Ph.D.)--University of Adelaide, Dept. of Community Medicine, 1995?

Background Colorectal cancer is becoming the commonest cancer in Hong Kong in 2011. Colorectal cancer screening is becoming a hot topic of discussion after the proposal of a local pilot screening program of colorectal cancer in the Policy Address 2014. Colorectal screening is traditionally performed by faecal occult blood test and optical colonoscopy. Computed tomographic colonography is a new imaging technology, with high sensitivity and specificity for clinically significant colonic lesions and polyps. It is therefore emerging as a new method for the colorectal cancer screening. Method This project aims to systemically review the literature, try to explore the potential utility and cost effectiveness of using computed tomographic colonography as one of the screening modality for asymptomatic patients aged 50 years or older. Results and Conclusion The results of the review are presented and conclusion is made. The limitation of the systematic review and its implications of local policy making are also discussed. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Breast cancer is a heterogeneous disease characterised by marked inter-individual variability in presentation, prognosis and clinical outcome. The recognition that morphological assessment has limited utility in stratifying patients into prognostic subgroups led to clinico-pathological classification of tumour biology, based on receptor expression using immunohistochemical (IHC) techniques. This standard is currently complemented by the development of gene expression profiling methodology that led to the identification of intrinsic molecular subtypes, reflecting tumour genetics as the true driver of biological activity in breast cancer. The study was based on the hypothesis that molecular classification of breast carcinomas integrated with established clinico-pathological risk factors will improve current diagnostic and risk management algorithms used in clinical decision-making. A pathology-supported genetic testing strategy was used to evaluate microarray-based gene profiling against diagnostic pathology techniques as the current standard. Clinico-pathological factors including age, number of positive axillary nodes, tumour size, grade, proliferation index and hormone receptor status was documented for 141 breast cancer patients (143 tumours) referred for microarray-based gene expression profiling between 2007 and 2014. Subsets of patients were selected from the database based on the inclusion criteria defined for three phases in which the study was performed, in order to determine 1) the percentage of patients stratified as having a low as opposed to high risk of distant recurrence using the 70-gene MammaPrint profile within the inclusion criteria, 2) correlation of HER2 status as determined by IHC and fluorescence in situ hybridisation (FISH) with microarray-based mRNA readout (TargetPrint), and 3) the relationship between hormone receptor determination as reported by standard IHC and molecular subtyping using the 80-gene BluePrint profile. Similar distribution patterns for MammaPrint low- and high-risk profiles were obtained irrespective of whether fresh tumour biopsies or formalin-fixed paraffin embedded (FFPE) tissue was used. During the first phase of the study, 60% of the 106 tumour specimens analysed with MammaPrint were classified as low-risk and 40% as high-risk using a newly-developed MammaPrint pre-screen algorithm (MPA) aimed at cost-saving. In the second phase of the study, performed in 102 breast tumours, discordant or equivocal HER2 results were found in four cases. Reflex testing confirmed the TargetPrint results in discordant cases, achieving 100% concordance regardless of whether fresh tumour or FFPE tissue was used for microarray analysis. For the third phase of the study 74 HER2-negative tumour samples were selected for comparative analysis. Statistically significant positive correlations were found between protein expression (IHC score) and mRNA (TargetPrint) levels for estrogen receptor (ER) (R=0.53, p<0.0001) as well as progesterone receptor (PR) (R=0.62, p<0.0001), while combined ER/PR tumour status was reported concordantly in 82.4% of these tumours. BluePrint was essential for interpretation of these results used in treatment decision-making. The MPA developed in South Africa in 2009 was validated in this study as an appropriate strategy to prevent chemotherapy overtreatment in patients with early-stage breast cancer. The use of microarray-based analysis proved to be a reliable ancillary method of assessing HER2 status in breast cancer patients. Risk reclassification based on the TargetPrint results helped to avoid unnecessary high treatment costs in false-positive cases, in addition to providing potentially life-saving treatment to those for whom it was indicated. While neither IHC nor TargetPrint estimation of intrinsic subtype correlated independently with the molecular subtype as indicated by BluePrint profiling, the ability to distinguish between basal-like and luminal tumours was enhanced when the combined protein and mRNA values was considered. Genomic profiling provided information over and above that obtained from routine clinico-pathological assessments. This finding supports the relevance of a pathology-supported genetic testing approach to breast cancer management, whereby advanced genomic testing is combined with existing clinico-pathological risk stratification methods for improved patient management. / AFRIKAANSE OPSOMMING: Borskanker is „n heterogene siekte wat gekenmerk word deur merkbare inter-individuele variasie in kliniese beeld, prognose en uitkoms. Die beperkings van morfologiese klassifikasie vir identifikasie van prognostiese subgroepe het gelei tot klinies-patologiese tumor karakterisering op grond van reseptor uitdrukking deur gebruik van immunohistochemiese (IHC) toetse. Hierdie standaard word tans gekomplementeer deur ontwikkeling van geenuitdrukking tegnologie wat gelei het tot die identifikasie van intrinsieke molekulêre subtipes, wat die tumor genetika reflekteer as die ware drywer van biologiese aktiwiteit in borskanker. Die huidige studie is gebaseer op die hipotese dat integrasie van die molekulêre klassifikasie van borskanker met konvensionele risiko klassifikasie skemas huidige diagnostiese en behandelings algoritmes kan verbeter vir kliniese besluitneming. „n Patologie-gesteunde strategie is gebruik om mikroplaat-gebaseerde geen profilering te evalueer teen standaard patologie diagnotiese tegnieke. Kliniese-patologiese faktore insluitend ouderdom, aantal positiewe aksillêre limfnodes, tumor grootte, gradering, proliferasie indeks en hormoon reseptor status is gedokumenteer in 141 borskanker pasiente (143 tumore) wat verwys is vir mikroplaat-gebaseerde geenuitdrukking profilering tussen 2007 en 2014. Pasiënt subgroepe is geselekteer uit die databasis volgens die insluitingskriteria soos gedefiniëer in die drie fases waarvolgens hierdie studie uitgevoer is, om vas te stel 1) watter proporsie pasiënte geklassifiseer word as lae- of hoë-risiko vir latere herhaling van die borskanker deur gebruik van die 70-geen MammaPrint profile binne die insluitingskriteria, 2) hoe korreleer HER2 status soos vasgestel deur IHC en fluoreserende in situ hybridisasie (FISH) toetsing met mikroplaat-gebaseerde RNA lesings (TargetPrint), en 3) wat die verwantskap is tussen hormoon reseptor status soos deur standaard IHC gerapporteer en molekulëre klassifikasie volgens die 80-geen BluePrint profiel. Soortgelyke verdelingspatrone vir MammaPrint lae- teenoor hoe-risiko profiele is waargeneem ongeag of vars tumor biopsies of formalien-gefikseerde paraffin bevattende weefsel gebruik is. Tydens die eerste fase van die studie is 60% van die 106 tumore as lae-risiko en 40% as hoë-risiko geklassifiseer met toepassing van die nuwe MammaPrint Presifting Algoritme (MPA) wat ontwikkel is met die doel op kostebesparing. In die tweede fase van die studie waar 102 tumore ingesluit is, het die resultate van vier gevalle verskil van mekaar of was onbepaald ten opsigte van HER2 status. Refleks herevaluering het die TargetPrint resultate bevestig in alle nie-ooreenstemmende gevalle, en 100% ooreenstemming is bereik ongeag of vars tumor biopsies of formalien-gefikseerde paraffin bevattende weefsel gebruik is vir mikroplaat analise. In die derde fase van die studie is 74 HER2-negative tumore selekteer vir vergelykende analise. Statisties beduidende positiewe korrelasies is waargeneem tussen proteïen uitdrukking (IHC) en mRNA (TargetPrint) vlakke vir die estrogeen reseptor (ER) (R=0.53, p<0.0001) sowel as progesteroon reseptor (PR) (R=0.62, p<0.0001), terwyl gekombineerde ER/PR reseptor status ooreenstemming getoon het in 82.4% tumore. BluePrint was noodsaaklik vir die korrekte interpretasie van die resultate wat gebruik is in kliniese besluitneming vir behandeling van pasiënte. The MPA wat in Suid Africa ontwikkel is in 2009, is gedurende hierdie studie bevestig as n toepaslike strategie om onnodige handeling met chemoterapie te voorkom in pasiënte met vroeë stadium borskanker. Die gebruik van mikroplaat-gebaseerde analise is aangetoon as „n betroubare aanvullende metode om HER2 status te evalueer. Risiko herklassifikasie gebaseer op TargetPrint resultate het onnodige hoë behandelingskoste in vals-positiewe gevalle vermy, sowel as om die verskaffing van potensieël lewensreddende behandeling vir die toepaslike pasiënte te verseker. Genomiese profilering het inligting addisioneel tot dit wat met roetine klinies-patologies metodes verkry kan word verskaf. Hierdie bevinding ondersteun die relevansie van „n patologie-gesteunde genetiese toets benadering tot hantering van borskanker, waardeur genomiese toetsing gekombineer word met bestaande klinies-patologiese risiko stratifisering metodes om pasiënt behandeling te verbeter.

published_or_final_version / Community Medicine / Master / Master of Public Health

Diagnoses using images made with non-ionizing ultrasound are based on qualitive criteria and are not more accurate than those made with mammography. Information about tissue state is lost in the processing required to produce ultrasound images, and textural information may not be perceptible to a human observer. This study uses statistical pattern recognition to classify ultrasound A-scans, before any processing other than amplification occurs. A U. I. Octoson was used to collect data from normal, benign, and malignant, in vivo breast tissues. Features based on textural or frequency content of received sound were computed from digitized A-scans. Most textural features have been used previously in image processing, while frequency features assumed differences in frequency-dependent attenuation. Data were collected at the University of Arizona from 17 malignant masses, 8 benign masses, and 7 normal tissues. Univariate and multivariate statistical tests were used to find combinations of features which discriminated best between the classes of tissue. Equal a priori probabilities were used in a Bayesian classifier to classify malignant vs. nonmalignant. Specificity of 76% (13 of 17 malignant masses correct) was found with a sensitivity of 80% (12 of 15 masses correct). A linear combination of one frequency feature and three textural features was used. For malignant vs. benign, sensitivity of 88% (15 of 17 masses) and specificity of 75% (6 of 8 masses) were found. Features used were the same as for classification of malignant vs. nonmalignant, except for modification of one textural feature. The inability to visually detect and gather data from some palpable masses means that further study is needed to determine the effectiveness of applying the method to all breast masses. A set of A-scans from Thomas Jefferson Hospital in Philadelphia was gathered using similar procedures, and analysed with the following results: 18 of 21 (86%) malignant masses, and 45 of 66 (68%) nonmalignant masses were classified correctly, using a linear combination of one textural feature and five frequency features. Confidence limits on the results show that the majority of masses can be classified correctly with this procedure, but success rates are not high enough for breast cancer screening.

<p>The Application of Magnetic Resonance (MRI) and Computed Tomography Imaging (CT) in the Diagnosis and Management of Maxillofacial Tumours. For decades maxillofacial surgeons over the world have been frustrated by the high and often fatal recurrence of certain advanced jaw tumours. This study conclusively proves that Computed Tomography and especially Magnetic Resonance Imaging significantly decreases recurrence of Odontogenic Keratocyst and Ameloblastoma and allows surgical planning to avoid these recurrences.</p>

Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor i västvärlden. Trots att behandlingsmetoderna har blivit bättre och dödsantalet minskat skapar det fortfarande omvårdnadsproblem inom sjukvården. En orsak kan vara att kvinnorna som drabbas måste gå igenom svåra behandlingar som ofta påverkar dem både fysiskt och psykiskt.            Syfte: Att beskriva kvinnors upplevelse av att drabbas av bröstcancer. Metod: En litteraturöversikt baserad på kvalitativa artiklar, som analyserades med en induktiv ansats. Resultat: Fyra kategorier framkom vid analysen: Att få en diagnos, Att få konsekvenser av behandlingen, Att få konsekvenser i vardagen samt Att ha tankar om framtiden. Att få en bröstcancerdiagnos upplevde kvinnorna som omtumlande. Flera av kvinnorna upplevde att bröstcancerprocessen gett dem en ny identitet, både kroppsligt och mentalt. Efter behandlingens slut fanns det fortfarande en rädsla hos en del av kvinnorna att cancern skulle komma tillbaka vilket påverkade deras syn på framtiden. Slutsats: Att drabbas av bröstcancer påverkade kvinnorna på olika sätt. Vissa såg positivt på upplevelsen när behandlingarna var över medan andra bara fokuserade på vad de hade förlorat. Eftersom kvinnornas upplevelse varierade är det viktigt att vårdpersonalen anpassar vården efter den enskildes behov och önskningar samt ger tydlig information för att skapa trygghet och lugn. / Background: Breast cancer is the most common form of cancer among women in the western world. Although treatment is improving and the mortality rate drops, problems still exist within health care. This may be because the women undergo difficult treatments which affect them physically and mentally. Purpose: To describe women’s experience of suffering from breast cancer. Method: A literature review based on qualitative articles, analyzed with an inductive approach. Results: The analysis resulted in four categories: Receiving a diagnosis, Experiencing consequences from treatment, Experiencing consequences in everyday life and Having thoughts about the future. The women experienced the breast cancer diagnosis as overwhelming. Several of the women experienced that the breast cancer process gave them a new identity, both physically and mentally. After completed treatment some women still feared cancer would return which affected their view of their future. Conclusion: Suffering from breast cancer affected women differently. Some women looked positively at the experience after the treatments was completed while others just focused on what they had lost. Because the women's experience varied, it’s important that healthcare staff adjust their care according to the individual's needs and desires, and provides the patients with clear information to create peace and security.

Skin cancer is a major medical problem. If not detected early enough, skin cancer like melanoma can turn fatal. As a result, early detection of skin cancer, like other types of cancer, is key for survival. In recent times, deep learning methods have been explored to create improved skin lesion diagnosis tools. In some cases, the accuracy of these methods has reached dermatologist level of accuracy. For this thesis, a full-fledged cloud-based diagnosis system powered by convolutional neural networks (CNNs) with near dermatologist level accuracy has been designed and implemented in part to increase early detection of skin cancer. A large range of client devices can connect to the system to upload digital lesion images and request diagnosis results from the diagnosis pipeline. The diagnosis is handled by a two-stage CNN pipeline hosted on a server where a preliminary CNN performs quality check on user requests, and a diagnosis CNN that outputs lesion predictions. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection