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Latest & greatest articles for cancer
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on cancer or other clinical topics then use Trip today.
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Methylation changes in faecal DNA: a marker for colorectal cancer screening? DNA methylation is a common molecular alteration in colorectal cancer cells. We report an assessment of faecal DNA from patients with colorectal cancer and controls to determine the feasibility, sensitivity, and specificity of this approach. By use of MethyLight analysis of faecal DNA from three independent sets of patients, we identified SFRP2 methylation as a sensitive single DNA-based marker for identification (...) of colorectal cancer in stool samples (sensitivity 90% [CI 56-100] and specificity 77% [46-95] in the training set [n=23]; sensitivity 77% [46-95] and specificity 77% [46-95] in an independent test set [n=26]). Whether a combination of genetic and epigenetic markers will identify colorectal cancer at an early stage remains to be shown.
Lung cancer in US women: a contemporary epidemic. Lung cancer is the leading cause of cancer death in US women and is responsible for as many deaths as breast cancer and all gynecological cancers combined. Most lung cancer is caused by cigarette smoke. Despite all that is known about the devastating effects of cigarettes, one quarter of women in the United States continue to smoke. Women are targeted in tobacco advertising, and teenage girls are often drawn to cigarette smoking under a variety (...) of social pressures. Following the increase in smoking, the death rate from lung cancer in US women rose 600% from 1930 to 1997. Women may be more susceptible than men to the carcinogenic properties of cigarette smoke. In addition, differences in the biology of lung cancer exist between the 2 sexes with higher levels of DNA adduct formation, increased CYP1A1 expression, decreased DNA repair capacity, and increased incidence of K-ras gene mutations in women. The novel estrogen receptor beta has also been
Doctors' communication of trust, care, and respect in breast cancer: qualitative study. OBJECTIVE: To determine how patients with breast cancer want their doctors to communicate with them. DESIGN: Qualitative study. SETTING: Breast unit and patients' homes. PARTICIPANTS: 39 women with breast cancer. MAIN OUTCOME MEASURE: Patients' reports of doctors' characteristics or behaviour that they valued or deprecated. RESULTS: Patients were not primarily concerned with doctors' communication skills (...) . Instead they emphasised doctors' enduring characteristics. Specifically, they valued doctors whom they believed were technically expert, had formed individual relationships with them, and respected them. They therefore valued forms of communication that are currently not emphasised in training and research and did not intrinsically value others that are currently thought important, including provision of information and choice. CONCLUSIONS: Women with breast cancer seek to regard their doctors
Ejaculation frequency and subsequent risk of prostate cancer. CONTEXT: Sexual activity has been hypothesized to play a role in the development of prostate cancer, but epidemiological data are virtually limited to case-control studies, which may be prone to bias because recall among individuals with prostate cancer could be distorted as a consequence of prostate malignancy or ongoing therapy. OBJECTIVE: To examine the association between ejaculation frequency, which includes sexual intercourse (...) , nocturnal emission, and masturbation and risk of prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: Prospective study using follow-up data from the Health Professionals Follow-up Study (February 1, 1992, through January 31, 2000) of 29 342 US men aged 46 to 81 years, who provided information on history of ejaculation frequency on a self-administered questionnaire in 1992 and responded to follow-up questionnaires every 2 years to 2000. Ejaculation frequency was assessed by asking participants to report
Shedding Light on Immunotherapy for Cancer 15070799 2004 04 08 2004 04 19 2016 10 25 1533-4406 350 14 2004 Apr 01 The New England journal of medicine N. Engl. J. Med. Shedding light on immunotherapy for cancer. 1461-3 Rosenberg Steven A SA National Cancer Institute, Bethesda, Md, USA. eng Z01 SC003811-32 Intramural NIH HHS United States Journal Article Review United States N Engl J Med 0255562 0028-4793 0 Cancer Vaccines 0 Membrane Proteins 0 Tnfsf14 protein, mouse 0 Tumor Necrosis Factor (...) Ligand Superfamily Member 14 0 Tumor Necrosis Factor-alpha AIM IM Science. 2002 Oct 25;298(5594):850-4 12242449 Nat Immunol. 2002 Nov;3(11):999-1005 12407407 Nat Med. 1998 Mar;4(3):321-7 9500606 Nat Immunol. 2004 Feb;5(2):141-9 14704792 J Exp Med. 2003 Aug 18;198(4):569-80 12925674 Animals Cancer Vaccines Disease Models, Animal Immunotherapy methods Lymphocytes, Tumor-Infiltrating Membrane Proteins genetics immunology Mice Neoplasms immunology therapy T-Lymphocytes immunology Tumor Necrosis Factor
Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83?000 women with breast cancer from 16 countries. BACKGROUND: The Collaborative Group on Hormonal Factors in Breast Cancer has brought together the worldwide epidemiological evidence on the possible relation between breast cancer and previous spontaneous and induced abortions. METHODS: Data on individual women from 53 studies undertaken in 16 countries with liberal abortion laws were checked (...) and analysed centrally. Relative risks of breast cancer--comparing the effects of having had a pregnancy that ended as an abortion with those of never having had that pregnancy--were calculated, stratified by study, age at diagnosis, parity, and age at first birth. Because the extent of under-reporting of past induced abortions might be influenced by whether or not women had been diagnosed with breast cancer, results of the studies--including a total of 44000 women with breast cancer--that used prospective
Pancreatic cancer. Pancreatic cancer remains a major unsolved health problem, with conventional cancer treatments having little impact on disease course. Almost all patients who have pancreatic cancer develop metastases and die. The main risk factors are smoking, age, and some genetic disorders, although the primary causes are poorly understood. Advances in molecular biology have, however, greatly improved understanding of the pathogenesis of pancreatic cancer. Many patients have mutations (...) of the K-ras oncogene, and various tumour-suppressor genes are also inactivated. Growth factors also play an important part. However, disease prognosis is extremely poor. Around 15-20% of patients have resectable disease, but only around 20% of these survive to 5 years. For locally advanced, unresectable, and metastatic disease, treatment is palliative, although fluorouracil chemoradiation for locally advanced and gemcitabine chemotherapy for metastatic disease can provide palliative benefits. Despite
Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. CONTEXT: Salvage radiotherapy may potentially cure patients with disease recurrence after radical prostatectomy, but previous evidence has suggested that it is ineffective in patients at the highest risk of metastatic disease progression. OBJECTIVE: To delineate patients who may benefit from salvage radiotherapy for prostate cancer recurrence by identifying variables associated with a durable response. DESIGN (...) by any amount, by a continued increase in PSA level after treatment, or by the initiation of androgen deprivation therapy after treatment. RESULTS: Over a median follow-up of 45 months, 250 patients (50%) experienced disease progression after treatment, 49 (10%) developed distant metastases, 20 (4%) died from prostate cancer, and 21 (4%) died from other or unknown causes. The 4-year progression-free probability (PFP) was 45% (95% confidence interval [CI], 40%-50%). By multivariable analysis
Caloric restriction and incidence of breast cancer. CONTEXT: Restricting caloric intake is one of the most effective ways to extend lifespan and to reduce spontaneous tumor occurrence in experimental animals, but whether similar associations hold in humans has not been appropriately studied. OBJECTIVE: To determine whether caloric restriction in early life reduces the risk of invasive breast cancer. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using data from the Swedish (...) Inpatient Registry, the Swedish Cancer Registry, the Swedish Death Registry, and the Swedish Fertility Registry. Participants were 7303 Swedish women hospitalized for anorexia nervosa prior to age 40 years between 1965 and 1998. Women were excluded (n = 31) if they were diagnosed with cancer prior to their first discharge from hospitalization for anorexia nervosa. MAIN OUTCOME MEASURE: Incidence of invasive breast cancer. RESULTS: Compared with the Swedish general population, women hospitalized
How the internet affects patients' experience of cancer: a qualitative study. OBJECTIVE: To explore how men and women with cancer talk about using the internet. DESIGN: Qualitative study using semistructured interviews collected by maximum variation sampling. SETTING: Respondents recruited throughout the United Kingdom during 2001-2. PARTICIPANTS: 175 men and women aged 19-83 years, with one of five cancers (prostate, testicular, breast, cervical, or bowel) diagnosed since 1992 and selected (...) to include different stages of treatment and follow up. RESULTS: Internet use, either directly or via friend or family, was widespread and reported by patients at all stages of cancer care, from early investigations to follow up after treatment. Patients used the internet to find second opinions, seek support and experiential information from other patients, interpret symptoms, seek information about tests and treatments, help interpret consultations, identify questions for doctors, make anonymous
Antibiotic use in relation to the risk of breast cancer. CONTEXT: Use of antibiotics may be associated with risk of breast cancer through effects on immune function, inflammation, and metabolism of estrogen and phytochemicals; however, clinical data on the association between antibiotic use and risk of breast cancer are sparse. OBJECTIVE: To examine the association between use of antibiotics and risk of breast cancer. DESIGN, SETTING, AND PARTICIPANTS: Case-control study among 2266 women older (...) than 19 years with primary, invasive breast cancer (cases) enrolled in a large, nonprofit health plan for at least 1 year between January 1, 1993, and June 30, 2001, and 7953 randomly selected female health plan members (controls), frequency-matched to cases on age and length of enrollment. Cases were ascertained from the Surveillance, Epidemiology, and End Results cancer registry. Antibiotic use was ascertained from computerized pharmacy records. MAIN OUTCOME MEASURE: Association between extent
A founder mutation of the MSH2 gene and hereditary nonpolyposis colorectal cancer in the United States. CONTEXT: Hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, is caused by mutations in the mismatch repair genes and confers an extraordinarily high risk of colorectal, endometrial, and other cancers. However, while carriers of these mutations should be identified, counseled, and offered clinical surveillance, at present the mutations are not tested (...) of the family from Pennsylvania through North Carolina, Alabama, Kentucky, Missouri, Iowa, Nebraska, Utah, Texas, and California have been documented, and carriers of the mutation have already been diagnosed in 14 states. In contrast, the deletion was not found among 407 European and Australian families with HNPCC. CONCLUSION: The postulated high frequency and continent-wide geographic distribution of a cancer-predisposing founder mutation of the MSH2 gene in a large, outbred (as opposed to genetically
C-reactive protein and the risk of incident colorectal cancer. CONTEXT: Inflammation may play a role in the pathogenesis of colorectal cancer; however, epidemiological evidence supporting this hypothesis in average-risk persons is sparse. OBJECTIVE: To determine the risk of incident colon and rectal cancer associated with elevated baseline plasma concentrations of C-reactive protein (CRP). DESIGN, SETTING, AND PARTICIPANTS: Prospective, nested case-control study of a cohort of 22 887 adults (...) (>18 years and Washington County, Maryland, residents) enrolled between May and October 1989 and followed up through December 2000. A total of 172 colorectal cancer cases were identified through linkage with the Washington County and Maryland State Cancer registries. Up to 2 controls (n = 342) were selected from the cohort for each case and matched by age, sex, race, and date of blood draw. MAIN OUTCOME MEASURE: Odds ratio (OR) of incident colon and rectal cancer. RESULTS: Plasma CRP
Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. BACKGROUND: Diagnostic X-rays are the largest man-made source of radiation exposure to the general population, contributing about 14% of the total annual exposure worldwide from all sources. Although diagnostic X-rays provide great benefits, that their use involves some small risk of developing cancer is generally accepted. Our aim was to estimate the extent of this risk on the basis of the annual number (...) of diagnostic X-rays undertaken in the UK and in 14 other developed countries. METHODS: We combined data on the frequency of diagnostic X-ray use, estimated radiation doses from X-rays to individual body organs, and risk models, based mainly on the Japanese atomic bomb survivors, with population-based cancer incidence rates and mortality rates for all causes of death, using life table methods. FINDINGS: Our results indicate that in the UK about 0.6% of the cumulative risk of cancer to age 75 years could
Effect of breast augmentation on the accuracy of mammography and cancer characteristics. CONTEXT: Breast augmentation is not associated with an increased risk of breast cancer; however, implants may interfere with the detection of breast cancer thereby delaying cancer diagnosis in women with augmentation. OBJECTIVE: To determine whether mammography accuracy and tumor characteristics are different for women with and without augmentation. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort (...) of 137 women with augmentation and 685 women without augmentation diagnosed with breast cancer between January 1, 1995, and October 15, 2002, matched (1:5) by age, race/ethnicity, previous mammography screening, and mammography registry, and 10 533 women with augmentation and 974 915 women without augmentation and without breast cancer among 7 mammography registries in Denver, Colo; Lebanon, NH; Albuquerque, NM; Chapel Hill, NC; San Francisco, Calif; Seattle, Wash; and Burlington, Vt. MAIN OUTCOME
Comparison of outcomes in cancer patients treated within and outside clinical trials: conceptual framework and structured review. BACKGROUND: Many oncologists believe that patients with cancer who enroll in clinical trials have better outcomes than those who do not enroll. We aimed to assess the empirical evidence that such a trial effect exists. METHODS: We developed a conceptual framework for comparison of trial and non-trial patients. We then did a comprehensive literature search to identify (...) studies that compared outcomes between these groups. We critically evaluated these studies to assess whether they provide valid and generalizable support for a trial effect. FINDINGS: We identified 26 comparisons, from 24 published articles, of outcomes among cancer patients enrolled and not enrolled in clinical trials. 21 comparisons used retrospective cohort designs. 14 comparisons provided some evidence that patients enrolled in trials have improved outcomes. However, strategies to control
Presentation on websites of possible benefits and harms from screening for breast cancer: cross sectional study. OBJECTIVE: To investigate whether information on mammographic screening presented on websites by interest groups is balanced, is independent of source of funding, and reflects recent findings. DESIGN: Cross sectional study using a checklist with 17 information items. SETTING: 27 websites in Scandinavian and English speaking countries. RESULTS: The 13 sites from advocacy groups
Cigarette tar yields in relation to mortality from lung cancer in the cancer prevention study II prospective cohort, 1982-8. OBJECTIVE: To assess the risk of lung cancer in smokers of medium tar filter cigarettes compared with smokers of low tar and very low tar filter cigarettes. DESIGN: Analysis of the association between the tar rating of the brand of cigarette smoked in 1982 and mortality from lung cancer over the next six years. Multivariate proportional hazards analyses used to assess (...) hazard ratios, with adjustment for age at enrollment, race, educational level, marital status, blue collar employment, occupational exposure to asbestos, intake of vegetables, citrus fruits, and vitamins, and, in analyses of current and former smokers, for age when they started to smoke and number of cigarettes smoked per day. SETTING: Cancer prevention study II (CPS-II). PARTICIPANTS: 364 239 men and 576 535 women, aged > or = 30 years, who had either never smoked, were former smokers, or were
Cost effectiveness analysis of intensive versus conventional follow up after curative resection for colorectal cancer. OBJECTIVE: To determine the cost effectiveness of intensive follow up compared with conventional follow up in patients with colorectal cancer. DESIGN: Incremental cost effectiveness analysis recognising differences in follow up strategies, based on effectiveness data from a meta-analysis of five randomised trials. SETTING: United Kingdom. MAIN OUTCOME MEASURES: Taking a health (...) cost threshold was ninefold and the effectiveness threshold was 3%. CONCLUSIONS: Based on the available data and current costs, intensive follow up after curative resection for colorectal cancer is economically justified and should be normal practice. There is a continuing need to evaluate the efficacy of specific surveillance tools: this study forms the basis for economic evaluations in such trials.
Enthusiasm for cancer screening in the United States. CONTEXT: Public health officials, physicians, and disease advocacy groups have worked hard to educate individuals living in the United States about the importance of cancer screening. OBJECTIVE: To determine the public's enthusiasm for early cancer detection. DESIGN, SETTING, AND PARTICIPANTS: Survey using a national telephone interview of adults selected by random digit dialing, conducted from December 2001 through July 2002. Five hundred (...) individuals participated (women aged > or =40 years and men aged > or =50 years; without a history of cancer). MAIN OUTCOME MEASURES: Responses to a survey with 5 modules: a general screening module (eg, value of early detection, total-body computed tomography); and 4 screening test modules: Papanicolaou test; mammography; prostate-specific antigen (PSA) test; and sigmoidoscopy or colonoscopy. RESULTS: Most adults (87%) believe routine cancer screening is almost always a good idea and that finding