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Tumours are categorized in three groups: low-risk non-muscle-invasive urothelial cancer (NMIUC) (pTa/pT1, low grade), high-risk NMIUC (pTa/pT1, high grade and any stage associated with carcinoma in situ), and muscle-invasive urothelial cancer (MIUC) (pT2, pT3, or pT4). Sensitivity of urine cytology and urinary TERT promoter mutations for detecting various risk categories of urothelial cancer (UC) in the DIAGURO case–control series in France.
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Finally, GEM is studying the potential for the detection of TERT promoter mutations in urine as non-invasive biomarkers for the early detection of bladder cancer in multicentre case–control and prospective cohort studies.įigure 2.
Gem shahrzad series 2 part 2 free#
GEM is also investigating the potential utility of studies that focus on detection of the HPV viral genome in circulating free DNA (cfDNA). Similarly, the studies on early detection of human papillomavirus (HPV)-related cancers investigate the potential for protein biomarkers to complement HPV antibody tests, for which an extremely high sensitivity and specificity has already been demonstrated. The lung cancer work focuses on the potential for proteomic biomarkers to improve the identification of preclinical lung cancer, and their implementation within population-based screening studies by low-dose computed tomography (LDCT). GEM is conducting several ambitious projects that aim to improve early detection of cancer through the development and validation of biomarker tests using pre-diagnostic biological samples within large cohort studies. Early detection of cancer to reduce mortality and morbidity These projects rely heavily on traditional epidemiological analyses conducted in large cohort studies, such as the European Prospective Investigation into Cancer and Nutrition ( EPIC) and the UK Biobank, and are complemented by extensive use of Mendelian randomization techniques, which avoid many biases that affect traditional epidemiology by use of genetic proxies.Īrea 3. GEM is also using observational and genetic techniques in tandem to infer causality of putative risk factors and to identify novel modifiable risk factors for cancer. A large part of this work will focus on the successful conclusion of the Mutographs project, due to be completed in 2023, in which whole-genome sequencing data have been generated on more than 4000 cancers across multiple cancer types, including oesophageal, renal, colorectal, pancreatic, bladder, gallbladder, and head and neck cancers. This area focuses on improving the understanding of cancer etiology using genomic and epidemiological techniques. Studying the causes of cancer though genomic techniques GEM is undertaking genetic studies of this cancer type, which is particularly relevant to South-East Asia.Īrea 2.
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GEM is coordinating a large genetic study of head and neck cancers across Europe, North America, Asia, and Latin America. GEM is carrying out the largest genetic studies of lymphomas within the International Lymphoma Epidemiology Consortium (InterLymph). Within the International Lung Cancer Case–Control Consortium (ILCCO), GEM is undertaking a very large genetic study of lung cancers, with the goal of using genetic profiles to assist in targeting of low-dose computed tomography (LDCT) screening for early detection of lung cancer.
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Where feasible, these studies will be expanded into understudied populations, and development will continue for the inclusion of genetic risk scores into cancer prevention programmes. The genetic studies focus primarily on cancer sites for which GEM has established a leading role in bringing together large case–control studies and patient series in collaboration with colleagues worldwide, including for lung cancer, head and neck cancers, kidney cancer, and lymphomas. GEM will continue to build upon and expand its previous successful efforts in identifying cancer susceptibility genes and how they influence cancer susceptibility. This area is a long-standing and core area of GEM’s research work. Understanding genetic susceptibility of multiple cancers These six areas are the following:Īrea 1. GEM’s work can be subdivided into six more general themes. Understanding variations in cancer incidence and survival.Somatic cancer genomics and molecular characterization of tumours.Building global capacity for cancer science.Early detection of cancer to reduce mortality and morbidity.Studying the causes of cancer though genomic techniques.Understanding genetic susceptibility of multiple cancers.