Everywhere in Europe the survival rate of cancer has improved. As of today, there are around 10 million European cancer survivors of which more than a third are of working age. Although not being a death sentence anymore, cancer risks to remain a life sentence preventing survivors to resume normal life. Research shows a higher unemployment rate in cancer survivors as compared to the cancer-free population. Also, individual testimonies illustrate challenges in obtaining health/life insurance, loans and mortgage.
Using novel individualized algorithms, insurance companies may better define the risk of covering patients with pas history of cancer. Herein is described a novel tool to offer individualized risk assessment for patients with history of cancer.
HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mu...Dr.Samsuddin Khan
Background: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.
Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).
Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/µL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.
Conclusion: The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.
Oncology Big Data: A Mirage or Oasis of Clinical Value? Michael Peters
The title of the presentation, Oncology Big Data: A Mirage or Oasis of Clinical Value, reflects what I believe the field of Oncology is challenged with on a growing basis, from a clinical and business side perspective.
Anal dysplasia: Diagnosis and Management, OR Everything you ever wanted to kn...CBRC
Screening, treatment and prevention of Anal
Intraepithelial Neoplasia (AIN) Presented by Joel Palefsky, UCSF School of Medicine, San Francisco at the 5th Annual Gay Men's Health Summit held in Vancouver, BC on November 9th and 10th, 2009.
HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mu...Dr.Samsuddin Khan
Background: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.
Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).
Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/µL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.
Conclusion: The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.
Oncology Big Data: A Mirage or Oasis of Clinical Value? Michael Peters
The title of the presentation, Oncology Big Data: A Mirage or Oasis of Clinical Value, reflects what I believe the field of Oncology is challenged with on a growing basis, from a clinical and business side perspective.
Anal dysplasia: Diagnosis and Management, OR Everything you ever wanted to kn...CBRC
Screening, treatment and prevention of Anal
Intraepithelial Neoplasia (AIN) Presented by Joel Palefsky, UCSF School of Medicine, San Francisco at the 5th Annual Gay Men's Health Summit held in Vancouver, BC on November 9th and 10th, 2009.
A diagnosis of DCIS often brings mixed messages. Is this a real breast cancer? What is the meaning of Stage 0? If this is not life threatening, why are the treatments similar to those recommended for an invasive cancer? Deborah Collyar, founder of Patient Advocates in Research, helps us interpret the new findings that will aid you in navigating this diagnosis.
Deborah Collyar, President, Patient Advocates In Research, discusses what new research is telling us about DCIS, both here and abroad. What is low risk DCIS? Is it okay to monitor your DCIS? Is Endocrine Therapy absolutely necessary? What does the future look like? Deborah addresses this and so much more.
DCIS Topic-Driven Round Table: Decision-Making and Treatment Choicesbkling
Facilitator Deb Hackenberry is joined by Cecilia Hammond, Senior Medical Science Liaison at Genomic Health, to discuss better decision-making and your treatment choices with DCIS.
Don't miss our upcoming webinars! Subscribe today!
Presented by: Dr. Poul Sorensen, MD, PhD, FRCPC; Dr. Muhammad Zulfiqar, MD; Ted Taylor, Patient Advocate
In this webinar, we will hear from Dr. Sorensen about his groundbreaking discovery and how it contributed to the development of tumour agnostic treatments. Dr. Zulfiqar, a medical oncologist at the BC Cancer Agency, will further discuss TRK fusion cancers and how he has been able to treat patients. Lastly, we will hear from Ted Taylor, a TRK fusion cancer patient diagnosed with glioblastoma (GBM) multiform being treated with Vitrakvi.
Watch the YouTube video: https://youtu.be/RAkItUeZ23Q
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Mills-Peninsula Health Services 2013 Cancer Symposium presentation - Brad Ekstrand, MD/PhD, California Cancer Care Mills-Peninsula Health Services San Mateo, CA
EAU - Guidelines on Prostate Cancer dr. ali mujtabaDr Ali MUJTABA
EAU - Guidelines on Prostate Cancer Organ Confined by Dr. Ali Mujtaba, Sindh Institute of Urology and Transplantation (SIUT)
https://www.youtube.com/watch?v=kXX9ItF4as4
https://www.youtube.com/watch?v=0m4YUI6Rr5w
A diagnosis of DCIS often brings mixed messages. Is this a real breast cancer? What is the meaning of Stage 0? If this is not life threatening, why are the treatments similar to those recommended for an invasive cancer? Deborah Collyar, founder of Patient Advocates in Research, helps us interpret the new findings that will aid you in navigating this diagnosis.
Deborah Collyar, President, Patient Advocates In Research, discusses what new research is telling us about DCIS, both here and abroad. What is low risk DCIS? Is it okay to monitor your DCIS? Is Endocrine Therapy absolutely necessary? What does the future look like? Deborah addresses this and so much more.
DCIS Topic-Driven Round Table: Decision-Making and Treatment Choicesbkling
Facilitator Deb Hackenberry is joined by Cecilia Hammond, Senior Medical Science Liaison at Genomic Health, to discuss better decision-making and your treatment choices with DCIS.
Don't miss our upcoming webinars! Subscribe today!
Presented by: Dr. Poul Sorensen, MD, PhD, FRCPC; Dr. Muhammad Zulfiqar, MD; Ted Taylor, Patient Advocate
In this webinar, we will hear from Dr. Sorensen about his groundbreaking discovery and how it contributed to the development of tumour agnostic treatments. Dr. Zulfiqar, a medical oncologist at the BC Cancer Agency, will further discuss TRK fusion cancers and how he has been able to treat patients. Lastly, we will hear from Ted Taylor, a TRK fusion cancer patient diagnosed with glioblastoma (GBM) multiform being treated with Vitrakvi.
Watch the YouTube video: https://youtu.be/RAkItUeZ23Q
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Mills-Peninsula Health Services 2013 Cancer Symposium presentation - Brad Ekstrand, MD/PhD, California Cancer Care Mills-Peninsula Health Services San Mateo, CA
EAU - Guidelines on Prostate Cancer dr. ali mujtabaDr Ali MUJTABA
EAU - Guidelines on Prostate Cancer Organ Confined by Dr. Ali Mujtaba, Sindh Institute of Urology and Transplantation (SIUT)
https://www.youtube.com/watch?v=kXX9ItF4as4
https://www.youtube.com/watch?v=0m4YUI6Rr5w
Geriatric Oncology
1. Relationship between aging and cancer
2. Constructs of frailty and multimorbidity
3. Evidence for geriatric assessment in older adults living with cancer
Study on Histopathological Correlation with ER, PR, and HER 2 Neu Receptor Status in Breast Carcinoma and its Prognostic Importance
Mahendra Singh, Jagdish Kumar*, Anita Omhare, Vandana Mishra, Chayanika Kala
http://dx.doi.org/10.21276/SSR-IIJLS.2019.5.1.3
The coronavirus SARS-CoV-2 (COVID-19) outbreak is having a profound impact on the management of patients with cancer.
In this review, we comprehensively investigate the various aspects of cancer care during the pandemic, taking advantage of
data generated in Asia and Europe at the frontline of the COVID-19 pandemic spread. Cancer wards have been subjected to
several modifications to protect patients and healthcare professionals from COVID-19 infection, while attempting to maintain cancer diagnosis, therapy, and research. In this setting, the management of COVID-19 infected patients with cancer is
particularly challenging. We also discuss the direct and potential remote impacts of the global pandemic on the mortality of
patients with cancer. As such, the indirect impact of the pandemic on the global economy and the potential consequences
in terms of cancer mortality are discussed. As the infection is spreading worldwide, we are obtaining more knowledge on
the COVID-19 pandemic consequences that are currently impacting and may continue to further challenge cancer care in
several countries. Raymond et al-2020-targeted_oncology.
see the following link : https://rdcu.be/b4mCG
Cancer still stands as the second leading cause of death (9.6 million deaths every year).1 With 18,433 victims from the coronavirus outbreak,2 Covid-19 infection is likely to increase cancer-related mortality, as case fatality rates are much higher for vulnerable populations, such as elderlies and those with coexisting conditions (cardiovascular disease, diabetes, chronic respiratory diseases, high blood pressure, and cancer).3
As healthcare providers are reorganizing to provide high priority to Covid-19 pandemic, shortages of hospital beds and availability of the healthcare workforces are observed, asking professionals in charge of cancer to postpone diagnosis and treatments.5 However, restricting in-hospital visits is resulting in postponing primary diagnosis and cancer therapies. Normalization of cancer diagnostic and therapy after the Covid-19 outbreak remains unknown. Moreover, the duration of the outbreak could impact the prognostic of several patients. Furthermore, medical societies have also implemented during Covid-19 outbreak low-evidence based but convenient recommendations to balance standard-of-care requirements and healthcare accessibility. Awareness of oncologists could help limiting the impact of coronavirus outbreak on cancer mortality.
Pratiquer la cancérologie en période COVID-19. Bibliographie du 27 mars 2020. Quels objectifs, quels moyens pour limiter les conséquences de la pandémie dans la prise en charge des patients en oncologie.
This short presentation made in Paris Saint-Joseph Hospital is aimed to help Understanding the impact of COVID-19 pandemia in Cancer patients in term of prevention, diagnostic, and treatment.
Thanks to Prof. Chavdar Pavlov, MD, PhD, MScD - Department Head of Therapy, Head of the Centre for Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia for helping organizing this event in Moscow.
L'IVS est un institut reconnu d'utilité publique. La soirée d'anniversaire en présence du professeur Jacques Caen, Fondateur de l'Institut, a permis de faire le lien entre les projets réalisés et les projets à venir. Les relations privilégiées avec la Chine ont été célébrées. Le soutient de la famille d'Yvon Taillandier a été remercié par l'évocation de l'artiste et de son oeuvre.
The biology of neuroendocrine tumors remains poorly understood. Thanks to the United Kingdom & Ireland Neuro-Endocrine Tumor Society for inviting me to overview current knowledges during its yearly meeting. Enclosed, please find attached the slides that were used for this lecture. I hope this will generate insights for pushing forward the discovery of novel targets and biomarkers.
Une année de cancérologie dans ce numéro spécial Cancérologue du Quotidien du Médecin incluant des sujets d'actualité sur les sujets médicaux et les priorités de l'INCa, l'assurance des patients ayant eu un cancer, les critères d'autorisation, la souffrance au travail, etc... Bonne lecture.
This lecture was part of an educational course performed by the IATTGI group this August in Buenos Aires and describes novel targets and novel drugs in hepatocellular carcinoma.
Neuroendocrine tumors are highly angiogenic and angiogenesis represents a major target for therapeutic interventions. Herein, are reviewed recent data on angiogenesis and anti-angiogenic agents in neuroendocrine tumors.
This presentation was made at the PAMM winter meeting in Verona (Italy) February 2019 and intended students to go through the basic methods used for phase I clinical trials.
This paper was presented at the EORTC-NCI-AACR meeting last week. The poster shows data on NOTCH expression in cell lines and evaluated the effects of NOCH inhibition.
This mouse model has been build up and tested to evaluate anticancer agents in hepatocellular carcinoma. This transgenic model can also be tested for the testing of checkpoint inhibitors and other immunoactive agents.
Le service d'oncologie médicale de l'hôpital Paris Saint-Joseph organise une semaine de rencontres et d'ateliers pratique pour les personnes soufrant de cancer du sein mais aussi d'autres formes de cancer - Manucure - sophrologie - lingerie
Pharmacology Forever ! has been set as a meeting in recognition of Frits Peters tremendous involvement in pharmacology. This presentation discusses latest drug development methods and is illustrated by exemple of new drugs and target in oncology.
This presentation summarizes data related to the CAR-T cell technology and its potential application for cancer therapy. This oral presentation was presented at the 39th PAMM winter meeting in Roma the 8th f February 2018 by Eric Raymond
Comment intégrer le geste chirurgicale dans la prise en charge pluridisciplinaire d'oncologie: néo-adjuvant, adjuvant, chirurgie programmée, chirurgie d'urgence
Paris Saint-Joseph Hospital offers a comprehensive multimodality of care for patients with a broad variety of cancers. The goal is to offer high level of technics and technology while offering humanized approaches.
More from Prof. Eric Raymond Oncologie Medicale (20)
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
1. INDIVIDUAL CANCER RISK ASSESSMENTS
USING CONDITIONAL SURVIVAL
Prof. Eric Raymond MD, PhD
Head Medical Oncology @ Paris Saint-Joseph Hospital
Chair of The PAMM Group EORTC
Medical Officer at SCOR – Paris
France
1
2. Challenges
• The incidence of most cancers has been increasing over the last 50 years, while
progresses in the detection and management of cancers have led to significant
increases in both prevalence and survival
• The number of patients newly diagnosed and those deemed long termcancer
‘survivors’ - patients fit and alive at more than five years after diagnosis - has been
increasing worldwide, yielding newchallenges for insurance companies
• Data in 2014 yielded an overall estimate of about 14.5 million cancer survivors in the United
States(>4% of the US population)
• Current epidemiology trends predict that the number of cancer survivors in the US will
increase by 31% by 2024 (19 millions)
• Long-termsurvivors have been constantly challenging insurance companies for
better coverage, who have adapted in return by offering innovative products and
underwriting approaches for these newclasses of customers
3. Cancers & Insurances
• Worldwide increase of cancer survivors: increasing needs of insurance
• Allow access to insurance coverage for access to credit to patient with past history of
cancer
• Cover cancer as a critical illness to cover expansive medical care wherever health care is
not mutualized by public services
• Cover income protection
• Cover disability and dependence
• Underwriting cancer has been mainly based on:
• Cancer type
• Staging: TNM or AJCC stage
• Immediate sequelae or morbidities linked to cancer and/or its treatment
• Possibilities of long-term complications from cancer therapy and/or recurrences
• Frequent updates needed to continuously meet scientific and medical progress:
• Difficult to estimate an individual risk based on current medical publications
• Difficult to implement rapidly changing and constantly evolving knowledge - especially
for oncology - at the forefront of medicine
3
4. 4
CANCER : Overall goal
Generate evidence-based information to improve assessments
Develop a mathematical model based on easily obtainable
variables, which can allow an accurate estimate of the excess
mortality rate of these individuals
How to accurately estimate a risk ?
Estimation of Conditional survival
5. The concept of conditional survival
• Estimation of prognostic at diagnostic is a valuable tool to select the appropriate
treatment strategies ‘chemotherapy, radiotherapy, surgery, targeted agent,
immunotherapy) for individual patients
• TNM, stage, grading classification are routinely used
• Derived Kaplan Meier survival estimate allow to identify groups at specific risk
• We need to understand that the prognostic of individual may evolve over time
(even in high risk patients) as the risk of dying of cancer reduce over time for those
who survive (long termsurvivor are better prognostic group regardless their initial
prognosis)
• Survival estimates need to be reevaluated at various time points after diagnosis to take
into account this paradigm
• This is what we call the estimation of conditional survival (corrected conditional survival
taking further into account the lack of relapse at particular time-points
5
6. Breast and colon cancers
6
Breast cancer
as a paradigm of a heterogeneous cancer type
Colon cancer
as more homogeneous tumor type
Some of the most frequent tumor types
R e f. S C O R U N D E R W R IT IN G C A N C E R P R O JE C T
O P T IM IZ IN G IN D IV ID U A L C A N C E R R A T IN G A S S E S S M E N T S B A S E D O N U P D A T E D A L G O R IT H M S - S C O R JU N E 2 0 1 7
7. 7
Engineered algorithms that used the SEER data set
20 US states registries on all cancer types
9,675,661 detailed cases of patient with cancer (2016)
Data regularly updated and validated
Algorithm Individual risk assessment
R e f. S C O R U N D E R W R IT IN G C A N C E R P R O JE C T
O P T IM IZ IN G IN D IV ID U A L C A N C E R R A T IN G A S S E S S M E N T S B A S E D O N U P D A T E D A L G O R IT H M S - S C O R JU N E 2 0 1 7
8. 8
Overall versus conditional cancer survival
R e f. S C O R U N D E R W R IT IN G C A N C E R P R O JE C T
O P T IM IZ IN G IN D IV ID U A L C A N C E R R A T IN G A S S E S S M E N T S B A S E D O N U P D A T E D A L G O R IT H M S - S C O R JU N E 2 0 1 7
10. Mortality estimates according to hormone receptor (HR) expression
10
— The outcome of breast cancer may
vary depending of phenotypic
characteristics:
ØHR positive tumors may have a
better overall prognosis but
keep the same risk of relapse
over time
ØHR negative tumors have a
worst prognosis that is
characterized by a higher risk of
early relapse
but the risk of relapse decreases
over time
R e f. S C O R U N D E R W R IT IN G C A N C E R P R O JE C T
O P T IM IZ IN G IN D IV ID U A L C A N C E R R A T IN G A S S E S S M E N T S B A S E D O N U P D A T E D A L G O R IT H M S - S C O R JU N E 2 0 1 7
11. T1N1M0 invasive ductal breast cancer
11
Corrected survival
Uncorrected survival
Survival at Diagnosis
HR+ HR-
R e f. S C O R U N D E R W R IT IN G C A N C E R P R O JE C T
O P T IM IZ IN G IN D IV ID U A L C A N C E R R A T IN G A S S E S S M E N T S B A S E D O N U P D A T E D A L G O R IT H M S - S C O R JU N E 2 0 1 7
13. Conditional survival at 3 years
Correctedsurvival
Uncorrectedsurvival
Survival atDiagnosis
Comparison scoring & KM
pT3N1 grade 3 colon cancer
13R e f. S C O R U N D E R W R IT IN G C A N C E R P R O JE C T
O P T IM IZ IN G IN D IV ID U A L C A N C E R R A T IN G A S S E S S M E N T S B A S E D O N U P D A T E D A L G O R IT H M S - S C O R JU N E 2 0 1 7
14. Conclusion
14
• The evaluation of trends in cancer trends and mortality is
an important part of the risk estimation for insurance
companies
• Cancer stands as one of the most prevalent and costly
disease worldwide with increasing number of long
survivors
• Evidence-based estimations of the risk based on large
databases and novel tools are essential to derive fair rating