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The US cancer statistics for 2017 were published early this year (http://onlinelibrary.wiley.com/doi/10.3322/caac.21387/epdf). Among all of the statistics, the most interesting one is the cancer statistics comparison between males and females. The table below shows the most common cancer expected new cases and deaths in men and women in 2017.

For men, prostate, lung and bronchus, and colorectal cancers account for 42% of all cases, with almost 1 in 5 new diagnoses being prostate cancerThe most common causes of cancer death are lung and bronchus, colorectum, and prostate.

For women, the 3 most common cancers are breast, lung and bronchus, and colorectum, which collectively represent one-half of all cases; breast cancer alone is expected to account for 30% of all new cancer diagnoses in women. Lung and bronchus, breast, and colorectum are the most common causes of cancer deaths. Changes in medical practice such as increased use of screening has effects on the incidence patterns.

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Prostate cancer incidence spiked in the late 1980s and early 1990s because of the widespread use of the prostate-specific antigen (PSA) testing which led to an increase in the detection of asymptomatic disease. It then dropped dramatically after the US Preventive Services Task Force recommended against routine use of the test due to concerns over overdiagnosis and overtreatment. This teaches us a good lesson about adopting any cancer screening tests, especially for a test like PSA with a high false positive rate. As illustrated in the figure below, the overall cancer incidence rate in men declined by about 2% per year, while it has remained generally stable in women.

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Not all testing is bad - one has to make choices based on each individual and many factors, e.g. lifestyle or heriditary risk factors. Genetics testing is on the rise and can offer many benefits for diagnosis, prognosis, and treatment decisions in cancer. Such tests can be very helpful, for example, in directing the best therapeutic option once a diagnosis is made and helping patients avoid chemotherapy that would otherwise not benefit them based on their genomic profile. The Association for Molecular Pathology (AMP) provides structure, leadership, and guidance for the field of molecular diagnostics. The AMP Annual Meeting is coming up in a few weeks and I am looking forward to see what new advancements have been made as well as the recommendations and guidelines for testing in this field.

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