The screening services we offer to patients is very complex and includes a brought rand of tests available.
The cancer screening services can be offered to self -referred patients in our laboratory facility directly or with a conjunction with doctors consultation and advise pre sampling. Some of tests like swabs need to be taken by the doctors not by the lab technicians or phlebotomy specialist. Therefore please keep in mind while booking to tell what test results are you looking to obtain so you would be advised by our reception of necessity to book with doctors consultation visit.
Please not that is is a general description of the screens available:
CA125, HE4 and ROMA (Risk of Ovarian Malignancy Algorithm)
Ovarian and Endometrial Cancer is the fourth or fifth most common cause of cancer-related deaths among women worldwide and is responsible for 5% of all cancer deaths in women. The high death rate is mostly attributable to its late detection. Earlier detection is essential for improved survival.
CA125 is, to date, the best known test for ovarian cancer diagnosis, and is the serum marker most widely used to monitor therapeutic response and to detect disease, or disease recurrence, for epithelial ovarian cancer. Its recognised limitations have prompted the need to develop biomarkers with better sensitivity for early stage diagnosis, with the ability to differentiate women with ovarian cancer from those with benign ovarian conditions. CA125 has a high false positive rate among women with benign gynaecological conditions such as endometriosis. Approximately 20% of ovarian cancers lack expression of CA125, and levels are not increased in nearly 40 – 50% of early stage ovarian cancers. The diagnostic value of CA-125 is compromised by its high false-positive rate.
HE4 is a new marker for ovarian carcinoma, which is over-expressed in patients with ovarian and some other cancers. When combined with CA125, HE4 raises the potential to discriminate benign from cancerous ovarian masses and has the strongest correlation with endometrial cancer of all markers tested to date. HE4 is consistently expressed in patients with ovarian cancer and has demonstrated an increased sensitivity and specificity over that of CA125 alone.
High HE4 with High CA125 would suggest ovarian cancer whereas an elevated CA125 without an associated elevated HE4 indicate benign conditions. A raised HE4 and normal CA125 would suggest the presence of either ovarian or possibly other type of cancer (e.g. endometrial). It is promising as a marker for early detection by differentiating women with ovarian cancer from women with benign ovarian conditions
A Risk of Ovarian Malignancy Algorithm (ROMA) classifies patients as being at low or high risk for malignant disease using both the CA125 and HE4 results, and a woman’s menopausal status. This risk is reported with results for both CA125 and HE4. ROMA calculates a risk of finding ovarian cancer during surgery. ROMA classifies patients as being at low or high risk for malignant disease.
HPV and Anal Cancer
High-risk HPV types are implicated in a substantial portion of anal, penile, and head and neck precancers and cancers. HPV 16 and 18 are the most common HPV types found in cervical cancer and are responsible for approximately 70% of these cancers.
Anal cancer rates in the UK have risen by 2.5 – 5 fold in the last 50 years. They are similar to the incidence rate of other external anogenital malignancy but certain subsets of the population have a high susceptibility to anal cancer:1
Men and women with HIV infection
Men who have sex with men
Anal cancer shows many similarities to cervical cancer: high risk HPV infection being the causative factor in most cases. Rates of High Risk HPV in anal cancer specimens are 83% men/95% women and with further advances in detection and classification, this may increase. Type16 is the most frequent HPV type detected followed by Type18, regardless of gender. The types being identified (16, 18, 31, 33, 45) are identical to the subtypes found in cervical cancer2 Smokers (men and women) are at particularly high risk for anal cancer, independent of age and other risk factors3.
Anal cytology is the candidate test for screening for prevention of anal cancer. Inspection and clinical examination includes cytological, perianal and intra-anal PAP smear sampling. Simultaneous HPV DNA by PCR testing increases the sensitivity of anal cytology andby using Liquid Based Cytology both cytological examination and HPV testing can be undertaken. Test values and screening performances are well documented5,6. Triage of atypical cytology can be performed according to gynaecological cancer screening procedures.
If HPV infection is identified, identifying low from high risk subtypes is helpful. Biopsy, excision and examination especially for HPV lesions is recommended. Follow up testing of HPV DNA by PCR will identify whether there is clearance or persistence of the virus. Persistence of HPV infection is, like cervical cancer, indicative of an increased risk of recurrence4.
PCA3 CE-Marked assay
Patients with an elevated serum total PSA value or abnormal digital rectal examination results are known to be at risk of prostate cancer and are recommended to undergo prostate needle biopsies. PSA remains a mainstay of prostate cancer detection but, alone, its performance leaves a large unexplored region of sensivitity and specificity, with the possibility of missed cancers and little alternative but to biopsy. The “Progensa PCA3 is a revolution for urologists: for the first time molecular biology and RNA testing are routinely available”**.
PCA3 testing allows a urologist to decide whether or not to perform, or to repeat, a prostate needle biopsy for the groups of patients at higher risk of having prostate cancer. PCA3 is specifically overexpressed in prostate tumour cells – not in benign or normal tissue and is not affected by the size of the prostate. PCA3 is prostate cancer specific, over expressed in >95% of malignant tissue, and is significantly up-regulated (60-100 fold) in prostate cancer. Testing for the presence of PCA3 in urine, collected following a Digital Rectal Exmaintion. The DRE releases prostate cells which are collected in a first catch urine following the DRE. Gen-Probe Progensa PCA3 urine sample collection tubes must be used. The PCA3 result is reported as a score; the higher the score the greater the probability of a positive prostate biopsy whilst the lower the score the likelihood of a positive biopsy decreases. The greatest diagnostic utility occurs at a cut off of 35. The PCA3 test finds the mRNA that is specific for prostate cancer and qualifies the amount. The higher the PCA3 score the greater the probability of prostate cancer. PCA3 when used as a reflex test can improve the specificity in prostate cancer and prevent many unnecessary prostate biopsies.*
Lung cancer is the second most common cancer in the UK (2009), accounting for around 13% of all new cancer cases (men 14%, women 11%). Lung cancer incidence rates in Scotland are among the highest in the world, reflecting the country’s history of high smoking prevalence. Lung cancer is typically not diagnosed until physical, non-specific symptoms present – usually, shortness of breath, chest, shoulder or back pain or persistent cough.
How many people survive lung cancer?
The earlier diagnosed the better – the five-year survival rate for early stage is 43-73%, while for later stage disease it is 2-13%1
The five-year survival rates for men and women diagnosed with lung cancer are 7.3% and 8.7% respectively2
How many people died from lung cancer in UK in 2008?
Around 96 people died every day (around 35,000 in 2009)1
The most common cause of cancer death in the UK (more than 20% of all cancer related deaths)1
The Oncimmune EarlyCDT®-LUNG is a blood test, measuring a panel of autoantibodies, or markers, to tumour proteins (antigens). The presence of one or more of these autoantibodies provides an early indication of tumour presence. This may be useful for patients with a history of smoking or prolonged exposure to chemicals in the work place. This test detects all types of lung cancer, and whilst it has better positive predictive value performance than CT scans with fewer false positives, it does not replace chest X-ray or CT scans but it may provide earlier signals than imaging alone can provide.
A positive result means that autoantibodies have been detected above a predetermined cut-off and this increased risk may warrant further investigations.
A negative result does not mean the patient is cancer-free – they are still at high risk for lung cancer from their existing risk factors and regular screening is therefore likely to continue.