Understanding cancer risk and screening for it

An overview of each major cancer, its incidence, average stage of detection, how it is screened for and how Prenuvo performs.
Cancer

Lung cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early symptoms of lung cancer such as a persistent cough or a shortness of breath are more likely than not to be confounded with benign conditions. Without effective routine screening it is traditionally diagnosed late.

Characteristics: Often quite aggressive due to easy access to blood supply.

Current screening: High risk patients are sometimes given a yearly CT scan. There is no population screening for lung cancer.

Prenuvo: Quite effective for screening and diagnosing malignant tumors. For nodules that ranged from 6-9mm, detection with 86.4% sensitivity & 92.3% specificity. For nodules ≥10 mm detection with 97% sensitivity and 96% specificity [21696559]

Cancer

Breast cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Symptoms of breast cancer become more difficult to miss as it grows. They include a lump in the breast, bloody discharge from the nipple, and changes in the shape or texture of the nipple or breast.

Characteristics: There are many types of breast cancer and the type that a patient has affects significantly how it spreads and reacts to treatment.

Current screening: Breast cancer enjoys high levels of awareness and well-established screening approaches. Many cancers are also detected early through self-examination. Patients with dense breasts are most likely to be diagnosed late as mammogram struggles to image dense breasts effectively.

Prenuvo: Very effective, particularly for screening women with dense breasts. One study found detection with 98.7% sensitivity and 65.8% specificity [29644993]. DWI MRI significantly outperforms other modalities in patients with dense breast tissue. At comparable specificity, the approach we use achieves higher sensitivity than mammogram. Mammogram is still important, as it is capable of picking up calcification, a tumor precursor.

Cancer

Prostate cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Symptoms include difficulty with urination, but sometimes there are no symptoms at all.

Characteristics: Some types of prostate cancer grow slowly. In some of these cases, monitoring is recommended. Other types are aggressive and require radiation, surgery, hormone therapy, chemotherapy, or other treatments.

Current screening: Prostate cancer is typically diagnosed via a manual examination for hardness (which not all prostate cancers exhibit) and high PSA levels. Because existing screening methods suffer low sensitivity, prostate cancer is rarely diagnosed at Stage I.

Prenuvo: Very effective, considered gold standard. For prostate cancer of all sizes, one meta study analysed all previous studies and found detection with 69% sensitivity and 89% specificity. [22997374]

Cancer

Colo-rectal cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: The most common symptom is rectal bleeding, but most people do not examine their stool routinely. Other symptoms such as abdominal pain, difficulties emptying the bowel and unexplained weigh loss are all commonly confused with benign conditions. As a result, diagnosis is typically quite late.

Characteristics: It is estimated that it takes up to 10 years for a precancerous polyp to develop into cancer. One cancer has invaded to colon wall it can progress quite quickly.

Current screening: A routine colonoscopy is a very effective way to screen for and prevent colon cancer. However, it is not the most pleasant procedure and so many patients do not follow age-appropriate screening guidelines.

Prenuvo: Effective particularly for cancer detection once it invades the colon wall (still stage 1). For polyps ≥6 mm, detection with 85.7% sensitivity, 84.2% specificity 22898697. For colon cancer of all sizes, one meta study analysed all previous studies and found detection with 95% sensitivity and 93% specificity. 26770325

Cancer

Liver cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Signs and symptoms of liver cancer often do not show up until the later stages of the disease which means that without a screening approach, it is often diagnosed late.

Characteristics: Liver cancer can be aggressive, particularly because it often affects people who already have a damaged liver.

Current screening: There is no routine screening for liver cancer.

Prenuvo: The Prenuvo scan images the liver in great detail. The sequences we use distinguish benign from malignant lesions with 97% sensitivity and 98% specificity [22226435].

Cancer

Thyroid cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: People typically experience lump, swelling or pain in the neck. Some people have no symptoms.

Characteristics: Most thyroid cancers are curable with appropriate treatment.

Current screening: There is no routine screening for thyroid cancer, mainly because it is often diagnosed by the patient as in unexplained lump in the neck.

Prenuvo: For distinguishing benign from malignant lesions with 97% sensitivity and 98% specificity [22226435].

Cancer

Pancreatic cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early pancreatic cancers often do not cause any signs or symptoms. By the time they do cause symptoms, they have often already spread outside the pancreas.

Characteristics: Pancreatic cancer is a particularly dangerous cancer for several reasons. First, the pancreas is a critical organ (there is no way to prolong life if it fails). Second, cancer tends to wrap around the descending aorta.

Current screening: There is no routine screening for pancreatic cancer.

Prenuvo: Our detailed imaging enables us to view both the pancreas in high detail but also the pancreatic duct where cancer likes to start. In clinical studies, our approach for detection of pancreatic adenocarcinoma was found to be 93% sensitivity and 89% specificity [28624015 A study investigating DWI, detected 20 mm+ tumors with 95.7% sensitivity and 100% specificity. 28784320].

Cancer

Bladder cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early stage bladder cancer often manifests with blood in the urine, but this can disappear for weeks at a time and is often confused with other benign conditions.

Characteristics: Most bladder cancers are diagnosed at an early stage and are highly treatable. However, even early-stage bladder cancer may recur in the bladder. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs or advances to a higher stage.

Current screening: There is no routine screening for bladder cancer.

Prenuvo: We see very clear images of the bladder wall. Using our approach for diagnosing malignant bladder wall lesions yields detection with at least 94.5% sensitivity and 87.5% specificity [29732204].

Cancer

Uterine cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early stage cancer is usually asymptomatic until it extends to the nearest anatomic structures, causing pain, dyspareunia, discharge or abnormal bleeding.

Characteristics: Most cases of uterine cancer occur between the ages of 60 and 70 years when it can grow less aggressively.

Current screening: There is no routine screening for uterine cancer.

Prenuvo: Our scans image the pelvis using a number of tissue weights and are effective for diagnosing uterine cancer. Clinical studies that use less comprehensive sequences than Prenuvo 73.9% sensitivity and 89.5% specificity. Adding DWI increased detection to 94.7% sensitivity [26162579].

Cancer

Cervical cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early stage cancer is usually asymptomatic until it extends to the nearest anatomic structures, causing pain, dyspareunia, discharge or abnormal bleeding.

Characteristics: Usually, cervical cancer is very slow growing, although in certain circumstances it can grow and spread quickly.

Current screening: A pap smear is the standard screening approach to cervical cancer, but it is only 55% sensitive to detection. An HPV test can be taken which has a sensitivity over 90%.

Prenuvo: Our scans image the pelvis using a number of tissue weights and are effective for diagnosing cervical cancer. Clinical studies that use less comprehensive sequences than Prenuvo 73.9% sensitivity and 89.5% specificity. Adding DWI increased detection to 94.7% sensitivity [26162579].

Cancer

Ovarian cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Ovarian cancer is usually asymptomatic in early stages, manifesting as bloating or abdominal discomfort that is confounded with routine conditions. Without effective screening it is typically diagnosed late with poor outcomes.

Characteristics: Ovarian cancer that develops out of cysts can rupture and easily spread cancerous cells throughout the abdomen, making treatment difficult.

Current screening: There is no common screening test for ovarian cancer. The only approved test is a CA-125 blood test but is know to be poor at detecting Ovarian cancer.

Prenuvo: We clearly view the ovary and can relatively easily distinguish between benign ovarian cysts and ovarian cancer. There are few clinical studies on our approach, however one found that for diagnosing recurrence ovarian cancer, detection achieved 98% sensitivity [27585490]. [26162579].

Cancer

Esophagus cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early esophageal cancer typically causes no signs or symptoms. As the disease progresses, patients might experience difficulty swallowing, weight loss, chest pain, indigestion or coughing.

Characteristics: Because it is often detected late, esophageal cancer is the sixth most common cause of cancer deaths worldwide.

Current screening: It is possible to screen for esophageal cancer using an endoscope, however in many health systems this is not common under a patient has high risk of cancer.

Prenuvo: The Prenuvo scan uses special sequences to review the esophagus which leads to better detection rates. Ordinary MRI is moderately successful in identifying esophageal cancers of all sizes, with detection with 67% sensitivity and 92% specificity [27767330].

Cancer

Kidney cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early kidney cancers do not usually cause any signs or symptoms and when they do, they are frequently confused with more common and benign conditions.

Characteristics: The most common kidney cancers can grow quite slowly and when detected can be successfully treated. But because kidney cancer is often detected late it often suffers poor outcomes.

Current screening: There is no standard screening tests for kidney cancer.

Prenuvo: The Prenuvo scan images the kidneys in detail. For differentiating benign features from malignant renal cell carcinoma, some studies have found detection with 91% sensitivity and 89% specificity [29230706].

Cancer

Larynx cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Laryngeal cancers that form on the vocal cords often cause hoarseness or a change in the voice. This can lead to them being found at a very early stage. For cancers that don’t start on the vocal cords, hoarseness occurs only after these cancers reach a later stage.

Characteristics: Although laryngeal cancer is often detected late, it is treatable and has a relatively good survival outlook.

Current screening: There is no standard screening tests for laryngeal cancer.

Prenuvo: The Prenuvo scan takes several images of the neck with different tissue weights increasing accuracy. One study that used standard MRI found For distinguishing laryngeal carcinomas from precancerous lesions, detection with 81.8% sensitivity and 64.7% specificity [23874693].

Cancer

Lymphoma

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early detection of lymphoma requires paying close attention to any lumps in the neck, groin or armpits. But because they are not painful, they are typically ignored, leading to a late diagnosis.

Characteristics: Lymphoma is considered reasonably treatable if caught early.

Current screening: There is no standard screening tests for lymphoma.

Prenuvo: The Prenuvo scan images the entire body which makes it useful in not only screening but staging of lymphoma. For assessment of residual disease after completion of therapy, at optimal b-values, detection with 100% sensitivity and 91.7% specificity [25952024]. Similar sensitivities have been found for initial diagnosis [21862763].

Cancer

Stomach cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Early detection of lymphoma requires paying close attention to any lumps in the neck, groin or armpits. But because they are not painful, they are typically ignored, leading to a late diagnosis.

Characteristics: Lymphoma is considered reasonably treatable if caught early.

Current screening: There is no standard screening tests for lymphoma.

Prenuvo: The Prenuvo scan images the stomach in detail using several methodologies. For diagnosis of stage I stomach cancer, detection with 75.0% sensitivity and 84.6% specificity [28265229] which is comparable to the standard approach using CT.

Cancer

Testicular cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: Testicular cancer normally appears as a painless, unilateral scrotal mass. In approximately 20% of cases, the first symptom is scrotal pain. As the mass is increasingly recognizable as the tumor develops, diagnosis tends to be early.

Characteristics: Most testicular cancers start in the cells that make sperm. The two most common types are seminoma tumors, which tend to grow slowly and on-seminomas, which tend to affect younger men. The outlook for testicular cancer is generally very good.

Current screening: The standard screening approach is self-examination.

Prenuvo: The Prenuvo scan images the stomach in detail using several methodologies. For diagnosis of stage I stomach cancer, detection with 75.0% sensitivity and 84.6% specificity [28265229] which is comparable to the standard approach using CT.

Cancer

Brain cancer

  • Lifetime odds
    %
  • Average stage of diagnosis
  • Average 5 year survival
    %

Symptoms: There are very few early symptoms but can include dizziness, seizures and headaches.

Characteristics: There are many different types of brain tumors that have widely different prognosis. The brain is very difficult to operate on which make treatment options often limited.

Current screening: There is not standard screen for brain cancer.

Prenuvo: Brain tumors typically have poor prognosis which is why early detection is key. The Prenuvo scan does a detailed evaluation of the brain to identify any lesions. Many studies have shown that the technique with use is sensitive to detection of many types of brain tumors and brain metastases [20886568].

Some general advice about our screening products:
  • All Prenuvo scans are effective in visualizing lesions 1.5 cm or larger in the chest, abdomen and pelvis. The comprehensive and head & torso package also evaluate the head and neck for lesions 1 cm or larger.
  • No Prenuvo scan evaluates the heart in detail, although we do see evidence of atherosclerosis (a leading cause of heart attacks) in other organs of the body.
  • No Prenuvo scan evaluates detailed lung micro-architecture but will assess for mediastinal/hilar adenopathy/carcinoma.
  • All Prenuvo scans are limited in the evaluation of the hollow viscus (bowel and stomach) but will detect bowel carcinoma constricting the colon.
  • No cartilage-based sequences are performed for any Prenuvo scan which limits detailed assessment of the joints.
  • As with any medical test, due to many factors including state of disease progression, body physiology, body position and body movement, there are limitations which make it impossible to detect all malignancies and conditions listed above