Understanding cancer risk and screening for it

An overview of each major cancer, its incidence, average stage at diagnosis, how it is currently 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 include a persistent cough and shortness of breath. These symptoms are also very common with benign conditions. Without effective routine screening it is traditionally diagnosed late.

Characteristics: Often quite aggressive due to access for tumor cells to enter and spread via the 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 of 86.4% sensitivity & 92.3% specificity. For nodules ≥10 mm detection of 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 obvious as the lesion grows. Symptoms 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 responds to treatment.

Current screening: Breast cancer detection benefits from high levels of awareness and well-established screening approaches such as mammogram. Many cancers are detected early through self-examination. Patients with dense breasts are most likely to be diagnosed late as mammogram is less effective in detecting abnormalities in dense breasts.

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, regular monitoring is recommended. Other types are aggressive and require radiation therapy, surgery, hormone therapy, chemotherapy, or other treatments.

Current screening: Prostate cancer is typically diagnosed via a transrectal digital examination for hardness combined with an elevated PSA level. Because existing screening methods have limitations in sensitivity and specificity, prostate cancer is rarely diagnosed in 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 include abdominal pain, difficulty emptying the bowel and unexplained weight loss. As these are general symptoms that are not specific, diagnosis of colon cancer is typically quite late.

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

Current screening: A routine colonoscopy is a very effective way to screen for and prevent colon cancer. However, due to the nature of the procedure 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 of 85.7% sensitivity, 84.2% specificity 22898697. For colon cancer of all sizes, one meta study analysed all previous studies and found detection of 95% sensitivity and 93% specificity [26770325].

Cancer

Liver cancer

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

Symptoms: Symptoms of liver cancer include weight loss, loss of appetite and abdominal pain. These symptoms usually only occur in the later stages of the disease. Without a screening approach, it is often diagnosed late

Characteristics: Liver cancer can be quite aggressive. Liver cancer is common in people who have a damaged liver (hepatitis, cirrhosis etc).

Current screening: There are no routine screening tests 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: Common symptoms include a lump, swelling or pain in the neck. This is not a specific set of symptoms.

Characteristics: Most thyroid cancers can be cured with timely, appropriate treatment.

Current screening: There are no routine screening tests for thyroid cancer.

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: Commonly, early stages of pancreatic cancer are asymptomatic. By the time symptoms arise, the cancer has often spread outside the pancreas.

Characteristics: Pancreatic cancer is a difficult cancer to treat. Pancreatic surgeries are difficult, and the relationship of the pancreas to the duodenum and biliary system is critical for digestion. Also, once pancreatic cancer spreads, it commonly surrounds essential arteries, rendering surgery a palliative option only.

Current screening: There are no routine screening tests for pancreatic cancer.

Prenuvo: Our detailed imaging enables us to view both the pancreas and pancreatic duct in great detail. 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 presents as blood in the urine. This is a non specific symptom, but one that should prompt early investigations.

Characteristics: Most bladder cancers are diagnosed at an early stage and are highly treatable. However even after treatment bladder cancer may recur. For this reason, people with bladder cancer typically need follow-up testing for years after treatment.

Current screening: There are no routine screening tests for bladder cancer.

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

Cancer

Uterine cancer

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

Symptoms: Early stages of uterine cancer are usually asymptomatic. When symptoms arise, symptoms include pain, pain during intercourse, discharge or abnormal bleeding.

Characteristics: Most cases of uterine cancer occur between the ages of 60 and 70. Usually uterine cancer is slow growing and the tumor is generally quite large at diagnosis.

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

Prenuvo: Our scans image the pelvis in great detail to aid in the early detection of uterine cancer. Clinical studies that use less comprehensive sequences than Prenuvo had 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 stages of cervical cancer are usually asymptomatic. When symptoms arise, symptoms include pain, pain during intercourse, pelvic pain or pressure, discharge or abnormal bleeding.

Characteristics: Cervical cancer is usually diagnosed between the ages of 35 and 44. Usually cervical cancer is slow growing.

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

Prenuvo: Our scans image the pelvis in great detail to aid in the early detection of cervical cancer. Clinical studies that use less comprehensive sequences than Prenuvo had 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 the early stages. When symptoms arise they are non-specific, including bloating and abdominal pain.

Characteristics: Cystic forms of ovarian cancer can rupture. This can spread cancerous cells throughout the pelvis and abdomen reducing the prognosis.

Current screening: There are no common screening tests for ovarian cancer. The CA-125 blood test is used a potential marker, but it lacks the sensitivity and specificity to be commonplace.

Prenuvo: Our scans image the pelvis is great detail. We can identify even small ovarian cysts. We can see over time when a cysts changes and evolves to have malignant features. There are few clinical studies on our approach, however one found that for diagnosing recurrence of ovarian cancer, detection achieved 98% sensitivity [27585490].

Cancer

Esophageal 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 and a chronic cough.

Characteristics: Because it is usually detected in later stages, 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. This is not commonly performed as a screening tool, but only when ongoing symptoms are present.

Prenuvo: The Prenuvo scan is aiming to improve the detection rates of esophageal cancer. Regular 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. When symptoms arise, they may be in the form of blood in the urine which is also a symptom of a kidney stone.

Characteristics: Kidney cancer is usually slow growing. Symptoms are usually only present when the cancer is advanced, leading to poor outcomes.

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

Prenuvo: The Prenuvo scan images the kidneys in high detail. For differentiating benign features from malignant renal cell carcinoma, 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 often affect the vocal cords, causing a hoarseness or a change in the voice. The closer to the vocal cords that these cancers originate, the earlier they are detected.

Characteristics: Even if laryngeal cancer is detected late, it is treatable and has a relatively good survival prognosis.

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

Prenuvo: The Prenuvo scan assesses the larynx quite well. One study that used standard MRI separated laryngeal cancer from precancerous or benign lesions 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. Because these lumps are not painful, they are typically ignored, leading to a late diagnosis.

Characteristics: Most forms of lymphoma have a good prognosis if detected early.

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

Prenuvo: The Prenuvo scan images the entire body which makes it useful in not only screening for, but also 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: Stomach cancer is rarely diagnosed in the early stages as symptoms appear quite late is its progress. Symptoms include nausea, vague abdominal pain, weight loss and loss of appetite.

Characteristics: Stomach cancer has a very good survival rate if detected in stage 1 (80%). Unfortunately it is rarely caught early. Stage 3 has a 20% survival rate.

Current screening: Endoscopy can be used as a screening tool for stomach cancer. In North America this is not commonly performed until symptoms are present.

Prenuvo: The Prenuvo scan images the stomach in very good detail. For diagnosis of stage I stomach cancer a sensitivity of 75.0% and specificity 84.6% was found [28265229]. This is comparable to the standard approach using CT.

Cancer

Testicular cancer

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

Symptoms: Testicular cancer usually appears as a painless, one sided scrotal mass. In approximately 20% of cases, the first symptom is scrotal pain.

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 non-seminomas, which are more aggressive. Non-seminomas tend to affect younger men. When treated early, the outlook for testicular cancer is generally very good.

Current screening: The standard screening approach to detect testicular cancer is self-examination.

Prenuvo: Because of the self-examination technique, there are very limited statistics in assessing the performance of MRI in detecting testicular cancer. For the detection of lymph node involvement sensitivity was 97%. [AJR.12.10319].

Cancer

Brain cancer

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

Symptoms: There are very few early symptoms for brain tumors, but when present symptoms 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 may limit treatment options.

Current screening: There are no standard screening tests for the early detection of brain tumors.

Prenuvo: Brain tumors typically have a poor prognosis which is why early detection is essential. The Prenuvo scan includes a very detailed analysis of the brain. MRI is widely known to be one of the most sensitive and specific imaging techniques for the brain. [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.
  • As with any medical test, there is a chance of a false positive or differential diagnosis for any result provided by your Prenuvo scan. You should discuss your results, decide any follow-up actions and only make changes to your health management based on discussion with your primary care physician.
  • While we strive to be comprehensive, the reading radiologist will not catalog every feature that fails to meet a threshold of clinical significance.