Breast cancer is caused by somatic mutation. As such, somatic mutation in breast cancer should be described to eluci-date the underlying mechanism. Next-generation sequencing has provided new insights into the genomics of breast cancer. New genes were identified and exhibited a relationship with breast cancer. Although these genes mutated at a low frequency, such genes in different cases could be categorized into specific pathways. Mutational signatures could be found in some cases, but such signatures were gener-ally not related to environmental exposure. Studies on intra-tumoral heterogeneity have revealed the ubiquitous presence of sub-clones in breast cancer;however, a major clone is also observed, accounting for>50%of tumor cells. Current advancements show that breast cancer genomics has been integrated into personalized medicine. Furthermore, a genome-informed and personalized molecular sub-typ-ing and treatment of breast cancer can be developed in the future.

Breast cancer has become the most common malignant tumor and the major cause of cancer-related death for women around the world. The number of patients shows an increasing trend recently. Breast cancer is a big threaten to wom?en’s health and quality of life. With the development of molecular biology, molecular biomarkers have been found assiciated with prognosis in patients with breast cancer, which makes it possible to predict cancer patient survival precisely and practi?cally. This review summarized those new developments of biomarkers on the prognosis of breast cancer.

Objective To investigate the trends in incidence and mortality of esophageal cancer from 1981 to 2002 in Tianjin,China and to predict future trends and facilitate future prevention.Methods All new cancer cases registered in the Tianjin Cancer Registry between 1981 and 2002 were reviewed.Yearly age-specific,crude and age-adjusted incidence rates were calculated for males and females.Secular trends of incidence and mortality were indicated by the estimated annual percentage change(EAPC).Results A total of 8206 cases of esophageal cancer were reported in Tianjin form 1981 to 2002,with 5533 males and before 45 years,but increased rapidly after 45 years.The median age of esophageal cancer cases was 69 years,with quartile range from 62 to 75 years.The peak for age specific incidence in females was 75-80 years,which was earlier than that in males(aged 80-85).But recent data indicated that the peak age in females had increased and became similar to that of the males.The crude and age-standardized incidence rates(ASIR)of esophageal cancer decreased in last 22 years.For male and female,crude incidence decreased by 2.22% and 3.56% per year and ASIR decreased by 5.18% and 6.56% per year.The mortality of esophageal cancer decreased in the last 22 years.Conclusion The incidence of esophageal cancer decreased in the last 22 years in Tianjin,but there is little overall improvement in survival.

Objective To identify snoRNA, which may be related to prognosis of gastric cancer. Methods Ninetygastric cancer patients who diagnosed at Tianjin Medical University Cancer Institute and Hospital were randomly collected in this study, and their clinical data were followed up. A total of 405 snoRNA expression profiles were analyzed in 90 gastric cancer patients. Patients were classified aslow expressiongroup orhigh expressiongroup according to the median expression of each snoRNA expression, which was calculated by univariate and multivariate survival analysis. We also screened out the snoRNAs, in which patients were survived differently. Patients were classified as high, middle, or low risk groups based on the snoRNA risk score. Values of age, gender, smoking, drinking, histological differentiation (well, moderately-differentiated and poorly differentiated), clinical stage (Ⅰ+Ⅱstage andⅢ+Ⅳstage), tumor size (<5 cm and≥5 cm), tumor location (upper 1/3 and others) and snoRNA risk score (high, middle, and low risk group) were assessed by multivariate Cox analysis. Results There were significant differences in overall survival and (or) progression-free survival rates in 19 patients with high and low snoRNAs expressions (P<0.05). Results of multivariate Cox analysis showed that patients with high expression of ACA61,ACA27 and U36A showed a higher overall survival and progression-free survival rates, while patients with high expression of ENSG00000206898 showed a lower overall survival and progression-free survival survival rates (P<0.01). SnoRNA risk score is an independent prognostic factor for patients with gastric cancer. Compared with low risk group, patients in middle risk group and in high risk group showed a shorter overall survival and progression-free survival rates (P<0.001). Conclusion The expressions of ACA61, ACA27, U36A and ENSG00000206898 are independent prognostic factors of gastric cancer. Low expressions of the first three indexes and high expressions of the last one predict a bad prognosis.

Objective: To investigate the potential application values of screening on breast cancer, using the single-nucleotide polymorphisms (SNPs) that were identified from the genome- wide association studies (GWASs). Methods: Two million Chinese women aged 35-69 years were simulated, based on both age distributions, age-specific incidence rates of breast cancer and the distribution of known risk factors, in 2013. Twenty-three SNPs identified from GWAS were further simulated. Both genetic-related risks explained by each SNPs and the improvement on the risks under reclassification, were used to select SNPs for the prediction on breast cancer among the targeted high-risk population. Further analyses were conducted to investigate the following items as: improvements on detection rates of breast cancer among the high-risk populations, areas under the curve (AUC) and the odds ratio (OR) among women at high risk. Results: A total of 12 SNPs were eligible for targeting the high-risk population of breast cancer. When high-risk populations were defined as women whose predicted risks were higher than the 95^th predicted risk of the whole population, the detection rate (146.99/100 000) among high-risked women predicted by 12 SNPs would be significantly lower than 177.46/100 000, which was predicted by the known risk factors (P<0.001), among the high-risked women. Among those women at high risk, the detection rate (229.00/100 000) predicted by integrating known risk factors and 12 SNPs was significantly higher than that predicted by known risk factors (P<0.001). Also, the AUC increased from 64.4% to 67.8% (P<0.001), and the OR of increased from 3.32 to 4.33, predicted by integrating known risk factors and 12 SNPs, for women at high risk on breast cancer. Conclusion Targeted SNPs that were identified from genome- wide association studies could be used to improve the detection rates as well as the overall accuracy of risk prediction so as to identify the potential high-risk women on breast cancer before carrying on the screening program.

Objective: To explore the effectiveness and cost of breast cancer screening strategy that is suitable for the current econom-ic conditions in China. Methods: We collected clinical and cost information of breast cancer screening for Chinese women based on previous screening programs conducted from February 2008 to December 2011 and collected the same information about breast can-cer cases diagnosed in hospitals at the same time. Markov models were developed to analyze the incremental cost-effectiveness ratios (ICER) for 132 breast cancer screening strategies compared to no screening for Chinese women. Results: In 2010, as compared to no screening, the most cost-effective breast cancer screening strategy was biennial screening with clinical breast examination (CBE) and breast ultrasound, in parallel, for women aged between 40 to 64. This screening strategy could save 1,394 quality-adjusted life years (QALY) per 100,000 women, and the cost of saving breast-cancer related QALY would be 91,944 RMB. Sensitivity analysis indicated that in 2016, the most cost-effective breast cancer screening strategy was biennial screening with CBE and mammography (MAM), in parallel, for women aged 40 to 64, with ICER of 159,637 RMB per QALY. Conclusions: Population-based breast cancer screening would be acceptable in the current conditions in China. As the Chinese economy and level of medical care improve, breast cancer screening would be more cost-effective.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Objective:To understand the current status of depression in older people aged 65 and over in Henan Province, and to study its influencing factors, with a focus on depression in older adults in grandparent families.Methods:A multi-stage stratified cluster sampling method was used.Baseline data about older people aged 65 and over were collected by self-designed questionnaires, the 15-item Geriatric Depression Scale(GDS-15)was used to assess depression.Results:A total of 7673 valid questionnaires about older adults aged 65 and over were collected, and the rate of depression was 29.52%(2265). Logistic regression analysis showed that 15 factors, such type of parenting, religious belief, region, degree of self-care, affected depression in older people aged 65 and above.Compared with regular parenting, grandparenting alone was a protective factor for depression[ OR(95% CI)=0.613(0.499-0.755), P<0.01]; compared with religious belief, no religious belief was a risk factor for depression[ OR(95% CI)=1.281(1.102-1.488), P<0.01]; compared with income ≥￥4000, incomes between ￥1000-1999[ OR(95% CI)=0.638(0.464-0.877), P<0.01], between ￥2000-2999[ OR(95% CI)=0.567(0.432-0.744), P<0.01]and between￥3000-3999[ OR(95% CI)=0.584(0.448-0.761), P<0.01]were protective factors for depression, with higher income showing stronger protection; compared with retirement, working had a protective effect, but the protective strength decreased in the order of working as urban labor, [ OR(95% CI)=0.332(0.273-0.405), P<0.01], as farmers[ OR(95% CI)=0.391(0.296-0.516), P<0.01], and as professionals or managers[ OR(95% CI)=0.514(0.402-0.656), P<0.01]; living in rural areas[ OR(95% CI)=0.686(0.586-0.804), P<0.01]and female[ OR(95% CI)=0.820(0.734-0.917), P<0.01]were risk factors for depression. Conclusions:There is currently a high rate of depression in older people aged 65 and over in Henan Province.Its influence factors are complicated and variable.Intervention measures taken by institutions need to adapt to specific circumstances.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Screening has been always considered as a double-edged sword. Cancer screening could save lives in some cases, however, in other cases, it might also turn people into overdiagnosis. Overdiagnosis is the diagnosis of cancer that will never cause symptoms or death during a patient's lifetime. Therefore, overdiagnosis might lead to unnecessary treatments and lifetime surveillance, and then increase economic burden and psychological burden. In this review, we focus on how to correctly evaluate the overdiagnosis rate, and how to avoid or reduce the harms caused by overdiagnosis in the future according to the reasons associated with overdiagnosis. After systematically reviewing the previous studies, we will try to identify the potential reasons associated with overdiagnosis in breast cancer screening with mammography, address how to correctly evaluate the overdiagnosis rate, and finally provide some suggestions to reduce the overdiagnosis.