On the growth rates of human malignant tumors: Implications for medical decision making

Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume doubling time (TVDT) can be counted in days. Cancers from the breast, prostate, and colon are frequently slow‐growing, displaying a TVDT of months o...

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Published inJournal of surgical oncology Vol. 65; no. 4; pp. 284 - 297
Main Authors Friberg, Sten, Mattson, Stefan
Format Journal Article
LanguageEnglish
Published New York Wiley Subscription Services, Inc., A Wiley Company 01.08.1997
Wiley-Liss
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ISSN0022-4790
1096-9098
DOI10.1002/(SICI)1096-9098(199708)65:4<284::AID-JSO11>3.0.CO;2-2

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Abstract Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume doubling time (TVDT) can be counted in days. Cancers from the breast, prostate, and colon are frequently slow‐growing, displaying a TVDT of months or years. Irrespective of their growth rates, most human tumors have been found: to start from one single cell, to have a long subclinical period, to grow at constant rates for long periods of time, to start to metastasize often even before the primary is detected, and to have metastases that often grow at approximately the same rate as the primary tumor. The recognition of basic facts in tumor cell kinetics is essential in the evaluation of important present‐day strategies in oncology. Among the facts emphasized in this review are: (1) Screening programs. Most tumors are several years old when detectable by present‐day diagnostic methods. This makes the term “early detection” questionable. (2) Legal trials. The importance of so‐called doctor's delay is often discussed, but the prognostic value of “early” detection is overestimated. (3) Analyses of clinical trials. Such analysis may be differentiated depending on the growth rates of the type of tumor studied. Furthermore, uncritical analysis of survival data may be misleading if the TVDT is not taken into consideration. (4) Analyses of epidemiological data. If causes of malignant tumors in humans are searched for, the time of exposure must be extended far back in the subject's history. (5) Risk estimations by insurance companies. For the majority of human cancers, the 5‐year survival rate is not a valid measurement for cure. Thus, basic knowledge of tumor kinetics may have important implications for political health programs, legal trials, medical science, and insurance policies. J. Surg. Oncol. 1997;65:284–297. © 1997 Wiley‐Liss, Inc.
AbstractList Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume doubling time (TVDT) can be counted in days. Cancers from the breast, prostate, and colon are frequently slow-growing, displaying a TVDT of months or years. Irrespective of their growth rates, most human tumors have been found: to start from one single cell, to have a long subclinical period, to grow at constant rates for long periods of time, to start to metastasize often even before the primary is detected, and to have metastases that often grow at approximately the same rate as the primary tumor. The recognition of basic facts in tumor cell kinetics is essential in the evaluation of important present-day strategies in oncology. Among the facts emphasized in this review are: (1) Screening programs. Most tumors are several years old when detectable by present-day diagnostic methods. This makes the term "early detection" questionable. (2) Legal trials. The importance of so-called doctor's delay is often discussed, but the prognostic value of "early" detection is overestimated. (3) Analyses of clinical trials. Such analysis may be differentiated depending on the growth rates of the type of tumor studied. Furthermore, uncritical analysis of survival data may be misleading if the TVDT is not taken into consideration. (4) Analyses of epidemiological data. If causes of malignant tumors in humans are searched for, the time of exposure must be extended far back in the subject's history. (5) Risk estimations by insurance companies. For the majority of human cancers, the 5-year survival rate is not a valid measurement for cure. Thus, basic knowledge of tumor kinetics may have important implications for political health programs, legal trials, medical science, and insurance policies.Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume doubling time (TVDT) can be counted in days. Cancers from the breast, prostate, and colon are frequently slow-growing, displaying a TVDT of months or years. Irrespective of their growth rates, most human tumors have been found: to start from one single cell, to have a long subclinical period, to grow at constant rates for long periods of time, to start to metastasize often even before the primary is detected, and to have metastases that often grow at approximately the same rate as the primary tumor. The recognition of basic facts in tumor cell kinetics is essential in the evaluation of important present-day strategies in oncology. Among the facts emphasized in this review are: (1) Screening programs. Most tumors are several years old when detectable by present-day diagnostic methods. This makes the term "early detection" questionable. (2) Legal trials. The importance of so-called doctor's delay is often discussed, but the prognostic value of "early" detection is overestimated. (3) Analyses of clinical trials. Such analysis may be differentiated depending on the growth rates of the type of tumor studied. Furthermore, uncritical analysis of survival data may be misleading if the TVDT is not taken into consideration. (4) Analyses of epidemiological data. If causes of malignant tumors in humans are searched for, the time of exposure must be extended far back in the subject's history. (5) Risk estimations by insurance companies. For the majority of human cancers, the 5-year survival rate is not a valid measurement for cure. Thus, basic knowledge of tumor kinetics may have important implications for political health programs, legal trials, medical science, and insurance policies.
Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume doubling time (TVDT) can be counted in days. Cancers from the breast, prostate, and colon are frequently slow-growing, displaying a TVDT of months or years. Irrespective of their growth rates, most human tumors have been found: to start from one single cell, to have a long subclinical period, to grow at constant rates for long periods of time, to start to metastasize often even before the primary is detected, and to have metastases that often grow at approximately the same rate as the primary tumor. The recognition of basic facts in tumor cell kinetics is essential in the evaluation of important present-day strategies in oncology. Among the facts emphasized in this review are: (1) Screening programs. Most tumors are several years old when detectable by present-day diagnostic methods. This makes the term "early detection" questionable. (2) Legal trials. The importance of so-called doctor's delay is often discussed, but the prognostic value of "early" detection is overestimated. (3) Analyses of clinical trials. Such analysis may be differentiated depending on the growth rates of the type of tumor studied. Furthermore, uncritical analysis of survival data may be misleading if the TVDT is not taken into consideration. (4) Analyses of epidemiological data. If causes of malignant tumors in humans are searched for, the time of exposure must be extended far back in the subject's history. (5) Risk estimations by insurance companies. For the majority of human cancers, the 5-year survival rate is not a valid measurement for cure. Thus, basic knowledge of tumor kinetics may have important implications for political health programs, legal trials, medical science, and insurance policies.
Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume doubling time (TVDT) can be counted in days. Cancers from the breast, prostate, and colon are frequently slow‐growing, displaying a TVDT of months or years. Irrespective of their growth rates, most human tumors have been found: to start from one single cell, to have a long subclinical period, to grow at constant rates for long periods of time, to start to metastasize often even before the primary is detected, and to have metastases that often grow at approximately the same rate as the primary tumor. The recognition of basic facts in tumor cell kinetics is essential in the evaluation of important present‐day strategies in oncology. Among the facts emphasized in this review are: (1) Screening programs. Most tumors are several years old when detectable by present‐day diagnostic methods. This makes the term “early detection” questionable. (2) Legal trials. The importance of so‐called doctor's delay is often discussed, but the prognostic value of “early” detection is overestimated. (3) Analyses of clinical trials. Such analysis may be differentiated depending on the growth rates of the type of tumor studied. Furthermore, uncritical analysis of survival data may be misleading if the TVDT is not taken into consideration. (4) Analyses of epidemiological data. If causes of malignant tumors in humans are searched for, the time of exposure must be extended far back in the subject's history. (5) Risk estimations by insurance companies. For the majority of human cancers, the 5‐year survival rate is not a valid measurement for cure. Thus, basic knowledge of tumor kinetics may have important implications for political health programs, legal trials, medical science, and insurance policies. J. Surg. Oncol. 1997;65:284–297. © 1997 Wiley‐Liss, Inc.
Author Mattson, Stefan
Friberg, Sten
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Keywords Human
Growth rate
Doubling time
Review
Malignant tumor
Epidemiology
Quality of life
Cancerology
Health policy
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Diagnosis
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1966; 198
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1963; 86
1983; 157
1973; 12
1995; 36
1932; 18
1980; 45
1958; 11
1989; 111
1976
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1971
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1965; 18
1977
1988; 104
1994; 343
1965; 2
1984; 53
1971; 7
1995; 60
1991; 47
1977; 37
1960; 48
1993; 71
1991; 88
1989; 141
1969; 5
1986; 46
1996; 61
1983; 21
1985
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1971; 2
1972; 14
1985; 55
1976; 38
1994; 74
1974; 291
1968; 55
1966; 20
1966; 2
1980; 25
1987; 10
1968; 49
1971; 61
1997; 65
1981; 126
1962; 3
1956; 76
1995; 13
1977; 40
1976; 2
1975; 36
1969; 16
1825; 115
1977; 87
1995; 2
1995; 1
1968; 40
1961; 14
1951; 42
1964; 159
1990; 81
1980; 156
1981; 67
1980; 16
1963; 16
1992; 70
1979; 46
1990; 66
1974; 65
1978; 89
1973; 65
1978; 42
1967; 3
1967; XXI
1994; 12
1988; 68
1995; 346
1960
1985; 30
1958; 188–191
1972; 30
1977; 13
1991; 326
1975; 62
1979; 43
1990; 8
1970; 49
1961; 27
1987; 26
1966
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Snippet Testicular carcinomas, pediatric tumors, and some mesenchymal tumors are examples of rapidly proliferating cell populations, for which the tumor volume...
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SubjectTerms Biological and medical sciences
Breast Neoplasms - pathology
Cell Division - physiology
Clinical Trials as Topic
Colonic Neoplasms - pathology
Decision Making
diagnostic level
doubling time
Epidemiology
Female
growth rate
human
Humans
lethal burden
Lung Neoplasms - secondary
Male
Medical sciences
neoplasm
Neoplasm Metastasis
Neoplasms - diagnosis
Neoplasms - pathology
period of risk
Prostatic Neoplasms - pathology
Risk
Survival Analysis
Testicular Neoplasms - pathology
Tumors
Title On the growth rates of human malignant tumors: Implications for medical decision making
URI https://api.istex.fr/ark:/67375/WNG-H6HVZTCS-G/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1002%2F%28SICI%291096-9098%28199708%2965%3A4%3C284%3A%3AAID-JSO11%3E3.0.CO%3B2-2
https://www.ncbi.nlm.nih.gov/pubmed/9274795
https://www.proquest.com/docview/79242572
Volume 65
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