Cancer is one of the most common diseases, with as many as 14 million new cases each year and accounting for over 8.8 million deaths around the globe. These notable figures are further aggravated by future projection of incidence and prevalence, wherein the total number of new cancer cases is predicted to increase by over 70% over the next 2 decades, paralleled by a similarly increasing number of deaths Notably, the total expenditure for cancer totaled approximates 125 billion US$ in 2010 in the United States, and is projected to increase to over 150 billion US$ in 2020. Lung cancer is the most frequent cause of death for cancer worldwide (1.69 million deaths), followed by hepatic malignancies (788,000 deaths), colorectal (774,000 deaths), gastric (754,000 deaths) and breast (571,000 deaths) cancers.
Like many other human chronic conditions, cancer is a clearly preventable disease. Notably, the World Cancer Research Fund has recently estimated that over 32% of cancer deaths can be avoided by ceasing cigarette smoke, whereas approximately 20% of all cancers may be prevented by reducing overweight, enhancing physical activity, limiting alcohol consumption, improving the nutritional status, but also reducing environmental or occupation exposure to carcinogenic substances. Irrespective of the unquestionable role of prevention in limiting the dramatic epidemiological burden of cancer, screening and early diagnosis are the cornerstones for establishing a timely therapeutic management, which may contribute to save many lives worldwide.
Unlike many other life-threatening diseases such as acute coronary syndrome and diabetes, laboratory diagnostics of cancer has been for long hamstrung. Despite many efforts have been made in the past decades, the armamentarium of in vitro diagnostics has remained considerably narrow in cancer, and mostly limited to the early diagnosis of specific malignancies, such as prostate cancer by means of prostate specific antigen (PSA) testing, or colorectal cancer with fecal occult blood (FOC) screening. Neither the use of traditional cancer biomarkers alone, nor their integration within cancer detection models by means of machine learning, were found to be clinically useful for screening occult cancers in the general population. Therefore, this approach must be firmly discouraged and additional strategies should be implemented. This special issue of Annals of Translational Medicine has hence been planned to provide an overview of current concepts and future perspectives in cancer diagnostics.
Myelofibrosis, either arising as a de novo condition or evolving from a previous polycythemia vera or essential thrombocythemia, is a chronic myeloproliferative disease characterized by a clonal expansion of hematopoietic progenitors. PKC epsilon has been earlier recognized as cancerogenic protein, which promotes cancer survival and invasiveness, but also playing a pivotal role in aberrant megakaryocytopoiesis in myelofibrosis. In an additional article of this special issue of Annals of Translational Medicine, Masselli et al. demonstrate that PKC epsilon is significantly over-expressed in myelofibrosis patients compared to healthy subjects. Moreover, the platelet expression of PKC epsilon was also found to be associated with high-risk disease and positive history of major cardiovascular events in patients with myelofibrosis, so highlighting the potential clinical usefulness of this protein as an index of disease aggressiveness and thrombotic risk in myelofibrosis.
Journal of Clinical chemistry and Laboratory Medicne