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  • br In summary we provide evidence


    In summary, we provide evidence of the inhibitory effect of aspirin on the stemness of human lung cancer 1898-66-4 and demonstrate that as-pirin impedes the exosome secretion and malignant paracrine effect of these cells.
    Fig. 7. Synergistic effect of aspirin and cisplatin on lung cancer cells. (A) Apoptosis of A549 cells was quantitatively measured by FACS after 24 h hypoxic culture.
    Data are representative images of 3 independent experiments. (B) Quantitative analysis of cell apoptotic analysis. Each bar is a mean ± SD of n = 3 experiments. (C)
    This work was supported by the Basic Research Project of Science and Technology Plan of Shenzhen (JCYJ20160422144516003).
    Conflict of Interest
    The authors have no conflicts of interest to declare.
    Appendix A. Supplementary data
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    Available online at
    Economic Evaluation
    Assessing the Cost-Effectiveness of Updated Breast Cancer Screening Guidelines for Average-Risk Women
    1Section of Cancer Economics and Policy, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 2Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
    Background: Several specialty societies have recently updated their breast cancer screening guidelines in late 2015/early 2016. Objectives: To evaluate the cost-effectiveness of US-based mammography screening guidelines. Methods: We developed a microsimulation model to generate the natural history of invasive breast cancer and capture how screening and treatment modified the natural course of the disease. We used the model to assess the cost-effectiveness of screening strategies, including annual screening starting at the age of 40 years, biennial screening starting at the age of 50 years, and a hybrid strategy that begins screening at the age of 45 years and transitions to biennial screening at the age of 55 years, combined with three cessation ages: 75 years, 80 years, and no upper age limit. Findings were summarized as incremental cost-effectiveness ratio (cost per quality-adjusted life-year [QALY]) and cost-effectiveness acceptability frontier. Results: The screening strategy that starts annual mammography at the age of 45 years and switches to biennial screening between the ages of 55 and 75 years was the most cost-
    effective, yielding an incremental cost-effectiveness ratio of $40,135/ QALY. Probabilistic analysis showed that the hybrid strategy had the highest probability of being optimal when the societal willingness to pay was between $44,000/QALY and $103,500/QALY. Within the range of commonly accepted societal willingness to pay, no optimal strategy involved screening with a cessation age of 80 years or older. Conclu-sions: The screening strategy built on a hybrid design is the most cost-effective for average-risk women. By considering the balance between benefits and harms in forming its recommendations, this hybrid screening strategy has the potential to optimize the health care sys-tem’s investment in the early detection and treatment of breast cancer.
    Keywords: breast cancer screening guidelines, cost-effectiveness analysis, microsimulation models, screening mammography
    Copyright © 2019, ISPOReThe Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc.
    Breast cancer is the most frequently diagnosed cancer in women and the second leading cause of cancer deaths for women in the United States [1]. The estimated number of incident cases of fe-male breast cancer in the United States for 2018 is 266,120, and it was estimated that 40,920 women in the United States would die of breast cancer in 2018 [1]. The benefit of screening mammog-raphy in cancer control has been established in clinical trials and observational and modeling studies. A systematic review pub-lished in 2015 concluded that screening mammography was associated with an approximately 20% reduction in breast cancer mortality among women at an average risk of developing breast cancer [2]. Nevertheless, growing awareness of the range of harms associated with breast cancer screening (e.g., false positives and overdiagnosis) [3] has raised interests and questions over what constitutes an optimal screening strategy that balances the harms and benefits of breast cancer screening at the population level.