br Results Conclusion ALU species and levels in serum
Results & Conclusion: ALU species 115 and 247 levels in serum were elevated in breast and prostate cancer patients compared to their counterpart healthy controls. DNA integrity was higher in prostate cancer patients than in the control, but in breast cancer patients was lower compared to
∗ Corresponding author at: Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle-Bu, Accra, Ghana.
E-mail addresses: [email protected], [email protected]
their controls. In prostate but not in breast cancers, DNA integrity increased with disease severity and higher staging.
Keywords Circulating cell-free DNA, DNA integrity, Breast cancer, Prostate cancer.
The incidence of cancer and its related mortality is on the rise and has become a major public health concern. Currently, it is the second leading cause of death globally and was re-sponsible for about 8.82 million deaths in, 2015 . The in-ternational Agency for Research on Cancers of the WHO in 2012 projected that by the year 2030, there would be approx-imately 21.7 million new cancer cases and 13 million can-cer deaths globally due to α-CEHC growth and increased life expectancy . Cancer incidence and mortality over the years have also seen a steady rise on the African continent with breast and prostate cancers among the leading causes of cancer deaths in females and males, respectively [1,3]. Breast cancer is the world’s commonest cancer in women, and simi-larly, the foremost cancer in women in Ghana with high mortal-ity rate [3,4]. WHO reported that about 2000 Ghanaian women were diagnosed with the disease in 2012 out of which 1000 (50%) died. Breast cancer has been identified as the second leading cause of cancer deaths in Ghana, with about 2900 cases being diagnosed annually and at least one of eight women with the disease dying . Prostate cancer is also, a leading cause of cancer-related death in men globally and particularly in Africa [5,6]. In 2012, there were 1094,916 inci-dent cases of prostate cancer with 307,481 deaths worldwide . In sub-Saharan Africa, the prevalence of prostate can-cer is gradually becoming a health burden particularly among men 70 years old and above . In Ghana, even though it remains the commonest cancer in men with high mortality, there is low awareness of the disease resulting in poor atti-tudes towards it with concomitant grave outcomes .
In light of these alarming trends, more pragmatic effort must be put in place to contain and manage cancers. A major challenge in Africa with cancer management, is late detec-tion, late report to hospitals and sometimes poorly resourced health facilities to manage the disease. Effective management of cancers results in higher survival rates in patients especially with early detection  necessitating vigorous research into new and effective ways of detecting the disease. These new ways of detection and/or outcome prediction should be rela-tively less expensive, easy to carry out, reliable and univer-sally acceptable. Furthermore, it provides an opportunity for non-invasive sampling of tumour/tissue DNA.
Circulating cell-free DNA (ccfDNA) are degraded DNA fragments released into the blood stream [11–13]. Chronicling its discovery, Iqbal et al.  states that, circulating cell-free DNA (cfDNA) in human plasma was rediscovered in 1966 by Tan et al.  in autoimmune disorders and later by Leon et al.  in 1977 in cancers after its initial discovery in 1948 by Mandel and Metais . The source of ccfDNA in healthy indi-viduals is solely by apoptosis, producing evenly sized shorter DNA fragments. In cancer patients however, necrosis pro-duces uneven longer DNA fragments in addition to the shorter fragments from apoptosis. [12,18,19]. Therefore, elevated lev-els of longer fragments of DNA in the blood stream has been targeted as a good marker for the presence of malignant tu-mour DNA [18–20]. The levels of ccfDNA in blood serum are
higher in cancer patients compared with healthy individuals [21–24]. Consequently, DNA integrity, the ratio of longer to shorter fragments has been explored for its usefulness in di-agnosis and prognosis of cancers. It has been suggested to be increased in cancer patients and particularly in metastatic cases than in non-metastatic cases. It has been found to pre-dict tumour progression, and regional lymph node metastases in primary breast cancer patients [19,24,25].
The use of DNA, within the cell or in circulation, as a biomarker in clinical medicine for early diagnosis, prognosis and monitoring of therapy has been a significant advance-ment in the biomedical field (12,13,26, 27). Circulating DNA as a biomarker will be easily accessible and cost effective, overcoming infrastructural limitations that face many develop-ing countries. In this study, ccfDNA levels and DNA integrity were assessed in blood sera of breast and prostate can-cer patients and compared against that of apparently healthy individuals.