Predictive value and clinical significance of increased SSAT-1 activity in healthy adults: graphical abstract TappiaParamjit S MaksymiukAndrew W SitarDaniel S AkhtarParveen S KhatunNazrina ParveenRahnuma AhmedRashiduzzaman AhmedRashid Bux ChengBrian HuangGina BachHoracio HiebertBrett RamjiawanBram 2019 Graphical Abstract. <div>Aim: Spermidine/spermine N1-acetyltransferase (SSAT-1) regulates cell growth, proliferation and death. Amantadine is converted by SSAT-1 to acetylamantadine (AA). Although SSAT-1 is activated in patients with cancer, a number of ostensibly healthy adult volunteers had higher than expected AA concentration. This study was undertaken to examine the outlier group. Results: In some of the outlier controls, higher than expected AA concentration was linked to increased serum carcinoembryonic antigen. Clinical and radiographic assessments revealed underlying abnormalities in other cases that could represent pre-malignant conditions. Hematology tests revealed elevations in white blood cells and platelets which are markers of inflammation. Conclusion: High urine concentration of AA could be used as a simple and useful test for screening of cancer in high risk populations. <div> </div></div>