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Aim: Spermidine/spermine N 1 -acetyltransferase (SSAT-1) regulates cell growth, proliferation and death. Amantadine is converted by SSAT-1 to acetylamantadine (AA). In our earlier studies, although SSAT-1 was activated in patients with cancer, a number of ostensibly healthy adult volunteers had higher than expected AA concentration. This study was therefore undertaken to examine the outlier group., Materials & Methods: A follow up of urine analysis for AA by liquid chromatography-tandem mass spectrometry as well as clinical assessments and additional blood analyses were conducted., 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 premalignant 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., Competing Interests: Financial & competing interests disclosure RB Ahmed is the President and CEO and B Cheng is the acting CTO of BioMark Diagnostics Inc. A Maksymiuk, DS Sitar, H Bach, PS Tappia and B Ramjiawan are minor shareholders of BioMark Diagnostics Inc. This study was supported, in part, by BioMark Diagnostics Inc. (BC, Canada) and the Maunders-McNeil Foundation (AB, Canada). LC–MS/MS analysis was conducted by Biopharmaceutical Research Inc. (BC, Canada). Infrastructural support was provided by the St Boniface Hospital Foundation and the University of Manitoba. Part of this work was published in abstract form in the 2019 ASCO meeting proceedings (online): https://meetinglibrary.asco.org/record/177214/abstract The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.