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International Journal of Environmental... Apr 2017Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further,... (Review)
Review
Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is to provide a systematic review of current BC screening programmes in WHO European Region to identify possible patterns. Multiple correspondence analysis was performed to evaluate the association among: measures of occurrence; GNI level; type of BC screening programme; organization of public information and awareness campaigns regarding primary prevention of modifiable risk factors; type of BC screening services; year of screening institution; screening coverage and data quality. A key difference between High Income (HI) and Low and Middle Income (LMI) States, emerging from the present data, is that in the former screening programmes are well organized, with approved screening centres, the presence of mobile units to increase coverage, the offer of screening tests free of charge; the fairly high quality of occurrence data based on high-quality sources, and the adoption of accurate methods to estimate incidence and mortality. In conclusion, the governments of LMI countries should allocate sufficient resources to increase screening participation and they should improve the accuracy of incidence and mortality rates.
Topics: Breast Neoplasms; Early Detection of Cancer; Europe; Female; Humans; Income; Mass Screening
PubMed: 28441745
DOI: 10.3390/ijerph14040452 -
Gastrointestinal Endoscopy Clinics of... Jul 2020The National Colorectal Cancer Roundtable (NCCRT) is an organization of organizations with staffing, funding and leadership provided by the American Cancer Society (ACS)... (Review)
Review
The National Colorectal Cancer Roundtable (NCCRT) is an organization of organizations with staffing, funding and leadership provided by the American Cancer Society (ACS) and guidance and funding by the Centers for Disease Control and Prevention (CDC). In 2014, ACS, CDC, and the NCCRT launched the 80% by 2018 campaign. This highly successful initiative activated hundreds of organizations to prioritize colorectal cancer screening, disseminated smart, evidence-based interventions, and ultimately led to 9.3 million more Americans being up to date with screening compared with the precampaign rate. It's new campaign, 80% in Every Community, is designed to address persistent screening disparities.
Topics: American Cancer Society; Colorectal Neoplasms; Early Detection of Cancer; Goals; History, 20th Century; History, 21st Century; Humans; Mass Screening; United States
PubMed: 32439084
DOI: 10.1016/j.giec.2020.02.013 -
Nature Reviews. Cardiology Jun 2015Preparticipation screening for unsuspected cardiovascular disease is a controversial topic in the medical and lay communities. Much attention has been directed towards... (Review)
Review
Preparticipation screening for unsuspected cardiovascular disease is a controversial topic in the medical and lay communities. Much attention has been directed towards young competitive athletes, particularly the proposed strategy of incorporating 12-lead electrocardiograms into the screening process, even on a national or worldwide basis. However, sudden deaths of young athletes owing to genetic or congenital heart diseases have a low incidence in the general population. Furthermore, young people not engaged in competitive sports can harbour the same conditions that cause sudden death in athletes, which has gone largely unrecognized. Notably, sudden deaths from these diseases are numerically far more common in the much larger population of nonathletes. In this Perspectives article, we propose that an ethical dilemma has emerged, raising the important public-health issue of whether young individuals should be arbitrarily excluded from potentially life-saving clinical screening evaluations because they do not engage in competitive sports programmes.
Topics: Cardiovascular Diseases; Death, Sudden, Cardiac; Electrocardiography; Ethics, Medical; Humans; Mass Screening; Sports
PubMed: 25707388
DOI: 10.1038/nrcardio.2015.21 -
Cleveland Clinic Journal of Medicine Jul 2017Diagnostic algorithms for venous thromboembolism exist, but most do not provide detailed guidance as to which patients, if any, may benefit from screening for... (Review)
Review
Diagnostic algorithms for venous thromboembolism exist, but most do not provide detailed guidance as to which patients, if any, may benefit from screening for thrombophilia. This article provides an overview of the optimized diagnosis of venous thromboembolism, with a focus on the appropriate use of thrombophilia screening.
Topics: Algorithms; Humans; Mass Screening; Patient Selection; Quality Improvement; Thrombophilia; Venous Thromboembolism
PubMed: 28696195
DOI: 10.3949/ccjm.84a.16049 -
PloS One 2015Screening for type 2 diabetes (T2DM) and individuals at risk of diabetes has been advocated, yet information on the response rate and diagnostic yield of different... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Screening for type 2 diabetes (T2DM) and individuals at risk of diabetes has been advocated, yet information on the response rate and diagnostic yield of different screening strategies are lacking.
METHODS
Studies (from 1998 to March/2015) were identified through Medline, Embase and the Cochrane library and included if they used oral glucose tolerance test (OGTT) and WHO-1998 diagnostic criteria for screening in a community setting. Studies were one-step strategy if participants were invited directly for OGTT and two, three/four step if participants were screened at one or more levels prior to invitation to OGTT. The response rate and diagnostic yield were pooled using Bayesian random-effect meta-analyses.
FINDINGS
47 studies (422754 participants); 29 one-step, 11 two-step and seven three/four-step were identified. Pooled response rate (95% Credible Interval) for invitation to OGTT was 65.5% (53.7, 75.6), 63.1% (44.0, 76.8), and 85.4% (76.4, 93.3) in one, two and three/four-step studies respectively. T2DM yield was 6.6% (5.3, 7.8), 13.1% (4.3, 30.9) and 27.9% (8.6, 66.3) for one, two and three/four-step strategies respectively. The number needed to invite to the OGTT to detect one case of T2DM was 15, 7.6 and 3.6 in one, two, and three/four-step strategies. In two step strategies, there was no difference between the response or yield rates whether the first step was blood test or risk-score. There was evidence of substantial heterogeneity in rates across study populations but this was not explained by the method of invitation, study location (rural versus urban) and developmental index of the country in which the study was performed.
CONCLUSIONS
Irrespective of the invitation method, developmental status of the countries and or rural/urban location, using a multi-step strategy increases the initial response rate to the invitation to screening for diabetes and reduces the number needed to have the final diagnostic test (OGTT in this study) for a definite diagnosis.
Topics: Diabetes Mellitus, Type 2; Glucose Tolerance Test; Humans; Mass Screening; Risk Factors
PubMed: 26325182
DOI: 10.1371/journal.pone.0135702 -
PloS One 2022We sought to evaluate the yield, cost, feasibility, and acceptability of routine tuberculosis (TB) screening of pregnant women in Cotonou, Benin.
OBJECTIVES
We sought to evaluate the yield, cost, feasibility, and acceptability of routine tuberculosis (TB) screening of pregnant women in Cotonou, Benin.
DESIGN
Mixed-methods, cross-sectional study with a cost assessment.
SETTING
Eight participating health facilities in Cotonou, Benin.
PARTICIPANTS
Consecutive pregnant women presenting for antenatal care at any participating site who were not in labor or currently being treated for TB from April 2017 to April 2018.
INTERVENTIONS
Screening for the presence of TB symptoms by midwives and Xpert MTB/RIF for those with cough for at least two weeks. Semi-structured interviews with 14 midwives and 16 pregnant women about experiences with TB screening.
PRIMARY AND SECONDARY OUTCOME MEASURES
Proportion of pregnant women with cough of at least two weeks and/or microbiologically confirmed TB. The cost per pregnant woman screened and per TB case diagnosed in 2019 USD from the health system perspective.
RESULTS
Out of 4,070 pregnant women enrolled in the study, 94 (2.3%) had a cough for at least two weeks at the time of screening. The average (standard deviation) age of symptomatic women was 26 ± 5 years and 5 (5.3%) had HIV. Among the 94 symptomatic women, 2 (2.3%) had microbiologically confirmed TB for a TB prevalence of 49 per 100,000 (95% CI: 6 to 177 per 100,000) among pregnant women enrolled in the study. The average cost to screen one pregnant woman for TB was $1.12 USD and the cost per TB case diagnosed was $2271 USD. Thematic analysis suggested knowledge of TB complications in pregnancy was low, but that routine TB screening was acceptable to both midwives and pregnant women.
CONCLUSION
Enhanced screening for TB among pregnant women is feasible, acceptable, and inexpensive per woman screened, however in this setting has suboptimal yield even if it can contribute to enhance TB case finding.
Topics: Adolescent; Adult; Benin; Costs and Cost Analysis; Female; Humans; Mass Screening; Middle Aged; Pregnancy; Pregnancy Complications; Pregnant Women; Prevalence; Tuberculosis, Pulmonary
PubMed: 35192665
DOI: 10.1371/journal.pone.0264206 -
The Journal of Prevention of... 2020
Topics: Alzheimer Disease; Cognitive Dysfunction; Early Diagnosis; Humans; Mass Screening; Mental Status and Dementia Tests; Primary Health Care
PubMed: 32463065
DOI: 10.14283/jpad.2020.16 -
Infectious Disease Clinics of North... Sep 2019Profound changes in technology have revolutionized laboratory testing for human immunodeficiency virus (HIV) since the first laboratory enzyme immunoassays that detected... (Review)
Review
Profound changes in technology have revolutionized laboratory testing for human immunodeficiency virus (HIV) since the first laboratory enzyme immunoassays that detected only immunoglobulin G (IgG) antibodies. Instrumented fourth-generation random-access chemiluminescent assays are now recommended for initial screening because they become reactive in as little as 2 weeks after infection. Using HIV-1 RNA viral load assays after a reactive initial test could confirm infection and provide useful clinical information. Early initiation of antiretroviral therapy and use of preexposure prophylaxis can alter the evolution of biomarkers and assay reactivity, leading to ambiguous test results.
Topics: Diagnostic Tests, Routine; HIV Infections; Humans; Immunoassay; Mass Screening; Molecular Diagnostic Techniques
PubMed: 31239094
DOI: 10.1016/j.idc.2019.04.001 -
Journal of Gastrointestinal Cancer Mar 2021Colorectal cancer is one of the most sprayed cancers; the gold standard of diagnostic is a colonoscopy. The quality of this examination is depended on many factors,...
INTRODUCTION
Colorectal cancer is one of the most sprayed cancers; the gold standard of diagnostic is a colonoscopy. The quality of this examination is depended on many factors, which includes doctors' experience.
PURPOSE
The purpose of this study is to establish the main factors affecting the completeness of colonoscopy in colorectal cancer screening.
MATERIALS AND METHODS
Endoscopists were questioned; descriptive statistics methods and logistic regression were used.
RESULTS AND DISCUSSION
The main factors that influence the quality of screening colonoscopy were identified: experience in colonoscopy, theoretical training, participation in the screening program, and number of annual colonoscopies. The calculated odds ratio for the selected dependent variable is calculated.
CONCLUSIONS
The experience for more than 5 years (p = 0.017) and at least 200 colonoscopies per year (p = 0.004) are the main factors that allow to perform complete colonoscopy in 90% or more of cases.
Topics: Clinical Competence; Colonoscopy; Colorectal Neoplasms; Early Detection of Cancer; Humans; Mass Screening; Quality Improvement; Surgeons; Surveys and Questionnaires
PubMed: 32303997
DOI: 10.1007/s12029-020-00402-2 -
Journal of Gynecology Obstetrics and... May 2021In France, the coexistence of individual screening (IS) and organized screening (OS) for breast cancer induces difficulties for primary care practitioners to position... (Comparative Study)
Comparative Study
BACKGROUND
In France, the coexistence of individual screening (IS) and organized screening (OS) for breast cancer induces difficulties for primary care practitioners to position themselves. This study assessed whether the risk of having a mammography with a high risk of malignancy (BI-RADS 4 or 5) was different between patients aged from 50 to 74year performing it as part of an IS or of the OS.
METHOD
This cross-sectional multicenter study included women aged 50-74, with no personal history of breast cancer, performing mammography in radiology centers in Paris (France). The nature of the screening (OS or IS), breast cancer risk (high risk: BI-RADS 4 or 5), risk factors and clinical breast examination (CBE) abnormalities were collected. Patients in the IS and OS group were matched on age, breast density, history of benign lesions and family history of breast cancer using a propensity score. The association between the nature of screening and the risk of malignancy was evaluated by conditional logistic regression.
RESULTS
Among 2190 included patients, 77 % performed a mammography with the IS and had more CBE abnormalities (23 % vs 11 %, p<0,001), a history of benign lesion (15 % vs 11 %, p=0.01) and a family history of breast cancer (42 % vs 29 %, p<0,001). After matching 503 OS patients with 941 IS patients, the risk of malignancy and the nature of the screening were not associated (OR=0.72 [0.35-1.47], p=0.50).
CONCLUSION
The risk of malignancy was not different whether the mammography was performed as part of the OS or IS.
Topics: Aged; Analysis of Variance; Breast Diseases; Breast Neoplasms; Cross-Sectional Studies; Family Health; Female; Humans; Logistic Models; Mammography; Mass Screening; Matched-Pair Analysis; Middle Aged; Paris; Propensity Score; Risk
PubMed: 33007526
DOI: 10.1016/j.jogoh.2020.101926