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Polski Przeglad Chirurgiczny Feb 2020Colorectal cancer (CRC) is the third most common malignancy in men and the second most common in women. The disease constitutes a significant civilization and social...
INTRODUCTION
Colorectal cancer (CRC) is the third most common malignancy in men and the second most common in women. The disease constitutes a significant civilization and social problem.
THE AIM
The aim of the study is to assess the sudy group's awareness and knowledge about CRC, as well as about its diagnostics and treatment.
MATERIAL AND METHODS
An online questionaire form was distributed in the study group regarding issues related to CRC, and followed by statistical analysis and interpretation of the obtained survey results.
RESULTS
After analysis, we found that a significant percentage of the surveyed sample group had basic knowledge and awareness in the area of CRC, whereas about half of the respondents did not consider themselves sufficiently informed about the disease.
CONCLUSIONS
Considering the scale of the problem posed by CRC, it is necessary to undertake broader action to promote knowledge about this disease and to carry out this type of research on a larger and more socioeconomically diverse population.
Topics: Adult; Aged; Awareness; Colorectal Neoplasms; Early Detection of Cancer; Educational Status; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Mass Screening; Middle Aged; Surveys and Questionnaires
PubMed: 32312915
DOI: 10.5604/01.3001.0013.8160 -
Dysphagia Feb 2020Dysphagia is a very common symptom in people of advanced age and with neurological diseases, although it often remains undiagnosed. At present, there are few assessment...
Dysphagia is a very common symptom in people of advanced age and with neurological diseases, although it often remains undiagnosed. At present, there are few assessment tools adapted for the Spanish-speaking population; of the few existing, most of them follow a self-reporting format, which requires a well-preserved cognitive state in the patient in order to be tested. Therefore, the main aim of this study was to design and validate an instrument for screening dysphagia without food, which could have a quick application and did not compromise the patient's safety. A secondary aim was to study the test's ability to examine this symptom in people with cognitive disorders. The study was carried out with 206 participants divided into three groups: people with dysphagia and with preserved cognitive abilities, people with dysphagia and with altered cognitive abilities, and people without dysphagia and with preserved cognitive skills (control group). Participants were assessed with the designed Oropharyngeal Dysphagia Screening Test for Patients and Professionals and other dysphagia tests. The results revealed appropriate psychometric features: reliability and validity both for screening dysphagia directly with the patients or if the tester is the professional caregiver responsible for feeding (in cases of altered cognitive abilities). As conclusion, the Oropharyngeal Dysphagia Screening Test for Patients and Professionals is an instrument of easy use and of short duration that has shown adequate results of reliability and validity, thus being useful for the screening of dysphagia in Spanish-speaking populations.
Topics: Aged; Aged, 80 and over; Cognitive Dysfunction; Deglutition Disorders; Female; Humans; Language; Male; Mass Screening; Nervous System Diseases; Psychometrics; Reproducibility of Results; Symptom Assessment
PubMed: 30887116
DOI: 10.1007/s00455-019-09999-4 -
Dermatology (Basel, Switzerland) 2024Current infectious disease screening recommendations for hidradenitis suppurativa (HS) are adopted from recommendations in chronic plaque psoriasis. No HS-specific...
Infectious Disease Screening prior to Systemic Immunomodulatory Therapy in Hidradenitis Suppurativa: Consensus Guidelines from the Asia-Pacific Hidradenitis Suppurativa Foundation.
BACKGROUND
Current infectious disease screening recommendations for hidradenitis suppurativa (HS) are adopted from recommendations in chronic plaque psoriasis. No HS-specific guidelines for infectious disease screening prior to immunomodulatory therapy have been developed.
OBJECTIVES
The aim of the study was to establish an expert Delphi consensus of recommendations regarding infectious disease screening prior to systemic immunomodulatory therapy in HS.
METHODS
Participants were identified via recent publications in the field and were sent a questionnaire regarding infectious diseases encountered in the setting of HS, and opinions regarding infectious disease screening prior to various systemic immunomodulatory therapies. All questions were informed by a systematic literature review regarding infections exacerbated or precipitated by immunomodulatory therapy. Questionnaire responses were followed by round-table discussion with a core group of 8 experts followed by a final round of questionnaires resulting in achievement of consensus.
RESULTS
44 expert HS physicians from 12 countries on 5 continents participated in the development of the expert consensus recommendations. Consensus recommendations include screening for hepatitis B, hepatitis C and tuberculosis in all individuals with HS prior to therapy. All immunomodulatory therapies (biologic and systemic immunosuppressant therapy) should be preceded by infectious disease screening including patient and location-specific considerations for endemic local diseases and high-risk activities and occupations. Clinical assessment has a significant role in determining the need for laboratory screening in the setting of many uncommon or tropical diseases such as leprosy, leishmaniasis and strongyloidiasis.
CONCLUSIONS
The presented consensus recommendations are the first specifically developed for pre-treatment infectious disease screening in HS.
Topics: Humans; Hidradenitis Suppurativa; Consensus; Delphi Technique; Mass Screening; Immunosuppressive Agents; Communicable Diseases; Immunomodulating Agents
PubMed: 37963431
DOI: 10.1159/000534575 -
The International Journal of Pharmacy... Oct 2020Improving the identification of depression in adults in primary care can produce clinical and economic benefits. Community Pharmacists may play a role in screening for...
BACKGROUND
Improving the identification of depression in adults in primary care can produce clinical and economic benefits. Community Pharmacists may play a role in screening for depression.
OBJECTIVE
To systematically review and evaluate the evidence for the feasibility, impact and cost-effectiveness of community pharmacists screening adults for depression.
METHODS
An electronic literature search using the databases EMBASE, PubMed and CINAHL Complete from January 2000 to September 2019 was undertaken to identify studies involving community pharmacists screening for depression. Data relating to sample size, population demographics and medical conditions of adults screened were extracted. Details around the screening model, process-related outcomes, clinical outcomes and economic outcomes were also extracted.
RESULTS
Ten studies using eight unique depression screening tools were identified. Ease of administration was the most common selection criterion (n = 4) while no reason was given in four studies. Seven studies reported that through screening, pharmacists could identify adults with undiagnosed depression. Pharmacists referred adults screening positive for assessment in seven studies and followed up participants in two studies. No study assessed the impact of screening on depressive symptoms or the cost-effectiveness of pharmacists screening for depression.
CONCLUSION
Community pharmacists are able to use depression screening tools to identify undiagnosed adults having symptoms of depression. However, there is little evidence around the impact of this screening on clinical and economic outcomes. Larger, well-designed studies that use a highly accurate, easily administered screening tool and include patient referral and follow-up and pharmacist training are warranted to provide evidence on the impact of community pharmacists screening adults for depression.
Topics: Community Pharmacy Services; Cost-Benefit Analysis; Depression; Feasibility Studies; Humans; Mass Screening; Pharmacists; Professional Role; Referral and Consultation
PubMed: 32776433
DOI: 10.1111/ijpp.12661 -
Value in Health : the Journal of the... Apr 2020To measure Australian population preferences for lung cancer screening and to explore whether these preferences are related to respondent characteristics and lung cancer...
OBJECTIVES
To measure Australian population preferences for lung cancer screening and to explore whether these preferences are related to respondent characteristics and lung cancer risk.
METHODS
An online ranking task was administered to a sample of 521 Australians between the ages of 50 and 80 with a history of cigarette smoking. Choice sets contained 2 alternative lungs screens and an opt-out, and respondents were asked to rank the 3 options. Both conditional logit and mixed logit analyses were conducted exploring both the forced choice between the 2 screens and identifying the types of respondent most likely to opt out of any screening. For this, respondent 6-year lung cancer risk was estimated and used as a covariate.
RESULTS
Respondents valued tests that involved breath or blood tests in addition to computerized tomography (CT), locations that were close to home, receiving results quickly, and minimizing radiation from the CT scan. Willingness to pay differed between relatively higher and lower risk individuals; higher risk individuals placed greater emphasis on convenience, result timeliness, and radiation. Respondent characteristics that predicted opting out of any screening included being male, fewer years of smoking, and not having a previous cancer diagnosis. Lung cancer risk did not influence the likelihood of opting out.
CONCLUSIONS
Uptake of lung cancer screening is likely to be changeable if different modalities of screening are provided, with effects likely differing across population subgroups.
Topics: Aged; Aged, 80 and over; Attitude to Health; Australia; Choice Behavior; Cigarette Smoking; Early Detection of Cancer; Female; Humans; Lung Neoplasms; Male; Mass Screening; Middle Aged; Patient Preference; Public Opinion; Risk; Sex Factors; Smokers
PubMed: 32327167
DOI: 10.1016/j.jval.2019.11.006 -
The American Journal of Gastroenterology Mar 2023Age is the strongest risk factor for colorectal cancer. Although there is updated guidance for the age at which to start screening, there is little guidance for...
Age is the strongest risk factor for colorectal cancer. Although there is updated guidance for the age at which to start screening, there is little guidance for individuals or their medical teams on how to decide when to stop. Current recommendations from the US Preventive Services Task Force and other societies focus primarily on age. For patients older than 85 years, guidelines discourage screening because the harms largely outweigh benefits. Although at a population level, the overall benefit of screening in older individuals decreases, one must individualize the recommendation based on comorbidities, functional status, screening history, and gender-not solely base it on age. Patient and caregiver preferences must also be thoroughly explored. Current models struggle with incorporating other colorectal cancer risk factors such as family history, previous adenomas, and modality of previous screening into recommendations and simulations, but are likely to improve with machine learning and whole electronic health record prediction-based approaches.
Topics: Aged; Humans; Age Factors; Colonic Neoplasms; Comorbidity; Early Detection of Cancer; Mass Screening; Risk Factors
PubMed: 36695761
DOI: 10.14309/ajg.0000000000002174 -
CMAJ : Canadian Medical Association... Nov 2021Active screening for tuberculosis (TB) involves systematic detection of previously undiagnosed TB disease or latent TB infection (LTBI). It may be an important step...
BACKGROUND
Active screening for tuberculosis (TB) involves systematic detection of previously undiagnosed TB disease or latent TB infection (LTBI). It may be an important step toward elimination of TB among Inuit in Canada. We aimed to evaluate the cost-effectiveness of community-wide active screening for TB infection and disease in 2 Inuit communities in Nunavik.
METHODS
We incorporated screening data from the 2 communities into a decision analysis model. We predicted TB-related health outcomes over a 20-year time frame, beginning in 2019. We assessed the cost-effectiveness of active screening in the presence of varying outbreak frequency and intensity. We also considered scenarios involving variation in timing, impact and uptake of screening programs.
RESULTS
Given a single large outbreak in 2019, we estimated that 1 round of active screening reduced TB disease by 13% (95% uncertainty range -3% to 27%) and was cost saving compared with no screening, over 20 years. In the presence of simulated large outbreaks every 3 years thereafter, a single round of active screening was cost saving, as was biennial active screening. Compared with a single round, we also determined that biennial active screening reduced TB disease by 59% (95% uncertainty range 52% to 63%) and was estimated to cost Can$6430 (95% uncertainty range -$29 131 to $13 658 in 2019 Can$) per additional active TB case prevented. With smaller outbreaks or improved rates of treatment initiation and completion for people with LTBI, we determined that biennial active screening remained reasonably cost-effective compared with no active screening.
INTERPRETATION
Active screening is a potentially cost-saving approach to reducing disease burden in Inuit communities that have frequent TB outbreaks.
Topics: Antitubercular Agents; Cost of Illness; Cost-Benefit Analysis; Decision Trees; Disease Outbreaks; Health Care Costs; Health Services, Indigenous; Humans; Incidence; Inuit; Mass Screening; Quebec; Tuberculosis
PubMed: 34725112
DOI: 10.1503/cmaj.210447 -
Journal of Primary Care & Community... 2023Social determinants of health (SDoH) influence health outcomes and screening for health-related social needs (HRSN) is a recommended pediatric practice. In 2018, Denver...
INTRODUCTION
Social determinants of health (SDoH) influence health outcomes and screening for health-related social needs (HRSN) is a recommended pediatric practice. In 2018, Denver Health and Hospitals (DH) implemented the Accountable Health Communities (AHC) model under the Centers for Medicare and Medicaid Services (CMS) and began using the AHC HRSN screening tool during selected well child visits (WCVs) at a DH Federally Qualified Health Center (FQHC). The current evaluation aimed to examine the program implementation and identify key lessons learned to inform the expansion of HRSN screening and referral to other populations and health systems.
METHODS
Patients who completed a WCV between June 1, 2020 and December 31, 2021 (N = 13 750) were evaluated. Frequencies and proportions were used to describe patient characteristics of those that had a WCV, were screened, and received resource information. Multivariable logistic regression models with odds ratios (OR) and 95% confidence intervals (CI) were used to determine the association between patient characteristics and completing HRSN screening and provision of resource information.
RESULTS
The screening tool was completed by 80% (n = 11 004) of caregivers bringing children to a WCV at the DH Westside Clinic, with over one-third (34.8%; n = 3830) reporting >1 social need. Food insecurity was the most common concern (22.3%; n = 2458). Non-English, non-Spanish (NENS) speakers were less likely to be screened (OR 0.43, 95% CI 0.33, 0.57) and less likely to report a social need (OR 0.59, 95% CI 0.42, 0.82) than speakers of English, after adjusting for age, race/ethnicity, and health insurance.
CONCLUSIONS
A high rate of screening indicates feasibility of administering HRSN screenings for pediatric patients in a busy FQHC. More than a third of patients reported one or more social needs, underscoring the importance to identity these needs and the opportunity to offer personalized resources. Comparatively lower rates of screening and potential underreporting among NENS may be indicative of the availability and acceptability of current translation procedures as well as how the tool translates linguistically and culturally. Our experience highlights the need to partner with community organizations and involve patients and families to ensure SDoH screening and care navigation is part of culturally-appropriate patient-centered care.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Young Adult; Child Health Services; Colorado; Community Health Centers; Mass Screening; Needs Assessment; Social Determinants of Health
PubMed: 37148221
DOI: 10.1177/21501319231171519 -
Value in Health : the Journal of the... Sep 2020Low uptake of cancer screening services is a global concern. Our aim was to understand factors that influence the screening decision, including screening and treatment... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Low uptake of cancer screening services is a global concern. Our aim was to understand factors that influence the screening decision, including screening and treatment subsidies and a gain-frame message designed to present screening as a win-win.
METHODS
We analyzed preferences for mammography and Pap smear among women in Singapore by means of discrete choice experiments while randomly exposing half of respondents to a gain-framed public health message promoting the benefits of screening.
RESULTS
Results showed that the message did not influence stated uptake, and given the levels shown, respondents were influenced more by treatment attributes, including effectiveness and out-of-pocket cost should they test positive, than by screening attributes, including the offer of a monetary incentive for screening. Respondents also underestimated the survival chances of screen-detected breast and cervical cancers.
CONCLUSIONS
Combined, these findings suggest that correcting misconceptions about screen-detected cancer prognosis or providing greater financial protection for those who test positive could be more effective and more cost-effective than subsidizing screening directly in increasing screening uptakes.
Topics: Adult; Breast Neoplasms; Choice Behavior; Early Detection of Cancer; Female; Health Knowledge, Attitudes, Practice; Health Services Needs and Demand; Humans; Mammography; Mass Screening; Middle Aged; Papanicolaou Test; Singapore; Surveys and Questionnaires; Uterine Cervical Neoplasms
PubMed: 32940243
DOI: 10.1016/j.jval.2020.06.004 -
AJR. American Journal of Roentgenology May 2022
Topics: Humans; Magnetic Resonance Imaging; Mass Screening; Mutation
PubMed: 34985317
DOI: 10.2214/AJR.21.27260