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Current Oncology (Toronto, Ont.) Jun 2018Although screening mammography has delivered many benefits since its introduction in Canada in 1988, questions about perceived harms warrant an up-to-date review. To... (Review)
Review
Although screening mammography has delivered many benefits since its introduction in Canada in 1988, questions about perceived harms warrant an up-to-date review. To help oncologists and physicians provide optimal patient recommendations, the literature was reviewed to find the latest guidelines for screening mammography, including benefits and perceived harms of overdiagnosis, false positives, false negatives, and technologic advances. For women 40-74 years of age who actually participate in screening every 1-2 years, breast cancer mortality is reduced by 40%. With appropriate corrections, overdiagnosis accounts for 10% or fewer breast cancers. False positives occur in about 10% of screened women, 80% of which are resolved with additional imaging, and 10%, with breast biopsy. An important limitation of screening is the false negatives (15%-20%). The technologic advances of digital breast tomosynthesis, breast ultrasonography, and magnetic resonance imaging counter the false negatives of screening mammography, particularly in women with dense breast tissue.
Topics: Biopsy; Breast Neoplasms; Early Detection of Cancer; False Positive Reactions; Female; History, 21st Century; Humans; Magnetic Resonance Imaging; Mammography; Mass Screening; Medical Oncology; Ultrasonography, Mammary
PubMed: 29910654
DOI: 10.3747/co.25.3770 -
The Surgical Clinics of North America Oct 2015Cancer screening has long been an important component of the struggle to reduce the burden of morbidity and mortality from cancer. Notwithstanding this history, many... (Review)
Review
Cancer screening has long been an important component of the struggle to reduce the burden of morbidity and mortality from cancer. Notwithstanding this history, many aspects of cancer screening remain poorly understood. This article presents a summary of basic principles of cancer screening that are relevant for researchers, clinicians, and public health officials alike.
Topics: Canada; Cost-Benefit Analysis; Early Detection of Cancer; False Positive Reactions; Humans; Mass Screening; Neoplasms; Practice Guidelines as Topic; Predictive Value of Tests; Risk Assessment; Sensitivity and Specificity; United States
PubMed: 26315516
DOI: 10.1016/j.suc.2015.05.009 -
The British Journal of Radiology Oct 2018Health screening can only be applied to populations, not individuals. For it to be effective, the initial screening test must be acceptable and reasonably accurate, the...
Health screening can only be applied to populations, not individuals. For it to be effective, the initial screening test must be acceptable and reasonably accurate, the disease must be treatable with better outcomes when treated early and the harm and cost associated with screening must not outweigh its benefits. Robust evidence is therefore required before systematic screening is implemented. Surveillance implies the testing of people at high risk of disease and is therefore distinct from screening in both scale (smaller) and intensity (greater). In both cases, however, clear information must be provided to potential participants so that they can weigh up the balance of benefit and harm before deciding on whether or not to engage in the process.
Topics: Adult; Cost-Benefit Analysis; Humans; Mass Screening
PubMed: 29589964
DOI: 10.1259/bjr.20180200 -
Journal of Internal Medicine Apr 2021
Topics: Humans; Mass Screening
PubMed: 33340170
DOI: 10.1111/joim.13216 -
Tidsskrift For Den Norske Laegeforening... Jan 2017
Topics: False Positive Reactions; Female; Humans; Mammography; Mass Screening
PubMed: 28127062
DOI: 10.4045/tidsskr.17.0051 -
Health Informatics Journal Dec 2019Autism spectrum disorder is associated with significant healthcare costs, and early diagnosis can substantially reduce these. Unfortunately, waiting times for an autism... (Review)
Review
Autism spectrum disorder is associated with significant healthcare costs, and early diagnosis can substantially reduce these. Unfortunately, waiting times for an autism spectrum disorder diagnosis are lengthy due to the fact that current diagnostic procedures are time-consuming and not cost-effective. Overall, the economic impact of autism and the increase in the number of autism spectrum disorder cases across the world reveal an urgent need for the development of easily implemented and effective screening methods. This article proposes a new mobile application to overcome the problem by offering users and the health community a friendly, time-efficient and accessible mobile-based autism spectrum disorder screening tool called ASDTests. The proposed ASDTests app can be used by health professionals to assist their practice or to inform individuals whether they should pursue formal clinical diagnosis. Unlike existing autism screening apps being tested, the proposed app covers a larger audience since it contains four different tests, one each for toddlers, children, adolescents and adults as well as being available in 11 different languages. More importantly, the proposed app is a vital tool for data collection related to autism spectrum disorder for toddlers, children, adolescent and adults since initially over 1400 instances of cases and controls have been collected. Feature and predictive analyses demonstrate small groups of autistic traits improving the efficiency and accuracy of screening processes. In addition, classifiers derived using machine learning algorithms report promising results with respect to sensitivity, specificity and accuracy rates.
Topics: Autistic Disorder; Early Diagnosis; Humans; Machine Learning; Mass Screening; Mobile Applications
PubMed: 30230414
DOI: 10.1177/1460458218796636 -
World Journal of Gastroenterology Aug 2019Since its original application, gastrointestinal (GI) endoscopy has undergone many innovative transformations aimed at expanding the scope, safety, accuracy,... (Review)
Review
Since its original application, gastrointestinal (GI) endoscopy has undergone many innovative transformations aimed at expanding the scope, safety, accuracy, acceptability and cost-effectiveness of this area of clinical practice. One method of achieving this has been to reduce the caliber of endoscopic devices. We propose the collective term "Miniature GI Endoscopy". In this Opinion Review, the innovations in this field are explored and discussed. The progress and clinical use of the three main areas of miniature GI endoscopy (ultrathin endoscopy, wireless endoscopy and scanning fiber endoscopy) are described. The opportunities presented by these technologies are set out in a clinical context, as are their current limitations. Many of the positive aspects of miniature endoscopy are clear, in that smaller devices provide access to potentially all of the alimentary canal, while conferring high patient acceptability. This must be balanced with the costs of new technologies and recognition of device specific challenges. Perspectives on future application are also considered and the efforts being made to bring new innovations to a clinical platform are outlined. Current devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms, therapeutic intervention and screening. Newer technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant.
Topics: Biomedical Technology; Endoscopy, Gastrointestinal; Equipment Design; Gastrointestinal Diseases; Humans; Inventions; Mass Screening; Miniaturization
PubMed: 31435163
DOI: 10.3748/wjg.v25.i30.4051 -
American Family Physician Mar 2001Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer... (Review)
Review
Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer.
Topics: Adolescent; Adult; Aged; Female; Guidelines as Topic; Humans; Insurance Coverage; Male; Mass Screening; Medicare; Middle Aged; Neoplasms; Patient Selection; United States
PubMed: 11277547
DOI: No ID Found -
The Journal of Molecular Diagnostics :... May 2020Testing asymptomatic individuals for unsuspected conditions is not new to the medical and public health communities. Protocols to develop screening tests are well... (Review)
Review
Testing asymptomatic individuals for unsuspected conditions is not new to the medical and public health communities. Protocols to develop screening tests are well established. However, the application of screening principles to inherited diseases presents unique challenges. Unlike most screening tests, the natural history and disease prevalence of most rare inherited diseases in an unselected population are unknown. It is difficult or impossible to obtain a truth set cohort for clinical validation studies. As a result, it is not possible to accurately calculate clinical positive and negative predictive values for likely pathogenic variants, which are commonly returned in genetic screening assays. In addition, many of the genetic conditions included in screening panels do not have clinical confirmatory tests. All these elements are typically required to justify the development of a screening test, according to the World Health Organization screening principles. Nevertheless, as the cost of DNA sequencing continues to fall, more individuals are opting to undergo genomic testing in the absence of a clinical indication. Despite the challenges, reasonable estimates can be deduced and used to inform test design strategies. Herein, we review basic test design principles and apply them to genetic screening.
Topics: Genetic Association Studies; Genetic Diseases, Inborn; Genetic Predisposition to Disease; Genetic Testing; Genetic Variation; Humans; Mass Screening; Research Design
PubMed: 32092541
DOI: 10.1016/j.jmoldx.2020.01.014 -
Digestive Diseases and Sciences Mar 2015
Topics: Colorectal Neoplasms; Healthcare Disparities; Humans; Mass Screening
PubMed: 25724168
DOI: 10.1007/s10620-015-3603-2