Science.gov

Sample records for cancer screening project

  1. Colon cancer screening

    MedlinePLUS

    Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening ... Colon cancer screening can detect polyps and early cancers in the intestines. This type of screening can find ...

  2. Stomach (Gastric) Cancer Screening

    MedlinePLUS

    ... Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Screening–Patient Version (PDQ®) What is screening? Screening ... are called diagnostic tests . General Information About Stomach (Gastric) Cancer Key Points Stomach cancer is a disease in ...

  3. Screening for cancer

    SciTech Connect

    Miller, A.B.

    1985-01-01

    This book contains three sections: Fundamentals of Screening, Screening Tests, and Screening for Specific Cancer Sites. Each section consists of several chapters. Some of the chapter titles are: Principles of Screening and of the Evaluation of Screening Programs; Economic Aspects of Screening; Cervical Cytology; Screening Tests for Bladder Cancer; Fecal Occult Blood Testing; Screening for Cancer of the Cervix; Screening for Gastric Cancer; and Screening for Oral Cancer.

  4. [Screening for breast cancer].

    PubMed

    Hessler, C

    1988-01-01

    On the "why", "whom" and "how" of breast screening for carcinoma, the following answers can be provided: Why? As there is no primary prevention, secondary prevention by early diagnosis is the only way to reduce breast cancer mortality. On the other hand, breast cancers discovered by screening can be conservatively treated more often than when they become symptomatic; this is especially important in young patients. For whom? Every woman over the age of 35-40 should be accepted for breast cancer screening. In countries such as Switzerland it is unthinkable to impose screening or even to send personal invitations for screening to the population. Only repeated information through newspapers, TV and conferences will induce women to come for screening. The costs would be paid for by the patient, as medical insurances do not cover this type of preventive medicine. How? Only screening through mammography with or without breast palpation, performed by paramedical personnel, can be considered, because of the cost. It should be done outside the senologic consultation setup for symptomatic patients where a doctor is in charge of the clinical consultation. As Doctor Van der Linde said at the end of his talk at the last Convention of the Swiss Senology Society in Lausanne, pilot projects for breast screening in Switzerland should be started. The Swiss Cancer Society has lately created a commission for early detection of breast cancer to study ways of launching a project. PMID:3165216

  5. Using Radiation Risk Models in Cancer Screening Simulations: Important Assumptions and Effects on Outcome Projections

    PubMed Central

    Lee, Janie M.; McMahon, Pamela M.; Lowry, Kathryn P.; Omer, Zehra B.; Eisenberg, Jonathan D.; Pandharipande, Pari V.; Gazelle, G. Scott

    2012-01-01

    Purpose: To evaluate the effect of incorporating radiation risk into microsimulation (first-order Monte Carlo) models for breast and lung cancer screening to illustrate effects of including radiation risk on patient outcome projections. Materials and Methods: All data used in this study were derived from publicly available or deidentified human subject data. Institutional review board approval was not required. The challenges of incorporating radiation risk into simulation models are illustrated with two cancer screening models (Breast Cancer Model and Lung Cancer Policy Model) adapted to include radiation exposure effects from mammography and chest computed tomography (CT), respectively. The primary outcome projected by the breast model was life expectancy (LE) for BRCA1 mutation carriers. Digital mammographic screening beginning at ages 25, 30, 35, and 40 years was evaluated in the context of screenings with false-positive results and radiation exposure effects. The primary outcome of the lung model was lung cancerspecific mortality reduction due to annual screening, comparing two diagnostic CT protocols for lung nodule evaluation. The Metropolis-Hastings algorithm was used to estimate the mean values of the results with 95% uncertainty intervals (UIs). Results: Without radiation exposure effects, the breast model indicated that annual digital mammography starting at age 25 years maximized LE (72.03 years; 95% UI: 72.01 years, 72.05 years) and had the highest number of screenings with false-positive results (2.0 per woman). When radiation effects were included, annual digital mammography beginning at age 30 years maximized LE (71.90 years; 95% UI: 71.87 years, 71.94 years) with a lower number of screenings with false-positive results (1.4 per woman). For annual chest CT screening of 50-year-old females with no follow-up for nodules smaller than 4 mm in diameter, the lung model predicted lung cancerspecific mortality reduction of 21.50% (95% UI: 20.90%, 22.10%) without radiation risk and 17.75% (95% UI: 16.97%, 18.41%) with radiation risk. Conclusion: Because including radiation exposure risk can influence long-term projections from simulation models, it is important to include these risks when conducting modeling-based assessments of diagnostic imaging. RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110352/-/DC1 PMID:22357897

  6. Breast Cancer Screening Methods

    MedlinePLUS Videos and Cool Tools

    ... medlineplus/videos/news/Screening_Methods_123015.html Breast Cancer Screening Methods HealthDay News Video - December 31, 2015 ... this page, please enable JavaScript. Play video: Breast Cancer Screening Methods For closed captioning, click the CC ...

  7. Breast cancer screenings

    MedlinePLUS

    Breast cancer screenings can help find breast cancer early, before you notice any symptoms. In many cases, finding breast cancer early makes it easier to treat or cure. But screenings also have risks, such as missing ...

  8. Prostate cancer screenings

    MedlinePLUS

    ... Blazina I, et al. Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services ... al. Cancer screening in the United States, 2014: a review of current American Cancer Society guidelines and current ...

  9. International Cancer Screening Network

    Cancer.gov

    Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Working Together to Evaluate Cancer Screening and Improve Outcomes Internationally About the ICSN Overview Participating Countries Contact

  10. Cervical Cancer Screening

    MedlinePLUS

    ... the place where a baby grows during pregnancy. Cancer screening is looking for cancer before you have any ... found early may be easier to treat. Cervical cancer screening is usually part of a woman's health checkup. ...

  11. Principles of Cancer Screening.

    PubMed

    Pinsky, Paul F

    2015-10-01

    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. PMID:26315516

  12. Prostate Cancer Screening

    MedlinePLUS

    The prostate is the gland below a man's bladder that produces fluid for semen. Cancer screening is looking for ... treat. There is no standard screening test for prostate cancer. Researchers are studying different tests to find ...

  13. Screening for Prostate Cancer

    MedlinePLUS

    ... for Primary Care Practice Published Recommendations Draft Summary Prostate Cancer: Screening Release Date: May 2012 This topic is ... against prostate-specific antigen (PSA)-based screening for prostate cancer. The USPSTF recommends against the service. There is ...

  14. Screening for colon cancer

    PubMed Central

    Heiken, J P

    2006-01-01

    Colorectal cancer screening reduces mortality in individuals 50 years and older. Each of the screening tests currently available has advantages and limitations, and there is no consensus as to which test or combination of tests is best. What is clear, however, is that the rates of colorectal cancer screening remain low. This review summarizes the clinical evidence supporting colorectal cancer screening in the average risk population and in high risk groups, discusses the advantages and disadvantages of the available screening tests, outlines the currently recommended guidelines for screening based on risk category, and discusses new and emerging technologies for colorectal cancer screening. PMID:17114066

  15. [Lung cancer screening].

    PubMed

    Snchez Gonzlez, M

    2014-01-01

    Lung cancer is a very important disease, curable in early stages. There have been trials trying to show the utility of chest x-ray or computed tomography in Lung Cancer Screening for decades. In 2011, National Lung Screening Trial results were published, showing a 20% reduction in lung cancer mortality in patients with low dose computed tomography screened for three years. These results are very promising and several scientific societies have included lung cancer screening in their guidelines. Nevertheless we have to be aware of lung cancer screening risks, such as: overdiagnosis, radiation and false positive results. Moreover, there are many issues to be solved, including choosing the appropriate group to be screened, the duration of the screening program, intervals between screening and its cost-effectiveness. Ongoing trials will probably answer some of these questions. This article reviews the current evidence on lung cancer screening. PMID:23830728

  16. Colorectal Cancer Screening

    MedlinePLUS

    ... health history can affect the risk of developing colon cancer. Anything that increases a person's chance of getting ... as familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer (HNPCC; Lynch Syndrome). Colorectal Cancer Screening Key Points ...

  17. Cervical Cancer Screening

    MedlinePLUS

    ... cases of cervical cancer and the number of deaths due to cervical cancer since 1950. Cervical dysplasia ... for cervical cancer helps decrease the number of deaths from the disease. Regular screening of women between ...

  18. Screening for colorectal cancer*

    PubMed Central

    Winawer, S. J.; Miller, D.

    1987-01-01

    Colorectal cancer is a good candidate for secondary prevention strategies. It appears to have a long lead time since most, if not all, of these cancers arise from premalignant adenomas, and several screening methods are available that might detect the cancer in a very early stage. However, there is little evidence at present to show that the available methods of early detection will actually decrease the mortality from colorectal cancer of a screened population as compared to a non-screened population. Studies that might convincingly provide this evidence are still in progress. This paper critically reviews the natural history of colorectal cancer, risk factors, screening trials and treatment. PMID:3555878

  19. Screening for Cervical Cancer

    MedlinePLUS

    ... Evidence-Based Practice Recommendations About the USPSTF Task Force 101 Resources Our Members Our Partners Reports to ... Professionals Recommendations from The Community Preventive Services Task Force on Promoting Cancer Screening Cancer Control P.L. ...

  20. Cervical cancer screening.

    PubMed Central

    Katz, A.

    1998-01-01

    OBJECTIVE: To review the role of family physicians in screening for cancer of the cervix, to review the evidence for screening, in particular, frequency and technique for screening, and to review the reasons cervical cancer has not been prevented and the role of family physicians in addressing these failures. QUALITY OF EVIDENCE: The value of screening has been established with level II evidence. Many of the unresolved issues are not supported either way by good evidence; level II and III evidence predominates. MAIN FINDINGS: In Canada, 1350 women were predicted to be diagnosed with cancer of the cervix in 1996. Most of these women had not been screened. Minority, rural, low-income, and older women face important barriers to screening. Family physicians have a role in reaching out to these women to provide effective health care, including cancer screening. When cancer screening is performed, it should conform to recommended techniques with appropriate follow up of abnormal test results. CONCLUSIONS: Family physicians have an important role in preventing cancer of the cervix. Efforts should be concentrated on encouraging a greater proportion of eligible women to be screened. Criteria are suggested for effective screening. PMID:9721422

  1. Prostate Cancer Screening.

    PubMed

    Mulhem, Elie; Fulbright, Nikolaus; Duncan, Norah

    2015-10-15

    Among American men, prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death. Although prostate-specific antigen (PSA) testing has been used to screen for prostate cancer for more than 25 years, the test has low sensitivity and specificity, and there is no clear evidence for determining what threshold warrants prostate biopsy. Only one of five randomized controlled trials of PSA screening showed an effect on prostate cancer-specific mortality, and the absolute reduction in deaths from prostate cancer was one per 781 men screened after 13 years of follow-up. None of the trials showed benefit in all-cause mortality, and screening increased prostate cancer diagnoses by about 60%. Harms of screening include adverse effects from prostate biopsy, overdiagnosis and overtreatment, and anxiety. One-half of screen-detected prostate cancers will not cause symptoms in the patient's lifetime, and 80% to 85% of men who choose observation will not die from prostate cancer within 15 years. Adverse effects of radical prostatectomy include perioperative complications, erectile dysfunction, and urinary incontinence. Radiation therapy can cause acute toxicity leading to urinary urgency, dysuria, diarrhea, and rectal pain; late toxicity includes erectile dysfunction, rectal bleeding, and urethral stricture. Despite variations across guidelines, no organization recommends routine PSA testing, and all endorse some form of shared decision-making before testing. If screening is performed, it should generally be discontinued at 70 years of age. PMID:26554408

  2. Cervical Cancer Screening

    MedlinePLUS

    ... douching, sexual intercourse, and using vaginal medications or hygiene products for 2 days before your test. You also should not have cervical cancer screening if you have your menstrual period. Glossary Biopsy: A minor surgical procedure to ...

  3. Endometrial Cancer Screening

    MedlinePLUS

    ... the following: Finding endometrial cancer may not improve health or help a woman live longer. False-negative test results can occur. False-positive test results can occur. Side effects may be caused by the test itself. Screening ...

  4. Screening for Prostate Cancer

    MedlinePLUS

    ... Clearinghouse (NGC) is a database developed by the U.S. government to make clinical guidelines widely available. The authors searched the database for U.S. guidelines about prostate cancer screening with PSA. They ...

  5. The African American Women and Mass Media Campaign: A CDC Breast Cancer Screening Project

    PubMed Central

    Hall, Ingrid J.; Rim, Sun Hee; Johnson-Turbes, C. Ashani; Vanderpool, Robin; Kamalu, Ngozi N.

    2015-01-01

    For decades, black radio has reached African American communities with relevant, culturally appropriate information, and it continues to be an ideal communication channel to use for contemporary health promotion. In an effort to combat excess breast cancer mortality rates and help eliminate cancer disparities among low-income African American women, the Centers for Disease Control and Prevention’s (CDC) Division of Cancer Prevention and Control designed, implemented, and evaluated the African American Women and Mass Media (AAMM) pilot campaign. The AAMM campaign uses black radio, radio stations with broad African American listenership, as a platform for targeted, culturally competent health promotion and outreach to low-income, African American women. The AAMM campaign uses radio advertisements and print materials disseminated in predominantly African American neighborhoods to promote awareness of breast cancer, early detection, and the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Evaluation of the AAMM campaign found that the campaign successfully reached its target audience of low-income, African American women and increased women’s awareness of breast cancer screening services through the Breast and Cervical Cancer Program in Savannah and Macon, Georgia. PMID:23072329

  6. Testicular Cancer Screening

    MedlinePLUS

    ... For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage . Information about ongoing clinical trials is available from the NCI Web site . There is no standard or routine screening test for testicular cancer. There ...

  7. Predictive Accuracy of the Liverpool Lung Project Risk Model for Stratifying Patients for Computed Tomography Screening for Lung Cancer

    PubMed Central

    Raji, Olaide Y.; Duffy, Stephen W.; Agbaje, Olorunshola F.; Baker, Stuart G.; Christiani, David C.; Cassidy, Adrian; Field, John K.

    2013-01-01

    Background External validation of existing lung cancer risk prediction models is limited. Using such models in clinical practice to guide the referral of patients for computed tomography (CT) screening for lung cancer depends on external validation and evidence of predicted clinical benefit. Objective To evaluate the discrimination of the Liverpool Lung Project (LLP) risk model and demonstrate its predicted benefit for stratifying patients for CT screening by using data from 3 independent studies from Europe and North America. Design Casecontrol and prospective cohort study. Setting Europe and North America. Patients Participants in the European Early Lung Cancer (EUELC) and Harvard casecontrol studies and the LLP population-based prospective cohort (LLPC) study. Measurements 5-year absolute risks for lung cancer predicted by the LLP model. Results The LLP risk model had good discrimination in both the Harvard (area under the receiver-operating characteristic curve [AUC], 0.76 [95% CI, 0.75 to 0.78]) and the LLPC (AUC, 0.82 [CI, 0.80 to 0.85]) studies and modest discrimination in the EUELC (AUC, 0.67 [CI, 0.64 to 0.69]) study. The decision utility analysis, which incorporates the harms and benefit of using a risk model to make clinical decisions, indicates that the LLP risk model performed better than smoking duration or family history alone in stratifying high-risk patients for lung cancer CT screening. Limitations The model cannot assess whether including other risk factors, such as lung function or genetic markers, would improve accuracy. Lack of information on asbestos exposure in the LLPC limited the ability to validate the complete LLP risk model. Conclusion Validation of the LLP risk model in 3 independent external data sets demonstrated good discrimination and evidence of predicted benefits for stratifying patients for lung cancer CT screening. Further studies are needed to prospectively evaluate model performance and evaluate the optimal population risk thresholds for initiating lung cancer screening. Primary Funding Source Roy Castle Lung Cancer Foundation. PMID:22910935

  8. Cervical Cancer Screening | Cancer Trends Progress Report

    Cancer.gov

    Screening methods used to find cervical changes that may lead to cervical cancer include the Pap test and human papillomavirus (HPV) testing. Such screening tests may find cancers early, when they are most treatable. Women who have never been screened or who have not been screened in the past 5 years face a greater risk of developing invasive cervical cancer.

  9. [Primary cervical cancer screening].

    PubMed

    Vargas-Hernndez, Vctor Manuel; Vargas-Aguilar, Vctor Manuel; Tovar-Rodrguez, Jos Mara

    2015-01-01

    Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis. PMID:26162490

  10. Risks of Stomach (Gastric) Cancer Screening

    MedlinePLUS

    ... Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Screening–Patient Version (PDQ®) What is screening? Screening ... are called diagnostic tests . General Information About Stomach (Gastric) Cancer Key Points Stomach cancer is a disease in ...

  11. Risks of Colorectal Cancer Screening

    MedlinePLUS

    ... health history can affect the risk of developing colon cancer. Anything that increases a person's chance of getting ... as familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer (HNPCC; Lynch Syndrome). Colorectal Cancer Screening Key Points ...

  12. Risks of Cervical Cancer Screening

    MedlinePLUS

    ... cases of cervical cancer and the number of deaths due to cervical cancer since 1950. Cervical dysplasia ... for cervical cancer helps decrease the number of deaths from the disease. Regular screening of women between ...

  13. Paying for Breast Cancer Screening

    MedlinePLUS

    ... screening coverage in your state. National Breast and Cervical Cancer Early Detection Program States are making breast cancer ... Disease Control and Preventions (CDCs) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) . The NBCCEDP attempts to ...

  14. [Colorectal cancer screening].

    PubMed

    Castells, Antoni

    2013-10-01

    Colorectal cancer is the paradigm of tumoral growth that is susceptible to preventive measures, especially screening. Various screening strategies with demonstrated efficacy and efficiency are currently available, notable examples being the fecal occult blood test and endoscopic tests. In addition, new modalities have appeared in the last few years that could become viable alternatives in the near future. The present article reviews the most important presentations on colorectal screening at the annual congress of the American Gastroenterological Association held in Orlando in May 2013, with special emphasis on the medium- and long-term results of strategies using the fecal occult blood test and flexible sigmoidoscopy, as well as initial experiences with the use of new biomarkers. PMID:24160954

  15. Cancer Screening: How Do Screening Tests Become Standard Tests?

    MedlinePLUS

    ... cancer symptoms. There are different kinds of screening tests. Screening tests include the following: Physical exam and ... are linked to some types of cancer. Screening tests have risks. Not all screening tests are helpful ...

  16. Cancer Screening in Older Adults.

    PubMed

    Wingfield, Sarah A; Heflin, Mitchell T

    2016-02-01

    Cancer screening is an important tool for reducing morbidity and mortality in the elderly. In this article, performance characteristics of commonly used screening tests for colorectal, lung, prostate, breast, and cervical cancers are discussed. Guidelines are emphasized and key issues to consider in screening older adults are highlighted. PMID:26614858

  17. American Cancer Society Lung Cancer Screening Guidelines

    PubMed Central

    Wender, Richard; Fontham, Elizabeth T. H.; Barrera, Ermilo; Colditz, Graham A.; Church, Timothy R.; Ettinger, David S.; Etzioni, Ruth; Flowers, Christopher R.; Gazelle, G. Scott; Kelsey, Douglas K.; LaMonte, Samuel J.; Michaelson, James S.; Oeffinger, Kevin C.; Shih, Ya-Chen Tina; Sullivan, Daniel C.; Travis, William; Walter, Louise; Wolf, Andrew M. D.; Brawley, Otis W.; Smith, Robert A.

    2013-01-01

    Findings from the National Cancer Institutes National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation. PMID:23315954

  18. Controversies in Lung Cancer Screening.

    PubMed

    Gill, Ritu R; Jaklitsch, Michael T; Jacobson, Francine L

    2016-02-01

    There remains an extensive debate over lung cancer screening, with lobbying for and against screening for very compelling reasons. The National Lung Screening Trial, International Early Lung Cancer Program, and other major screening studies favor screening with low-dose CT scans and have shown a reduction in lung cancer-specific mortality. The increasing incidence of lung cancer and the dismal survival rate for advanced disease despite improved multimodality therapy have sparked an interest in the implementation of national lung cancer screening. Concerns over imaging workflow, radiation dose, management of small nodules, overdiagnosis bias, lead-time and length-time bias, emerging new technologies, and cost-effectiveness continue to be debated. The authors address each of these issues as they relate to radiologic practice. PMID:26846531

  19. Use of risk projection models to estimate mortality and incidence from radiation-induced breast cancer in screening programs

    NASA Astrophysics Data System (ADS)

    Ramos, M.; Ferrer, S.; Villaescusa, J. I.; Verd, G.; Salas, M. D.; Cuevas, M. D.

    2005-02-01

    The authors report on a method to calculate radiological risks, applicable to breast screening programs and other controlled medical exposures to ionizing radiation. In particular, it has been applied to make a risk assessment in the Valencian Breast Cancer Early Detection Program (VBCEDP) in Spain. This method is based on a parametric approach, through Markov processes, of hazard functions for radio-induced breast cancer incidence and mortality, with mean glandular breast dose, attained age and age-at-exposure as covariates. Excess relative risk functions of breast cancer mortality have been obtained from two different case-control studies exposed to ionizing radiation, with different follow-up time: the Canadian Fluoroscopy Cohort Study (1950-1987) and the Life Span Study (1950-1985 and 1950-1990), whereas relative risk functions for incidence have been obtained from the Life Span Study (1958-1993), the Massachusetts tuberculosis cohorts (1926-1985 and 1970-1985), the New York post-partum mastitis patients (1930-1981) and the Swedish benign breast disease cohort (1958-1987). Relative risks from these cohorts have been transported to the target population undergoing screening in the Valencian Community, a region in Spain with about four and a half million inhabitants. The SCREENRISK software has been developed to estimate radiological detriments in breast screening. Some hypotheses corresponding to different screening conditions have been considered in order to estimate the total risk associated with a woman who takes part in all screening rounds. In the case of the VBCEDP, the total radio-induced risk probability for fatal breast cancer is in a range between [5 10-6, 6 10-4] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 10-3. The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs.

  20. Community collaboration to increase foreign-born women¿s participation in a cervical cancer screening program in Sweden: a quality improvement project

    PubMed Central

    2014-01-01

    Introduction The prevailing inequities in healthcare have been well addressed in previous research, especially screening program participation, but less attention has been paid to how to overcome these inequities. This paper explores a key factor of a successful improvement project: collaboration with local doulas to raise cervical cancer screening participation by more than 40 percent in an area with a large number of foreign-born residents. Methods Data was collected through two focus group discussions with the doulas in order to design interventions and debrief after interventions had been carried out in the community. Various tools were used to analyze the verbal data and monitor the progress of the project. Results Three major themes emerged from the focus group discussions: barriers that prevent women from participating in the cervical cancer screening program, interventions to increase participation, and the role of the doulas in the interventions. Conclusions This paper suggests that several barriers make participation in cervical cancer screening program more difficult for foreign-born women in Sweden. Specifically, these barriers include lack of knowledge concerning cancer and the importance of preventive healthcare services and practical obstacles such as unavailable child care and language skills. The overarching approach to surmount these barriers was to engage persons with a shared cultural background and mother tongue as the target audience to verbally communicate information. The doulas who helped to identify barriers and plan and execute interventions gained increased confidence and a sense of pride in assisting to bridge the gap between healthcare providers and users. PMID:25106490

  1. Risks of Endometrial Cancer Screening

    MedlinePLUS

    ... the following: Finding endometrial cancer may not improve health or help a woman live longer. False-negative test results can occur. False-positive test results can occur. Side effects may be caused by the test itself. Screening ...

  2. New Cervical Cancer Screening Guidelines

    MedlinePLUS Videos and Cool Tools

    ... reading health news for healthier living. Related MedlinePlus Health Topics Cervical Cancer Screening HPV About MedlinePlus Site ... Rockville Pike, Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page ...

  3. [Overdiagnosis in cancer screening].

    PubMed

    Cervera Deval, J; Sents Crivill, M; Zulueta, J J

    2015-01-01

    In screening programs, overdiagnosis is defined as the detection of a disease that would have gone undetected without screening when that disease would not have resulted in morbimortality and was treated unnecessarily. Overdiagnosis is a bias inherent in screening and an undesired effect of secondary prevention and improved sensitivity of diagnostic techniques. It is difficult to discriminate a priori between clinically relevant diagnoses and those in which treatment is unnecessary. To minimize the effects of overdiagnosis, screening should be done in patients at risk. PMID:25174786

  4. Screening for prostate cancer

    NASA Technical Reports Server (NTRS)

    Weirich, Stephen A.

    1993-01-01

    Despite recent advances in both the survival and cure rates for many forms of cancer, unfortunately the same has not been true for prostate cancer. In fact, the age-adjusted death rate from prostate cancer has not significantly improved since 1949, and prostate cancer remains the most common cancer in American men, causing the second highest cancer mortality rate. Topics discussed include the following: serum testosterone levels; diagnosis; mortality statistics; prostate-sppecific antigen (PSA) tests; and the Occupational Medicine Services policy at LeRC.

  5. Cervical cancer screening at crossroads.

    PubMed

    Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez-Prada; Dugu, Pierre-Antoine; Sander, Bente Braad; Bonde, Jesper; Rebolj, Matejka

    2014-08-01

    Cervical screening has been one of the most successful public health prevention programmes. For 50 years, cytology formed the basis for screening, and detected cervical intraepithelial lesions (CIN) were treated surgically to prevent progression to cancer. In a high-risk country as Denmark, screening decreased the incidence of cervical cancer from 34 to 11 per 100,000, age-standardized rate (World Standard Population). Screening is, however, also expensive; Denmark (population: 5.6 million) undertakes close to half a million tests per year, and has 6-8 CIN-treated women for each prevented cancer case. The discovery of human papillomavirus (HPV) as the cause of cervical cancer dramatically changed perspectives for disease control. Screening with HPV testing was launched around 1990, and preventive HPV vaccination was licensed in 2006. Long-term randomized controlled trials (RCT) demonstrated that HPV testing provides better protection against cervical cancer than cytology, but it requires extra repeated testing. HPV vaccination RCTs, furthermore, have proved that HPV vaccination protects against vaccine-type high-grade CIN in women vaccinated prior to sexual activity, but less so in women vaccinated later. The challenge now is therefore to find an algorithm for screening of a heterogeneous population including non-vaccinated women; women vaccinated prior to start of sexual activity; and women vaccinated later. PMID:25046198

  6. Breast Cancer Screening Rates

    MedlinePLUS

    ... is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast cancer. Source for graph data: Centers for Disease Control and Prevention (CDC). Cancer ...

  7. Esophageal Cancer Screening

    MedlinePLUS

    ... the type of cells that become malignant (cancerous): Squamous cell carcinoma : Cancer that begins in squamous cells , the thin, ... adenocarcinoma each year and fewer new cases of squamous cell carcinoma. Squamous cell carcinoma of the esophagus is found ...

  8. Liver (Hepatocellular) Cancer Screening

    MedlinePLUS

    ... United States than in other parts of the world. Liver cancer is uncommon in the United States, ... is the fourth most common cancer in the world. In the United States, men, especially Chinese American ...

  9. Screening for Cervical Cancer

    MedlinePLUS

    ... The USPSTF found new evidence that addressed the gaps identi?ed in the previous recommendation and allowed the USPSTF to recommend HPV testing combined with cytol- ogy as an acceptable screening strategy for women aged 30 to 65 years who prefer to lengthen their screening interval be- ...

  10. Data Mining Approaches for Genomic Biomarker Development: Applications Using Drug Screening Data from the Cancer Genome Project and the Cancer Cell Line Encyclopedia

    PubMed Central

    Covell, David G.

    2015-01-01

    Developing reliable biomarkers of tumor cell drug sensitivity and resistance can guide hypothesis-driven basic science research and influence pre-therapy clinical decisions. A popular strategy for developing biomarkers uses characterizations of human tumor samples against a range of cancer drug responses that correlate with genomic change; developed largely from the efforts of the Cancer Cell Line Encyclopedia (CCLE) and Sanger Cancer Genome Project (CGP). The purpose of this study is to provide an independent analysis of this data that aims to vet existing and add novel perspectives to biomarker discoveries and applications. Existing and alternative data mining and statistical methods will be used to a) evaluate drug responses of compounds with similar mechanism of action (MOA), b) examine measures of gene expression (GE), copy number (CN) and mutation status (MUT) biomarkers, combined with gene set enrichment analysis (GSEA), for hypothesizing biological processes important for drug response, c) conduct global comparisons of GE, CN and MUT as biomarkers across all drugs screened in the CGP dataset, and d) assess the positive predictive power of CGP-derived GE biomarkers as predictors of drug response in CCLE tumor cells. The perspectives derived from individual and global examinations of GEs, MUTs and CNs confirm existing and reveal unique and shared roles for these biomarkers in tumor cell drug sensitivity and resistance. Applications of CGP-derived genomic biomarkers to predict the drug response of CCLE tumor cells finds a highly significant ROC, with a positive predictive power of 0.78. The results of this study expand the available data mining and analysis methods for genomic biomarker development and provide additional support for using biomarkers to guide hypothesis-driven basic science research and pre-therapy clinical decisions. PMID:26132924

  11. Breast Cancer Screening

    MedlinePLUS

    ... screening tests are being studied in clinical trials. Thermography Thermography is a procedure in which a special camera ... thermogram. There have been no clinical trials of thermography to find out how well it detects breast ...

  12. Biomarkers in Cervical Cancer Screening

    PubMed Central

    Wentzensen, Nicolas; von Knebel Doeberitz, Magnus

    2007-01-01

    In industrialized countries, population wide cytological screening programs using the Pap test have led to a substantial reduction of the incidence of cervical cancer. Despite this evident success, screening programs that rely on Pap-stained cytological samples have several limitations. First, a number of equivocal or mildly abnormal test results require costly work up by either repeated retesting or direct colposcopy and biopsy, since a certain percentage of high grade lesions that require immediate treatment hide among these unclear test results. This work up of mildly abnormal or equivocal cytological tests consumes a large amount of the overall costs spent for cervical cancer screening. Improved triage of these samples might substantially reduce the costs. Cervical cancer is induced by persistent infections with oncogenic human papilloma viruses (HPV). While HPV infection is an indispensable factor, it is not sufficient to cause cancer. The majority of acute HPV infections induce low grade precursor lesions that are cleared spontaneously after several months in more than 90% of cases, and less than 10% eventually progress to high grade lesions or invasive cancer. Progression is characterized by the deregulated expression of the viral oncogenes E6 and E7 in infected basal and parabasal cells. Novel biomarkers that allow monitoring these essential molecular events in histological or cytological specimens are likely to improve the detection of lesions that have a high risk of progression in both primary screening and triage settings. In this review, we will discuss potential biomarkers for cervical cancer screening with a focus on the level of clinical evidence that supports their application as novel markers in refined cervical cancer screening programs. PMID:17627065

  13. Projection screen having reduced ambient light scattering

    DOEpatents

    Sweatt, William C.

    2010-05-11

    An apparatus and method for improving the contrast between incident projected light and ambient light reflected from a projection screen are described. The efficiency of the projection screen for reflection of the projected light remains high, while permitting the projection screen to be utilized in a brightly lighted room. Light power requirements from the projection system utilized may be reduced.

  14. Unique interactive projection display screen

    SciTech Connect

    Veligdan, J.T.

    1997-11-01

    Projection systems continue to be the best method to produce large (1 meter and larger) displays. However, in order to produce a large display, considerable volume is typically required. The Polyplanar Optic Display (POD) is a novel type of projection display screen, which for the first time, makes it possible to produce a large projection system that is self-contained and only inches thick. In addition, this display screen is matte black in appearance allowing it to be used in high ambient light conditions. This screen is also interactive and can be remotely controlled via an infrared optical pointer resulting in mouse-like control of the display. Furthermore, this display need not be flat since it can be made curved to wrap around a viewer as well as being flexible.

  15. Lung Cancer Screening

    MedlinePLUS

    ... Currents Blog Research Findings Drug Approvals Precision Medicine Leadership Views 2017 Annual Plan & Budget Proposal All Press ... NCI NCI Overview History Contributing to Cancer Research Leadership Director's Page Previous NCI Directors NCI Organization Advisory ...

  16. Skin Cancer Screening

    MedlinePLUS

    ... the body's largest organ . It protects against heat, sunlight, injury, and infection . Skin also helps control body ... cancer risk factors include: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  17. Breast and Cervical Cancer Screening

    PubMed Central

    Ludman, Evette J.; Ichikawa, Laura E.; Simon, Gregory E.; Rohde, Paul; Arterburn, David; Operskalski, Belinda H.; Linde, Jennifer A.; Jeffery, Robert W.

    2010-01-01

    Background Obesity and depression may each be associated with less cervical and breast cancer screening. Studies have examined obesity or depression alone, but not together, despite the established link between them. Purpose To disentangle the effects of depression and obesity on receipt of breast and cervical cancer screening. Methods A stratified sampling design was used to recruit women aged 40–65 years with information on BMI from an integrated health plan in Washington in 2003–2005. A telephone survey included the PHQ-9 for depression, weight, and height. Automated data assessed Paps for 3097 women over a 3-year period and screening mammograms over a 2-year period for 2163 women aged ≥51 years. Logistic regression models (conducted in 2008) examined the association between obesity and depression and receipt of screening tests. Results In univariate logistic regression models, women were less likely to receive a Pap if they were obese (OR = 0.53, 95% CI 0.41–0.69) or depressed (OR = 0.60, 95% CI= 0.42–0.87). Women were less likely to receive a screening mammogram if they were depressed (OR = 0.45, 95% CI= 0.30–0.67). In multivariable models, only obesity remained significantly associated with lower likelihood of Pap screening (OR =0.67, 95% CI= 0.0.49–0.93) and only depression remained significantly associated with less screening mammography (OR =0.49, 95% CI 0.31–0.76). Obesity and depression did not interact significantly in either model. Conclusions Obesity and depression appear to have specific effects on receipt of different cancer screening tests. PMID:20171532

  18. Screening for Cervical Cancer

    MedlinePLUS

    ... causes cervical cancer. To learn more about these tests and what happens during them, visit the Web sites listed at the end of this fact ... evidence about the benefits and harms of the test. The grades are explained in the box at ... Web site to read the full recommendation statement on ...

  19. Cervical cancer: screening and prevention.

    PubMed

    Behtash, Nadereh; Mehrdad, Nili

    2006-01-01

    Cancer of the cervix is the second most common life-threatening cancer among women worldwide and both incidence and mortality rates are likely to be underestimated in developing countries. HPV high risk strains play at least the major if not an absolutely necessary role in the etiology. The concept of cervical intraepithelial neoplasia (CIN) was introduced in 1968 as an equivalent to the term dysplasia, which means abnormal maturation. Cervical cancer progresses slowly from preinvasive CIN to invasive cancer and therefore screening for dysplasia is an important public health effort worldwide, given the accessibility of the primary organ site, the acceptability of current screening methods, and the long preinvasive period in which to detect disease and successfully intervene. It is widely accepted that detection and treatment of HPV-related dysplastic epithelial change in the form of CIN-2 and CIN-3 can prevent the development of invasive cervical cancer in individual patients. The mainstay of screening programs has been the Pap smear, introduced originally by George Papanicolaou in 1941. However, considerable numbers of false-negative Pap smears may occur with the traditional Pap technique, mostly due to sampling error. More recently, the use of liquid-based technologies such as ThinPrep and AutoCyte Prep have gained popularity, in part because of evidence suggesting reduction in the incidence of inadequate smears. It is also hoped that the ability to identify patients with oncogenic HPV types will lead to improved detection in women more likely to have squamous intraepithelial lesions. Hybrid Capture 2 is the latest refinement of HPV tests and has been described as having enhanced sensitivity. HPV DNA testing can be used as an adjunct to cytology in routine cervical disease screening programs. Establishment of the link between HPV and cervical cancer has further provided the impetus for research into prophylactic vaccination against the most common HPV types associated with the disease, HPV 16 and 18. Initial studies have provided evidence that L1 virus-like particle vaccines against HPV types (as monovalent, bivalent, or quadrivalent vaccines) prevent at least 90% of incident and persistent infections and their associated precursors of cervical cancer. This vaccine has sustained long-term vaccine efficacy against incident and persistent infections and in the long term should provide an answer to the cervical cancer problem. For the vast majority of women who have already been infected, however, continued screening and resection need to be emphasized. PMID:17250453

  20. Quebec breast cancer screening program

    PubMed Central

    Nguyen, Minh-Nguyet; Larocque, Diane; Paquette, Daniel; Irace-Cima, Alejandra

    2009-01-01

    OBJECTIVE To identify physicians perceptions of breast cancer prevention in order to generate strategies to increase womens participation in the Quebec breast cancer screening program (QBCSP). DESIGN Qualitative study using archival data and in-depth interviews. SETTING Laval, Que, a suburban city north of Montreal. PARTICIPANTS Twenty family physicians and 1 gynecologist practising in Laval who had received at least 1 screening mammography report in 2004 or 2005. METHODS Archival data were obtained in order to refine our understanding of the QBCSP. In-depth individual interviews were conducted with participating physicians until data saturation was reached in order to determine physicians knowledge of, beliefs and attitudes about, and behaviour toward preventive breast cancer practices, as well as their suggestions for enhancing patient compliance. The interviews were recorded, transcribed, and coded, and the content was analyzed. MAIN FINDINGS Respondents indicated that the screening age groups, the age for beginning clinical breast examination, and the instructions to patients about breast self-examination should be harmonized. Letters to patients should be shortened, simplified, and endorsed by physicians. Screening mammography reports should include more details and be clearer about patient follow-up. The need for patients to sign authorization forms for transmission of information related to their participation in the QBCSP should be reinforced by their physicians. Following abnormal mammogram results, services and procedures should be simplified and delays in appointments decreased. Referral for orphan patients (ie, patients without family physicians) should be supervised by nurse practitioners, with physician consultations when needed. CONCLUSION This study provides a qualitative understanding of improvements or modifications needed in order to reach a screening mammography participation rate sufficient to reduce breast cancer mortality in women. PMID:19509208

  1. Lung cancer screening: identifying the high risk cohort

    PubMed Central

    Marcus, Michael W.; Raji, Olaide Y.

    2015-01-01

    Low dose computed tomography (LDCT) is a viable screening tool for early lung cancer detection and mortality reduction. In practice, the success of any lung cancer screening programme will depend on successful identification of individuals at high risk in order to maximise the benefit-harm ratio. Risk prediction models incorporating multiple risk factors have been recognised as a method of identifying individuals at high risk of developing lung cancer. Identification of individuals at high risk will facilitate early diagnosis, reduce overall costs and also improve the current poor survival from lung cancer. This review summarises the current methods utilised in identifying high risk cohorts for lung cancer as proposed by the Liverpool Lung Project (LLP) risk model, Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial risk models and the prediction model for lung cancer death using quintiles. In addition, the cost-effectiveness of CT screening and future perspective for selecting high risk individuals is discussed. PMID:25984362

  2. Radiation risk of lung cancer screening.

    PubMed

    Frank, Luba; Christodoulou, Emmanuel; Kazerooni, Ella A

    2013-12-01

    Lung cancer screening with low dose computed tomography (CT) is the only method ever proven to reduce lung cancer-specific mortality in high-risk current and former cigarette smokers. Radiation exposure from annual screening CT examinations and subsequent CT and nuclear medicine testing to further evaluate positive screening CTs is sometimes raised as a reason to avoid screening and is often misunderstood. With all testing, there are potential benefits and risks. As we sit on the brink of widespread adoption of lung cancer screening CT, we aim to explain why the risks associated with radiation exposure from lung cancer screening are very low and should not be used to avoid screening or dissuade individuals who qualify for screening CT to participate in a lung cancer screening program. PMID:24258564

  3. Cervical Cancer Prevention and Screening: Financial Issues

    MedlinePLUS

    ... pre-cancers are treated Next Topic Additional resources Cervical cancer prevention and screening: Financial issues Financial issues can ... to tell you up front. National Breast and Cervical Cancer Early Detection Program All states are making cervical ...

  4. Skin cancer prevention and screening.

    PubMed

    Holm, Richard P

    2015-01-01

    Skin cancer is the most common and recognizable of all cancers. The human dermis can turn malignant due to excessive solar exposure and chronic injury, with the influence of genetic risk and inherited pigmentation. Basal cell carcinoma, the most common skin cancer in lighter pigmented individuals, spreads locally, and usually appears pearly and often ulcerative. Squamous cell carcinoma, the most common skin cancer in darker pigmented people, metastasizes to lymph nodes 2-5 percent of the time, appears often scaly, smooth, nodular, ulcerative, or even pigmented. Malignant melanoma accounts for 2 percent of skin cancers, but for the vast majority of skin cancer deaths. All three can mimic each other. Solar or ultraviolet (UV) light exposure is the most common carcinogen; however, any chronic irritant can increase the risk, and efforts to avoid such exposure is apropos. Though not yet absolutely proven, skin cancer research strongly supports the following statements: sunscreen is protective, tanning devices are causative, and the routine screening of high-risk individuals is preventative. Authorities strongly recommend avoiding excess sun and UV light, using sunscreen, and keeping a watchful eye for unusual skin lesions. PMID:25985614

  5. Implementation of HPV-testing for cervical cancer screening in programmatic contexts: The Jujuy demonstration project in Argentina.

    PubMed

    Arrossi, Silvina; Thouyaret, Laura; Laudi, Rosa; Marn, Oscar; Ramrez, Josefina; Paolino, Melisa; Herrero, Rolando; Campanera, Alicia

    2015-10-01

    The aim of this article is to present results of programmatic introduction of HPV testing with cytologic triage among women 30 years and older in the province of Jujuy, Argentina, including description of the planning phase and results of program performance during the first year. We describe the project implementation process, and calculate key performance indicators using SITAM, the national screening information system. We also compare disease detection rates of HPV testing in 2012 with cytology as performed during the previous year. HPV testing with cytology triage was introduced through a consensus-building process. Key activities included establishment of algorithms and guidelines, creating the HPV laboratory, training of health professionals, information campaigns for women and designing the referral network. By the end of 2012, 100% (n?=?270) of public health care centers were offering HPV testing and 22,834 women had been HPV tested, 98.5% (n?=?22,515) were 30+. HPV positivity among women over 30 was 12.7%, 807 women were HPV+ and had abnormal cytology, and 281 CIN2+ were identified. CIN2+ detection rates was 1.25 in 2012 and 0.62 in 2011 when the program was cytology based (p?=?0.0002). This project showed that effective introduction of HPV testing in programmatic contexts of low-middle income settings is feasible and detects more disease than cytology. PMID:25807897

  6. Screening for Psychosocial Risk in Pediatric Cancer

    PubMed Central

    Kazak, Anne E.; Brier, Moriah; Alderfer, Melissa A.; Reilly, Anne; Parker, Stephanie Fooks; Rogerwick, Stephanie; Ditaranto, Susan; Barakat, Lamia P.

    2012-01-01

    Major professional organizations have called for psychosocial risk screening to identify specific psychosocial needs of children with cancer and their families and facilitate the delivery of appropriate evidence-based care to address these concerns. However, systematic screening of risk factors at diagnosis is rare in pediatric oncology practice. Subsequent to a brief summary of psychosocial risks in pediatric cancer and the rationale for screening, this review identified three screening models and two screening approaches (Distress Thermometer [DT], Psychosocial Assessment Tool [PAT]), among many more papers calling for screening. Implications of broadly implemented screening for all patients across treatment settings are discussed. PMID:22492662

  7. Organizational Factors and the Cancer Screening Process

    PubMed Central

    Zapka, Jane; Edwards, Heather; Taplin, Stephen H.

    2010-01-01

    Cancer screening is a process of care consisting of several steps and interfaces. This article reviews what is known about the association between organizational factors and cancer screening rates and examines how organizational strategies can address the steps and interfaces of cancer screening in the context of both intraorganizational and interorganizational processes. We reviewed 79 studies assessing the relationship between organizational factors and cancer screening. Screening rates are largely driven by strategies to 1) limit the number of interfaces across organizational boundaries; 2) recruit patients, promote referrals, and facilitate appointment scheduling; and 3) promote continuous patient care. Optimal screening rates can be achieved when health-care organizations tailor strategies to the steps and interfaces in the cancer screening process that are most critical for their organizations, the providers who work within them, and the patients they serve. PMID:20386053

  8. CRN - Cancer Screening Research: Ovarian Cancer

    Cancer.gov

    The objective of this project is to describe end of life care and factors that may be associated with care (or lack of it) for women who die of ovarian cancer. An important goal of this study is to examine end-of-life care among a group of these patients who are diverse in terms of race, ethnicity, socioeconomic status, and geographic location. A special focus of this project is the experience of end-of-life care in managed care organizations.

  9. Colorectal cancer screening and surveillance.

    PubMed

    Short, Matthew W; Layton, Miles C; Teer, Bethany N; Domagalski, Jason E

    2015-01-15

    Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. Preventive Services Task Force recommends against routine screening after 75 years of age. Options for screening include high-sensitivity fecal occult blood testing annually, flexible sigmoidoscopy every five years with high-sensitivity fecal occult blood testing every three years, or colonoscopy every 10 years. In 2012, the U.S. Multi-Society Task Force on Colorectal Cancer updated its surveillance guidelines to promote the appropriate use of colonoscopy resources and reduce harms from delayed or unnecessary procedures; these guidelines provide recommendations for when to repeat colonoscopy based on findings. Adenomatous and serrated polyps have malignant potential and warrant early surveillance colonoscopy. Patients with one or two tubular adenomas that are smaller than 10 mm should have a repeat colonoscopy in five to 10 years. Repeat colonoscopy at five years is recommended for patients with nondysplastic serrated polyps that are smaller than 10 mm. Patients with three to 10 adenomas found during a single colonoscopy, an adenoma or serrated polyp that is 10 mm or larger, an adenoma with villous features or high-grade dysplasia, a sessile serrated polyp with cytologic dysplasia, or a traditional serrated adenoma are at increased risk of developing advanced neoplasia during surveillance and should have a repeat colonoscopy in three years. More than 10 synchronous adenomas warrant surveillance colonoscopy in less than three years. Colonoscopy may be repeated in 10 years if distal, small (less than 10 mm) hyperplastic polyps are the only finding. PMID:25591210

  10. Cervical cancer screening. Organised screening to avoid unnecessary conisation.

    PubMed

    2010-08-01

    The incidence of cervical cancer and related deaths has fallen gradually since 1970 in several European countries. The following article examines the role of screening in this reduced mortality, and the potential harms of cervical screening, based on a review of the literature using the standard Prescrire methodology. Cervical cancer is mainly due to persistent infection with certain types of human papillomavirus. Progression to invasive cervical cancer is slow and infrequent. Cervical screening is based on taking a sample of superficial cervical cells for the detection of atypical cells associated with malignant transformation. Women with suspect findings initially undergo colposcopy, followed by more invasive procedures such as biopsy, conisation and surgery, if necessary. Detection of high-grade lesions is similarly efficient whether the sampled cervical epithelial cells are examined immediately on slides or first suspended in a preservative solution (liquid-based cytology). The sensitivity of cervical smear testing for detecting high-grade intraepithelial lesions depends on the sample quality and the experience and training of the person who collects the sample and the person who reads the slides. False-positive and false-negative results are frequent. There are no randomised trials comparing outcomes between women who have regular cervical screening and women who are never screened. Several case-control studies have shown a strong statistical correlation between screening and a reduced risk of cervical cancer. In particular, a British study showed that the risk of being diagnosed with invasive cancer between the ages of 40 and 65 years was 4 times lower among women who had been screened in the previous 5 years than in women who had not been screened. Historical studies, which can only provide a low level of evidence, suggest that the decline in cervical cancer mortality observed in several parts of the world is proportional to participation in screening. In England, the decline in cervical cancer accelerated when screening was better organised and participation increased markedly. Conisation consists of partial surgical excision of the cervix, sometimes for diagnostic purposes after a suspect smear result. It can cause bleeding and has been linked to a risk of preterm delivery in subsequent pregnancies. Most comparative studies have focused on organised screening programmes. In one case-control study, organised screening was more effective than opportunistic screening in reducing the incidence of cervical cancer. The results of case-control studies and epidemiological studies suggest that screening is unnecessary before the age of 21, or in the 3 years after first intercourse. Some data suggest that screening should continue until age 70, at least for some women. Pregnancy is associated with an increased frequency of atypical cells. Immunodepression, due to HIV infection for example, increases the risk of cervical cancer, but the optimal screening frequency for these women is not known. All current guidelines recommend colposcopy for women with high-grade lesions, with a view to performing a biopsy or conisation. In summary, screening has not been shown to reduce the risk of cervical cancer in randomised controlled trials, but retrospective comparisons strongly suggest that regular well-organised smear testing prevents a number of deaths due to cervical cancer. It should be remembered that many cellular atypia found on cervical smears never progress to cancer. The frequency of overdiagnosis has not been studied. Smear-based screening appears to have very few serious adverse effects. In practice, despite the lack of solid evidence, it seems unreasonable not to recommend screening for cervical cancer. Organised screening is preferable to opportunistic screening performed without quality controls and without research to optimise screening strategy. PMID:20939454

  11. Interval cancers in the Dutch breast cancer screening programme

    PubMed Central

    Fracheboud, J; Koning, H J de; Beemsterboer, P M M; Boer, R; Verbeek, A L M; Hendriks, J H C L; Ineveld, B M van; Broeders, M J M; Bruyn, A E de; Maas, P J van der

    1999-01-01

    The nationwide breast cancer screening programme in The Netherlands for women aged 5069 started in 1989. In our study we assessed the occurrence and stage distribution of interval cancers in women screened during 19901993. Records of 0.84 million screened women were linked to the regional cancer registries yielding a follow-up of at least 2.5 years. Age-adjusted incidence rates and relative (proportionate) incidences per tumour size including ductal carcinoma in-situ were calculated for screen-detected and interval cancers, and cancers in not (yet) screened women, comparing them with published data from the UK regions North West and East Anglia. In total 1527 interval cancers were identified: 0.95 and 0.99 per 1000 woman-years of follow-up in the 2-year interval after initial and subsequent screens respectively. In the first year after initial screening interval cancers amounted to 27% (26% after subsequent screens) of underlying incidence, and in the second year to 52% (55%). Generally, interval cancers had a more favourable tumour size distribution than breast cancer in not (yet) screened women. The Dutch programme detected relatively less (favourable) invasive cancers in initial screens than the UK programme, whereas the number of interval cancers confirms UK findings. Measures should be considered to improve the detection of small invasive cancers and to reduce false-negative rates, even if this will lead to increasing referral rates. 1999 Cancer Research Campaign PMID:10555768

  12. How to improve colon cancer screening rates

    PubMed Central

    Alberti, Luiz Ronaldo; Garcia, Diego Paim Carvalho; Coelho, Debora Lucciola; De Lima, David Correa Alves; Petroianu, Andy

    2015-01-01

    Colorectal carcinoma is a common cause of death throughout the world and may be prevented by routine control, which can detect precancerous neoplasms and early cancers before they undergo malignant transformation or metastasis. Three strategies may improve colon cancer screening rates: convince the population about the importance of undergoing a screening test; achieve higher efficacy in standard screening tests and make them more available to the community and develop new more sensitive and efficacious screening methods and make them available as routine tests. In this light, the present study seeks to review these three means through which to increase colon cancer screening rates. PMID:26688708

  13. Prostate cancer screening among military service members.

    PubMed

    Joseph, Hyacinth J; Hickey, James R

    2004-04-01

    This retrospective study investigated the characteristic of military male beneficiaries age 50 years and older who were screened for prostate cancer at a medical center in the Pacific Regional Command. Data were collected on male patients who were seen in three adult outpatient clinics from December 1999 through November 2001. Two research questions were asked: What are the characteristics of men age 50 and older who were screened for prostate cancer? Are there variations in prostate cancer screening based on age, ethnicity, and military status? Data were analyzed using descriptive statistics. The sample was predominantly Caucasian and Asian/Pacific Islander who were over age 67. Although there was evidence of screening in 68% of the sample, 13% of the men had been screened according to the American Cancer Society's recommendations. The findings support the need for a prostate cancer screening policy for the Department of Defense. PMID:15132224

  14. Lung Cancer Screening: Subsequent Evidences of National Lung Screening Trial

    PubMed Central

    2014-01-01

    The US National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality and a 6.7% decrease in all-cause mortality. The NLST is the only trial showing positive results in a high-risk population, such as in patients with old age and heavy ever smokers. Lung cancer screening using a low-dose chest computed tomography might be beneficial for the high-risk group. However, there may also be potential adverse outcomes in terms of over diagnosis, bias and cost-effectiveness. Until now, lung cancer screening remains controversial. In this review, we wish to discuss the evolution of lung cancer screening and summarize existing evidences and recommendations. PMID:25237375

  15. Promoting colorectal cancer screening among Haitian Americans

    PubMed Central

    Coughlin, Steven S.; Lubetkin, Erica I.; Hay, Jennifer L.; Raphael, Renald; Smith, Selina A.

    2015-01-01

    Background Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns. Methods In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research. Results Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of the curability of colorectal cancer, preventive practices, and preferred sources of information among Haitian Americans and other ethnic subgroups of U.S. Blacks. Awareness of colorectal cancer screening tests, risk perception, healthcare provider recommendation, and self-reported use of screening are suboptimal among Haitian Americans and other subgroups. In preliminary quantitative studies, Haitian immigrants have been found to have lower colorectal cancer screening rates than other groups such as African Americans. Conclusions Culturally appropriate educational interventions are needed to encourage Haitian American adults aged ? 50 years to undergo screening for colorectal cancer and to ensure that they are well informed about the value of healthy eating and physical activity. PMID:26819972

  16. Screening for breast cancer in a high-risk series

    SciTech Connect

    Woodard, E.D.; Hempelmann, L.H.; Janus, J.; Logan, W.; Dean, P.

    1982-01-01

    A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammograpy was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, use of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening.

  17. Screening for breast cancer in a high-risk series

    SciTech Connect

    Woodard, E.D.; Hempelmann, L.H.; Janus, J.; Logan, W.; Dean, P.

    1982-01-01

    A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer Institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammography was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, use of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening.

  18. Assessment of a cancer screening program.

    PubMed

    Rabeneck, Linda; Lansdorp-Vogelaar, Iris

    2015-12-01

    Several Asian countries are implementing nationwide cancer screening programs. Assessment of the effectiveness of these programs is critical to their success as this is the only way to ensure that the benefits of screening outweigh the harms. In this paper we focus on colorectal cancer (CRC) screening to illustrate the principles of screening program assessment. The International Agency for Research on Cancer (IARC) has defined organized screening, distinguishing it from opportunistic screening. The key advantage of organized screening is that it provides greater protection against the possible harms of screening. Since screening is a process, not simply a test, the effectiveness of a program depends on the quality of each step in the cancer screening process. The evaluation of long-term screening program outcomes (CRC incidence and mortality) will not be observable for many years, given the time it takes to plan, pilot and implement a program. However, early performance indicators of the impact of screening should be monitored to give an early indication whether the program is on track. The European Union (EU) has recommended a minimum dataset to be collected and reported regularly by a screening program. Using information from these data tables, early performance indicators can be generated (e.g., participation rate, proportion of screen-detected cancers that are early-stage). Subsequently, modeling the natural history of the disease can be very helpful to estimate long-term outcomes, making use of these directly measured early performance indicators. Modeling can also be used to estimate the cost-effectiveness of a screening program and the potential impact of changes in policy, as illustrated by its recent use in the Netherlands to change the definition of a positive fecal immunochemical test (FIT) for the CRC screening program. Programs should consider modeling as an important component of screening program evaluation. PMID:26651258

  19. Tailored Telephone Counseling Increases Colorectal Cancer Screening

    ERIC Educational Resources Information Center

    Rawl, Susan M.; Christy, Shannon M.; Monahan, Patrick O.; Ding, Yan; Krier, Connie; Champion, Victoria L.; Rex, Douglas

    2015-01-01

    To compare the efficacy of two interventions to promote colorectal cancer screening participation and forward stage movement of colorectal cancer screening adoption among first-degree relatives of individuals diagnosed with adenomatous polyps. One hundred fifty-eight first-degree relatives of individuals diagnosed with adenomatous polyps were

  20. Panel's strategies to increase colorectal cancer screening

    Cancer.gov

    Rates of screening for colorectal cancer are consistently lower than those for other types of cancer, particularly breast and cervical. Although the screening rates in the target population--adults over age 50--have increased from 20-30 percent in 1997 to

  1. Tailored Telephone Counseling Increases Colorectal Cancer Screening

    ERIC Educational Resources Information Center

    Rawl, Susan M.; Christy, Shannon M.; Monahan, Patrick O.; Ding, Yan; Krier, Connie; Champion, Victoria L.; Rex, Douglas

    2015-01-01

    To compare the efficacy of two interventions to promote colorectal cancer screening participation and forward stage movement of colorectal cancer screening adoption among first-degree relatives of individuals diagnosed with adenomatous polyps. One hundred fifty-eight first-degree relatives of individuals diagnosed with adenomatous polyps were…

  2. International Collaboration Enhances Cancer Screening Efforts

    Cancer.gov

    CGH is working with the International Agency for Research on Cancer (IARC) and the Pan American Health Organization (PAHO) on the ESTAMPA Study, a multi-centric study of cervical cancer screening and triage with HPV testing. This study compares screening of 50,000 women in 10 Latin American countries for visual, cytological, and molecular triage methods, or combination of these methods, for their performance and cost-effectiveness among women participating in HPV-based screening programs.

  3. Breast cancer screening. First Nations communities in New Brunswick.

    PubMed Central

    Tatemichi, Sue; Miedema, Baukje; Leighton, Shelley

    2002-01-01

    OBJECTIVE: To determine use of breast cancer screening and barriers to screening among women in First Nations communities (FNCs). DESIGN: Structured, administered survey. SETTING: Five FNCs in New Brunswick. PARTICIPANTS: One hundred thirty-three (96%) of 138 eligible women between the ages of 50 and 69 years. INTERVENTIONS: After project objectives, methods, and expected outcomes were discussed with community health representatives, we administered a 32-item questionnaire on many aspects of breast cancer screening. MAIN OUTCOME MEASURES: Rate of use of mammography and other breast cancer screening methods, and barriers to screening. RESULTS: Some 65% of participants had had mammography screening within the previous 2 years. Having mammography at recommended intervals and clinical breast examinations (CBEs) yearly were significantly associated with having had a physician recommend the procedures (P < .001). A family history of breast cancer increased the odds of having a mammogram 2.6-fold (P < .05, 95% confidence interval [CI] 1.03 to 6.54). Rates of screening differed sharply by whether a family physician was physically practising in the community or not (P < .05, odds ratio 2.68, 95% CI 1.14 to 6.29). CONCLUSION: Women in FNCs in one health region in New Brunswick have mammography with the same frequency as off-reserve women. A family physician practising part time in the FNCs was instrumental in encouraging women to participate in breast cancer screening. PMID:12113195

  4. Percentage of Adults Who Receive Colorectal Cancer Screening as Appropriate

    MedlinePLUS

    ... Screening as Appropriate Percentage of Adults Who Receive Colorectal Cancer Screening as Appropriate Colorectal cancer is the second ... Age Group Percentage of Adults Who Receive Recommended Colorectal Cancer Screening by Age Group 78pm-ubty Download these ...

  5. Colorectal Cancer Screening, Version 1.2015.

    PubMed

    Provenzale, Dawn; Jasperson, Kory; Ahnen, Dennis J; Aslanian, Harry; Bray, Travis; Cannon, Jamie A; David, Donald S; Early, Dayna S; Erwin, Deborah; Ford, James M; Giardiello, Francis M; Gupta, Samir; Halverson, Amy L; Hamilton, Stanley R; Hampel, Heather; Ismail, Mohammad K; Klapman, Jason B; Larson, David W; Lazenby, Audrey J; Lynch, Patrick M; Mayer, Robert J; Ness, Reid M; Rao, M Sambasiva; Regenbogen, Scott E; Shike, Moshe; Steinbach, Gideon; Weinberg, David; Dwyer, Mary A; Freedman-Cass, Deborah A; Darlow, Susan

    2015-08-01

    The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Colorectal Cancer Screening provide recommendations for selecting individuals for colorectal cancer screening, and for evaluation and follow-up of colon polyps. These NCCN Guidelines Insights summarize major discussion points of the 2015 NCCN Colorectal Cancer Screening panel meeting. Major discussion topics this year were the state of evidence for CT colonography and stool DNA testing, bowel preparation procedures for colonoscopy, and guidelines for patients with a positive family history of colorectal cancer. PMID:26285241

  6. Screening for Prostate Cancer: The Debate Continues

    PubMed Central

    Matrana, Marc R.; Atkinson, Bradley

    2013-01-01

    Other than skin cancer, prostate cancer is the most frequently diagnosed cancer in men, and it is the second leading cause of cancer-related death for males in the United States. Screening for prostate cancer using prostate-specific antigen testing became widely used by the late 1980s, augmenting the digital rectal exam. This led to a decline in the percentage of prostate cancer cases that were metastatic at diagnosis and a decrease in prostate cancer mortality. But some argued it led to overtreatment of prostate cancers as well. Recently, the U.S. Preventive Services Task Force (USPSTF) issued recommendations against routine prostate cancer screening in asymptomatic patients. The recent recommendations have created much controversy among medical professionals, patient advocate groups, and the general public. Most prostate cancer screening recommendations from professional organizations agree that an informed discussion and review of each individual patient’s clinical situation should drive the decision to screen or not to screen, but the current USPSTF recommendations largely remove patient and provider autonomy in this regard. They do not contribute toward personalized screening based on individualized patient risk profiles, characteristics, and preferences. PMID:25031977

  7. Cancer Screening Behaviors of African American Women Enrolled in a Community-Based Cancer Prevention Trial

    PubMed Central

    Reiter, Paul L.

    2011-01-01

    Abstract Background African American women have increased mortality rates for cervical, breast, and colorectal cancers, yet not all receive the recommended screening tests for these cancers. We characterized the cancer screening behaviors of African American women enrolled in a community-based cancer prevention trial. Methods We examined cross-sectional data from 1123 African American customers aged ?18 years from 37 beauty salons in North Carolina who completed the North Carolina BEAUTY and Health Project baseline survey. Mixed logistic regression models were used to identify correlates of receiving cervical, breast, and colorectal cancer screening tests within recommended screening guidelines. Results Overall, 94% (1026 of 1089) of women aged ?18 years reported receiving a Pap smear test within the last 3 years, 70% (298 of 425) of women aged ?40 years reported receiving a mammography within the last year, and 64% (116 of 180) of women aged ?50 years were considered to be within recommended screening guidelines for colorectal cancer. Age was correlated with recent Pap smear testing and mammography. Women who reported receiving a recent Pap smear test were more likely to report a mammogram in the last year, and women with a recent mammogram were more likely to be within recommended screening guidelines for colorectal cancer. Many women reported multiple barriers to getting recommended cancer screening tests. Conclusions Almost all women reported receiving a Pap smear test within the last 3 years. Future interventions should focus on increasing breast and colorectal cancer screening among African American women. PMID:21332413

  8. Cancer prevention and population-based screening.

    PubMed

    Luciani, Silvana; Vardy, Lianne; Paci, Eugenio; Adewole, Isaac; Sasco, Annie; Calvacante, Tania

    2009-01-01

    Cancer prevention, screening and early detection can provide some of the greatest public health benefits for cancer control. In low resource settings, where cancer control is challenged by limited human, financial and technical resources, cancer prevention and screening are of utmost importance and can provide significant impacts on the cancer burden. Public policies, social, environmental and individual level interventions which promote and support healthy eating and physical activity can lower cancer risks. Tobacco use, a significant cancer risk factor, can be reduced through the application of key mandates of the World Health Organization Framework Convention on Tobacco Control. In addition, cancer screening programs, namely for cervical and breast cancers, can have a significant impact on reducing cancer mortality, including in low resource settings. Comprehensive cancer control programs require interventions for cancer prevention, screening and early detection, and involve sectors outside of health to create supportive environments for healthy ways of life. Sharing experiences in implementing cancer control programs in different settings can create opportunities for interchanging ideas and forming international alliances. PMID:19999950

  9. Cancer screening practices of nurse practitioners.

    PubMed

    Warren, B; Pohl, J M

    1990-06-01

    The Nurse Practitioner's (NP) role in providing quality primary care with emphasis on health promotion is well established. Yet the NP's actual cancer detection activities are unknown. To determine the cancer screening and detection activities of NPs in adult primary care settings, a questionnaire survey was developed from the American Cancer Society's "Guidelines for the Cancer-Related Checkup" and current cancer detection literature. The survey was distributed to primary care NPs throughout the state of Michigan (n = 97). Pearson correlation coefficients were applied to the data to establish the relationship of cancer screening practices by NPs to specific age groups and by gender. Practitioners reported significantly higher frequencies of recommended screening for adult women than for adult men. Although at a lower risk for developing cancer, younger and early middle-aged adults (19-39 years) received significantly higher frequencies of recommended screening than middle-aged and older adults. NPs believe that cancer screening and counseling are consistent with their role except in the areas of male physical exam (testes, prostate) and invasive procedures such as sigmoids for men and women. The broader implications for further research, organization of primary care services, and strategies to increase nurses' involvement in cancer screening practices are presented. PMID:2354426

  10. Lung Cancer Screening with Low Dose CT

    PubMed Central

    Caroline, Chiles

    2014-01-01

    SUMMARY The announcement of the results of the NLST, showing a 20% reduction in lung-cancer specific mortality with LDCT screening in a high risk population, marked a turning point in lung cancer screening. This was the first time that a randomized controlled trial had shown a mortality reduction with an imaging modality aimed at early detection of lung cancer. Current guidelines endorse LDCT screening for smokers and former smokers ages 55 to 74, with at least a 30 pack year smoking history. Adherence to published algorithms for nodule follow-up is strongly encouraged. Future directions for screening research include risk stratification for selection of the screening population, and improvements in the diagnostic follow-up for indeterminate pulmonary nodules. As with screening for other malignancies, screening for lung cancer with LDCT has revealed that there are indolent lung cancers which may not be fatal. More research is necessary if we are to maximize the risk-benefit ratio in lung cancer screening. PMID:24267709

  11. ACR Appropriateness Criteria on colorectal cancer screening.

    PubMed

    Yee, Judy; Rosen, Max Paul; Blake, Michael A; Baker, Mark E; Cash, Brooks D; Fidler, Jeff L; Grant, Thomas H; Greene, Frederick L; Jones, Bronwyn; Katz, Douglas S; Lalani, Tasneem; Miller, Frank H; Small, William C; Sudakoff, Gary S; Warshauer, David M

    2010-09-01

    Colorectal cancer remains one of the most common causes of cancer death in this country. This malignancy is ideally suited for screening because the detection and removal of the precursor adenomatous polyp can prevent most colorectal cancers from ever forming. The choice of a test for screening involves consideration of various individual parameters, including patient age and the presence of risk factors for the development of colorectal cancer. Computed tomographic colonography (CTC) has emerged as the leading imaging technique for colorectal cancer screening in average-risk individuals on the basis of the evidence presented in this paper. The double-contrast barium enema is an alternative imaging test that is appropriate particularly when CTC is not available. In 2008, the American Cancer Society guideline for colorectal cancer screening was revised jointly with the US Multi-Society Task Force on Colorectal Cancer and the ACR to include CTC every 5 years as an option for average-risk individuals. Computed tomographic colonography is also the preferred test for colon evaluation after an incomplete colonoscopy. Imaging tests including CTC and the double-contrast barium enema are usually not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the new colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging. PMID:20816627

  12. Cervical cancer screening among Latinas: the importance of referral and participation in parallel cancer screening behaviors.

    PubMed

    Borrayo, Evelinn A; Thomas, Jenifer J; Lawsin, Catalina

    2004-01-01

    Low cancer screening participation among medically underserved Latinas is largely due to lack of active referral to screening procedures by health care providers. We explored how physicians' referral and instruction on parallel screening procedures discriminates Latinas' cervical cancer screening practices in the context of relevant variables such as sociodemographic characteristics, health insurance, history of cancer, and level of acculturation. Of 153 women surveyed, 100 were compliant with yearly Pap smear while 53 were not compliant. Discriminant function analysis revealed that health care provider interventions and parallel breast cancer screening behaviors were significant discriminators between women who obtained a Pap smear within a year and those who were less compliant. A change in public health policy that facilitates to medically underserved Latinas access to reliable sources of health care referrals and services might increase their regular use of cervical cancer screening, which could potentially result in a reduction in cancer treatment costs and in lives lost to cervical cancer among these women. PMID:15130859

  13. Lung cancer screening overdiagnosis: reports of overdiagnosis in screening for lung cancer are grossly exaggerated.

    PubMed

    Mortani Barbosa, Eduardo J

    2015-08-01

    The National Lung Cancer Screening Trial (NLST) demonstrated a mortality reduction benefit associated with low-dose computed tomography (LDCT) screening for lung cancer. There has been considerable debate regarding the benefits and harms of LDCT lung cancer screening, including the challenges related to its practical implementation. One of the controversies regards overdiagnosis, which conceptually denotes diagnosing a cancer that, either because of its indolent, low-aggressiveness biologic behavior or because of limited life expectancy, is unlikely to result in significant morbidity during the patient's remainder lifetime. In theory, diagnosing and treating these cancers offer no measurable benefit while incurring costs and risks. Therefore, if a screening test detects a substantial number of overdiagnosed cancers, it is less likely to be effective. It has been argued that LDCT screening for lung cancer results in an unacceptably high rate of overdiagnosis. This article aims to defend the opposite stance. Overdiagnosis does exist and to a certain extent is inherent to any cancer-screening test. Nonetheless, the concept is less dualistic and more nuanced than it has been suggested. Furthermore, the average estimates of overdiagnosis in LDCT lung cancer screening based on the totality of published data are likely much lower than the highest published estimates, if a careful definition of a positive screening test reflecting our current understanding of lung cancer biology is utilized. This article presents evidence on why reports of overdiagnosis in lung cancer screening have been exaggerated. PMID:25772581

  14. Screening and early detection of lung cancer.

    PubMed

    Van't Westeinde, Susan C; van Klaveren, Rob J

    2011-01-01

    Lung cancer with an estimated 342,000 deaths in 2008 (20% of total) is the most common cause of death from cancer, followed by colorectal cancer (12%), breast cancer (8%), and stomach cancer (7%) in Europe. In former smokers, the absolute lung cancer risk remains higher than in never-smokers; these data therefore call for effective secondary preventive measures for lung cancer in addition to smoking cessation programs. This review presents and discusses the most recent advances in the early detection and screening of lung cancer.An overview of randomized controlled computerized tomography-screening trials is given, and the role of bronchoscopy and new techniques is discussed. Finally, the approach of (noninvasive) biomarker testing in the blood, exhaled breath, sputum, and bronchoscopic specimen is reviewed. PMID:21263260

  15. The Korean guideline for cervical cancer screening.

    PubMed

    Min, Kyung Jin; Lee, Yoon Jae; Suh, Mina; Yoo, Chong Woo; Lim, Myong Cheol; Choi, Jaekyung; Ki, Moran; Kim, Yong Man; Kim, Jae Weon; Kim, Jea Hoon; Park, Eal Whan; Lee, Hoo Yeon; Lim, Sung Chul; Cho, Chi Heum; Hong, Sung Ran; Dang, Ji Yeon; Kim, Soo Young; Kim, Yeol; Lee, Won Chul; Lee, Jae Kwan

    2015-07-01

    The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass-screening program. Furthermore, a new method has been introduced in cervical cancer screening. Therefore, the committee for cervical cancer screening in Korea updated the recommendation statement established in 2002. The new version of the guideline was developed by the committee using evidence-based methods. The committee reviewed the evidence for the benefits and harms of the Papanicolaou test, liquid-based cytology, and human papillomavirus (HPV) testing, and reached conclusions after deliberation. The committee recommends screening for cervical cancer with cytology (Papanicolaou test or liquid-based cytology) every three years in women older than 20 years of age (recommendation A). The cervical cytology combined with HPV test is optionally recommended after taking into consideration individual risk or preference (recommendation C). The current evidence for primary HPV screening is insufficient to assess the benefits and harms of cervical cancer screening (recommendation I). Cervical cancer screening can be terminated at the age of 74 years if more than three consecutive negative cytology reports have been confirmed within 10 years (recommendation D). PMID:26197860

  16. Patient Beliefs About Colon Cancer Screening.

    PubMed

    Ely, John W; Levy, Barcey T; Daly, Jeanette; Xu, Yinghui

    2016-03-01

    Only about half of eligible individuals undergo colon cancer screening. We have limited knowledge about the patient beliefs that adversely affect screening decisions and about which beliefs might be amenable to change through education. As part of a clinical trial, 641 rural Iowans, aged 52 to 79 years, reported their beliefs about colon cancer screening in response to a mailed questionnaire. Consenting subjects were randomized into four groups, which were distinguished by four levels of increasingly intensive efforts to promote screening. Two of the groups received mailed educational materials and completed a follow-up questionnaire, which allowed us to determine whether their beliefs about screening changed following the education. We also completed a factor analysis to identify underlying (latent) factors that might explain the responses to 33 questions about readiness, attitudes, and perceived barriers related to colon cancer screening. The strongest predictors of a patient's stated readiness to be screened were a physician's recommendation to be screened (1 point difference on 10-point Likert scale, 95 % confidence interval [CI], 0.5 to 1.6 point difference), a family history of colon cancer (0.85-point Likert scale difference, 95 % CI, 0.1 to 1.6), and a belief that health-care decisions should be mostly left to physicians rather than patients (Spearman correlation coefficient 0.21, P < .001). Of the 33 questionnaire items about screening beliefs, 11 (33 %) changed favorably following the educational intervention. In the factor analysis, the 33 items were reduced to 8 underlying factors, such as being too busy to undergo screening and worries about screening procedures. We found a limited number of underlying factors that may help explain patient resistance to colon cancer screening. PMID:25619196

  17. Problems of cervical cancer screening programmes

    PubMed Central

    Rang, E.H.; Tod, E.D.M.

    1988-01-01

    The feasibility of using an age-sex register as a basis for a cervical cancer screening programme was investigated in a London practice serving both inner city and suburban populations. Only about 25% of 810 women aged 35-59 years who had not recently been screened responded to an invitation to attend a practice well woman clinic for a cervical smear. Nearly 30% of the invitations were returned `not known at this address' and there was no reply from the remaining 45%. A high proportion of incorrect addresses considerably reduces the effectiveness of a cancer screening programme based on an age-sex register covering an area with a mobile population and also makes it difficult to follow up women with abnormal smears adequately. Opportunistic screening remains essential and every effort should be made to encourage women to be responsible for their own cancer screening programmes. PMID:3255814

  18. New testing for lung cancer screening.

    PubMed

    Tanner, Nichole T; Mehta, Hiren; Silvestri, Gerard A

    2012-02-01

    Lung cancer is the leading cause of cancer-related death worldwide. At the time of initial presentation, most patients are at an advanced stage of disease with an associated poor prognosis.Those diagnosed and treated at earlier stages have a significantly better outcome, with 5-year survival for stage I disease approaching 75%. Ideally, a screening strategy for lung cancer would detect disease at an earlier stage and allow for potential surgical cure in those with cancer and avoid unnecessary morbidity in those without. Until recently, there had not been a screening test that demonstrated a mortality reduction in lung cancer. The National Lung Cancer Screening Trial showed that screening high-risk persons with low-dose CT scanning could significantly reduce lung cancer mortality; however, there are difficulties in generalizing these results to the community. Several new testing techniques, including measurement of volatile organic compounds in exhaled breath, an airway epithelial gene expression biomarker, and serum sampling for antibodies to tumor-associated antigens, are currently being evaluated and may prove useful as part of a screening algorithm for lung cancer. PMID:22489353

  19. Cancer screening trials: nuts and bolts.

    PubMed

    Prorok, Philip C; Marcus, Pamela M

    2010-06-01

    The most rigorous and valid approach to evaluating cancer screening modalities is the randomized controlled trial (RCT). RCTs are major undertakings and the intricacies of trial design, operations, and management are generally underappreciated by the typical researcher. The purpose of this article is to inform the reader of the "nuts and bolts" of designing and conducting cancer screening RCTs. Following a brief introduction as to why RCTs are critical in evaluating screening modalities, we discuss design considerations, including the choice of design type and duration of follow-up. We next present an approach to sample-size calculations. We then discuss aspects of trial implementation, including recruitment, randomization, and data management. A discussion of commonly employed data analyses comes next, and includes methods for the primary analysis (comparison of cause-specific mortality rates between the screened and control arms for the cancer of interest), as well as for secondary endpoints such as sensitivity. We follow with a discussion of sequential monitoring and interim analysis techniques, which are used to examine the primary outcome while the trial is ongoing. We close with thoughts on lessons learned from past cancer screening RCTs and provide recommendations for future trials. Throughout the presentation we illustrate topics with examples from completed or ongoing RCTs, including the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial and the National Lung Screening Trial (NLST). PMID:20709206

  20. Towards better implementation of cancer screening in Europe through improved monitoring and evaluation and greater engagement of cancer registries.

    PubMed

    Anttila, Ahti; Lnnberg, Stefan; Ponti, Antonio; Suonio, Eero; Villain, Patricia; Coebergh, Jan Willem; von Karsa, Lawrence

    2015-01-01

    Proposals to improve implementation, monitoring and evaluation of breast, cervical and colorectal cancer screening programmes have been developed in a European project involving scientists and professionals experienced in cancer registration (EUROCOURSE). They call for a clear and more active role for cancer registries through better interfaces with cancer screening programmes and adapting data contents of cancer registries for evaluation purposes. Cancer registries are recognised as essential for adequate evaluation of cancer screening programmes, but they are not involved in screening evaluation in several European countries. This is a key barrier to improving the effectiveness of programmes across Europe. The variation in Europe in the implementation of cancer screening offers a unique opportunity to learn from best practices in collaboration between cancer registries and screening programmes. Population-based cancer registries have experience and tools in collecting and analysing relevant data, e.g. for diagnostic and therapeutic determinants of mortality. In order to accelerate improvements in cancer control we argue that cancer registries should take co-responsibility in promoting effective screening evaluation in Europe. Additional investments are vital to further development of infrastructures and activities for screening evaluation and monitoring in the national settings and also at the pan-European level. The EUROCOURSE project also aimed to harmonise implementation of the European quality assurance guidelines for cancer screening programmes across Europe through standardising routine data collection and analysis, and definitions for key performance indicators for screening registers. Data linkage between cancer and screening registers and other repositories of demographic data and cause of death and where available clinical registers is key to implementing the European screening standards and thereby reducing the burden of disease through early detection. Greater engagement of cancer registries in this collaborative effort is also essential to develop adequate evaluation of innovations in cancer prevention and care. PMID:25483785

  1. Results of Colorectal Cancer Screening of the National Cancer Screening Program in Korea, 2008

    PubMed Central

    Shim, Jung Im; Han, Mi Ah; Lee, Hoo-Yeon; Choi, Kui Sun; Jun, Jae Kwan; Park, Eun-Cheol

    2010-01-01

    Purpose This study aims to investigate the current situation of national colorectal cancer screening by analyzing participation rates, positive rates of screening methods and screening rate of secondary screening tests in colorectal screening of the national cancer screening program in 2008. Materials and Methods With database about target population and screened individuals of the national cancer screening program, the results of target population and participants of colorectal cancer screening in 2008 were analyzed. Among adults aged over 50 years of medical aid and beneficiaries of national health insurance paying lower 50% premiums in the total subscribers, 4,640,365 were target population of colorectal cancer screening and the data of 984,915 undergoing fecal occult blood test (FOBT) as a primary screening were analyzed. Results The colorectal cancer screening rate was 21.2% and the rates of national health insurance subscribers, females and the elderly aged 60-64 years were higher than those of others. The recipients with a positive result in FOBT recorded approximately 7.5%. Medical aid beneficiaries (7.9%), males (8.8%) and seniors aged over 75 years (9.1%) showed higher positive rates than the average one. Out of the FOBT positive recipients, 43.0% took a secondary screening and the rate undergoing colonoscopy (31.4%) was higher than that of doing double-contrast barium enema test (11.6%). Conclusion Colorectal cancer screening rate of medical aid beneficiaries and people paying lower 50% premiums among national health insurance subscribers, was different according to demographic characters (gender, age and types of health insurance). This finding meant that screening for the vulnerable needed to be encouraged by considering socio-demographic characters. Additionally, more efforts were necessary to increase the secondary screening rate of people with a positive result in primary one. PMID:21253320

  2. Beyond MQSA: Measuring the quality of breast cancer screening programs

    PubMed Central

    Rauscher, Garth H.; Murphy, Anne Marie; Orsi, Jennifer M.; Dupuy, Danielle M.; Grabler, Paula M.; Weldon, Christine B.

    2014-01-01

    OBJECTIVE A high quality screening mammography program should find breast cancer when it exists, when it’s small, and ensure that suspicious findings receive prompt follow-up. The Mammography Quality Standards Act (MQSA) guidelines related to tracking outcomes are insufficient for assessing quality of care. We used data from a quality improvement project to determine whether mammography screening facilities could show that they met certain quality benchmarks beyond those required by MQSA. METHODS Participating facilities (N=52) provided aggregate data on screening mammograms conducted in calendar year 2009 and corresponding diagnostic follow-up, including lost to follow-up and timing of diagnostic imaging and biopsy, cancer detection rates, and the proportion of cancers detected as minimal and early stage tumors. RESULTS The percentage of institutions meeting each benchmark varied from 27% to 83%. Facilities with American College of Surgeons or National Comprehensive Cancer Network designation were more likely to meet benchmarks pertaining to cancer detection and early detection, and Disproportionate Share facilities were less likely to meet benchmarks pertaining to timeliness of care. CONCLUSIONS Results suggest a combination of care quality issues and incomplete tracking of patients. To accurately measure quality of the breast cancer screening process, it is critical that there be complete tracking of patients with abnormal screening mammograms so that results can be interpreted solely in terms of quality of care. The Mammography Quality Standards Act guidelines for tracking outcomes and measuring quality indicators should be strengthened to better assess quality of care. PMID:24261339

  3. Crunching Numbers: What Cancer Screening Statistics Really Tell Us

    Cancer.gov

    Cancer screening studies have shown that more screening does not necessarily translate into fewer cancer deaths. This article explains how to interpret the statistics used to describe the results of screening studies.

  4. Chemoprevention studies within lung cancer screening programmes

    PubMed Central

    Veronesi, G; Guerrieri-Gonzaga, A; Infante, M; Bonanni, B

    2015-01-01

    While aggressive tobacco control and help to stop smoking are essential weapons in the fight against lung cancer, screening with low-dose computed tomography (LDCT) in high-risk populations and chemoprevention may also contribute to reducing lung cancer deaths. Persons undergoing LDCT screening are an ideal population to be tested for agents potentially able to prevent the development of lung cancer by the regression of precancerous lesions, which are routinely monitored as part of the screening process. Peripheral subsolid nodules appear as particularly suitable targets, since many are adenocarcinoma precursors. A study on inhaled budesonide (a potential chemopreventive drug) for 1 year found that the mean size of non-solid lung nodules was significantly reduced over 5 years of follow-up, compared to inhaled placebo, in a population of high-risk individuals with indeterminate lung nodules not requiring immediate specific investigation for lung cancer and detected as part of a lung cancer screening program with LDCT. A new randomised placebo-controlled phase-II trial to test the ability of aspirin to induce the regression of non-solid and partially solid nodules detected by LDCT screening has been started. The effect of aspirin on a miRNA signature able to predict the presence of both cancer and precancerous lesions in high-risk asymptomatic individuals is also being monitored in the trial. This signature was previously shown to predict the presence of both lung cancer and non-solid lung nodules in asymptomatic individuals. PMID:26635901

  5. European Code against Cancer, 4th Edition: Cancer screening.

    PubMed

    Armaroli, Paola; Villain, Patricia; Suonio, Eero; Almonte, Maribel; Anttila, Ahti; Atkin, Wendy S; Dean, Peter B; de Koning, Harry J; Dillner, Lena; Herrero, Rolando; Kuipers, Ernst J; Lansdorp-Vogelaar, Iris; Minozzi, Silvia; Paci, Eugenio; Regula, Jaroslaw; Trnberg, Sven; Segnan, Nereo

    2015-12-01

    In order to update the previous version of the European Code against Cancer and formulate evidence-based recommendations, a systematic search of the literature was performed according to the methodology agreed by the Code Working Groups. Based on the review, the 4th edition of the European Code against Cancer recommends: "Take part in organized cancer screening programmes for: Organized screening programs are preferable because they provide better conditions to ensure that the Guidelines for Quality Assurance in Screening are followed in order to achieve the greatest benefit with the least harm. Screening is recommended only for those cancers where a demonstrated life-saving effect substantially outweighs the potential harm of examining very large numbers of people who may otherwise never have, or suffer from, these cancers, and when an adequate quality of the screening is achieved. EU citizens are recommended to participate in cancer screening each time an invitation from the national or regional screening program is received and after having read the information materials provided and carefully considered the potential benefits and harms of screening. Screening programs in the European Union vary with respect to the age groups invited and to the interval between invitations, depending on each country's cancer burden, local resources, and the type of screening test used For colorectal cancer, most programs in the EU invite men and women starting at the age of 50-60 years, and from then on every 2 years if the screening test is the guaiac-based fecal occult blood test or fecal immunochemical test, or every 10 years or more if the screening test is flexible sigmoidoscopy or total colonoscopy. Most programs continue sending invitations to screening up to the age of 70-75 years. For breast cancer, most programs in the EU invite women starting at the age of 50 years, and not before the age of 40 years, and from then on every 2 years until the age of 70-75 years. For cervical cancer, if cytology (Pap) testing is used for screening, most programs in the EU invite women starting at the age of 25-30 years and from then on every 3 or 5 years. If human papillomavirus testing is used for screening, most women are invited starting at the age of 35 years (usually not before age 30 years) and from then on every 5 years or more. Irrespective of the test used, women continue participating in screening until the age of 60 or 65 years, and continue beyond this age unless the most recent test results are normal. PMID:26596722

  6. Psychiatric morbidity after screening for breast cancer.

    PubMed Central

    Dean, C; Roberts, M M; French, K; Robinson, S

    1986-01-01

    One hundred and thirty two women with normal breast screening results were interviewed six months after their attendance at the Edinburgh Breast Screening Clinic. Eight percent of women said screening had made them more anxious about developing breast cancer. Thirty eight percent said they were more aware of the disease since screening but they regarded this as advantageous. Seventy percent of the women were still practising breast self-examination. There was no difference in the psychiatric morbidity of the screened sample when compared with a matched random sample community control group. Neither was there any difference in the General Health Questionnaire case rates before and after screening. Screening does not appear to increase the prevalence of psychiatric morbidity. Twenty nine percent of the interview sample were examining their breasts more than once a month--21% once a week or more. However, these frequent self-examiners did not have a greater prevalence of psychiatric morbidity than their matched controls. PMID:3711771

  7. Colorectal Cancer Screening: Tests, Strategies, and Perspectives

    PubMed Central

    Stracci, Fabrizio; Zorzi, Manuel; Grazzini, Grazia

    2014-01-01

    Screening has a central role in colorectal cancer (CRC) control. Different screening tests are effective in reducing CRC-specific mortality. Influence on cancer incidence depends on test sensitivity for pre-malignant lesions, ranging from almost no influence for guaiac-based fecal occult blood testing (gFOBT) to an estimated reduction of 6690% for colonoscopy. Screening tests detect lesions indirectly in the stool [gFOBT, fecal immunochemical testing (FIT), and fecal DNA] or directly by colonic inspection [flexible sigmoidoscopy, colonoscopy, CT colonography (CTC), and capsule endoscopy]. CRC screening is cost-effective compared to no screening but no screening strategy is clearly better than the others. Stool tests are the most widely used in worldwide screening interventions. FIT will soon replace gFOBT. The use of colonoscopy as a screening test is increasing and this strategy has superseded all alternatives in the US and Germany. Despite its undisputed importance, CRC screening is under-used and participation rarely reaches 70% of target population. Strategies to increase participation include ensuring recommendation by physicians, introducing organized screening and developing new, more acceptable tests. Available evidence for DNA fecal testing, CTC, and capsule endoscopy is reviewed. PMID:25386553

  8. Oral cancer screening: serum Raman spectroscopic approach.

    PubMed

    Sahu, Aditi K; Dhoot, Suyash; Singh, Amandeep; Sawant, Sharada S; Nandakumar, Nikhila; Talathi-Desai, Sneha; Garud, Mandavi; Pagare, Sandeep; Srivastava, Sanjeeva; Nair, Sudhir; Chaturvedi, Pankaj; Murali Krishna, C

    2015-11-01

    Serum Raman spectroscopy (RS) has previously shown potential in oral cancer diagnosis and recurrence prediction. To evaluate the potential of serum RS in oral cancer screening, premalignant and cancer-specific detection was explored in the present study using 328 subjects belonging to healthy controls, premalignant, disease controls, and oral cancer groups. Spectra were acquired using a Raman microprobe. Spectral findings suggest changes in amino acids, lipids, protein, DNA, and ?-carotene across the groups. A patient-wise approach was employed for data analysis using principal component linear discriminant analysis. In the first step, the classification among premalignant, disease control (nonoral cancer), oral cancer, and normal samples was evaluated in binary classification models. Thereafter, two screening-friendly classification approaches were explored to further evaluate the clinical utility of serum RS: a single four-group model and normal versus abnormal followed by determining the type of abnormality model. Results demonstrate the feasibility of premalignant and specific cancer detection. The normal versus abnormal model yields better sensitivity and specificity rates of 64 and 80%; these rates are comparable to standard screening approaches. Prospectively, as the current screening procedure of visual inspection is useful mainly for high-risk populations, serum RS may serve as a useful adjunct for early and specific detection of oral precancers and cancer. PMID:26580700

  9. Oral cancer screening: serum Raman spectroscopic approach

    NASA Astrophysics Data System (ADS)

    Sahu, Aditi K.; Dhoot, Suyash; Singh, Amandeep; Sawant, Sharada S.; Nandakumar, Nikhila; Talathi-Desai, Sneha; Garud, Mandavi; Pagare, Sandeep; Srivastava, Sanjeeva; Nair, Sudhir; Chaturvedi, Pankaj; Murali Krishna, C.

    2015-11-01

    Serum Raman spectroscopy (RS) has previously shown potential in oral cancer diagnosis and recurrence prediction. To evaluate the potential of serum RS in oral cancer screening, premalignant and cancer-specific detection was explored in the present study using 328 subjects belonging to healthy controls, premalignant, disease controls, and oral cancer groups. Spectra were acquired using a Raman microprobe. Spectral findings suggest changes in amino acids, lipids, protein, DNA, and β-carotene across the groups. A patient-wise approach was employed for data analysis using principal component linear discriminant analysis. In the first step, the classification among premalignant, disease control (nonoral cancer), oral cancer, and normal samples was evaluated in binary classification models. Thereafter, two screening-friendly classification approaches were explored to further evaluate the clinical utility of serum RS: a single four-group model and normal versus abnormal followed by determining the type of abnormality model. Results demonstrate the feasibility of premalignant and specific cancer detection. The normal versus abnormal model yields better sensitivity and specificity rates of 64 and 80% these rates are comparable to standard screening approaches. Prospectively, as the current screening procedure of visual inspection is useful mainly for high-risk populations, serum RS may serve as a useful adjunct for early and specific detection of oral precancers and cancer.

  10. Prevalence of cervical neoplastic lesions and Human Papilloma Virus infection in Egypt: National Cervical Cancer Screening Project

    PubMed Central

    Abd El All, Howayda S; Refaat, Amany; Dandash, Khadiga

    2007-01-01

    Background Data from Egyptian studies provide widely varying estimates on the prevalence of pre-malignant and malignant cervical abnormalities and human papilloma virus (HPVs) infection. To define the prevalence and risk factors of pre-invasive and invasive cervical cancer (cacx), a community based full-scale cross sectional, household survey including 5453 women aged between 35 and 60 years was conducted. Methods The study period was between February 2000 and December 2002. Initially, conventional Papanicolaou (Pap) smears were evaluated using the Bethesda system (TBS), followed by colposcopic guided biopsy (CGB) for all epithelial abnormalities (EA). In a third step, HPV was tested on all EA by in-situ hybridization (ISH) using first the broad spectrum HPV probe recognizing HPVs 6, 11, 16, 18, 30, 31, 35, 45, 51 and 52 followed by subtyping with probes 6/11, 16/18 and 31/33. Lastly, unequivocal cases were immunostained for herpes simplex type-2 (HSV-2), cytomegalovirus (CMV), and human immunodeficiency virus (HIV). Results EA representing 7.8% (424/5453), were categorized into atypical squamous cell of undetermined significance (ASCUS) (34.4%), atypical glandular cell of undetermined significance (AGCUS) (15.3%), combined ASCUS and AGCUS (3.1%), low grade squamous intraepithelial lesions (SIL) (41.0%), high grade SIL (5.2%) and invasive lesions (1%). CGB of EA (n = 281) showed non neoplastic lesions (12.8%), atypical squamous metaplasia (ASM) (19.2%), cervical intraepithelial neoplasia I (CIN) (44.4%), CIN II (4.4%), CINIII (2.8%), endocervical lesions (5.2%), combined squamous and endocervical lesions (10.0%), invasive squamous cell carcinoma (SCC) (0.02%) and extranodal marginal zone B cell lymphoma (MZBCL) (0.02%). The overall predictive value of cytology was 87% while the predictive value for high grade lesions was 80%. On histological basis, HPVs were present in 94.3% of squamous lesions while it was difficult to be identified in endocervical ones. ISH revealed positivity for pan HPV in 65.9% of the studied biopsies (n = 217), with incorporation of the viral genome HPV 6/11, 16/18 and 31/33 in 11.1%, 33.3% and 17.1% respectively. Multiple HPVs infections were identified in 0.02%. Conclusion Pre-invasive high grade lesions and invasive cervical carcinoma represent 0.5% and 0.04% respectively in Egyptian women. HPV mostly 16/18 as a risk factor (p < 0.001), was frequently associated with mixed infections (p < 0.001) and bilharzial infestation (p < 0.001). PMID:17610742

  11. Risks of Esophageal Cancer Screening

    MedlinePLUS

    ... the type of cells that become malignant (cancerous): Squamous cell carcinoma : Cancer that begins in squamous cells , the thin, ... adenocarcinoma each year and fewer new cases of squamous cell carcinoma. Squamous cell carcinoma of the esophagus is found ...

  12. What Women Need to Know about Colon Cancer Screening

    MedlinePLUS

    ... you love): What Women Need to Know about Colon Cancer Screening March is National Colorectal Cancer Awareness Month ... the United States. Tests used for screening for colon cancer include digital rectal exam, stool blood test, barium ...

  13. Cervical cancer screening service utilisation in UK.

    PubMed

    Labeit, Alexander; Peinemann, Frank; Kedir, Abbi

    2013-01-01

    This study investigates empirically how past screening behaviour, individual and household characteristics affect the current uptake of cervical cancer screening in UK. For the conceptual framework, we use a modified Grossman model which is extended for non-economic factors. A dynamic version of a random effects panel probit model with initial conditions is estimated on the balanced sub-sample of the data. The analysis sample is restricted to women of age 16 and older and grouped into different age categories with respect to the NHS Cervical Screening Programme (NHSCSP). As dataset a balanced panel data of 857 women with 11,998 observations from the British Household Panel Study (BHPS) for the period from 1992 to 2008 is used for the analysis. Results suggest show that previous screening uptake, age, partner status, employment status and a previous GP visit have a significant influence on the likelihood of the uptake of cervical cancer screening. PMID:23917486

  14. Colorectal cancer screening practices in Saskatchewan

    PubMed Central

    Deobald, Ray; Graham, Peter; Chad, Jennifer; Di Gregorio, Carlo; Johnstone, Jennifer; Balbuena, Lloyd; Kenyon, Chris; Lees, Mark

    2013-01-01

    Abstract Objective To evaluate current colorectal cancer (CRC) screening practices in Saskatchewan and identify barriers to screening with the goal of improving current practice. Design Survey of family physicians. Setting Saskatchewan. Participants A total of 773 family physicians were surveyed. Main outcome measures Demographic characteristics, individual screening practices, and perceived barriers to screening. Results The response rate to the survey was 44.5%. When asked what method they used for fecal occult blood testing, almost 40% of respondents were either unsure or did not answer the question. Of those who did respond, 35.8% employed hemoccult testing following digital rectal examination, a practice not recommended for CRC screening. Screening guidelines for average-risk patients were generally well adhered to, with 79.9% of respondents recommending screening beginning at age 50. For screening patients at increased risk of CRC owing to family history, only 64.2% of respondents began screening 10 years before the age of the index patient at diagnosis. Physicians who were more likely to follow guidelines were female, in practice fewer than 10 years, trained in Canada, and practising in urban areas. More than 90% of family physicians agreed that a standard provincewide screening program would be beneficial. Conclusion We have identified considerable knowledge gaps with regard to CRC screening. There is confusion about which fecal occult blood tests are recommended for screening. Also, screening guidelines for patients with a family history of CRC are poorly understood. These findings suggest that better physician education about CRC screening is required. Introduction of a provincewide screening program should improve overall screening success. PMID:24336561

  15. Screening for Breast Cancer: Current Status, Problems, Prospects

    PubMed Central

    Devitt, James E.

    1985-01-01

    The effect on breast cancer mortality of physical screening examinations and/or mammography will only be clear when current prospective studies are complete. The National Breast Screening Study will materially advance understanding of the value of current screening techniques. Until this information is available, however, physicians should consider practicing annual physical examinations of the breast in women over age 45, provided at least five minutes is spent in such examinations, which should consist of inspection as well as palpation of the breast in both the sitting and reclining position. If mammography of the caliber available to the American Breast Cancer Detection Project Centres is available, clinicians should consider periodic screening mammographic examinations. PMID:21279147

  16. Perceived benefits: a predictor of participation in prostate cancer screening.

    PubMed

    Tingen, M S; Weinrich, S P; Heydt, D D; Boyd, M D; Weinrich, M C

    1998-10-01

    Prostate cancer is the most frequently diagnosed major cancer and the second cause of cancer-related deaths among men. With early detection through screening and timely treatment, 9 out of 10 men will survive a minimum of 5 years. However, with late diagnoses, only 3 out of 10 men will have a 5-year minimum survival rate. Guided by a conceptual map, this correlational research examined perceived benefits as a predictor of participation in free prostate cancer screening. Perceived benefits are the personal belief and valuing of screening for early detection of prostate cancer. All subjects received one of four educational interventions: traditional, peer educator, client navigator, or combination. Participation in prostate cancer screening was measured by compliance with the American Cancer Society's Guidelines, which included a digital rectal exam (DRE) and/or a prostate-specific antigen (PSA) blood test. The purposive sample (n = 1,522) of men, ages 40 to 70 years, was recruited from randomly selected churches, barbershops, industries, housing projects, and car dealerships in a southeastern state. Seventy-two percent of the sample was African American. Predictors of participation in free prostate cancer screening were these: perceived benefits, being white, having at least a high school education, being married, and receiving the client navigator or combination educational intervention. The Benefits Scale was significant (p = 0.013, odds ratio (OR) = 1.059) as a predictor for participation in screening when all demographic variables and educational interventions were controlled. Practice implications for nursing are discussed and recommendations for future research are presented. PMID:9775485

  17. Improving Colorectal Cancer Screening by Using Community Volunteers

    PubMed Central

    Katz, Mira L.; Tatum, Cathy; Dickinson, Stephanie L.; Murray, David M.; Long-Foley, Kristie; Cooper, M. Robert; Daven, Morgan; Paskett, Electra D.

    2014-01-01

    BACKGROUND The goal of the Carolinas Cancer Education and Screening (CARES) Project was to improve colorectal cancer (CRC) screening among low-income women in subsidized housing communities in 11 cities in North and South Carolina who were traditionally underserved by cancer control efforts. METHODS Cross-sectional samples were randomly selected from housing authority lists at 5 timepoints in this nonrandomized community-based intervention study. Face-to-face interviews focused on CRC knowledge, beliefs, barriers to screening, and screening behaviors. The intervention components were based on a previous evidence-based program. RESULTS A total of 2098 surveys were completed. Seventy-eight percent of the respondents were African American, 62% were 65+ years, and 4% were married. At baseline, the rate of CRC screening within guidelines was 49.3% and physician recommendation was the strongest predictor (odds ratio [OR] = 21.9) of being within guidelines. There was an increase in positive beliefs about CRC screening (P =.010) and in the intention to complete CRC screening in the next 12 months (P =.053) after the intervention. The odds of being within CRC screening guidelines for women living in a city that had received the intervention were not significantly different from women living in a city that had not received the intervention (P =.496). CONCLUSIONS Although CRC screening rates were not significantly better after the intervention, there was a positive change in beliefs about screening and intention to be screened. The results suggest that the dissemination of an evidence-based behavioral intervention may require a longer duration to engage hard-to-reach populations and change behaviors. PMID:17665496

  18. The PLCO Cancer Screening Trial: Background, Goals, Organization, Operations, Results.

    PubMed

    Gohagan, John K; Prorok, Philip C; Greenwald, Peter; Kramer, Barnett S

    2015-01-01

    The randomized PLCO trial was designed to answer four primary questions: does screening for these cancers using often promoted tests reduce cancer-specific mortality? Nearly 155,000 men and women were allocated to screening or usual care arms in a 1:1 ratio under a centralized, secure randomization algorithm at ten competitively selected screening centers nationwide. Screened men received PSA blood tests and digital rectal examinations. Screened women received CA125 blood tests and trans-vaginal ultrasound. Both men and women in the screened arm received anterolateral view chest x-ray and 60 cm flexible sigmoidoscopy. Blood specimens were collected at each screening visit and buccal cell DNA was collected once from the usual care participants. Histology slides were collected for cancer cases. Participants completed a baseline questionnaire covering health and risk factors and a dietary questionnaire. Data collected on standardized machine-readable forms were scanned remotely at screening and laboratory sites utilizing PLCO dedicated, NCI provided and configured computer systems for quality checks, archiving, and analysis. Comprehensive quality assurance was implemented over recruitment, consenting, randomization, screening, data management, records keeping, patient-specific screening results reporting, follow-up, and data analysis. Performance and data quality were monitored on-site and remotely by data edits, site visits, and random record audits. Specially trained and certified professionals performed screening procedures and medical record abstracting. An independent committee of medical specialists reviewed and certified case-specific cause of death. Scientific leadership was provided by NCI Project Officers, PLCO principal investigators, external consultants, and an independent data and safety monitoring board. PMID:26238115

  19. Prostate Cancer Screening Results from the Prostate, Lung, Colorectal, and Ovarian Cancer Randomized Screening Trial: Questions and Answers

    Cancer.gov

    The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial is a large-scale clinical trial to determine whether certain cancer screening tests can help reduce deaths from prostate, lung, colorectal, and ovarian cancer. By using screening tests for cancer, doctors may be able to discover and treat cancers that might otherwise kill a person.

  20. Cancer screening in the United States, 2016: A review of current American Cancer Society guidelines and current issues in cancer screening.

    PubMed

    Smith, Robert A; Andrews, Kimberly; Brooks, Durado; DeSantis, Carol E; Fedewa, Stacey A; Lortet-Tieulent, Joannie; Manassaram-Baptiste, Deana; Brawley, Otis W; Wender, Richard C

    2016-03-01

    Answer questions and earn CME/CNE Each year the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines, including the update of the breast cancer screening guideline, discuss quality issues in colorectal cancer screening and new developments in lung cancer screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey. CA Cancer J Clin 2016;66:95-114. © 2016 American Cancer Society. PMID:26797525

  1. Prostate cancer screening: and yet it moves!

    PubMed Central

    Kwiatkowski, Maciej; Randazzo, Marco; Kluth, Luis; Manka, Lukas; Huber, Andreas; Recker, Franz

    2015-01-01

    The debate of prostate cancer (PCa) screening has been shaped over decades. There is a plethora of articles in the literature supporting as well as declining prostate-specific antigen (PSA) screening. Does screening decrease PCa mortality? With the long-term results of the European Randomized Study of Screening for Prostate (ERSPC) the answer is clearly YES. It moves! However, in medicine there are no benefits without any harm and thus, screening has to be performed in targeted and smart way-or in other words-in a risk-adapted fashion when compared with the way it was done in the past. Here, we discuss the main findings of the ERSPC trials and provide insights on how the future screening strategies should be implemented. PMID:25532573

  2. Screening for breast cancer with mammography

    SciTech Connect

    Sickles, E.A. )

    1991-10-01

    Mammography is generally accepted as a useful problem-solving clinical tool in characterizing known breast lesions, so that appropriate and timely treatment can be given. However, it remains grossly underutilized at what it does best: screening. The major strengths of mammography are (a) its ability to detect breast cancer at a smaller, potentially more curable stage than any other examination, and (b) its proved efficacy in reducing breast cancer mortality in asymptomatic women aged 40-74. If, as has recently been estimated, screening with mammography and physical examination can be expected to lower breast cancer deaths by 40%-50% among those actually examined (13), then the lives of almost 20,000 U.S. women might be saved each year if screening were to become very widely used. The challenges of the next decade are clear, to mount much more effective campaigns to educate physicians and lay women about the life-saving benefits of breast cancer screening, to devise increasingly effective and lower cost screening strategies, to further improve the current high quality of mammographic imaging despite its increasing proliferation, and to train large numbers of breast imaging specialists to guarantee that the growing case load of screening and problem-solving mammograms is interpreted with a very high level of skill.

  3. Risks of Breast Cancer Screening

    MedlinePLUS

    ... screening tests are being studied in clinical trials. Thermography Thermography is a procedure in which a special camera ... thermogram. There have been no clinical trials of thermography to find out how well it detects breast ...

  4. Opting Out of Cervical Cancer Screening

    PubMed Central

    Cooper, Crystale Purvis; Saraiya, Mona

    2015-01-01

    Background Some primary care physicians choose not to provide cervical cancer screening. Purpose To investigate the characteristics and screening beliefs of family practitioners and internists who treat adult women in outpatient settings but perform no routine Pap tests. Methods A survey of U.S. primary care physicians (N = 892) was conducted and analyzed in 2012. Results Participants who performed no Pap tests during a typical month (17.2% of family practitioners and 44.3% of internists) generally reported that they referred patients to gynecologists for cervical cancer screening. The most significant predictor of Pap test non-provision was agreement that patients are best served by having Pap tests performed by gynecologists (AOR = 8.80, 95% CI = 5.58, 13.88, p < 0.001). Conclusions The perception that patients benefit from cervical cancer screening administered by gynecologists may deter screening in primary care settings, resulting in missed opportunities to offer screening to women who are never or rarely screened. PMID:24953518

  5. Advanced endoscopic technologies for colorectal cancer screening

    PubMed Central

    Obstein, Keith L; Valdastri, Pietro

    2013-01-01

    Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide. Diagnosing colorectal has been increasingly successful due to advances in technology. Flexible endoscopy is considered to be an effective method for early diagnosis and treatment of gastrointestinal cancer, making it a popular choice for screening programs. However, millions of people who may benefit from endoscopic colorectal cancer screening fail to have the procedure performed. Main reasons include psychological barriers due to the indignity of the procedure, fear of procedure related pain, bowel preparation discomfort, and potential need for sedation. Therefore, an urgent need for new technologies addressing these issues clearly exists. In this review, we discuss a set of advanced endoscopic technologies for colorectal cancer screening that are either already available or close to clinical trial. In particular, we focus on visual-inspection-only advanced flexible colonoscopes, interventional colonoscopes with alternative propulsion mechanisms, wireless capsule colonoscopy, and technologies for intraprocedural bowel cleansing. Many of these devices have the potential to reduce exam related patient discomfort, obviate the need for sedation, increase diagnostic yield, reduce learning curves, improve access to screening, and possibly avert the need for a bowel preparation. PMID:23382621

  6. Screening for cervical cancer in Poland.

    PubMed

    Wronkowski, Z; Zieli?ski, J; Rekosz, M

    1993-01-01

    Despite the growing number of PAP tests performed in Poland every year, (approximately 3 million per year in 1992) the mortality rates of cervical cancer are stable or increasing. With the intention of changing this unfavourable situation, a team of specialists in 1988 has developed a model for cervical cancer screening in Poland. Six experimental centres were chosen for the implementation of this model. The principles of the screening system were as follows: 1) population-based; 2) individual invitations; 3) computer assisted; 4) reproducible; 5) cytotechnicians' participation; 6) target population 30-60 years; 7) frequency of PAP tests: every 3 years. Preliminary data from the population of 25,841 which was covered by the screening campaign in Warsaw showed a 70.1% attendance rate and detectability of 3 cases per 1,000 screened women. PMID:8200380

  7. Using hair to screen for breast cancer

    NASA Astrophysics Data System (ADS)

    James, Veronica; Kearsley, John; Irving, Tom; Amemiya, Yoshiyuki; Cookson, David

    1999-03-01

    We have studied hair using fibre X-ray diffraction studies with synchrotron radiation and find that hair from breast-cancer patients has a different intermolecular structure to hair from healthy subjects. These changes are seen in all samples of scalp and pubic hair taken from women diagnosed with breast cancer. All the hair samples from women who tested positive for a mutation of the BRCA1 gene, which is associated with a higher risk of breast cancer, also show these changes. Because our results are so consistent, we propose that such hair analyses may be used as a simple, non-invasive screening method for breast cancer.

  8. Selection Criteria for Lung-Cancer Screening

    PubMed Central

    Tammemgi, Martin C.; Katki, Hormuzd A.; Hocking, William G.; Church, Timothy R.; Caporaso, Neil; Kvale, Paul A.; Chaturvedi, Anil K.; Silvestri, Gerard A.; Riley, Tom L.; Commins, John; Berg, Christine D.

    2014-01-01

    BACKGROUND The National Lung Screening Trial (NLST) used risk factors for lung cancer (e.g., ?30 pack-years of smoking and <15 years since quitting) as selection criteria for lung-cancer screening. Use of an accurate model that incorporates additional risk factors to select persons for screening may identify more persons who have lung cancer or in whom lung cancer will develop. METHODS We modified the 2011 lung-cancer risk-prediction model from our Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial to ensure applicability to NLST data; risk was the probability of a diagnosis of lung cancer during the 6-year study period. We developed and validated the model (PLCOM2012) with data from the 80,375 persons in the PLCO control and intervention groups who had ever smoked. Discrimination (area under the receiver-operating-characteristic curve [AUC]) and calibration were assessed. In the validation data set, 14,144 of 37,332 persons (37.9%) met NLST criteria. For comparison, 14,144 highest-risk persons were considered positive (eligible for screening) according to PLCOM2012 criteria. We compared the accuracy of PLCOM2012 criteria with NLST criteria to detect lung cancer. Cox models were used to evaluate whether the reduction in mortality among 53,202 persons undergoing low-dose computed tomographic screening in the NLST differed according to risk. RESULTS The AUC was 0.803 in the development data set and 0.797 in the validation data set. As compared with NLST criteria, PLCOM2012 criteria had improved sensitivity (83.0% vs. 71.1%, P<0.001) and positive predictive value (4.0% vs. 3.4%, P = 0.01), without loss of specificity (62.9% and. 62.7%, respectively; P = 0.54); 41.3% fewer lung cancers were missed. The NLST screening effect did not vary according to PLCOM2012 risk (P = 0.61 for interaction). CONCLUSIONS The use of the PLCOM2012 model was more sensitive than the NLST criteria for lung-cancer detection. PMID:23425165

  9. Screening and early detection of lung cancer.

    PubMed

    Vansteenkiste, J; Dooms, C; Mascaux, C; Nackaerts, K

    2012-09-01

    The greatest news of the past year in this field was the first large-scale early detection trial that could prove a 20% reduction in lung cancer-related mortality by screening high-risk individuals with low-dose computed tomography (LDCT). Several expert groups and medical societies have assessed the data and concluded that LDCT screening for lung cancer is, however, not ready for large-scale population-based implementation. Too many open questions remain, such as definition of the at-risk population, timing and intervals of screening, optimal method of acquisition and interpretation of the images, how to handle (false) positive findings, and especially cost-effectiveness in relation to other lung cancer prevention strategies, mainly smoking cessation. Further analyses and several ongoing European trials are eagerly awaited. Much hope also resides in the use of biomarkers, as their use in, e.g., blood or exhaled air may provide more easy-to-use tests to better stratify high-risk populations for screening studies. While exciting research is ongoing in this domain--e.g. with microRNAs--none of the tests has yet reached sufficient validation for clinical use. Early central lung cancers are more difficult to visualise by CT. For these patients, standard bronchoscopy, complemented by autofluoresence endoscopy, has been studied in different screening and follow-up settings. PMID:22987984

  10. Risks of Lung Cancer Screening

    MedlinePLUS

    ... Currents Blog Research Findings Drug Approvals Precision Medicine Leadership Views 2017 Annual Plan & Budget Proposal All Press ... NCI NCI Overview History Contributing to Cancer Research Leadership Director's Page Previous NCI Directors NCI Organization Advisory ...

  11. Risks of Skin Cancer Screening

    MedlinePLUS

    ... the body's largest organ . It protects against heat, sunlight, injury, and infection . Skin also helps control body ... cancer risk factors include: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  12. Endoscopy in screening for digestive cancer.

    PubMed

    Lambert, Ren

    2012-12-16

    The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett's esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of superficial capillaries; then characterization of the morphology of the lesion according to the Paris classification and prediction of the risk of malignancy and depth of invasion, with the help of chromoscopy, magnification and image processing with neutrophil bactericidal index or FICE. Then treatment decision offers 3 options according to histologic prediction: abstention, endoscopic resection, surgery. The rigorous quality control of endoscopy will reduce the miss rate of lesions and the occurrence of interval cancer. PMID:23293721

  13. ACR Appropriateness Criteria colorectal cancer screening.

    PubMed

    Yee, Judy; Kim, David H; Rosen, Max P; Lalani, Tasneem; Carucci, Laura R; Cash, Brooks D; Feig, Barry W; Fowler, Kathryn J; Katz, Douglas S; Smith, Martin P; Yaghmai, Vahid

    2014-06-01

    Colorectal cancer is the third leading cause of cancer deaths in the United States. Most colorectal cancers can be prevented by detecting and removing the precursor adenomatous polyp. Individual risk factors for the development of colorectal cancer will influence the particular choice of screening tool. CT colonography (CTC) is the primary imaging test for colorectal cancer screening in average-risk individuals, whereas the double-contrast barium enema (DCBE) is now considered to be a test that may be appropriate, particularly in settings where CTC is unavailable. Single-contrast barium enema has a lower performance profile and is indicated for screening only when CTC and DCBE are not available. CTC is also the preferred test for colon evaluation following an incomplete colonoscopy. Imaging tests including CTC and DCBE are not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the updated colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:24793959

  14. New era of colorectal cancer screening

    PubMed Central

    El Zoghbi, Maysaa; Cummings, Linda C

    2016-01-01

    Colorectal cancer (CRC) is the 2nd most common cancer in women and 3rd most common cancer in men worldwide. Most CRCs develop from adenomatous polyps arising from glandular epithelium. Tumor growth is initiated by mutation of the tumor suppressor gene APC and involves other genetic mutations in a stepwise process over years. Both hereditary and environmental factors contribute to the development of CRC. Screening has been proven to reduce the incidence of CRC. Screening has also contributed to the decrease in CRC mortality in the United States. However, CRC incidence and/or mortality remain on the rise in some parts of the world (Eastern Europe, Asia, and South America), likely due to factors including westernized diet, lifestyle, and lack of healthcare infrastructure. Multiple screening options are available, ranging from direct radiologic or endoscopic visualization tests that primarily detect premalignant or malignant lesions such as flexible sigmoidoscopy, optical colonoscopy, colon capsule endoscopy, computed tomographic colonography, and double contrast barium enema - to stool based tests which primarily detect cancers, including fecal DNA, fecal immunochemical test, and fecal occult blood test. The availability of some of these tests is limited to areas with high economic resources. This article will discuss CRC epidemiology, pathogenesis, risk factors, and screening modalities with a particular focus on new technologies. PMID:26981176

  15. Cervical Cancer Screening and Perceived Information Needs

    ERIC Educational Resources Information Center

    Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark

    2005-01-01

    Purpose: To identify women's sources of information about cervical cancer screening, information which women report receiving during Pap consultations, information they would like to receive, and the relationships between perceived information needs, personal characteristics and information sources. Design/methodology/approach: Logistic regression…

  16. Knowledge of Breast Cancer and Screening Practices

    ERIC Educational Resources Information Center

    Vahabi, Mandana

    2005-01-01

    Objective: To assess young women's breast health knowledge and explore its relation to the use of screening mammography. Methods: A convenience sample of 180 women aged 25-45 residing in Toronto, Canada, with no history of breast cancer and mammography received an information brochure and four questionnaires which assessed their knowledge of

  17. Knowledge of Breast Cancer and Screening Practices

    ERIC Educational Resources Information Center

    Vahabi, Mandana

    2005-01-01

    Objective: To assess young women's breast health knowledge and explore its relation to the use of screening mammography. Methods: A convenience sample of 180 women aged 25-45 residing in Toronto, Canada, with no history of breast cancer and mammography received an information brochure and four questionnaires which assessed their knowledge of…

  18. Cervical Cancer Screening and Perceived Information Needs

    ERIC Educational Resources Information Center

    Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark

    2005-01-01

    Purpose: To identify women's sources of information about cervical cancer screening, information which women report receiving during Pap consultations, information they would like to receive, and the relationships between perceived information needs, personal characteristics and information sources. Design/methodology/approach: Logistic regression

  19. New era of colorectal cancer screening.

    PubMed

    El Zoghbi, Maysaa; Cummings, Linda C

    2016-03-10

    Colorectal cancer (CRC) is the 2(nd) most common cancer in women and 3(rd) most common cancer in men worldwide. Most CRCs develop from adenomatous polyps arising from glandular epithelium. Tumor growth is initiated by mutation of the tumor suppressor gene APC and involves other genetic mutations in a stepwise process over years. Both hereditary and environmental factors contribute to the development of CRC. Screening has been proven to reduce the incidence of CRC. Screening has also contributed to the decrease in CRC mortality in the United States. However, CRC incidence and/or mortality remain on the rise in some parts of the world (Eastern Europe, Asia, and South America), likely due to factors including westernized diet, lifestyle, and lack of healthcare infrastructure. Multiple screening options are available, ranging from direct radiologic or endoscopic visualization tests that primarily detect premalignant or malignant lesions such as flexible sigmoidoscopy, optical colonoscopy, colon capsule endoscopy, computed tomographic colonography, and double contrast barium enema - to stool based tests which primarily detect cancers, including fecal DNA, fecal immunochemical test, and fecal occult blood test. The availability of some of these tests is limited to areas with high economic resources. This article will discuss CRC epidemiology, pathogenesis, risk factors, and screening modalities with a particular focus on new technologies. PMID:26981176

  20. Reducing Barriers to Use of Breast Cancer Screening

    Cancer.gov

    Investigation to determine whether a telephone counseling intervention aimed at women who are known to underuse breast cancer screening can with, or without, an accompanying educational intervention for their physicians, increase use of breast cancer screening.

  1. Black Smokers Less Likely to Get Lung Cancer Screening

    MedlinePLUS

    ... 157850.html Black Smokers Less Likely to Get Lung Cancer Screening Racial differences in smoking patterns probably why, ... black and white Americans may lead to lower lung cancer screening rates for blacks, new research suggests. Researchers ...

  2. Thinking beyond the treatment effect in screening for lung cancer.

    PubMed

    Jha, Saurabh

    2015-08-01

    In the optimism surrounding screening for lung cancer, the downsides of screening should not be ignored. The article examines the dark side of screening, which is not an unmitigated good. PMID:26100199

  3. Screening spectroscopy of prostate cancer

    NASA Astrophysics Data System (ADS)

    Yermolenko, S. B.; Voloshynskyy, D. I.; Fedoruk, O. S.

    2015-11-01

    The aim of the study was to establish objective parameters of the field of laser and incoherent radiation of different spectral ranges (UV, visible, IR) as a non-invasive optical method of interaction with different samples of biological tissues and fluids of patients to determine the state of prostate cancer and choosing the best personal treatment. The objects of study were selected venous blood plasma of patient with prostate cancer, histological sections of rat prostate gland in the postoperative period. As diagnostic methods have been used ultraviolet spectrometry samples of blood plasma in the liquid state, infrared spectroscopy middle range (2,5-25 microns) dry residue of plasma by spectral diagnostic technique of thin histological sections of biological tissues.

  4. Cancer Screening: Should Cancer Screening be Essential Component of Primary Health Care in Developing Countries?

    PubMed Central

    Bobdey, Saurabh; Balasubramanium, Ganesh; Kumar, Abhinendra; Jain, Aanchal

    2015-01-01

    Background: Cancer is a fatal disease and is on the rise across the globe. In India, breast, cervix and the oral cavity are the leading cancer sites, but, unfortunately, in-spite of availability of screening tools, there is no organized cancer screening program in India. The main objective of this study was to review the performance of various cancer screening modalities in a resource poor setting. Methods: MEDLINE and web of science electronic database was searched from January 1990 to December 2013, using keywords such as breast cancer, cervical cancer, oral cancer and their corresponding mesh terms were also used in combination with Boolean operators OR, AND. Two authors independently selected studies published in English and conducted in India. A total of 16 studies was found relevant and eligible for the review. The data on sensitivity and specificity of various screening tool was extracted and analyzed. Results: Most of the reported screening trails in India are on cervical cancer and few on breast and oral cancer screening. The pooled estimates of sensitivity and specificity of cervical cancer screening test such as visual inspection with acetic acid, magnified visual inspection with acetic acid, visual inspection with Lugol's iodine, cytology (Papanicolaou smear) and human papillomavirus deoxyribonucleic acid was found to be 68.76% and 84.02%, 63.27% and 85.43%, 81.86% and 87.03%, 63.25% and 93.17% and 75.04% and 91.66%, respectively. Sensitivity and specificity of clinical breast examination was found to be 94.30% and 94.30%, respectively. Oral cancer screening through visual inspection by trained health care worker was found to have 87.90% sensitivity and 92.05% specificity. Conclusions: Our study highlights the availability and success of visual screening tools in early detection and mortality reduction of major neoplasia in resource-poor health care settings and recommends implementation of oral and cervical cancer screening as part of assured primary health care package in developing countries. PMID:26236443

  5. Reduction Mammaplasty and Breast Cancer Screening.

    PubMed

    Ortiz-Pomales, Yan T; Priyanka Handa; Newell, Mary S; Losken, Albert

    2016-04-01

    Breast reduction surgery is one of the most popular procedures performed by plastic surgeons; based on the current literature, it is safe and does not have a negative impact on identifying breast cancer in women. There are no evidence-based data to confirm the utility of unique screening protocols for women planning to undergo reduction surgery or for those who already had reduction. Women undergoing this surgery should not deviate from the current recommendations of screening mammography in women older than 40 years of average risk. Experienced radiologist can readily distinguish postsurgical imaging findings of rearranged breast parenchyma from malignancy. PMID:27012791

  6. Gastric cancer: Prevention, screening and early diagnosis

    PubMed Central

    Pasechnikov, Victor; Chukov, Sergej; Fedorov, Evgeny; Kikuste, Ilze; Leja, Marcis

    2014-01-01

    Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori (H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing. No organized screening programs can be found outside Asia (Japan and South Korea). Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern. Searches for new screening biomarkers, including microRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach. PMID:25320521

  7. State of the Art Review: Colorectal Cancer Screening

    PubMed Central

    Slomka, Teresa

    2013-01-01

    Although colorectal cancer is the third leading cause of cancer-related deaths in the U.S., the burden of this disease could be dramatically reduced by increased utilization of screening. Evidence-based recommendations and guidelines from national societies recommend screening all average risk adults starting at age fifty. However, the myriad of screening options and slight differences in screening recommendations between guidelines may lead to confusion among patients and their primary care providers. This goal of this review is to briefly summarize the colorectal cancer screening guidelines issued by three major organizations, compare their recommendations, and address emerging issues in colorectal cancer screening. PMID:23539676

  8. Improving colorectal cancer screening: fact and fantasy

    NASA Astrophysics Data System (ADS)

    Van Dam, Jacques

    2008-02-01

    Premalignant diseases of the gastrointestinal tract, such as Barrett's esophagus, long-standing ulcerative colitis, and adenomatous polyps, have a significantly increased risk for development of adenocarcinoma, most often through an intermediate stage of dysplasia. Adenocarcinoma of the colon is the second most common cancer in the United States. Because patients with colorectal cancer often present with advanced disease, the outcomes are associated with significant morbidity and mortality. Effective methods of early detection are essential. As non-polypoid dysplasia is not visible using conventional endoscopy, surveillance of patients with Barrett's esophagus and ulcerative colitis is performed via a system in which multiple random biopsies are obtained at prescribed intervals. Sampling error and missed diagnoses occur frequently and render current screening methods inadequate. Also, the examination of a tissue biopsy is time consuming and costly, and significant intra- and inter-observer variation may occur. The newer methods discussed herein demonstrate the potential to solve these problems by early detection of disease with high sensitivity and specificity. Conventional endoscopy is based on the observation of white light reflected off the tissue surface. Subtle changes in color and shadow reveal structural changes. New developments in optical imaging go beyond white light, exploiting other properties of light. Several promising methods will be discussed at this meeting and shall be briefly discussed below. However, few such imaging modalities have arrived at our clinical practice. Some much more practical methods to improve colorectal cancer screening are currently being evaluated for their clinical impact. These methods seek to overcome limitations other than those of detecting dysplasia not visible under white light endoscopy. The current standard practice of colorectal cancer screening utilizes colonoscopy, an uncomfortable, sometimes difficult medical procedure. Efforts to improve the practice of colonoscopy will be described. Another limitation of the current practice is the inability to detect polypoid neoplasia that is hidden from view under white light imaging by the natural folds that occur within the colon. A device to overcome this limitation will also be described. Efforts to improve colorectal cancer screening (and thereby decrease the death rate of this second leading cause of cancer death in the United States) are progressing in many arenas. The researcher, basic or clinical, should maintain an up to date overview of the field and how each new technological advance is likely to have a role in the screening and early detection of colorectal cancer.

  9. Contributions of the European trials (European randomized screening group) in computed tomography lung cancer screening.

    PubMed

    Heuvelmans, Marjolein A; Vliegenthart, Rozemarijn; Oudkerk, Matthijs

    2015-03-01

    Lung cancer is the leading cause of cancer-related death worldwide. In 2011, the largest lung cancer screening trial worldwide, the US National Lung Screening Trial, published a 20% decrease in lung cancer-specific mortality in the computed tomography (CT)-screened group, compared with the group screened by chest x-ray. On the basis of this trial, different US guidelines recently have recommended CT lung cancer screening. However, several questions regarding the implementation of lung cancer screening need to be answered. In Europe, several lung cancer screening trials are ongoing. It is planned to pool the results of the lung cancer screening trials in European randomized lung cancer CT screening (EUCT). By pooling of the data, EUCT hopes to be able to provide additional information for the discussion of some important issues regarding the implementation of lung cancer screening by low-dose CT, including: the determination of the optimal screen population, the comparison between a volume-based and diameter-based nodule management protocol, and the determination of optimal screen intervals. PMID:25635703

  10. Barriers to Cancer Screening by Rural Appalachian Primary Care Providers

    ERIC Educational Resources Information Center

    Shell, Renee; Tudiver, Fred

    2004-01-01

    Rural Appalachia has significantly higher overall cancer mortality compared with national rates, and lack of cancer screening is believed to be one of the contributing factors. Reducing the cancer disparity in this region must include strategies to address suboptimal cancer screening practices by rural Appalachian primary care providers (PCPs). To…

  11. Barriers to Cancer Screening by Rural Appalachian Primary Care Providers

    ERIC Educational Resources Information Center

    Shell, Renee; Tudiver, Fred

    2004-01-01

    Rural Appalachia has significantly higher overall cancer mortality compared with national rates, and lack of cancer screening is believed to be one of the contributing factors. Reducing the cancer disparity in this region must include strategies to address suboptimal cancer screening practices by rural Appalachian primary care providers (PCPs). To

  12. Microfluidic Devices for Cancer Screening by N-Glycan Analysis | Division of Cancer Prevention

    Cancer.gov

    Project Summary A microfluidic-based screening method will be developed to differentiate different disease states of cancer. The screening method is based on high-resolution microchip electrophoresis coupled with laser-induced fluorescence detection. N-Glycan profiles are generated for all samples and compared by statistical analysis. The method relies on the analysis of the entire N-glycan profile, not a single biomarker, to provide sufficient differentiation among control individuals, patients suffering from various stages of cancer, and patients with pre-malignant diseases.

  13. Computed tomography colonography for colorectal cancer screening.

    PubMed

    Tewari, Virendra; Tewari, Deepali; Gress, Frank G

    2013-03-01

    Colorectal cancer screening has been shown to help prevent cancer-related death. Concerns about suboptimal adherence to conventional colonoscopy has led to the search for alternative screening modalities. Computed tomography colono-graphy (CTC) is a highly sensitive and minimally invasive alternative modality. The American College of Radiology has established a standardized reporting system for CTC. The advantages of CTC include complete colonic examination and extraluminal imaging in a single breath hold time. Lack of sensitivity in the evaluation of flat lesions and radiation exposure are the main concerns with this modality. Although the usefulness of CTC has been demonstrated in academic centers, larger studies in community settings are needed to facilitate its adoption by healthcare services. PMID:23961265

  14. Colorectal Cancer Screening Activities in ICSN Countries

    Cancer.gov

    Targeted Prevention Programs Branch Canberra, ACT, Australia Following the successful pilot program that ran from 2002-2004, a National Bowel Cancer Screening Program which uses immunochemical FOBT, followed by colonoscopy if indicated, will be introduced. The first phase of the program (2006-2008) will target people turning 55 or 65 years of age between 1 May 2006 and 30 June 2008 and those who participated in the pilot program.

  15. Barriers to planning and conducting a screening: prostate cancer.

    PubMed

    McDougall, Graham J; Adams, Mary Louise; Voelmeck, Wayne F

    2004-01-01

    African American men participated in a screening initiative and completed the 22-item Barriers to Prostate Cancer Screening Checklist. Forty-three men received a digital rectal exam (DRE) and prostate specific antigen (PSA) laboratory test. The age of the males was M = 56.4 (range = 45-76) years; 47% were compliant with the American Cancer Society annual screening guidelines for high-risk individuals. Nineteen men from the screened group completed a 22-item Response to Barriers Checklist. The barrier ranked a "big problem" for not getting a prostate exam, and the highest by 32% (n = 6) of the sample was "Too many things going on in their lives." The lowest ranked problem by 100% of the participants was "Takes too long to get an appointment." Two individuals reported taking the over-the-counter supplement, saw palmetto. It is important that when planning a health screening in the community, both barriers and advantages be evaluated during the planning and before the implementation phase of the project. PMID:15592249

  16. Screening for and surveillance of gastric cancer

    PubMed Central

    Compare, Debora; Rocco, Alba; Nardone, Gerardo

    2014-01-01

    Although the prevalence of gastric cancer (GC) progressively decreased during the last decades, due to improved dietary habit, introduction of food refrigeration and recovered socio-economic level, it still accounts for 10% of the total cancer-related deaths. The best strategy to reduce the mortality for GC is to schedule appropriate screening and surveillance programs, that rises many relevant concerns taking into account its worldwide variability, natural history, diagnostic tools, therapeutic strategies, and cost-effectiveness. Intestinal-type, the most frequent GC histotype, develops through a multistep process triggered by Helicobacter pylori (H. pylori) and progressing from gastritis to atrophy, intestinal metaplasia (IM), and dysplasia. However, the majority of patients infected with H. pylori and carrying premalignant lesions do not develop GC. Therefore, it remains unclear who should be screened, when the screening should be started and how the screening should be performed. It seems reasonable that screening programs should target the general population in eastern countries, at high prevalence of GC and the high-risk subjects in western countries, at low prevalence of GC. As far as concern surveillance, currently, we are lacking of standardized international recommendations and many features have to be defined regarding the optimal diagnostic approach, the patients at higher risk, the best timing and the cost-effectiveness. Anyway, patients with corpus atrophic gastritis, extensive incomplete IM and dysplasia should enter a surveillance program. At present, screening and surveillance programs need further studies to draw worldwide reliable recommendations and evaluate the impact on mortality for GC. PMID:25320506

  17. Canadian cancer screening disparities: a recent historical perspective

    PubMed Central

    Kerner, J.; Liu, J.; Wang, K.; Fung, S.; Landry, C.; Lockwood, G.; Zitzelsberger, L; Mai, V.

    2015-01-01

    Across Canada, introduction of the Pap test for cervical cancer screening, followed by mammography for breast cancer screening and, more recently, the fecal occult blood test for colorectal cancer screening, has contributed to a reduction in cancer mortality. However, another contribution of screening has been disparities in cancer mortality between certain populations. Here, we explore the disparities associated with breast and cervical cancer screening and preliminary data concerning disparities in colorectal cancer screening. Although some disparities in screening utilization have been successfully reduced over time (for example, mammography and Pap test screening in rural and remote populations), screening utilization data for other populations (for example, low-income groups) clearly indicate that disparities have existed and continue to exist across Canada. Organized screening programs in Canada have been able to successfully engage 80% of women for regular cervical cancer screening and 70% of women for regular mammography screening, but of the women who remain to be reached or engaged in regular screening, those with the least resources, those who are the most isolated, and those who are least culturally integrated into Canadian society as a whole are over-represented. Population differences are also observed for utilization of colorectal cancer screening services. The research literature on interventions to promote screening utilization provides some evidence about what can be done to increase participation in organized screening by vulnerable populations. Adaption and adoption of evidence-based screening promotion interventions can increase the utilization of available screening services by populations that have experienced the greatest burden of disease with the least access to screening services. PMID:25908914

  18. Knowledge, Attitudes and Practices Regarding Cervical Cancer and Screening among Haitian Health Care Workers

    PubMed Central

    Zahedi, Leilah; Sizemore, Emma; Malcolm, Stuart; Grossniklaus, Emily; Nwosu, Oguchi

    2014-01-01

    It is estimated that Haiti has the highest incidence of cervical cancer in the Western Hemisphere. There are currently no sustainable and affordable cervical cancer screening programs in Haiti. The current status of screening services and knowledge of health care professionals was assessed through a Knowledge, Attitudes, and Practices survey on cervical cancer screening and prevention. It was distributed to Project Medishare for Haiti health care workers (n = 27) in the Central Plateau. The majority (22/27) of participants stated pre-cancerous cells could be detected through screening, however, only four had ever performed a pap smear. All of the participants felt a screening program should be started in their area. Our data establishes that knowledge is fairly lacking among healthcare workers and there is an opportunity to train them in simple, cost effective screen-and-treat programs that could have a great impact on the overall health of the population. PMID:25390794

  19. Cervical cancer screening among Chinese Americans

    PubMed Central

    Taylor, Victoria M.; Jackson, J. Carey; Tu, Shin-Ping; Yasui, Yutaka; Schwartz, Stephen M.; Kuniyuki, Alan; Acorda, Elizabeth; Lin, Kathy; Hislop, Gregory

    2006-01-01

    Study purpose Chinese women in North America have high rates of invasive cervical cancer and low levels of Papanicolaou (Pap) testing use. This study examined Pap testing barriers and facilitators among Chinese American women. Basic procedures A community-based, in-person survey of Chinese women was conducted in Seattle, Washington during 1999. Four hundred and thirty-two women in the 2079 years age-group were included in this analysis. The main outcome measures were a history of at least one previous Pap smear and Pap testing within the last 2 years. Main findings Nineteen percent of the respondents had never received cervical cancer screening and 36% had not been screened in the previous 2 years. Eight characteristics were independently associated with a history of at least one Pap smear: being married, thinking Pap testing is necessary for sexually inactive women, lack of concerns about embarrassment or cancer being discovered, having received a physician or family recommendation, having obtained family planning services in North America, and having a regular provider. The following characteristics were independently associated with recent screening: thinking Pap testing is necessary for sexually inactive women, lack of concern about embarrassment, having received a physician recommendation, having obtained obstetric services in North America, and having a regular provider. Principal conclusions Pap testing levels among the study respondents were well below the National Cancer Institutes Year 2000 goals. The findings suggest that cervical cancer control interventions for Chinese are more likely to be effective if they are multifaceted. 2002 International Society for Preventive Oncology. Published by Elsevier Science Ltd. All rights reserved. PMID:12102148

  20. Mortality reduction from gastric cancer by endoscopic and radiographic screening.

    PubMed

    Hamashima, Chisato; Shabana, Michiko; Okada, Katsuo; Okamoto, Mikizo; Osaki, Yoneatsu

    2015-12-01

    To evaluate mortality reduction from gastric cancer by endoscopic screening, we undertook a population-based cohort study in which both radiographic and endoscopic screenings for gastric cancer have been carried out. The subjects were selected from the participants of gastric cancer screening in two cities in Japan, Tottori and Yonago, from 2007 to 2008. The subjects were defined as participants aged 40-79 years who had no gastric cancer screening in the previous year. Follow-up of mortality was continued from the date of the first screening to the date of death or up to December 31, 2013. A Cox proportional hazards model was used to estimate the relative risk (RR) of gastric cancer incidence, gastric cancer death, all cancer deaths except gastric cancer death, and all-causes death except gastric cancer death. The number of subjects selected for endoscopic screening was 9950 and that for radiographic screening was 4324. The subjects screened by endoscopy showed a 67% reduction of gastric cancer compared with the subjects screened by radiography (adjusted RR by sex, age group, and resident city = 0.327; 95% confidence interval [CI], 0.118-0.908). The adjusted RR of endoscopic screening was 0.968 (95%CI, 0.675-1.387) for all cancer deaths except gastric cancer death, and 0.929 (95%CI, 0.740-1.168) for all-causes death except gastric cancer death. This study indicates that endoscopic screening can reduce gastric cancer mortality by 67% compared with radiographic screening. This is consistent with previous studies showing that endoscopic screening reduces gastric cancer mortality. PMID:26432528

  1. The Partnership for Cancer Prevention: Addressing Access to Cervical Cancer Screening among Latinas in South Carolina

    PubMed Central

    Parra-Medina, Deborah; Hilfinger Messias, DeAnne K.; Fore, Elizabeth; Mayo, Rachel; Petry, Denyse; Das, Irene Prabhu

    2015-01-01

    Background Cancer is a leading cause of morbidity and morality among Hispanics, the fastest growing population group in South Carolina (SC). The Partnership for Cancer Prevention (PCP) was established to build partnerships and community capacity to address cervical cancer early detection and control among the growing Latina population in SC. In this paper we report on the initial PCP community-based participatory research (CBPR) project. Methods PCP members engaged in a multi-method, participatory research project to assess cervical cancer related resources and needs among Latinas and healthcare providers. To explore attitudes and behaviors related to women's health in general and more specifically, female cancer, PCP members conducted 8 focus group sessions with 38 Spanish-speaking women. To assess the availability and perceived importance of culturally and linguistically appropriate services, PCP members conducted a survey of providers (n=46) and support personnel (n=30) at 14 clinical sites that provide cancer screening services. Results Health care access issues were Latinas' main concerns. For information and assistance in accessing and navigating the health care system, they relied on informal social networks and community outreach workers. Latina participants voiced misunderstandings about cancer risk and most appeared to lack a prevention orientation. Practitioners concerns included the assessment and documentation of patients' language preference and ability, provision of language assistance for limited-English-proficient (LEP) patients, and bilingual staff. Conclusions Building on the findings of this participatory research initiative, PCP members identified the following action strategies to promote cervical cancer screening among Latinas in SC: culturally appropriate cervical cancer awareness messages and outreach strategies geared towards increasing participation in cervical cancer screening and follow-up; maintenance of active community partnerships for health promotion, cancer risk reduction, and improved access to care; and increasing the capacity of the health care systems in SC to address Hispanic health concerns. PMID:20108722

  2. Effectively Communicating Colorectal Cancer Screening Information to Primary Care Providers: Application for State, Tribe or Territory Comprehensive Cancer Control Coalitions

    ERIC Educational Resources Information Center

    Redmond, Jennifer; Vanderpool, Robin; McClung, Rebecca

    2012-01-01

    Background: Patients are more likely to be screened for colorectal cancer if it is recommended by a health care provider. Therefore, it is imperative that providers have access to the latest screening guidelines. Purpose: This practice-based project sought to identify Kentucky primary care providers' preferred sources and methods of receiving

  3. Effectively Communicating Colorectal Cancer Screening Information to Primary Care Providers: Application for State, Tribe or Territory Comprehensive Cancer Control Coalitions

    ERIC Educational Resources Information Center

    Redmond, Jennifer; Vanderpool, Robin; McClung, Rebecca

    2012-01-01

    Background: Patients are more likely to be screened for colorectal cancer if it is recommended by a health care provider. Therefore, it is imperative that providers have access to the latest screening guidelines. Purpose: This practice-based project sought to identify Kentucky primary care providers' preferred sources and methods of receiving…

  4. The relationship of health numeracy to cancer screening.

    PubMed

    Schapira, Marilyn M; Neuner, Joan; Fletcher, Kathlyn E; Gilligan, Mary Ann; Hayes, Elisabeth; Laud, Purushottam

    2011-03-01

    Health numeracy is associated with increased understanding of cancer risk reduction information and improved control of chronic disease. A cross-sectional survey was conducted among a primary care population to evaluate the effect of health numeracy on breast, cervical, and colorectal cancer screening. No association was found between health numeracy and cancer screening. However, at a baseline screening rate of 85%, increased knowledge (RR 1.06, 95% CI 1.02-1.08) and decreased perceived barriers (RR 0.93, 95% CI 0.92-0.95) were associated with increased screening rates. In conclusion, health numeracy was not predictive of cancer screening among a primary care population. PMID:20577913

  5. Biological aggressiveness of prostate cancer in the Finnish screening trial.

    PubMed

    Laurila, Marita; Tammela, Teuvo L J; Auvinen, Anssi; Isola, Jorma; Visakorpi, Tapio; Luukkaala, Tiina; Mttnen, Liisa; Ruutu, Mirja; Ala-Opas, Martti; Mildh, Markus; Martikainen, Paula

    2009-02-01

    Prostate cancer aggressiveness was evaluated based on pathologic characterization of cases detected in the Finnish prostate cancer screening trial. The trial population consists of 80,458 men aged 55-67 years. A total of 32,000 men were randomized to the screening arm. The remaining 48,000 men formed the control arm. The interval cases and cancers among nonparticipants and in the control arm were identified from the Finnish Cancer Registry. Random samples were selected from screen-detected cases (126 of 543 in the first and 133 of 508 in the second round) and control arm cancers (133 out of 863), in addition to all 92 interval cancers and 106 cases among nonparticipants. All the biopsies were regraded according to the Gleason system. The expression of the proliferation antigen Ki-67 was determined in 479 cases (72%). More than half of the tumors diagnosed in the first round of screening were high-grade cancers (Gleason 7 or higher). In the second round, the proportion of low-grade cancers increased from 47% to 70%. Cancers in the screening arm were more commonly focal and fewer bilateral cancers were detected. The cancers among nonparticipants were the most aggressive group. The aggressiveness of the interval cancers was between the cancers detected in the first and the second round. Our results indicate that prostate cancers detected through screening are less biologically aggressive. This was most notable after the first screening round. Nonparticipants had more aggressive cancers. PMID:19004023

  6. Molecular markers for colorectal cancer screening.

    PubMed

    Dickinson, Brandon T; Kisiel, John; Ahlquist, David A; Grady, William M

    2015-09-01

    Colorectal cancer (CRC), although a significant cause of morbidity and mortality worldwide, has seen a declining incidence and mortality in countries with programmatic screening. Faecal occult blood testing and endoscopic approaches are the predominant screening methods currently. The discovery of the adenoma-carcinoma sequence and a greater understanding of the genetic and epigenetic changes that drive the formation of CRC have contributed to innovative research to identify molecular markers for highly accurate, non-invasive screening tests for CRC. DNA, proteins, messenger RNA and micro-RNA have all been evaluated. The observation of tumour cell exfoliation into the mucocellular layer of the colonic epithelium and proven stability of DNA in a harsh stool environment make stool DNA a particularly promising marker. The development of a clinically useful stool DNA test has required numerous technical advances, including optimisation in DNA stabilisation, the development of assays with high analytical sensitivity, and the identification of specific and broadly informative molecular markers. A multitarget stool DNA test, which combines mutant and methylated DNA markers and a faecal immunochemical test, recently performed favourably in a large cross-sectional validation study and has been approved by the US Food and Drug Administration for the screening of asymptomatic, average-risk individuals. The ultimate way in which molecular marker screening assays will be used in clinical practice will require additional studies to determine optimal screening intervals, factors affecting compliance, management of false-positive results, and the use of these assays in high-risk populations, as well as other considerations. PMID:25994221

  7. [Results and development in cancer screening programs].

    PubMed

    Cinquetti, S; De Marchi, C; Menegon, T

    2008-01-01

    In order to contribute to the definition of good model for cancer screening programs, the paper reports an overview of Veneto Local Health Units' results according to required "gold standard" defined by the authors. The analysis was based on a standard attesting that the program is running stabely and a standard for the organisation requiring that general management is performed by a unique central unit, supplied with a unique software and a working group equipped with specific know-how. Ten of the 21 Locale Health Unit of Veneto Region chose to assign to Prevention Department (Public Health Department) all the three screening programs included in the National Prevention Plan. Among these we found the two achieving the defined gold standard (Thiene and Pieve di Soligo). Management model implemented in these units showed a framework for excellence. PMID:18773602

  8. [Cervical cancer screening: past--present--future].

    PubMed

    Breitenecker, G

    2009-12-01

    Despite the undisputed and impressive success which has been achieved since the 1960s by cervical cytology in the fight against cervical cancer and its precursor stages, during which the mortality rate in industrialized countries over the last 40 years has been reduced by two-thirds to three-quarters, a perfect and error-free screening procedure is still a long way off and will probably never be reached. There are two main reasons for this, the lack of adequate coverage and suboptimal quality and assessment of smears. Two screening procedures are in use Europe, an opportunistic and an organized system. Both systems have many advantages but also disadvantages. In organized programs the coverage is higher (up to 80%), although similar numbers are also achieved by non-organized programs over a 3-year cycle, even if they cannot be so exactly documented. The decision on which system is used depends on the health system of the country, public or non-public, and many other national circumstances. However, in both systems prerequisites for a satisfactory result is a high quality in the sampling technique, the processing and the assessment. Therefore, several guidelines have been introduced by state and medical societies for internal and external quality assurance. New technologies, such as thin-layer cytology or automation for replacement or support of conventional cytology liquid-based cytology proved not to be superior enough to justify the high costs of these systems. The recognition of the strong causal relationship between persistent infection with high-risk human papillomavirus (HPV) types and cervical cancer and its precursors has resulted in the development of comparably simple tests. Primary screening using HPV typing alone is not recommended in opportunistic screening due to the low specificity but high sensitivity because it leads to many clinically irrelevant results which place women under stress. In organized screening HPV testing is always and only possible in combination with cytology. Various models and approaches are in the testing phase and appear promising. HPV testing is on the other hand well accepted and recommended as a triage test to select women with equivocal smear results (Pap group III, ASCUS) if a biopsy is required or can be followed up and also for follow-up of patients after cone biopsy. However, vaccination of young girls against oncogenic HPV types which has now become widespread still leaves many questions open for the future because the observation period is too short. There is justified hope that this will become a valuable tool in cervical cancer control and may lead to a substantial reduction in the burden of cervical cancer in the future. However, as the current vaccines on the market do not cover all oncogenic virus types and the effects of vaccination will only be observed after many years, the necessity of a cytological screening will remain unrestricted. Therefore, cervical cytology will remain as the trusted, simple to use, economic and proven, like no other method for early cancer detection, efficient procedure even in the foreseeable future. If carried out with the highest quality demands it will play a central role in the early detection of cervical cancer. PMID:19756616

  9. Current issues and future perspectives of gastric cancer screening

    PubMed Central

    Hamashima, Chisato

    2014-01-01

    Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and screen and treat method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening. PMID:25320514

  10. Screening All Women for Breast Cancer Genes Not Feasible

    MedlinePLUS

    ... 154586.html Screening All Women for Breast Cancer Genes Not Feasible: Study Price of genetic tests would ... 11, 2015 (HealthDay News) -- Screening all women for gene mutations that increase the risk of breast and ...

  11. Selection of Rear Projection Screens for Learning Carrels.

    ERIC Educational Resources Information Center

    Smith, Edgar A.

    The selection of a rear projection screen for a learning carrel should take into account the viewing angle involved. In some carrels, the viewer can be seated in front of the screen (i.e., on the normal axis) since the screen is used primarily to present information. In these cases, where the screen will be viewed only from a restricted range, a

  12. Selection and Specification of Rear-Projection Screens.

    ERIC Educational Resources Information Center

    Vlahos, Petro

    1961-01-01

    The characteristics of the rear-projection screen are examined in detail. Numerical constants are provided that define these characteristics for practical screens and convert foot-candles to footlamberts. A procedure is given by which an optimum screen may be specified for a specific application. Contents include--(1) introduction, (2) projection

  13. Colorectal Cancer Screening in Inflammatory Bowel Disease.

    PubMed

    Sengupta, Neil; Yee, Eric; Feuerstein, Joseph D

    2016-04-01

    Patients with long-standing ulcerative colitis (UC) or Crohn's colitis are at increased risk of developing colorectal cancer (CRC). Given that most cases of CRC are thought to arise from dysplasia, previous guidelines have recommended endoscopic surveillance with random biopsies obtained from all segments of the colon involved by endoscopic or microscopic inflammation. However, recent evidence has suggested that the majority of dysplastic lesions in patients with inflammatory disease (IBD) are visible, and data have been supportive of chromoendoscopy with targeted biopsies of visible lesions versus traditional random biopsies. This review article will discuss the risk of colon cancer in patients with IBD, as well as current recommendations for CRC screening and surveillance in patients with UC or Crohn's colitis. PMID:26646250

  14. Health Literacy and Cancer Screening: A Systematic Review

    PubMed Central

    Oldach, Benjamin R.; Katz, Mira L.

    2013-01-01

    Objective To evaluate published evidence about health literacy and cancer screening. Methods Seven databases were searched for English language articles measuring health literacy and cancer screening published in 1990-2011. Articles meeting inclusion criteria were independently reviewed by two investigators using a standardized data abstraction form. Abstracts (n=932) were reviewed and full text retrieved for 83 articles. Ten articles with 14 comparisons of health literacy and cancer screening according to recommended medical guidelines were included in the analysis. Results Most articles measured health literacy using the S-TOFHLA instrument and documented cancer screening by self-report. There is a trend for an association of inadequate health literacy and lower cancer screening rates, however, the evidence is mixed and limited by study design and measurement issues. Conclusion A patient's health literacy may be a contributing factor to being within recommended cancer screening guidelines. Practice Implications Future research should: be conducted using validated health literacy instruments; describe the population included in the study; document cancer screening test completion according to recommended guidelines; verify the completion of cancer screening tests by medical record review; adjust for confounding factors; and report effect size of the association of health literacy and cancer screening. PMID:24207115

  15. Bladder Cancer Screening in Aluminum Smelter Workers

    PubMed Central

    Taiwo, Oyebode A.; Slade, Martin D.; Cantley, Linda F.; Tessier-Sherman, Baylah; Galusha, Deron; Kirsche, Sharon R.; Donoghue, A. Michael

    2015-01-01

    Objective: To present results of a bladder cancer screening program conducted in 18 aluminum smelters in the United States from January 2000 to December 2010. Methods: Data were collected on a cohort of workers with a history of working in coal tar pitch volatile exposed areas including urine analysis for conventional cytology and ImmunoCyt/uCyt+ assay. Results: ImmunoCyt/uCyt+ and cytology in combination showed a sensitivity of 62.30%, a specificity of 92.60%, a negative predictive value of 99.90%, and a positive predictive value of 2.96%. Fourteen cases of bladder cancer were detected, and the standardized incidence ratio of bladder cancer was 1.18 (95% confidence interval, 0.65 to 1.99). Individuals who tested positive on either test who were later determined to be cancer free had undergone expensive and invasive tests. Conclusions: Evidence to support continued surveillance of this cohort has not been demonstrated. PMID:25525927

  16. CDC Vital Signs: Cancer Screenings: Colorectal Cancer and Breast Cancer

    MedlinePLUS

    ... or rec- tum, and is often called simply “colon cancer.” It is the #2 cause of cancer deaths ... women are particularly at risk of dying from colon cancer. ◊◊In 2006, more than 139,000 people learned ...

  17. Prostate Cancer Screening in Jamaica: Results of the Largest National Screening Clinic

    PubMed Central

    Morrison, Belinda F.; Aiken, William; Mayhew, Richard; Gordon, Yulit; Reid, Marvin

    2016-01-01

    Prostate cancer is highly prevalent in Jamaica and is the leading cause of cancer-related deaths. Our aim was to evaluate the patterns of screening in the largest organized screening clinic in Jamaica at the Jamaica Cancer Society. A retrospective analysis of all men presenting for screening at the Jamaica Cancer Society from 1995 to 2005 was done. All patients had digital rectal examinations (DRE) and prostate specific antigen (PSA) tests done. Results of prostate biopsies were noted. 1117 men of mean age 59.9 ± 8.2 years presented for screening. The median documented PSA was 1.6 ng/mL (maximum of 5170 ng/mL). Most patients presented for only 1 screen. There was a gradual reduction in the mean age of presentation for screening over the period. Prostate biopsies were requested on 11% of screening visits; however, only 59% of these were done. 5.6% of all persons screened were found to have cancer. Of the cancers diagnosed, Gleason 6 adenocarcinoma was the commonest grade and median PSA was 8.9 ng/mL (range 1.5–1059 ng/mL). Older men tend to screen for prostate cancer in Jamaica. However, compliance with regular maintenance visits and requests for confirmatory biopsies are poor. Screening needs intervention in the Jamaican population.

  18. The relationship between socio-economic status and cancer detection at screening

    NASA Astrophysics Data System (ADS)

    Taylor-Phillips, Sian; Ogboye, Toyin; Hamborg, Tom; Kearins, Olive; O'Sullivan, Emma; Clarke, Aileen

    2015-03-01

    It is well known that socio-economic status is a strong predictor of screening attendance, with women of higher socioeconomic status more likely to attend breast cancer screening. We investigated whether socio-economic status was related to the detection of cancer at breast screening centres. In two separate projects we combined UK data from the population census, the screening information systems, and the cancer registry. Five years of data from all 81 screening centres in the UK was collected. Only women who had previously attended screening were included. The study was given ethical approval by the University of Warwick Biomedical Research Ethics committee reference SDR-232-07- 2012. Generalised linear models with a log-normal link function were fitted to investigate the relationship between predictors and the age corrected cancer detection rate at each centre. We found that screening centres serving areas with lower average socio-economic status had lower cancer detection rates, even after correcting for the age distribution of the population. This may be because there may be a correlation between higher socio-economic status and some risk factors for breast cancer such as nullparity (never bearing children). When applying adjustment for age, ethnicity and socioeconomic status of the population screened (rather than simply age) we found that SDR can change by up to 0.11.

  19. Breast Cancer Screening in an Era of Personalized Regimens

    PubMed Central

    Onega, Tracy; Beaber, Elisabeth F.; Sprague, Brian L.; Barlow, William E.; Haas, Jennifer S.; Tosteson, Anna N.A.; Schnall, Mitchell D.; Armstrong, Katrina; Schapira, Marilyn M.; Geller, Berta; Weaver, Donald L.; Conant, Emily F.

    2014-01-01

    Breast cancer screening holds a prominent place in public health, health care delivery, policy, and womens health care decisions. Several factors are driving shifts in how population-based breast cancer screening is approached, including advanced imaging technologies, health system performance measures, health care reform, concern for overdiagnosis, and improved understanding of risk. Maximizing benefits while minimizing the harms of screening requires moving from a 1-size-fits-all guideline paradigm to more personalized strategies. A refined conceptual model for breast cancer screening is needed to align womens risks and preferences with screening regimens. A conceptual model of personalized breast cancer screening is presented herein that emphasizes key domains and transitions throughout the screening process, as well as multilevel perspectives. The key domains of screening awareness, detection, diagnosis, and treatment and survivorship are conceptualized to function at the level of the patient, provider, facility, health care system, and population/policy arena. Personalized breast cancer screening can be assessed across these domains with both process and outcome measures. Identifying, evaluating, and monitoring process measures in screening is a focus of a National Cancer Institute initiative entitled PROSPR (Population-based Research Optimizing Screening through Personalized Regimens), which will provide generalizable evidence for a risk-based model of breast cancer screening, The model presented builds on prior breast cancer screening models and may serve to identify new measures to optimize benefits-to-harms tradeoffs in population-based screening, which is a timely goal in the era of health care reform. PMID:24830599

  20. Screening for familial and hereditary prostate cancer.

    PubMed

    Lynch, Henry T; Kosoko-Lasaki, Omofolasade; Leslie, Stephen W; Rendell, Marc; Shaw, Trudy; Snyder, Carrie; D'Amico, Anthony V; Buxbaum, Sarah; Isaacs, William B; Loeb, Stacy; Moul, Judd W; Powell, Isaac

    2016-06-01

    Prostate cancer (PC) has the highest degree of genetic transmission of any form of malignancy. In some families, the hereditary pattern is so strong as to mimic an autosomal dominance trait. We reviewed the known predisposing genetic markers to assess possible strategies for screening of families at risk. We carried out a systematic literature search using the Pubmed service of the National Center for Biotechnology Information (NCBI) and several gene libraries, including the NCBI SNP Library, the Online Mendelian Inheritance in Man® Catalog of Human Genes and Genetic Disorders (OMIM) and SNPedia to obtain known gene loci, SNPs and satellite markers associated with PC. We further cross referenced information on identified loci comparing data from different articles and gene reference sites. Whenever possible, we recorded the odds ratio (OR) for the allele associated with PC. In multiple different linkage studies, many independent PC associated loci have been identified on separate chromosomes. Genome-wide association studies have added many more markers to the set derived from linkage investigations. A subset of the alleles is associated with early onset and aggressive cancer. Due to the great heterogeneity, the OR for any one allele predicting future development of this malignancy is low. The strongest predictors are the BRCA2 mutations, and the highly penetrant G84E mutation in HOXB13. The presence of multiple risk alleles is more highly predictive than a single allele. Technical limitations on screening large panels of alleles are being overcome. It is appropriate to begin supplementing prostate specific antigen testing with alleles, such as BRCA2 and HOXB13, disclosed by targeted genomic analysis in families with an unfavorable family cancer history. Future population studies of PC should include genomic sequencing protocols, particularly in families with a history of PC and other malignancies. PMID:26638190

  1. Survival Analysis of Patients with Interval Cancer Undergoing Gastric Cancer Screening by Endoscopy

    PubMed Central

    Hamashima, Chisato; Shabana, Michiko; Okamoto, Mikizo; Osaki, Yoneatsu; Kishimoto, Takuji

    2015-01-01

    Aims Interval cancer is a key factor that influences the effectiveness of a cancer screening program. To evaluate the impact of interval cancer on the effectiveness of endoscopic screening, the survival rates of patients with interval cancer were analyzed. Methods We performed gastric cancer-specific and all-causes survival analyses of patients with screen-detected cancer and patients with interval cancer in the endoscopic screening group and radiographic screening group using the Kaplan-Meier method. Since the screening interval was 1 year, interval cancer was defined as gastric cancer detected within 1 year after a negative result. A Cox proportional hazards model was used to investigate the risk factors associated with gastric cancer-specific and all-causes death. Results A total of 1,493 gastric cancer patients (endoscopic screening group: n = 347; radiographic screening group: n = 166; outpatient group: n = 980) were identified from the Tottori Cancer Registry from 2001 to 2008. The gastric cancer-specific survival rates were higher in the endoscopic screening group than in the radiographic screening group and the outpatients group. In the endoscopic screening group, the gastric cancer-specific survival rate of the patients with screen-detected cancer and the patients with interval cancer were nearly equal (P = 0.869). In the radiographic screening group, the gastric cancer-specific survival rate of the patients with screen-detected cancer was higher than that of the patients with interval cancer (P = 0.009). For gastric cancer-specific death, the hazard ratio of interval cancer in the endoscopic screening group was 0.216 for gastric cancer death (95%CI: 0.054-0.868) compared with the outpatient group. Conclusion The survival rate and the risk of gastric cancer death among the patients with screen-detected cancer and patients with interval cancer were not significantly different in the annual endoscopic screening. These results suggest the potential of endoscopic screening in reducing mortality from gastric cancer. PMID:26023768

  2. Health Information Seeking and Cancer Screening Adherence Rates.

    PubMed

    Shneyderman, Yuliya; Rutten, Lila J Finney; Arheart, Kristopher L; Byrne, Margaret M; Kornfeld, Julie; Schwartz, Seth J

    2016-03-01

    Effective screening tools are available for many of the top cancer killers in the USA. Searching for health information has previously been found to be associated with adhering to cancer screening guidelines, but Internet information seeking has not been examined separately. The current study examines the relationship between health and cancer Internet information seeking and adherence to cancer screening guidelines for breast, cervical, and colorectal cancer in a large nationally representative dataset. The current study was conducted using data from the Health Information National Trends Survey from 2003 and 2007. The study examined age-stratified models which correlated health and cancer information seeking with getting breast, cervical, and colorectal cancer screening on schedule, while controlling for several key variables. Internet health and cancer information seeking was positively associated with getting Pap screening on schedule, while information seeking from any sources was positively associated with getting colorectal screening on schedule. People who look for health or cancer information are more likely to get screened on schedule. Some groups of people, however, do not exhibit this relationship and, thus, may be more vulnerable to under-screening. These groups may benefit more from targeted interventions that attempt to engage people in their health care more actively. PMID:25619195

  3. Targeted Cancer Screening in Average-Risk Individuals

    PubMed Central

    Marcus, Pamela M.; Freedman, Andrew N.; Khoury, Muin J.

    2015-01-01

    Targeted cancer screening refers to use of disease risk information to identify those most likely to benefit from screening. Researchers have begun to explore the possibility of refining screening regimens for average-risk individuals using genetic and non-genetic risk factors and previous screening experience. Average-risk individuals are those not known to be at substantially elevated risk, including those without known inherited predisposition, without comorbidities known to increase cancer risk, and without previous diagnosis of cancer or pre-cancer. In this paper, we describe the goals of targeted cancer screening in average-risk individuals, present factors on which cancer screening has been targeted, discuss inclusion of targeting in screening guidelines issued by major U.S. professional organizations, and present evidence to support or question such inclusion. Screening guidelines for average-risk individuals currently target age; smoking (lung cancer only); and, in some instances, race; family history of cancer; and previous negative screening history (cervical cancer only). No guidelines include common genomic polymorphisms. RCTs suggest that targeting certain ages and smoking histories reduces disease-specific cancer mortality, although some guidelines extend ages and smoking histories based on statistical modeling. Guidelines that are based on modestly elevated disease risk typically have either no or little evidence of an ability to affect a mortality benefit. In time, targeted cancer screening is likely to include genetic factors and past screening experience as well as non-genetic factors other than age, smoking, and race, but it is of utmost importance that clinical implementation be evidence-based. PMID:26165196

  4. Cervical and Vaginal Cancer Screening (Pap Test and Pelvic Exam)

    MedlinePLUS

    ... service covered? Search Medicare.gov for covered items Cervical & vaginal cancer screenings How often is it covered? Medicare Part ... pay for them. Related resources National Cancer Institutecervical cancer information CDCcervical cancer information U.S. Preventive Services ...

  5. New Screening Proposals: the Federal Joint Commission Defines the Parameters for Cervical Cancer Screening from 2018

    PubMed Central

    Hillemanns, P.; Mallmann, P.; Beckmann, M. W.

    2016-01-01

    The Gynecology Oncology Working Group (AGO e. V.) unequivocally welcomes the decision taken by the German Federal Joint Commission (Gemeinsamer Bundesausschuss, G-BA) on March 19, 2015 regarding screening for cervical cancer. AGO is convinced that, in view of recent medical advances, this evidence-based decision will improve screening for cervical cancer. PMID:26941445

  6. Screening for colorectal cancer in Italy: 2011-2012 survey.

    PubMed

    Zorzi, Manuel; Mangone, Lucia; Anghinoni, Emanuela; Baracco, Susanna; Borciani, Elisabetta; Caldarella, Adele; Falcini, Fabio; Fanetti, Anna Clara; Ferretti, Stefano; Giorgi Rossi, Paolo; Michiara, Maria; Randi, Giorgia; Stracci, Fabrizio; Vicentini, Massimo; Zucchetto, Antonella; Zappa, Marco

    2015-01-01

    The impact of organized screening programmes on colorectal cancer (CRC) can be observed at a population level only several years after the implementation of screening. We compared CRC characteristics by diagnostic modality (screen-detected, non-screen-detected) as an early outcome to monitor screening programme effectiveness. Data on CRCs diagnosed in Italy from 2000 to 2008 were collected by several cancer registries. Linkage with screening datasets made it possible to divide the cases by geographic area, implementation of screening, and modality of diagnosis (screen-detected, non-screen-detected).We compared the main characteristics of the different subgroups of CRCs through multivariate logistic regression models. The study included 23,668 CRCs diagnosed in subjects aged 50-69 years, of which 11.9% were screen-detected (N=2,806), all from the North-Centre of Italy. Among screen-detected CRCs, we observed a higher proportion of males, of cases in the distal colon, and a higher mean age of the patients. Compared with pre-screening cases, screen-detected CRCs showed a better distribution by stage at diagnosis (OR for stage III or IV: 0.40, 95%CI: 0.36-0.44) and grading (OR for poorly differentiated CRCs was 0.86, 95%CI: 0.75-1.00). Screen-detected CRCs have more favourable prognostic characteristics than non-screen-detected cases. A renewed effort to implement screening programmes throughout the entire country is recommended. PMID:26405782

  7. Behavioral economics: "nudging" underserved populations to be screened for cancer.

    PubMed

    Purnell, Jason Q; Thompson, Tess; Kreuter, Matthew W; McBride, Timothy D

    2015-01-01

    Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice. PMID:25590600

  8. Update on prevention and screening of cervical cancer

    PubMed Central

    McGraw, Shaniqua L; Ferrante, Jeanne M

    2014-01-01

    Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical cancer development and its precursors is the human papillomavirus (HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methods for cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals. PMID:25302174

  9. The PLCO Cancer Screening Trial: Q and A

    Cancer.gov

    The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial is a large, randomized study to determine whether the use of certain screening tests will reduce the risk of dying of those four cancers. In addition to answering questions about the

  10. Anal cancer and intraepithelial neoplasia screening: A review

    PubMed Central

    Leeds, Ira L; Fang, Sandy H

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors early in the disease process. It is thought that such a strategy of identifying early anal intraepithelial neoplasia will reduce the incidence of invasive anal cancer. The low prevalence of anal cancer in the general population prevents the use of routine screening. However, routine screening of selected populations has been shown to be a more promising strategy. Potential screening modalities include digital anorectal exam, anal Papanicolaou testing, human papilloma virus co-testing, and high-resolution anoscopy. Additional research associating high-grade dysplasia treatment with anal cancer prevention as well as direct comparisons of screening regimens is necessary to develop further anal cancer screening recommendations. PMID:26843912

  11. Social Construction of Cervical Cancer Screening among Panamanian Women

    ERIC Educational Resources Information Center

    Calvo, Arlene; Brown, Kelli McCormack; McDermott, Robert J.; Bryant, Carol A.; Coreil, Jeanine; Loseke, Donileen

    2012-01-01

    Background: Understanding how "health issues" are socially constructed may be useful for creating culturally relevant programs for Hispanic/Latino populations. Purpose: We explored the constructed meanings of cervical cancer and cervical cancer screening among Panamanian women, as well as socio-cultural factors that deter or encourage screening

  12. A Social Marketing Approach To Increasing Breast Cancer Screening Rates.

    ERIC Educational Resources Information Center

    Bryant, Carol A.; Forthofer, Melinda S.; McCormack Brown, Kelli; Alfonso, Moya Lynn; Quinn, Gwen

    2000-01-01

    Used social marketing to identify factors influencing women's breast cancer screening behaviors. Data from focus groups and interviews with diverse women highlighted women's attitudes, knowledge, and barriers regarding screening. Results were used to develop a comprehensive social marketing plan to motivate irregular users of breast cancer

  13. Cancer Screening Rates in a Student-Run Free Clinic

    PubMed Central

    Hu, Zishuo Ian; Smith, Dylan M.

    2016-01-01

    Background: In the United States and in New York State, individuals with no health insurance have consistently lower screening rates for breast and cervical cancer than those with health insurance and are also more likely to be diagnosed with advanced stages of cancer. Our objective was to compare the cancer screening rates among patients at a free student-run clinic to state and national data. To our knowledge, ours is the first study examining breast and cervical screening rates and their relation to insurance status, income level, education level, race, and marital status in a suburban free student-run clinic. Methods: As part of their intake from fall 2012 to spring 2013, patients at the Stony Brook Health Outreach and Medical Education Clinic in Stony Brook, NY, filled out a 26-item survey that included questions about race, income, education level, marital status, and cancer screening status. We compared the screening rates reported by our patients to published state and national rates. Results: Breast and cervical cancer screening rates reported by 165 patients treated at our free student-run clinic were lower than the overall state and national averages. No significant associations between race, income, education level, or marital status and cancer screening rates were detected. Conclusion: Cancer screening rates at our free student-run clinic for the uninsured were lower than the overall state and national rates. These findings are consistent with previous reports of lower cancer preventive care utilization among the uninsured and suggest that insurance status has been a significant barrier to obtaining cancer screenings among our clinic population. Increasing cancer screening rates at student-run clinics may be a cost-effective secondary prevention activity that can decrease cancer mortality.

  14. Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise

    PubMed Central

    Militello, Laura G.; Saleem, Jason J.; Borders, Morgan R.; Sushereba, Christen E.; Haverkamp, Donald; Wolf, Steven P.; Doebbeling, Bradley N.

    2016-01-01

    Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration’s EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability. PMID:26973441

  15. Acceptability of Cervical Cancer Screening in Rural Mozambique

    ERIC Educational Resources Information Center

    Audet, Carolyn M.; Matos, Carla Silva; Blevins, Meridith; Cardoso, Aventina; Moon, Troy D.; Sidat, Mohsin

    2012-01-01

    In Zambezia province, Mozambique, cervical cancer (CC) screening was introduced to rural communities in 2010. Our study sought to determine whether women would accept screening via pelvic examination and visual inspection with acetic acid (VIA) at two clinical sites near the onset of a new CC screening program. A cross-sectional descriptive study…

  16. Acceptability of Cervical Cancer Screening in Rural Mozambique

    ERIC Educational Resources Information Center

    Audet, Carolyn M.; Matos, Carla Silva; Blevins, Meridith; Cardoso, Aventina; Moon, Troy D.; Sidat, Mohsin

    2012-01-01

    In Zambezia province, Mozambique, cervical cancer (CC) screening was introduced to rural communities in 2010. Our study sought to determine whether women would accept screening via pelvic examination and visual inspection with acetic acid (VIA) at two clinical sites near the onset of a new CC screening program. A cross-sectional descriptive study

  17. How does early detection by screening affect disease progression? Modeling estimated benefits in prostate cancer screening

    PubMed Central

    Wever, Elisabeth M.; Draisma, Gerrit; Heijnsdijk, Eveline A.M.; de Koning, Harry J.

    2016-01-01

    Background Simulation models are essential tools for estimating benefits of cancer screening programs. Such models include a screening-effect model which represents how early detection by screening followed by treatment affects disease-specific survival. Two commonly used screening-effect models are the stage-shift model, where mortality benefits are explained by the shift to more favorable stages due to earlier detection, and the cure model, where early detection enhances the chances of cure from disease. Objective This paper describes the commonly used screening-effect models and analyses their predicted mortality benefit in a model for prostate cancer screening. Method The MISCAN simulation model was used to predict the reduction of prostate cancer mortality in the European Randomized Study of Screening for Prostate Cancer (ERSPC) Rotterdam. The screening-effect models were included in the model. For each model the predictions of prostate cancer mortality reduction in ERSPC-Rotterdam were calculated. We compared four screening-effect models, which are versions of the stage-shift model or the cure model. Results The stage-shift models predicted, after a follow-up of nine years reductions in prostate cancer mortality varying from 38% to 63% for ERSPC-Rotterdam compared with a 27% observed in the overall ERSPC. The cure models predicted reductions in prostate cancer mortality varying from 21% to 27%. Conclusions The differences in predicted mortality reductions show the importance of validating models to observed trial mortality data. Using the stage-shift models to include the effect of screening considerably over-estimated the mortality reduction. Therefore, the stage-shift models should be used with care, especially when modeling the effect of screening for cancers with long lead-times, such as prostate cancer. PMID:21406620

  18. Colorectal cancer prevention in Europe: burden of disease and status of screening programs.

    PubMed

    Altobelli, E; Lattanzi, A; Paduano, R; Varassi, G; di Orio, F

    2014-05-01

    Colorectal cancer is a major public health challenge worldwide. In Europe it is the first malignancy in terms of incidence and the second in terms of mortality in both genders. Despite evidence indicating that removal of premalignant and early-stage cancer lesion scan greatly reduce mortality, remarkable differences are still found among countries both in terms of organized screening programs and of the tests used. In 2003 the European Council recommended that priority be given to activation of organized cancer screening programs, and various states have been making significant efforts to adopt effective prevention programs with international quality standards and centralizing screening organization and result evaluation. After a 2008 European Union report on the state of screening program, activation highlighted that little more than 50% (12/22) of Member States had colorectal cancer screening programs, Screening programs have been adopted or earlier pilot projects have been extended nationwide. This paper examines the state of activation and the screening strategies of colorectal cancer screening programs in EU States as of July 2013. PMID:24530610

  19. Colorectal cancer screening with virtual colonoscopy

    NASA Astrophysics Data System (ADS)

    Ge, Yaorong; Vining, David J.; Ahn, David K.; Stelts, David R.

    1999-05-01

    Early detection and removal of colorectal polyps have been proven to reduce mortality from colorectal carcinoma (CRC), the second leading cause of cancer deaths in the United States. Unfortunately, traditional techniques for CRC examination (i.e., barium enema, sigmoidoscopy, and colonoscopy) are unsuitable for mass screening because of either low accuracy or poor public acceptance, costs, and risks. Virtual colonoscopy (VC) is a minimally invasive alternative that is based on tomographic scanning of the colon. After a patient's bowel is optimally cleansed and distended with gas, a fast tomographic scan, typically helical computed tomography (CT), of the abdomen is performed during a single breath-hold acquisition. Two-dimensional (2D) slices and three-dimensional (3D) rendered views of the colon lumen generated from the tomographic data are then examined for colorectal polyps. Recent clinical studies conducted at several institutions including ours have shown great potential for this technology to be an effective CRC screening tool. In this paper, we describe new methods to improve bowel preparation, colon lumen visualization, colon segmentation, and polyp detection. Our initial results show that VC with the new bowel preparation and imaging protocol is capable of achieving accuracy comparable to conventional colonoscopy and our new algorithms for image analysis contribute to increased accuracy and efficiency in VC examinations.

  20. Impact of Lung Cancer Screening Results on Smoking Cessation

    PubMed Central

    Berg, Christine D.; Riley, Thomas L.; Cunningham, Christopher R.; Taylor, Kathryn L.

    2014-01-01

    Background Lung cancer screening programs may provide opportunities to reduce smoking rates among participants. This study evaluates the impact of lung cancer screening results on smoking cessation. Methods Data from Lung Screening Study participants in the National Lung Screening Trial (NLST; 20022009) were used to prepare multivariable longitudinal regression models predicting annual smoking cessation in those who were current smokers at study entry (n = 15489, excluding those developing lung cancer in follow-up). The associations of lung cancer screening results on smoking cessation over the trial period were analyzed. All hypothesis testing used two sided P values. Results In adjusted analyses, smoking cessation was strongly associated with the amount of abnormality observed in the previous years screening (P < .0001). Compared with those with a normal screen, individuals were less likely to be smokers if their previous years screen had a major abnormality that was not suspicious for lung cancer (odds ratio [OR] = 0.811; 95% confidence interval [CI] = 0.722 to 0.912; P < .001), was suspicious for lung cancer but stable from previous screens (OR = 0.785; 95% CI = 0.706 to 0.872; P < .001), or was suspicious for lung cancer and was new or changed from the previous screen (OR = 0.663; 95% CI = 0.607 to 0.724; P < .001). Differences in smoking prevalence were present up to 5 years after the last screen. Conclusions Smoking cessation is statistically significantly associated with screen-detected abnormality. Integration of effective smoking cessation programs within screening programs should lead to further reduction in smoking-related morbidity and mortality. PMID:24872540

  1. African American Primary Care Physicians’ Prostate Cancer Screening Practices

    PubMed Central

    Ross, Louie E.; Hall, Ingrid J.

    2015-01-01

    Introduction Prostate cancer is the most common cancer and the second leading cause of cancer death among men in the United States. African American (AA) men have greater prostate cancer burden than other men. Little is known about AA primary care physicians’ (PCPs) practices regarding prostate cancer screening. Methods We analyzed data from the 2007–2008 National Survey of Primary Care Physicians’ Practices Regarding Prostate Cancer Screening. The current study included 604 AA PCPs. Outcomes assessed were (a) offering screening using the prostate-specific antigen (PSA) test, (b) use of screening discussions to involve patients in the decision to screen, and (c) having a discussion policy to try to talk the patient into getting the screening tests. Results Most AA PCPs were male (52%), younger than 50 years (61%), and had 21% to 100% AA patients in their practices (74%). The majority (94%) of AA PCPs offered prostate cancer screening using PSA, discussed the tests with their male patients to involve them in the decision to screen (83%), and had a policy to try to talk the patient into getting the screening tests (77%). Multivariate analysis showed that offering screening, use of discussions, and a usual policy to encourage taking the screening tests varied mainly by practice-related factors, including practice type, practice location, and percentage of AA patients in the practice. Conclusion Data from this study indicate that most AA PCPs reported high proscreening behaviors for all 3 outcomes. Additionally, practice- and screening-related factors may be important when examining AA PCP screening behaviors. PMID:24327595

  2. 4-Kallikrein Test and Kallikrein Markers in Prostate Cancer Screening.

    PubMed

    McDonald, Michelle L; Parsons, J Kellogg

    2016-02-01

    A preponderance of clinical evidence supports a significant public health benefit for prostate-specific antigen (PSA)-based screening and early detection of prostate cancer in appropriately counseled and selected men. Population-based screening with PSA decreases prostate cancer mortality; however, because of relatively poor specificity, PSA-based screening may also increase the detection of clinically insignificant cancers that would otherwise never require treatment. Use of newer biomarkers that increase the specificity for prostate cancer detection may aid in risk stratification and the appropriate identification of men for prostate biopsy. The authors review the 4-kallikrein panel and 4K probability score. PMID:26614027

  3. Screening for cervical cancer: when theory meets reality

    PubMed Central

    2011-01-01

    Cervical cancer screening reduces morbidity and mortality due to cervical cancer. However, there are many factors that determine the success of any cervical cancer prevention effort: the prevalence of human papillomavirus infection in general population, the existence of an organized screening program and the corresponding coverage, the existence and quality of the field and laboratory facilities for screening and diagnostic follow-up, and the facilities available for treating diagnosed lesions. Monitoring the patient path or "chain of action" for each patient with an abnormal screening result is of crucial importance. Cost-effectiveness models are widely used by decision-makers to determine which cervical cancer screening program would maximize health benefits within a given, usually limited, set of resources. Regardless of their level of sophistication, however, these models cannot replace empirical evaluations of the effectiveness of screening programs. Cervical cancer prevention activities need to be monitored and evaluated in each country where they are introduced to see that they meet performance standards. Policy-makers responsible for allocating resources for cervical cancer prevention have a duty to allocate resources not only for cervical cancer screening, but also for screening program surveillance. PMID:21668947

  4. The role of cancer worry in cancer screening: a theoretical and empirical review of the literature.

    PubMed

    Hay, Jennifer L; Buckley, Tamara R; Ostroff, Jamie S

    2005-07-01

    This paper reviews findings regarding the influence of cancer worry on cancer screening behaviors. The role of cancer worry in motivating cancer screening has been pursued for over 30 years. Recent concerns that high levels of cancer worry may impede the screening behavior of high-risk individuals have further prioritized this area of research. Despite heavy attention in the literature, there is currently no theoretical or empirical consensus concerning whether cancer worry motivates or inhibits cancer screening behaviors. We focus the review on four questions: (1) What is cancer worry? (2) To what extent are people worried about cancer? (3) What are the predominant theoretical approaches to understanding the role of cancer worry in cancer screening behaviors? (4) What is the empirical evidence for the role of cancer worry in cancer screening behaviors? We identify factors that have hampered theoretical and empirical advancement, including divergent definitions and measurement strategies for cancer worry, low to moderate levels of cancer worry even among those at high risk, and a reliance on cross-sectional research designs. The review clarifies the current state of this literature, and proposes future research strategies, including an expanded emphasis on cancer worry and cancer screening among men and diverse racial/ethnic groups. PMID:15490428

  5. Colorectal Cancer Screening: Stool DNA and Other Noninvasive Modalities

    PubMed Central

    Bailey, James R.; Aggarwal, Ashish; Imperiale, Thomas F.

    2016-01-01

    Colorectal cancer screening dates to the discovery of pre-cancerous adenomatous tissue. Screening modalities and guidelines directed at prevention and early detection have evolved and resulted in a significant decrease in the prevalence and mortality of colorectal cancer via direct visualization or using specific markers. Despite continued efforts and an overall reduction in deaths attributed to colorectal cancer over the last 25 years, colorectal cancer remains one of the most common causes of malignancy-associated deaths. In attempt to further reduce the prevalence of colorectal cancer and associated deaths, continued improvement in screening quality and adherence remains key. Noninvasive screening modalities are actively being explored. Identification of specific genetic alterations in the adenoma-cancer sequence allow for the study and development of noninvasive screening modalities beyond guaiac-based fecal occult blood testing which target specific alterations or a panel of alterations. The stool DNA test is the first noninvasive screening tool that targets both human hemoglobin and specific genetic alterations. In this review we discuss stool DNA and other commercially available noninvasive colorectal cancer screening modalities in addition to other targets which previously have been or are currently under study. PMID:26934885

  6. The National Lung Screening Trial (NLST) | Division of Cancer Prevention

    Cancer.gov

    The National Lung Screening Trial (NLST) compared two ways of detecting lung cancer: low-dose helical computed tomography (CT) and standard chest X-ray. Both chest X-rays and low-dose helical CT scans have been used to find lung cancer early, but the effects of these screening techniques on lung cancer mortality rates had not been determined. NLST enrolled 53,454 current or former heavy smokers from 33 sites and coordinating centers across the United States.

  7. Quantification of harms in cancer screening trials: literature review

    PubMed Central

    Thomsen, Maria F; Rodrigues, David S; Jørgensen, Karsten J; Brodersen, John

    2013-01-01

    Objectives To assess how often harm is quantified in randomised trials of cancer screening. Design Two authors independently extracted data on harms from randomised cancer screening trials. Binary outcomes were described as proportions and continuous outcomes with medians and interquartile ranges. Data sources For cancer screening previously assessed in a Cochrane review, we identified trials from their reference lists and updated the search in CENTRAL. For cancer screening not assessed in a Cochrane review, we searched CENTRAL, Medline, and Embase. Eligibility criteria for selecting studies Randomised trials that assessed the efficacy of cancer screening for reducing incidence of cancer, cancer specific mortality, and/or all cause mortality. Data extraction Two reviewers independently assessed articles for eligibility. Two reviewers, who were blinded to the identity of the study’s authors, assessed whether absolute numbers or incidence rates of outcomes related to harm were provided separately for the screening and control groups. The outcomes were false positive findings, overdiagnosis, negative psychosocial consequences, somatic complications, invasive follow-up procedures, all cause mortality, and withdrawals because of adverse events. Results Out of 4590 articles assessed, 198 (57 trials, 10 screening technologies) matched the inclusion criteria. False positive findings were quantified in two of 57 trials (4%, 95% confidence interval 0% to 12%), overdiagnosis in four (7%, 2% to 18%), negative psychosocial consequences in five (9%, 3% to 20%), somatic complications in 11 (19%, 10% to 32%), use of invasive follow-up procedures in 27 (47%, 34% to 61%), all cause mortality in 34 (60%, 46% to 72%), and withdrawals because of adverse effects in one trial (2%, 0% to 11%). The median percentage of space in the results section that reported harms was 12% (interquartile range 2-19%). Conclusions Cancer screening trials seldom quantify the harms of screening. Of the 57 cancer screening trials examined, the most important harms of screening—overdiagnosis and false positive findings—were quantified in only 7% and 4%, respectively. PMID:24041703

  8. Health care systems redesign project to improve dysphagia screening.

    PubMed

    Daggett, Virginia S; Woodward-Hagg, Heather; Damush, Teresa M; Plue, Laurie; Russell, Scott; Allen, George; Williams, Linda S; Chumbler, Neale R; Bravata, Dawn M

    2015-01-01

    The purpose of this project was to improve dysphagia-screening processes in a tertiary Veterans Affairs Medical Center. The dysphagia-screening tool was redesigned on the basis of frontline clinician feedback, clinical guidelines, user satisfaction, and multidisciplinary expertise. The revised tool triggered a speech-language consult for positive screens and demonstrated higher scores in user satisfaction and task efficiency. Systems redesign processes were effective for redesigning the tool and implementing practice changes with clinicians involved in dysphagia screening. PMID:25463001

  9. Effectively Communicating Colorectal Cancer Screening Information to Primary Care Providers: Application for State, Tribe or Territory Comprehensive Cancer Control Coalitions

    PubMed Central

    Redmond, Jennifer; Vanderpool, Robin; McClung, Rebecca

    2016-01-01

    Background Patients are more likely to be screened for colorectal cancer if it is recommended by a health care provider. Therefore, it is imperative that providers have access to the latest screening guidelines. Purpose This practice-based project sought to identify Kentucky primary care providers preferred sources and methods of receiving colorectal cancer information to improve state comprehensive cancer control provider outreach initiatives. Methods Four focus groups were conducted with primary care physicians, nurse practitioners, and physician assistants. Discussion included preferred sources and methods of receiving updated screening guidelines, legislation, and statewide public awareness campaign materials. Results Providers (N = 17) identified their preferred methods for receiving colorectal cancer information as: routine emails from trusted sources (colleagues, professional societies and research, and advocacy agencies), scientific journals, existing conferences, and the media. Discussion When delivering colorectal cancer information to primary care providers, multiple approaches are needed. An ideal partner for dissemination of information is state comprehensive cancer control coalitions, considering their prioritization of colorectal cancer screening and existing networks of partners who were identified as trusted sources. Translation to Health Education Practice Assessment of primary care providers preferred methods and sources of receiving colorectal cancer information informs strategies for practice among comprehensive cancer control coalitions.

  10. Quality assurance in pathology in colorectal cancer screening and diagnosisEuropean recommendations

    PubMed Central

    Quirke, Phil; Risio, Mauro; Lambert, Ren; von Karsa, Lawrence

    2010-01-01

    In Europe, colorectal cancer is the most common newly diagnosed cancer and the second most common cause of cancer deaths, accounting for approximately 436,000 incident cases and 212,000 deaths in 2008. The potential of high-quality screening to improve control of the disease has been recognized by the Council of the European Union who issued a recommendation on cancer screening in 2003. Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document consists of ten chapters and an extensive evidence base. The content of the chapter dealing with pathology in colorectal cancer screening and diagnosis is presented here in order to promote international discussion and collaboration leading to improvements in colorectal cancer screening and diagnosis by making the principles and standards recommended in the new EU Guidelines known to a wider scientific community. PMID:21061133

  11. Transcriptomic molecular markers for screening human colon cancer in stool and tissue.

    PubMed

    Ahmed, Farid E; Vos, Paul; iJames, Stephanie; Lysle, Donald T; Allison, Ron R; Flake, Gordon; Sinar, Dennis R; Naziri, Wade; Marcuard, Stefan P; Pennington, Rodney

    2007-01-01

    There is a need for sensitive and specific diagnostic molecular markers that can be used to monitor early patterns of gene expression in non-invasive exfoliated colonocytes shed in the stool, and in situ in adenoma-carcinoma epithelium of the colon. RNA-based detection methods are more comprehensive than either DNA-, protein- or methylation-based screening methods. By routinely and systematically being able to perform quantitative gene expression studies on these samples using less than ten colon cancer genes selected by the enormous resources of the National Cancer Institute's Cancer Genome Anatomy Project, we were able to monitor changes at various stages in the neoplastic process, allowing for reliable diagnostic screening of colon cancer particularly at the early, pre-malignant stages. Although the expression of some of the genes tested in tissue showed less variability in normal or cancerous patients than in stool, the stool by itself is suitable for screening. Thus, a transcriptomic approach using stool or tissue samples promises to offer more sensitivity and specificity than currently used molecular screening methods for colon cancer. A larger prospective clinical study utilizing stool and tissue samples derived from many control and colon cancer patients, to allow for a statistically valid analysis, is now urgently required to determine the true sensitivity and specificity of the transcriptomic screening approach for this preventable cancer. PMID:17726236

  12. Relationship between Cancer Worry and Stages of Adoption for Breast Cancer Screening among Korean Women

    PubMed Central

    Choi, Eunji; Lee, Yoon Young; Yoon, Hyo Joong; Lee, Sangeun; Suh, Mina; Park, Boyoung; Jun, Jae Kwan; Kim, Yeol; Choi, Kui Son

    2015-01-01

    Background The possibility of developing breast cancer is a concern for all women; however, few studies have examined the relationship between cancer worry and the stages of adoption for breast cancer screening in Korea. Here, we investigated the associations between cancer worry, the stages of adopting breast cancer screening, and socio-demographic factors known to influence screening behaviors. Methods This study was based on the 2013 Korean National Cancer Screening Survey, an annual cross-sectional survey that utilized nationally representative random sampling to investigate cancer screening rates. Data were analyzed from 1,773 randomly selected women aged 4074 years. Chi-squared tests and multinomial logistic analyses were conducted to determine the associations between cancer worry and the stages of adoption for breast cancer screening and to outline the factors associated with each stage. Results Korean women were classified into the following stages of adoption for breast cancer screening: pre-contemplation (24.7%), contemplation (13.0%), action/maintenance (50.8%), relapse risk (8.9%), and relapse (2.6%). Women in the action/maintenance stages reported more moderate to higher levels of worry about getting cancer than those in the pre-contemplation stage. Further, age of 4049 years and having private cancer insurance were associated with women in the action/maintenance stages. Conclusion Interventions to address breast cancer worry may play an important role in increasing participation and equity in breast cancer screening. PMID:26186652

  13. Screening of women at high familial risk of breast cancer.

    PubMed

    Narod, Steven A

    2010-07-01

    Evaluation of: Kuhl C, Weigel S, Schrading S et al.: Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J. Clin. Oncol. 28, 1450-1457 (2010). In the EVA trial, Kuhl et al. screened 687 women at high risk of breast cancer for up to 3 years with annual MRI. A total of 27 breast cancers were diagnosed, including 11 DCIS and two local recurrences. There were no interval cancers. This data suggests that MRI screening can be used to downstage breast cancers, but larger studies with longer follow-up periods are required to confirm these findings. PMID:20597614

  14. Development of lung cancer CT screening operating support system

    NASA Astrophysics Data System (ADS)

    Ishigaki, Rikuta; Hanai, Kozou; Suzuki, Masahiro; Kawata, Yoshiki; Niki, Noboru; Eguchi, Kenji; Kakinuma, Ryutaro; Moriyama, Noriyuki

    2009-02-01

    In Japan, lung cancer death ranks first among men and third among women. Lung cancer death is increasing yearly, thus early detection and treatment are needed. For this reason, CT screening for lung cancer has been introduced. The CT screening services are roughly divided into three sections: office, radiology and diagnosis sections. These operations have been performed through paper-based or a combination of paper-based and an existing electronic health recording system. This paper describes an operating support system for lung cancer CT screening in order to make the screening services efficient. This operating support system is developed on the basis of 1) analysis of operating processes, 2) digitalization of operating information, and 3) visualization of operating information. The utilization of the system is evaluated through an actual application and users' survey questionnaire obtained from CT screening centers.

  15. The Relationship of Health Numeracy to Cancer Screening

    PubMed Central

    Schapira, Marilyn M.; Neuner, Joan; Fletcher, Kathlyn E.; Gilligan, Mary Ann; Laud, Purushottam; Hayes, Elisabeth

    2014-01-01

    Background Health numeracy is associated with increased understanding of cancer risk reduction information and improved control of chronic disease. Methods A cross-sectional survey was conducted among a primary care population to evaluate the effect of health numeracy on breast, cervical, and colorectal cancer screening. Results No association was found between health numeracy and cancer screening. However, at a baseline screening rate of 85%, increased knowledge (RR 1.06, 95% CI 1.021.08) and decreased perceived barriers (RR 0.93, 95% CI 0.920.95) were associated with increased screening rates. Conclusions Health numeracy was not predictive of cancer screening among a primary care population. PMID:20577913

  16. Cancer screening among Native Americans in eastern North Carolina.

    PubMed

    Farmer, Deborah F; Bell, Ronny A; Stark, Nancy

    2005-11-01

    The purpose of the study is to explore cancer screening predictors and practices among Lumbee Indians in eastern North Carolina. Interviewers from the community conducted phone interviews with 333 men and 456 women aged 40 and older randomly selected from the Lumbee Tribal roll as part of the Lumbee Diabetes and Health Survey. The survey has sections on demographic information and health conditions, family history of chronic conditions, and health behaviors. This paper reports on cancer screening behaviors. Rates of ever being screened for breast, cervical, prostate and colon cancer were relatively high compared with overall national rates. Predictors included younger age, better health, more education, and lifestyle factors such as engaging in regular physical activity and not smoking. Future research should focus on developing culturally appropriate campaigns to increase the frequency of cancer screening to conform to guidelines, and educational programs and interventions to reach Lumbee Indians most at risk for not being screened. PMID:16311489

  17. Colorectal cancer screening: a global overview of existing programmes.

    PubMed

    Schreuders, Eline H; Ruco, Arlinda; Rabeneck, Linda; Schoen, Robert E; Sung, Joseph J Y; Young, Graeme P; Kuipers, Ernst J

    2015-10-01

    Colorectal cancer (CRC) ranks third among the most commonly diagnosed cancers worldwide, with wide geographical variation in incidence and mortality across the world. Despite proof that screening can decrease CRC incidence and mortality, CRC screening is only offered to a small proportion of the target population worldwide. Throughout the world there are widespread differences in CRC screening implementation status and strategy. Differences can be attributed to geographical variation in CRC incidence, economic resources, healthcare structure and infrastructure to support screening such as the ability to identify the target population at risk and cancer registry availability. This review highlights issues to consider when implementing a CRC screening programme and gives a worldwide overview of CRC burden and the current status of screening programmes, with focus on international differences. PMID:26041752

  18. Better Check Your Bowels: Screening for Colon and Rectal Cancer

    MedlinePLUS

    ... disclaimer . Subscribe Better Check Your Bowels Screening for Colon and Rectal Cancer Colorectal cancer is the second-leading cause of ... give me the results, and when? Gut Check Colon and Rectal Cancer NIHSeniorHealth: Colorectal Cance r Colonoscopy Virtual Colonoscopy Colorectal ...

  19. Prostate cancer screening and health care system distrust in Philadelphia

    PubMed Central

    Yang, Tse-Chuan; Matthews, Stephen A.; Anderson, Roger T.

    2013-01-01

    Objective We aim to examine whether distrust of health care system (hereafter distrust) is associated with prostate cancer screening and whether different dimensions of distrust demonstrate similar relationships with prostate cancer screening. Method With data on 1,784 men aged 45–75 from the Philadelphia metropolitan area, we first applied factor analysis to generate factor scores capturing two distrust sub-scales: competence and values. We then implemented logistic regressions to estimate the relationships between distrust and prostate cancer screening, controlling for covariates related to demographics (e.g., race and age), socioeconomic status (e.g., poverty status and education), health care resources (e.g., insurance status), and health status (i.e., self-rated health). Results Without considering any other covariates, both competence and values distrust were negatively associated to the receipt of prostate cancer screening. After accounting for other covariates shown above, values distrust remained negatively associated with the odds of receiving prostate cancer screening (OR=0.89, 95% CI=[0.81, 0.98]) but competence distrust was not a significant predictor. Conclusions Values distrust was independently associated with prostate cancer screening. Macro-level change in the health care system may influence men’s health behaviors. Our findings suggested that efforts to make the health care system more transparent and enhanced communications between men and health providers may facilitate prostate cancer screening. PMID:23775208

  20. Colorectal Cancer Screening: Stool DNA and Other Noninvasive Modalities.

    PubMed

    Bailey, James R; Aggarwal, Ashish; Imperiale, Thomas F

    2016-03-23

    Colorectal cancer screening dates to the discovery of precancerous adenomatous tissue. Screening modalities and guidelines directed at prevention and early detection have evolved and resulted in a significant decrease in the prevalence and mortality of colorectal cancer via direct visualization or using specific markers. Despite continued efforts and an overall reduction in deaths attributed to colorectal cancer over the last 25 years, colorectal cancer remains one of the most common causes of malignancy-associated deaths. In attempt to further reduce the prevalence of colorectal cancer and associated deaths, continued improvement in screening quality and adherence remains key. Noninvasive screening modalities are actively being explored. Identification of specific genetic alterations in the adenoma-cancer sequence allow for the study and development of noninvasive screening modalities beyond guaiac-based fecal occult blood testing which target specific alterations or a panel of alterations. The stool DNA test is the first noninvasive screening tool that targets both human hemoglobin and specific genetic alterations. In this review we discuss stool DNA and other commercially available noninvasive colorectal cancer screening modalities in addition to other targets which previously have been or are currently under study. PMID:26934885

  1. Lung Cancer Screening: Computed Tomography Radiation and Protocols.

    PubMed

    Murugan, Venkatesh A; Kalra, Mannudeep K; Rehani, Madan; Digumarthy, Subba R

    2015-09-01

    Recent studies have supported the use of low-dose computed tomography (LDCT) of the chest as a screening tool for lung cancer. Several professional organizations have now included LDCT screening in high-risk populations in their guidelines. The United States Preventive Services Task Force has added LDCT to its lung cancer-screening guidelines as of December 2013. Recently, the Centers for Medicare and Medicaid Services acknowledged that the evidence for LDCT lung cancer screening is adequate, provided that eligibility criteria are met. As widespread use of LDCT is anticipated, the radiation dose associated with LDCT needs to be optimized. The American College of Radiology-Society of Thoracic Radiology collaboration and the National Comprehensive Cancer Care Network recently provided some guidelines for LDCT utilization for lung cancer screening. There are several scanning and image reconstruction techniques that can be used for reducing radiation dose in LDCT lung cancer screening. This review article presents protocols and guidelines for use of LDCT in lung cancer screening and describes our early experience in implementing LDCT at our institution. PMID:25856411

  2. Optimal breast cancer screening strategies for older women: current perspectives

    PubMed Central

    Braithwaite, Dejana; Demb, Joshua; Henderson, Louise M

    2016-01-01

    Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models. PMID:26893548

  3. Impact of screening mammography on breast cancer mortality.

    PubMed

    Bleyer, Archie; Baines, Cornelia; Miller, Anthony B

    2016-04-15

    The degree to which observed reductions in breast cancer mortality is attributable to screening mammography has become increasingly controversial. We examined this issue with three fundamentally different approaches: (i) Chronology-the temporal relationship of the onset of breast cancer mortality decline and the national implementation of screening mammography; (ii) Magnitude-the degree to which breast cancer mortality declined relative to the amount (penetration) of screening mammography; (iii) Analogy-the pattern of mortality rate reductions of other cancers for which population screening is not conducted. Chronology and magnitude were assessed with data from Europe and North America, with three methods applied to magnitude. A comparison of eight countries in Europe and North America does not demonstrate a correlation between the penetration of national screening and either the chronology or magnitude of national breast cancer mortality reduction. In the United States, the magnitude of the mortality decline is greater in the unscreened, younger women than in the screened population and regional variation in the rate of breast cancer mortality reduction is not correlated with screening penetrance, either as self-reported or by the magnitude of screening-induced increase in early-stage disease. Analogy analysis of United States data identifies 14 other cancers with a similar distinct onset of mortality reduction for which screening is not performed. These five lines of evidence from three different approaches and additional observations discussed do not support the hypothesis that mammography screening is a primary reason for the breast cancer mortality reduction in Europe and North America. PMID:26562826

  4. refinement of an educational toolkit to Promote Cervical Cancer Screening among hispanic immigrant Women in rural Southern Georgia

    PubMed Central

    Watson-Johnson, Lisa C.; Bhagatwala, Jigar; Reyes-Garcia, Claudia; Hinojosa, Andrea; Mason, Mondi; Meade, Cathy D.; Luque, John S.

    2013-01-01

    Summary Cervical cancer incidence and mortality continue to affect Hispanic women in the U.S. disproportionately. Our project sought to refine a cervical cancer intervention designed for use by community health workers, or promotoras, in rural southern Georgia. We collaborated with Hispanic promotoras to refine a Spanish language educational flipchart featuring cervical cancer topic areas for use in screening promotion. PMID:23698684

  5. Physician use of persuasion and colorectal cancer screening.

    PubMed

    Lafata, Jennifer Elston; Wunderlich, Tracy; Flocke, Susan A; Oja-Tebbe, Nancy; Dyer, Karen E; Siminoff, Laura A

    2015-03-01

    The impact of patient-physician communication on subsequent patient behavior has rarely been evaluated in the context of colorectal cancer (CRC) screening discussions. We describe physicians' use of persuasive techniques when recommending CRC screening and evaluate its association with patients' subsequent adherence to screening. Audio recordings of N?=?414 periodic health examinations were joined with screening use data from electronic medical records and pre-/post-visit patient surveys. The association between persuasion and screening was assessed using generalized estimating equations. According to observer ratings, primary care physicians frequently use persuasive techniques (63 %) when recommending CRC screening, most commonly argument or refutation. However, physician persuasion was not associated with subsequent screening adherence. Physician use of persuasion may be a common vehicle for information provision during CRC screening discussions; however, our results do not support the sole reliance on persuasive techniques if the goal is to improve adherence to recommended screening. PMID:25729457

  6. A Personalized Automated Messaging System to Improve Adherence to Prostate Cancer Screening: Research Protocol

    PubMed Central

    2012-01-01

    Background Public adherence to cancer screening guidelines is poor. Patient confusion over multiple recommendations and modalities for cancer screening has been found to be a major barrier to screening adherence. Such problems will only increase as screening guidelines and timetables become individualized. Objective We propose to increase compliance with cancer screening through two-way rich media mobile messaging based on personalized risk assessment. Methods We propose to develop and test a product that will store algorithms required to personalize cancer screening in a central database managed by a rule-based workflow engine, and implemented via messaging to the patient’s mobile phone. We will conduct a randomized controlled trial focusing on prostate cancer screening to study the hypothesis that mobile reminders improve adherence to screening guidelines. We will also explore a secondary hypothesis that patients who reply to the messaging reminders are more engaged and at lower risk of non-adherence. We will conduct a randomized controlled trial in a sample of males between 40 and 75 years (eligible for prostate cancer screening) who are willing to receive text messages, email, or automated voice messages. Participants will be recruited from a primary care clinic and asked to schedule prostate cancer screening at the clinic within the next 3 weeks. The intervention group will receive reminders and confirmation communications for making an appointment, keeping the appointment, and reporting the test results back to the investigators. Three outcomes will be evaluated: (1) the proportion of participants who make an appointment with a physician following a mobile message reminder, (2) the proportion of participants who keep the appointment, and (3) the proportion of participants who report the results of the screening (via text or Web). Results This is an ongoing project, supported by by a small business commercialization grant from the National Center for Advancing Translational Sciences of the National Institutes of Health. Conclusions We believe that the use of centralized databases and text messaging could improve adherence with screening guidelines. Furthermore, we anticipate this method of increasing patient engagement could be applied to a broad range of health issues, both inside and outside of the context of cancer. This project will be an important first step in determining the feasibility of personalized text messaging to improve long-term adherence to screening recommendations. PMID:23612443

  7. Alternative technologies in cervical cancer screening: a randomised evaluation trial

    PubMed Central

    Anttila, Ahti; Hakama, Matti; Kotaniemi-Talonen, Laura; Nieminen, Pekka

    2006-01-01

    Background Cervical cancer screening programmes have markedly reduced the incidence and mortality rates of the disease. A substantial amount of deaths from the disease could be prevented further by organised screening programmes or improving currently running programmes. Methods/Design We present here a randomised evaluation trial design integrated to the Finnish cervical cancer screening programme, in order to evaluate renewal of the programme using emerging technological alternatives. The main aim of the evaluation is to assess screening effectiveness, using subsequent cancers as the outcome and screen-detected pre-cancers as surrogates. For the time being, approximately 863,000 women have been allocated to automation-assisted cytology, human papillomavirus (HPV) DNA testing, or to conventional cytology within the organised screening programme. Follow-up results on subsequent cervical cancers will become available during 20072015. Discussion Large-scale randomised trials are useful to clarify effectiveness and cost-effectiveness issues of the most important technological alternatives in the screening programmes for cervical cancer. PMID:17042938

  8. Improving compliance with cervical cancer screening guidelines

    PubMed Central

    Goodell, Cara; Castro, Eduardo; Thomas, Jen; Kuehl, Thomas J.; Wehbe-Janek, Hania; Hinskey, Meghan

    2015-01-01

    Current cervical cancer screening guidelines for the care of healthy women include HPV cotesting with all Papanicolaou (Pap) smears after the age of 30. To improve compliance with current guidelines, we instituted two processes: first, simplifying the ordering process to a single order for Pap smear plus HPV cotesting using an electronic medical record system (EMR); and second, providing education for clinic staff. Baseline and postintervention data were collected by retrospective chart review. Patients were selected during three intervals: prior to the transition to Epic EMR, after the transition to Epic, and after an educational intervention. Compliance with standard guidelines was evaluated in relation to the trial intervals, type of provider, patient age, and duration from the previous Pap smear. Provider type was analyzed by considering gynecologists versus nongynecologist providers, and physicians versus mid-level providers. Overall, the percentage of compliance with HPV test ordering did not differ (P = 0.21) between intervals. Univariate analyses performed to identify factors likely to be associated with the practice of ordering HPV cotesting only involved the type of provider. In conclusion, transition to Epic and a training session had minimal impact on compliance with ordering HPV cotesting at the time of a Pap smear except among family practice physicians, who did significantly improve their compliance rate. Gynecologists and mid-level providers were more compliant with ordering HPV cotesting throughout, but did not significantly improve after the interventions. PMID:26424938

  9. [Cancer screening from the perspective of public health ethics].

    PubMed

    Marckmann, G; In der Schmitten, J

    2014-03-01

    Cancer screening programs aim at reducing the tumor-related morbidity and mortality by early detection of malignant tumors or precancerous lesions. The basic ethical dilemma in cancer screening is, however, that many people have to be exposed to the burdens and risks of the intervention for a few people to benefit from early cancer diagnosis. This article discusses under which conditions it is ethically acceptable to offer or even recommend cancer screening. First, the benefit of the program in terms of a reduced cancer-related mortality should be proven by randomized controlled trials. The risks and burdens of the program related to the side effects of the investigation itself, false-positive findings, as well as overdiagnoses and overtherapy should be in an acceptable relationship to the expected benefit of the program. In addition to a solid empirical scientific basis, the benefit-harm evaluation necessarily involves value judgments. The potential participants in the screening program therefore should receive transparent, objective, unbiased, and understandable information to enable them to make a truly informed choice about participation. Given the complex benefit-risk assessment, it is discussed whether-and if so under which circumstances-it is ethically acceptable to make a recommendation for or against participation in a cancer screening program. Socioempirical research, such as focus group studies and public deliberations, can be used to elicit the preferences and value judgments of members of the target population that should be taken into consideration in recommendations about a cancer screening program. PMID:24562708

  10. Adapting the Australian system: is an organized screening program feasible in Malaysia?--an overview of cervical cancer screening in both countries.

    PubMed

    Rashid, Rima Ma; Dahlui, Maznah; Mohamed, Majdah; Gertig, Dorota

    2013-01-01

    Cervical cancer is the third most common form of cancer that strikes Malaysian women. The National Cancer Registry in 2006 and 2007 reported that the age standardized incidence (ASR) of cervical cancer was 12.2 and 7.8 per 100,000 women, respectively. The cumulative risk of developing cervical cancer for a Malaysian woman is 0.9 for 74 years. Among all ethnic groups, the Chinese experienced the highest incidence rate in 2006, followed by Indians and Malays. The percentage cervical cancer detected at stage I and II was 55% (stage I: 21.0%, stage II: 34.0%, stage III: 26.0% and stage IV: 19.0%). Data from Ministry of Health Malaysia (2006) showed a 58.9% estimated coverage of pap smear screening conducted among those aged 30-49 years. Only a small percentage of women aged 50-59 and 50-65 years old were screened, 14% and 13.8% coverage, respectively. Incidence of cervical cancer was highest (71.6%) among those in the 60-65 age group (MOH, 2003). Currently, there is no organized population-based screening program available for the whole of Malaysia. A pilot project was initiated in 2006, to move from opportunistic cervical screening of women who attend antenatal and postnatal visits to a population based approach to be able to monitor the women through the screening pathway and encourage women at highest risk to be screened. The project was modelled on the screening program in Australia with some modifications to suit the Malaysian setting. Substantial challenges have been identified, particularly in relation to information systems for call and recall of women, as well as laboratory reporting and quality assurance. A cost-effective locally-specific approach to organized screening, that will provide the infrastructure for increasing participation in the cervical cancer screening program, is urgently required. PMID:23679334

  11. Screening for colorectal cancer: possible improvements by risk assessment evaluation?

    PubMed

    Nielsen, Hans J; Jakobsen, Karen V; Christensen, Ib J; Brnner, Nils

    2011-11-01

    Emerging results indicate that screening improves survival of patients with colorectal cancer. Therefore, screening programs are already implemented or are being considered for implementation in Asia, Europe and North America. At present, a great variety of screening methods are available including colono- and sigmoidoscopy, CT- and MR-colonography, capsule endoscopy, DNA and occult blood in feces, and so on. The pros and cons of the various tests, including economic issues, are debated. Although a plethora of evaluated and validated tests even with high specificities and reasonable sensitivities are available, an international consensus on screening procedures is still not established. The rather limited compliance in present screening procedures is a significant drawback. Furthermore, some of the procedures are costly and, therefore, selection methods for these procedures are needed. Current research into improvements of screening for colorectal cancer includes blood-based biological markers, such as proteins, DNA and RNA in combination with various demographically and clinically parameters into a "risk assessment evaluation" (RAE) test. It is assumed that such a test may lead to higher acceptance among the screening populations, and thereby improve the compliances. Furthermore, the involvement of the media, including social media, may add even more individuals to the screening programs. Implementation of validated RAE and progressively improved screening methods may reform the cost/benefit of screening procedures for colorectal cancer. Therefore, results of present research, validating RAE tests, are awaited with interest. PMID:21854094

  12. Practice Bulletin No. 157: Cervical Cancer Screening and Prevention.

    PubMed

    2016-01-01

    The incidence of cervical cancer in the United States has decreased more than 50% in the past 30 years because of widespread screening. In 1975, the rate was 14.8 per 100,000 women. By 2011, it decreased to 6.7 per 100,000 women. Mortality from the disease has undergone a similar decrease from 5.55 per 100,000 women in 1975 to 2.3 per 100,000 women in 2011 (). The American Cancer Society (ACS) estimated that there would be 12,900 new cases of cervical cancer in the United States in 2015, with 4,100 deaths from the disease (). Cervical cancer is much more common worldwide, particularly in countries without screening programs, with an estimated 527,624 new cases of the disease and 265,672 resultant deaths each year (). When cervical cancer screening programs have been introduced into communities, marked reductions in cervical cancer incidence have followed ().New technologies for cervical cancer screening continue to evolve, as do recommendations for managing the results. In addition, there are different risk-benefit considerations for women at different ages, as reflected in age-specific screening recommendations. In 2011, the ACS, the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) updated their joint guidelines for cervical cancer screening (), as did the U.S. Preventive Services Task Force (USPSTF) (). Subsequently, in 2015, ASCCP and the Society of Gynecologic Oncology (SGO) issued interim guidance for the use of a human papillomavirus (HPV) test for primary screening for cervical cancer that was approved in 2014 by the U.S. Food and Drug Administration (FDA) (). The purpose of this document is to provide a review of the best available evidence regarding the prevention and early detection of cervical cancer. PMID:26695583

  13. Practice Bulletin No. 157 Summary: Cervical Cancer Screening and Prevention.

    PubMed

    2016-01-01

    The incidence of cervical cancer in the United States has decreased more than 50% in the past 30 years because of widespread screening. In 1975, the rate was 14.8 per 100,000 women. By 2011, it decreased to 6.7 per 100,000 women. Mortality from the disease has undergone a similar decrease from 5.55 per 100,000 women in 1975 to 2.3 per 100,000 women in 2011 (1). The American Cancer Society (ACS) estimated that there would be 12,900 new cases of cervical cancer in the United States in 2015, with 4,100 deaths from the disease (2). Cervical cancer is much more common worldwide, particularly in countries without screening programs, with an estimated 527,624 new cases of the disease and 265,672 resultant deaths each year (3). When cervical cancer screening programs have been introduced into communities, marked reductions in cervical cancer incidence have followed (4, 5).New technologies for cervical cancer screening continue to evolve, as do recommendations for managing the results. In addition, there are different risk-benefit considerations for women at different ages, as reflected in age-specific screening recommendations. In 2011, the ACS, the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) updated their joint guidelines for cervical cancer screening (6), as did the U.S. Preventive Services Task Force (USPSTF) (7). Subsequently, in 2015, ASCCP and the Society of Gynecologic Oncology (SGO) issued interim guidance for the use of a human papillomavirus (HPV) test for primary screening for cervical cancer that was approved in 2014 by the U.S. Food and Drug Administration (FDA) (8). The purpose of this document is to provide a review of the best available evidence regarding the prevention and early detection of cervical cancer. PMID:26695578

  14. Awareness of breast cancer and screening procedures among Malaysian women.

    PubMed

    Kanaga, K C; Nithiya, J; Shatirah, M F V Noor

    2011-01-01

    Breast cancer is the most frequently occurring cancer in women globally and early detection increases the survival rate of patients. Therefore, this study was done to determine factors which influence the awareness of breast cancer and practice of screening procedures. A cross-sectional study was performed on 125 women aged 19-60 years in urban and rural areas in Malaysia using a validated questionnaire covering knowledge of breast cancer and screening practices. A total of 99.2% respondents knew that breast cancer is the leading cancer with a mean knowledge of 67.3 15.3% for urban and 50.2 14.7% for rural women Mann Whitney U showed rural women had significantly less awareness compared to urban women (p< 0.05). Spearman correlation test showed a significant positive relationship between education and awareness (p< 0.05). Regarding awareness of the screening methods, 92.8%, 50.4% and 47.2% of respondents correctly answered questions on capability of BSE, CBE and mammography, respectively. In conclusion, the study showed awareness of breast cancer and practice of screening procedures increases with higher education and urban living. Therefore, there is an urgent need for an intensive breast cancer awareness campaign and availablity of screening centres prioritized in rural areas. PMID:22292634

  15. Colon Cancer Screening Rates on the Rise in NYC

    MedlinePLUS

    ... be one reason why, and might serve as model for other cities, experts say ... cancer screening rates in New York City rose 40 percent over four years, possibly due to the efforts of a coalition ...

  16. Discovery – Lung Cancer Screening Saves Lives: The NLST

    Cancer.gov

    NCI funded the National Lung Screening Trial, an eight-year study that used new technology to detect small, aggressive tumors early enough to surgically remove them. This approach reduced lung cancer deaths among participants by 20 percent.

  17. Older Hispanic women, health literacy, and cervical cancer screening.

    PubMed

    Flores, Bertha E; Acton, Gayle J

    2013-11-01

    Approximately 90 million people in the United States lack basic literacy skills, which affect health behaviors. Cervical cancer is preventable and treatable, yet few older Hispanic women seek screening and continue to be a high-risk group for cervical cancer. A literature review was conducted to address the relationship between cervical cancer screening, health literacy, and older Hispanic women. Eighty studies were reviewed, and nine addressed health literacy and Hispanic women. One study addressed the association between functional health literacy and Pap smear screening among older Hispanic women. Few studies have explored the association between preventive cervical cancer screening and health literacy among older Hispanic women. Nurses must assess health literacy and be prepared to provide care, which is culturally, and linguistically appropriate to improve health outcomes. Further research is needed to be inclusive of all populations including older Hispanic women. PMID:23729023

  18. Discovery Lung Cancer Screening Saves Lives: The NLST

    Cancer.gov

    NCI funded the National Lung Screening Trial, an eight-year study that used new technology to detect small, aggressive tumors early enough to surgically remove them. This approach reduced lung cancer deaths among participants by 20 percent.

  19. Many Older Americans May Get Unneeded Breast, Prostate Cancer Screenings

    MedlinePLUS

    ... not recommended for certain individuals, he added. Robert Smith, vice president for cancer screening at the American ... estimate whether somebody has 10 years to live, Smith said. The report was published online Jan. 21 ...

  20. Grantee Spotlight: Dr. Kolawole Okuyemi - Improving Cervical Cancer Screening Attitudes

    Cancer.gov

    Dr. Kolawole Okuyumi is studying cervical cancer screening attitudes and behaviors of African immigrants and refugees in Minnesota, and introducing “cancer” and “cervix” to their everyday vocabulary.

  1. 50 years of screening in the Nordic countries: quantifying the effects on cervical cancer incidence

    PubMed Central

    Vaccarella, S; Franceschi, S; Engholm, G; Lönnberg, S; Khan, S; Bray, F

    2014-01-01

    Background: Nordic countries' data offer a unique possibility to evaluate the long-term benefit of cervical cancer screening in a context of increasing risk of human papillomavirus infection. Methods: Ad hoc-refined age-period-cohort models were applied to the last 50-year incidence data from Denmark, Finland, Norway and Sweden to project expected cervical cancer cases in a no-screening scenario. Results: In the absence of screening, projected incidence rates for 2006–2010 in Nordic countries would have been between 3 and 5 times higher than observed rates. Over 60 000 cases or between 41 and 49% of the expected cases of cervical cancer may have been prevented by the introduction of screening in the late 1960 s and early 1970 s. Conclusions: Our study suggests that screening programmes might have prevented a HPV-driven epidemic of cervical cancer in Nordic countries. According to extrapolations from cohort effects, cervical cancer incidence rates in the Nordic countries would have been otherwise comparable to the highest incidence rates currently detected in low-income countries. PMID:24992581

  2. Lung Nodule and Cancer Detection in CT Screening

    PubMed Central

    Rubin, Geoffrey D

    2015-01-01

    Fundamental to the diagnosis of lung cancer in CT scans is the detection and interpretation of lung nodules. As the capabilities of CT scanners have advanced, higher levels of spatial resolution reveal tinier lung abnormalities. While not all detected lung nodules should be reported, radiologists strive to detect all nodules that might have relevance to cancer diagnosis. Although medium to large lung nodules are detected consistently, inter-reader agreement and reader sensitivity for lung nodule detection diminish substantially as nodule size falls below 8–10 mm. The difficulty in establishing an absolute reference standard presents a challenge to the reliability of studies performed to evaluate lung nodule detection. In the interest of improving detection performance, investigators are using eye tracking to analyze the effectiveness with which radiologists search CT scans relative to their ability to recognize nodules within their search path to determine if strategies might exist to improve performance across readers. Beyond the viewing of transverse CT reconstructions, image processing techniques such as thin-slab maximum intensity projections are used to substantially improve reader performance. Finally, the development of computer-aided detection has continued to evolve with the expectation that one day it will serve routinely as a tireless partner to the radiologist to enhance detection performance without significant prolongation of the interpretive process. This review provides an introduction to the current understanding of these varied issues as we enter the era of widespread lung cancer screening. PMID:25658477

  3. Using Client Reminders to Increase Colorectal Cancer Screening in Montana, 2012

    PubMed Central

    Williamson, Laura L.; Merchant, Leah; Lengerich, Eugene J.

    2014-01-01

    Background Colorectal cancer (CRC) is the third leading cause of cancer death for men and women in the United States. CRC screening can save lives by detecting precancerous polyps that are then removed or by detecting cancer early when treatment is most effective. Community Context CRC screening participation in Montana is low. To increase screening participation among Montanans with health insurance, the Montana Cancer Control Programs (MCCP) partnered with a small association health organization (AHO). This partnership implemented a postcard campaign to increase CRC screening participation among the AHOs enrollees. Methods Postcards were sent to 1,011 people insured through the AHO; 504 people were mailed 1 postcard and 507 people were mailed 2 postcards. Evaluation of the campaign assessed recall of the campaign among people who received 1 postcard versus people who received 2 postcards. Outcome Women were 60% more likely to recall receiving the postcards than were men. People who received 2 postcards were 2.3 times as likely to recall receiving them as were people who received 1 postcard. Interpretation The MCCP considers this collaborative project with an AHO a promising approach to implementing evidence-based colorectal cancer screening interventions. The MCCP plans to partner with additional AHOs in Montana to evaluate CRC screening participation among their enrollees. PMID:24698529

  4. Standardization for transcriptomic molecular markers to screen human colon cancer.

    PubMed

    Ahmed, Farid E; Vos, Paul W; Ijames, Stephanie; Lysle, Donald T; Flake, Gordon; Sinar, Dennis R; Naziri, Wade; Marcuard, Stephan P

    2007-01-01

    Establishing test performance criteria for a transcriptomic colon cancer marker approach must be carried out in a standardized fashion in order tso ensure that the test will perform the same way in any laboratory, anywhere. Condition of sample preservation and shipping prior to total RNA extraction is critical, and we recommend preserving stool samples in an appropriate preservative and shipping them in cold packs so as to keep stools at 4 degrees C. It is not necessary to isolate colonocytes to obtain adequate RNA for testing. It is, however, important to obtain samples from both mucin-rich and non-mucin rich to have a good representation of both left- and right-side colon cancers. Employing a commercial total RNA extraction kit that contains an RLT buffer from Qiagen Corporation (Valencia, CA, USA) removes bacterial RNA from stool preparations and results in a high yield of undegraded RNA of human origin. Genes selected based on the enormous resources of NCI's Cancer Genome Anatomy project give good results. Primers for PCR should span more than one exon. Use of semiquantitative PCR, preferably with several reference housekeeping genes of various copy numbers, depending on tested genes, should enhance confidence in the quantitative results. Having standardized the testing conditions in our ongoing work, it is now imperative that a larger prospective randomized clinical study utilizing stool and tissue samples derived from several control and colon cancer patients, to allow for statistically valid analyses, be conducted in order to determine the true sensitivity and specificity of the transcriptomic screening approach for this cancer whose incidence is on the rise worldwide. PMID:18204205

  5. Screening for lung cancer using low dose computed tomography.

    PubMed

    Tammemagi, Martin C; Lam, Stephen

    2014-01-01

    Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant screening and the appropriate management of lung nodules found at screening. An accurate risk prediction model is more efficient than age and pack years of smoking alone at identifying those who will develop lung cancer and die from the disease. Algorithms are available for assessing people who screen positive to determine who needs additional imaging or invasive investigations. Concerns about low dose computed tomography screening include false positive results, overdiagnosis, radiation exposure, and costs. Further work is needed to define the frequency and duration of screening and to refine risk prediction models so that they can be used to assess the risk of lung cancer in special populations. Another important area is the use of computer vision software tools to facilitate high throughput interpretation of low dose computed tomography images so that costs can be reduced and the consistency of scan interpretation can be improved. Sufficient data are available to support the implementation of screening programs at the population level in stages that can be expanded when found to perform well to improve the outcome of patients with lung cancer. PMID:24865600

  6. Screening for Cancer by Residents in an Internal Medicine Program.

    ERIC Educational Resources Information Center

    Lynch, Garrett R.; Prout, Marianne N.

    1986-01-01

    A study of cancer screening by internal medicine residents in an inner-city clinic revealed that screening was more frequent for male patients, and breast examinations and Pap smears were performed on less than a third of female patients, suggesting a need for more intensive early-detection education of residents. (MSE)

  7. Lung cancer screening: history, current perspectives, and future directions.

    PubMed

    Sharma, Divakar; Newman, Thomas G; Aronow, Wilbert S

    2015-10-12

    Lung cancer has remained the leading cause of death worldwide among all cancers. The dismal 5-year survival rate of 16% is in part due to the lack of symptoms during early stages and lack of an effective screening test until recently. Chest X-ray and sputum cytology were studied extensively as potential screening tests for lung cancer and were conclusively proven to be of no value. Subsequently, a number of studies compared computed tomography (CT) with the chest X-ray. These studies did identify lung cancer in earlier stages. However, they were not designed to prove a reduction in mortality. Later trials have focused on low-dose CT (LDCT) as a screening tool. The largest US trial - the National Lung Screening Trial (NLST) - enrolled approximately 54,000 patients and revealed a 20% reduction in mortality. While a role for LDCT in lung cancer screening has been established, the issues of high false positive rates, radiation risk, and cost effectiveness still need to be addressed. The guidelines of the international organizations that now include LDCT in lung cancer screening are reviewed. Other methods that may improve earlier detection such as positron emission tomography, autofluorescence bronchoscopy, and molecular biomarkers are also discussed. PMID:26528348

  8. Lung cancer screening: history, current perspectives, and future directions

    PubMed Central

    Sharma, Divakar; Newman, Thomas G.

    2015-01-01

    Lung cancer has remained the leading cause of death worldwide among all cancers. The dismal 5-year survival rate of 16% is in part due to the lack of symptoms during early stages and lack of an effective screening test until recently. Chest X-ray and sputum cytology were studied extensively as potential screening tests for lung cancer and were conclusively proven to be of no value. Subsequently, a number of studies compared computed tomography (CT) with the chest X-ray. These studies did identify lung cancer in earlier stages. However, they were not designed to prove a reduction in mortality. Later trials have focused on low-dose CT (LDCT) as a screening tool. The largest US trial – the National Lung Screening Trial (NLST) – enrolled approximately 54,000 patients and revealed a 20% reduction in mortality. While a role for LDCT in lung cancer screening has been established, the issues of high false positive rates, radiation risk, and cost effectiveness still need to be addressed. The guidelines of the international organizations that now include LDCT in lung cancer screening are reviewed. Other methods that may improve earlier detection such as positron emission tomography, autofluorescence bronchoscopy, and molecular biomarkers are also discussed. PMID:26528348

  9. Cancer screening behaviors among Korean-American women.

    PubMed

    Juon, H S; Choi, Y; Kim, M T

    2000-01-01

    The goals of this study were to evaluate breast and cervical cancer screening tests and to examine the correlates of cancer screening behaviors. A cross-sectional face-to-face survey of 438 Korean-American women residing in Maryland was conducted. About 50% of women age 18 and older had had a Pap smear and 46.6% of these women age 40 and older had had a mammogram in the past 2 years. In multiple logistic regression analyses, the strongest correlate of screening behaviors was having a regular medical checkup. Age and acculturation were found to be important correlates of cancer screening tests: Women less than 50 years of age were more likely to have cancer screening tests than those 50 years and older. English language proficiency was associated with having a mammogram and the proportion of life spent in the United States was associated with having a Pap smear. Employment interacted with marital status for a Pap smear, with those married and unemployed being less likely to have a Pap smear than women who were both married and employed. For strategies to increase cancer-screening tests among Korean-American women, we need to aim at developing culturally appropriate educational programs about cancer for less acculturated and recent immigrants. PMID:11198273

  10. Secondary solid cancer screening following hematopoietic cell transplantation.

    PubMed

    Inamoto, Y; Shah, N N; Savani, B N; Shaw, B E; Abraham, A A; Ahmed, I A; Akpek, G; Atsuta, Y; Baker, K S; Basak, G W; Bitan, M; DeFilipp, Z; Gregory, T K; Greinix, H T; Hamadani, M; Hamilton, B K; Hayashi, R J; Jacobsohn, D A; Kamble, R T; Kasow, K A; Khera, N; Lazarus, H M; Malone, A K; Lupo-Stanghellini, M T; Margossian, S P; Muffly, L S; Norkin, M; Ramanathan, M; Salooja, N; Schoemans, H; Wingard, J R; Wirk, B; Wood, W A; Yong, A; Duncan, C N; Flowers, M E D; Majhail, N S

    2015-08-01

    Hematopoietic stem cell transplant (HCT) recipients have a substantial risk of developing secondary solid cancers, particularly beyond 5 years after HCT and without reaching a plateau overtime. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal to facilitate implementation of cancer screening appropriate to HCT recipients. The working group reviewed guidelines and methods for cancer screening applicable to the general population and reviewed the incidence and risk factors for secondary cancers after HCT. A consensus approach was used to establish recommendations for individual secondary cancers. The most common sites include oral cavity, skin, breast and thyroid. Risks of cancers are increased after HCT compared with the general population in skin, thyroid, oral cavity, esophagus, liver, nervous system, bone and connective tissues. Myeloablative TBI, young age at HCT, chronic GVHD and prolonged immunosuppressive treatment beyond 24 months were well-documented risk factors for many types of secondary cancers. All HCT recipients should be advised of the risks of secondary cancers annually and encouraged to undergo recommended screening based on their predisposition. Here we propose guidelines to help clinicians in providing screening and preventive care for secondary cancers among HCT recipients. PMID:25822223

  11. The National Lung Screening Trial (NLST) | Division of Cancer Prevention

    Cancer.gov

    The National Lung Screening Trial (NLST) compared two ways of detecting lung cancer: low-dose helical computed tomography (CT) and standard chest X-ray. Both chest X-rays and low-dose helical CT scans have been used to find lung cancer early, but the effects of these screening techniques on lung cancer mortality rates had not been determined. NLST enrolled 53,454 current or former heavy smokers from 33 sites and coordinating centers across the United States. | The National Lung Screening Trial (NLST) compared two ways of detecting lung cancer: participants who received low-dose helical CT scans had a 20% lower risk of dying from lung cancer than participants who received standard chest X-rays.

  12. Hereditary and common familial colorectal cancer: evidence for colorectal screening.

    PubMed

    Samadder, N Jewel; Jasperson, Kory; Burt, Randall W

    2015-03-01

    Colorectal cancer (CRC) is the fourth most common cancer among men and women. Between 3 and 6% of all CRCs are attributed to well-defined inherited syndromes, including Lynch syndrome, familial adenomatous polyposis, MUTYH-associated polyposis and several hamartomatous conditions. Up to 30% of CRC cases exhibit common familial risk, likely related to a combination of inherited factors and environment. Identification of these patients through family history and appropriate genetic testing can provide estimates of cancer risk that inform appropriate cancer screening, surveillance and/or preventative interventions. This article examines the colon cancer syndromes, their genetic basis, clinical management and evidence supporting colorectal screening. It also deals with the category of common (non-syndromic) familial risk including risk determination and screening guidelines. PMID:25501924

  13. Screening history of cervical cancers in Emilia-Romagna, Italy: defining priorities to improve cervical cancer screening.

    PubMed

    Rossi, Paolo Giorgi; Caroli, Stefania; Mancini, Silvia; de' Bianchi, Priscilla Sassoli; Finarelli, Alba C; Naldoni, Carlo; Bucchi, Lauro; Falcini, Fabio

    2015-03-01

    Most invasive cervical cancers in industrialized countries are due to the lack of Pap test coverage, very few are due to screening failures. This study aimed at quantifying the proportion of invasive cancers occurring in nonscreened or underscreened women and that in women with a previous negative screening, that is, screening failure, during the first two screening rounds (1996-2002) and in the following rounds (2003-2008) in the Emilia-Romagna region. All cases of invasive cancers registered in the regional cancer registry between 1996 and 2008 were classified according to screening history through a record linkage with the screening programme registry. The incidence significantly decreased from 11.6/100 000 to 8.7/100 000; this decrease is due to a reduction in squamous cell cancers (annual percentage change -6.2; confidence interval: -7.8, -4.6) and advanced cancers (annual percentage change -6.6; confidence interval: -8.8, -4.3), whereas adenocarcinomas and microinvasive cancers were essentially stable. The proportion of cancers among women not yet invited and among nonresponders decreased over the two periods, from 45.5 to 33.3%. In contrast, the proportion of women with a previous negative Pap test less than 5 years and 5 years or more before cancer incidence increased from 5.7 to 13.3% and from 0.3 to 5.5%, respectively. Although nonattendance of the screening programme remains the main barrier to cervical cancer control, the introduction of a more sensitive test, such as the human papillomavirus DNA test, could significantly reduce the burden of disease. PMID:24787379

  14. Interval Cancers in a Population-Based Screening Program for Colorectal Cancer in Catalonia, Spain

    PubMed Central

    Garcia, M.; Domnech, X.; Vidal, C.; Torn, E.; Mil, N.; Binefa, G.; Benito, L.; Moreno, V.

    2015-01-01

    Objective. To analyze interval cancers among participants in a screening program for colorectal cancer (CRC) during four screening rounds. Methods. The study population consisted of participants of a fecal occult blood test-based screening program from February 2000 to September 2010, with a 30-month follow-up (n = 30,480). We used hospital administration data to identify CRC. An interval cancer was defined as an invasive cancer diagnosed within 30 months of a negative screening result and before the next recommended examination. Gender, age, stage, and site distribution of interval cancers were compared with those in the screen-detected group. Results. Within the study period, 97 tumors were screen-detected and 74 tumors were diagnosed after a negative screening. In addition, 17 CRC (18.3%) were found after an inconclusive result and 2 cases were diagnosed within the surveillance interval (2.1%). There was an increase of interval cancers over the four rounds (from 32.4% to 46.0%). When compared with screen-detected cancers, interval cancers were found predominantly in the rectum (OR: 3.66; 95% CI: 1.518.88) and at more advanced stages (P = 0.025). Conclusion. There are large numbers of cancer that are not detected through fecal occult blood test-based screening. The low sensitivity should be emphasized to ensure that individuals with symptoms are not falsely reassured. PMID:25802515

  15. Evidence-Based Assessment in Case Management to Improve Abnormal Cancer Screen Follow-Up

    ERIC Educational Resources Information Center

    Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah

    2005-01-01

    The authors describe an evidence-based assessment protocol for intensive case management to improve screening diagnostic follow-up developed through a research project in breast and cervical cancer early detection funded by the Centers for Disease Control and Prevention. Three components of an evidence-based approach to assessment are presented

  16. Racial differences in breast cancer screening, knowledge and compliance.

    PubMed Central

    Harris, Dawne M.; Miller, Jane E.; Davis, Diane M.

    2003-01-01

    BACKGROUND: Breast cancer is the second leading cause of cancer death among women in the United States. Although the incidence of breast cancer is 13% higher in white women, mortality in black women is 28% higher, due to histological and socioeconomic factors. Existing research regarding racial differences in compliance with breast cancer screening recommendations has found conflicting results. METHODS: Data on more than 4,500 women were taken from the 1992 National Health Interview Survey, a nationally representative, population-based sample survey. Logistic regression was used to estimate the relative odds of knowledge of breast self-exam (BSE) and mammograms, and compliance with BSE, clinical breast exams (CBE), and mammograms. RESULTS: Black women were less likely than white women to be aware of and use breast cancer screening tests. However, among women who were aware of screening tests, compliance was higher among black women. Women with low educational attainment, low cancer knowledge, and no usual source of care were less likely to be CBE or mammogram compliant. Socioeconomic differences were larger for the two clinical tests than for BSE. CONCLUSIONS: Programs should inform women about cancer screening tests and remove barriers that hinder women from receiving clinical screening exams. PMID:12934865

  17. Advanced breast cancer incidence following population-based mammographic screening

    PubMed Central

    Autier, P.; Boniol, M.; Middleton, R.; Dor, J.-F.; Hry, C.; Zheng, T.; Gavin, A.

    2011-01-01

    Background: Breast cancer mortality is declining in many Western countries. If mammography screening contributed to decreases in mortality, then decreases in advanced breast cancer incidence should also be noticeable. Patients and methods: We assessed incidence trends of advanced breast cancer in areas where mammography screening is practiced for at least 7 years with 60% minimum participation and where population-based registration of advanced breast cancer existed. Through a systematic Medline search, we identified relevant published data for Australia, Italy, Norway, Switzerland, The Netherlands, UK and the USA. Data from cancer registries in Northern Ireland, Scotland, the USA (Surveillance, Epidemiology and End Results (SEER), and Connecticut), and Tasmania (Australia) were available for the study. Criterion for advanced cancer was the tumour size, and if not available, spread to regional/distant sites. Results: Age-adjusted annual percent changes (APCs) were stable or increasing in ten areas (APCs of ?0.5% to 1.7%). In four areas (Firenze, the Netherlands, SEER and Connecticut) there were transient downward trends followed by increases back to pre-screening rates. Conclusions: In areas with widespread sustained mammographic screening, trends in advanced breast cancer incidence do not support a substantial role for screening in the decrease in mortality. PMID:21252058

  18. The comparative and cost-effectiveness of HPV-based cervical cancer screening algorithms in El Salvador.

    PubMed

    Campos, Nicole G; Maza, Mauricio; Alfaro, Karla; Gage, Julia C; Castle, Philip E; Felix, Juan C; Cremer, Miriam L; Kim, Jane J

    2015-08-15

    Cervical cancer is the leading cause of cancer death among women in El Salvador. Utilizing data from the Cervical Cancer Prevention in El Salvador (CAPE) demonstration project, we assessed the health and economic impact of HPV-based screening and two different algorithms for the management of women who test HPV-positive, relative to existing Pap-based screening. We calibrated a mathematical model of cervical cancer to epidemiologic data from El Salvador and compared three screening algorithms for women aged 30-65 years: (i) HPV screening every 5 years followed by referral to colposcopy for HPV-positive women (Colposcopy Management [CM]); (ii) HPV screening every 5 years followed by treatment with cryotherapy for eligible HPV-positive women (Screen and Treat [ST]); and (iii) Pap screening every 2 years followed by referral to colposcopy for Pap-positive women (Pap). Potential harms and complications associated with overtreatment were not assessed. Under base case assumptions of 65% screening coverage, HPV-based screening was more effective than Pap, reducing cancer risk by ? 60% (Pap: 50%). ST was the least costly strategy, and cost $2,040 per year of life saved. ST remained the most attractive strategy as visit compliance, costs, coverage, and test performance were varied. We conclude that a screen-and-treat algorithm within an HPV-based screening program is very cost-effective in El Salvador, with a cost-effectiveness ratio below per capita GDP. PMID:25639903

  19. A transparent projection screen based on plasmonic Ag nanocubes.

    PubMed

    Saito, Koichiro; Tatsuma, Tetsu

    2015-12-28

    A transparent and colourless projection screen is fabricated by depositing a silver nanocube sub-monolayer on a titania thin film. Backward scattering of the silver nanocubes is enhanced by titania in the blue and red regions, to which human eyes are less sensitive. As a result, this screen, which is cost-effective even for large areas, allows projection of full colour images. PMID:26592208

  20. PSA Screening Has Led to Overtreatment of Many Prostate Cancers

    Cancer.gov

    Screening for prostate cancer with the prostate-specific antigen (PSA) test has led to overtreatment of many prostate cancers, including aggressive treatments in older men considered to be at low risk for progression of the disease according to a study published in the July 26, 2010 Archives of Internal Medicine.

  1. Social Construction of Cervical Cancer Screening among Panamanian Women

    ERIC Educational Resources Information Center

    Calvo, Arlene; Brown, Kelli McCormack; McDermott, Robert J.; Bryant, Carol A.; Coreil, Jeanine; Loseke, Donileen

    2012-01-01

    Background: Understanding how "health issues" are socially constructed may be useful for creating culturally relevant programs for Hispanic/Latino populations. Purpose: We explored the constructed meanings of cervical cancer and cervical cancer screening among Panamanian women, as well as socio-cultural factors that deter or encourage screening…

  2. Colorectal Cancer Deaths Attributable to Nonuse of Screening in the United States

    PubMed Central

    Meester, Reinier G.S.; Doubeni, Chyke A.; Lansdorp-Vogelaar, Iris; Goede, S.L.; Levin, Theodore R.; Quinn, Virginia P.; van Ballegooijen, Marjolein; Corley, Douglas A.; Zauber, Ann G.

    2015-01-01

    Purpose Screening is a major contributor to colorectal cancer (CRC) mortality reductions in the U.S., but is underutilized. We estimated the fraction of CRC deaths attributable to nonuse of screening to demonstrate the potential benefits from targeted interventions. Methods The established MISCAN-colon microsimulation model was used to estimate the population attributable fraction (PAF) in people aged ≥50 years. The model incorporates long-term patterns and effects of screening by age and type of screening test. PAF for 2010 was estimated using currently available data on screening uptake; PAF was also projected assuming constant future screening rates to incorporate lagged effects from past increases in screening uptake. We also computed PAF using Levin's formula to gauge how this simpler approach differs from the model-based approach. Results There were an estimated 51,500 CRC deaths in 2010, about 63% (N∼32,200) of which were attributable to non-screening. The PAF decreases slightly to 58% in 2020. Levin's approach yielded a considerably more conservative PAF of 46% (N∼23,600) for 2010. Conclusions The majority of current U.S. CRC deaths are attributable to non-screening. This underscores the potential benefits of increasing screening uptake in the population. Traditional methods of estimating PAF underestimated screening effects compared with model-based approaches. PMID:25721748

  3. Population screening for cancer-related germline gene mutations.

    PubMed

    Grann, Victor R; Jacobson, Judith S

    2002-06-01

    Over the past 5 years, tests for germline (heritable) gene mutations associated with high risk of chronic diseases, such as breast cancer, have become increasingly available. Appropriately used, tests for such mutations could lead to reductions in disease morbidity and mortality. Population screening has been proposed for some cancer-related mutations; however, not all populations are suitable for such screening. The benefits of screening and preventive treatments for individuals with cancer-related mutations in different populations depend on the prevalence and penetrance of the mutation, the mortality associated with the disease, the age of the person screened at testing, and the potential effects of preventive measures on risk of developing the disease, quality of life, and costs. The criteria normally used to assess cancer screening tests can be applied, with some modifications, to tests for cancer-related genetic mutations and can help physicians, insurance companies, and health-policy makers to decide whether or not specific genetic tests should be used to screen specific populations. PMID:12107021

  4. Developments in Screening Tests and Strategies for Colorectal Cancer

    PubMed Central

    Sovich, Justin L.; Sartor, Zachary; Misra, Subhasis

    2015-01-01

    Background. Worldwide, colorectal cancer (CRC) is the third most common cancer in men and second most common in women. It is the fourth most common cause of cancer mortality. In the United States, CRC is the third most common cause of cancer and second most common cause of cancer mortality. Incidence and mortality rates have steadily fallen, primarily due to widespread screening. Methods. We conducted keyword searches on PubMed in four categories of CRC screening: stool, endoscopic, radiologic, and serum, as well as news searches in Medscape and Google News. Results. Colonoscopy is the gold standard for CRC screening and the most common method in the United States. Technological improvements continue to be made, including the promising “third-eye retroscope.” Fecal occult blood remains widely used, particularly outside the United States. The first at-home screen, a fecal DNA screen, has also recently been approved. Radiological methods are effective but seldom used due to cost and other factors. Serum tests are largely experimental, although at least one is moving closer to market. Conclusions. Colonoscopy is likely to remain the most popular screening modality for the immediate future, although its shortcomings will continue to spur innovation in a variety of modalities. PMID:26504799

  5. Celebrity appeal: reaching women to promote colorectal cancer screening.

    PubMed

    Cooper, Crystale Purvis; Gelb, Cynthia A; Lobb, Kathleen

    2015-03-01

    The Centers for Disease Control and Prevention's Screen for Life: National Colorectal Cancer Action Campaign works with the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance to develop public service announcements (PSAs) featuring celebrities. Selection of Screen for Life celebrity spokespersons is based on a variety of factors, including their general appeal and personal connection to colorectal cancer. Screen for Life PSAs featuring celebrities have been disseminated exclusively through donated media placements and have been formatted for television, radio, print, and out-of-home displays such as dioramas in airports, other transit stations, and shopping malls. A 2012 national survey with women aged 50-75 years (n=772) investigated reported exposure to Screen for Life PSAs featuring actor Terrence Howard. In total, 8.3% of women recalled exposure to the PSAs. Celebrity spokespersons can attract the attention of both target audiences and media gatekeepers who decide which PSAs will receive donated placements. PMID:25521047

  6. Celebrity Appeal: Reaching Women to Promote Colorectal Cancer Screening

    PubMed Central

    Cooper, Crystale Purvis; Gelb, Cynthia A.; Lobb, Kathleen

    2015-01-01

    The Centers for Disease Control and Prevention’s Screen for Life: National Colorectal Cancer Action Campaign works with the Entertainment Industry Foundation’s National Colorectal Cancer Research Alliance to develop public service announcements (PSAs) featuring celebrities. Selection of Screen for Life celebrity spokespersons is based on a variety of factors, including their general appeal and personal connection to colorectal cancer. Screen for Life PSAs featuring celebrities have been disseminated exclusively through donated media placements and have been formatted for television, radio, print, and out-of-home displays such as dioramas in airports, other transit stations, and shopping malls. A 2012 national survey with women aged 50–75 years (n = 772) investigated reported exposure to Screen for Life PSAs featuring actor Terrence Howard. In total, 8.3% of women recalled exposure to the PSAs. Celebrity spokespersons can attract the attention of both target audiences and media gatekeepers who decide which PSAs will receive donated placements. PMID:25521047

  7. Risks of Liver (Hepatocellular) Cancer Screening

    MedlinePLUS

    ... United States than in other parts of the world. Liver cancer is uncommon in the United States, ... is the fourth most common cancer in the world. In the United States, men, especially Chinese American ...

  8. Cancer Information Summaries: Screening/Detection

    MedlinePLUS

    ... 2013 2012 2011 Media Resources Media Contacts Multicultural Media Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Cancer Currents Blog About NCI NCI Overview History Contributing to Cancer Research Leadership Director's Page Previous NCI Directors NCI Organization ...

  9. A qualitative exploration of Malaysian cancer patients’ perceptions of cancer screening

    PubMed Central

    2013-01-01

    Background Despite the existence of different screening methods, the response to cancer screening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancer screening and early diagnosis. Methods A qualitative methodology was used to collect in-depth information from cancer patients. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian) were approached. Twenty semi-structured interviews were conducted. All interviews were audiotaped, transcribed verbatim, and translated into English for thematic content analysis. Results Thematic content analysis yielded four major themes: awareness of cancer screening, perceived benefits of cancer screening, perceived barriers to cancer screening, and cues to action. The majority of respondents had never heard of cancer screening before their diagnosis. Some participants reported hearing about mammogram and Pap smear tests but did not undergo screening due to a lack of belief in personal susceptibility. Those who had negative results from screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constraints were reported as barriers to cancer screening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including the role of mass media in disseminating the message ‘prevention is better than cure’. Conclusions Patients’ narratives revealed some significant issues that were in line with the Health Belief Model which could explain negative health behaviour. The description of the personal experiences of people with cancer could provide many cues to action for those who have never encountered this potentially deadly disease, if incorporated into health promotion activities. PMID:23331785

  10. Special Section: New Ways to Detect Colon Cancer 3-D virtual screening now being used

    MedlinePLUS

    ... Special Section: Colorectal Cancer New Ways to Detect Colon Cancer 3-D virtual screening now being used Past ... and techniques for 3-D virtual colonoscopy for colon cancer screening. "Things click in the life of an ...

  11. Socioeconomic Disparities in Colorectal Cancer Screening in Korea

    PubMed Central

    Suh, Mina; Choi, Kui Son; Lee, Hoo-Yeon; Hahm, Myung-Il; Lee, Yoon Young; Jun, Jae Kwan; Park, Eun-Cheol

    2015-01-01

    Abstract Colorectal cancer (CRC) is a common cancer worldwide. The incidence and mortality rates of CRC are higher among lower socioeconomic status (SES) populations. We investigated the association between different indicators of SES and CRC screening rates in Korea. The eligible study population included males and females aged 50 to 74 years who participated in a nationwide cross-sectional survey (20102012). The compliance with recommendation category was applicable to participants who had undergone a fecal occult blood test (FOBT), double-contrast barium enema, or colonoscopy within 1, 5, or 10 years, respectively. In total, 6221 subjects (51.4% female, 55.6% aged 50 years) were included in the final analysis. Lower household income was significantly negatively related to compliance with screening recommendations (P for trend?screening rate using the FOBT; male sex, older age, higher household income, having supplemental insurance, family history of cancer, and poor self-reported health were associated with a higher screening rate using colonoscopy. Lower household income was associated with a higher screening rate using the FOBT and with a lower screening rate using colonoscopy. To increase the rate of CRC screening using colonoscopy, efforts should be made toward improving the education and promotion of screening to the low household income target population. PMID:26426605

  12. [Cancer screening in Hungary: World Bank supported model programs].

    PubMed

    Bod, M; Dbrssy, L; Liszka, G; Ott, S; Pter, Z

    1997-07-13

    Since 1995, a model cancer screening program has been in operation in Hungary, the overall purpose of which is to promote the establishment of effective and efficient screening programs by means of adapting the internationally agreed principles of organized screening to the needs and opportunities in Hungary. The establishment and operation of a national population-based cancer registration system is an other aim of the Program. The model program--financed partly from a loan from the World Bank, partly from local funds provided by the Government of Hungary--is to develop standard procedure for cervical, breast and colorectal screening and to end up with tested recommendations for introduction of organized screening of proved effectiveness, integrated into the health care system, on country-wide service bases in Hungary. PMID:9280875

  13. Successes and challenges in population-based cancer screening.

    PubMed

    Spayne, Mary; Rabeneck, Linda; Guerriero, Lynn

    2015-01-01

    Cancer Care Ontario's (CCO's) organized breast, colorectal and cervical cancer screening programs are in different stages of development and maturity. Headed by clinical and scientific leads, the programs reflect a deep understanding of how to design, evaluate and report on programs based on evidence and best practice. Guided by a CCO-Ministry of Health and Long-Term Care ("the Ministry") joint committee and supported by recent investments in information technology infrastructure, the programs provide high-quality cancer screening to Ontario's eligible population. PMID:25562129

  14. A Community Capacity-Enhancement Approach to Breast and Cervical Cancer Screening among Older Women of Color

    ERIC Educational Resources Information Center

    Bullock, Karen; McGraw, Sarah A.

    2006-01-01

    In the Screening Older Minority Women project, the authors applied a community capacity-enhancement approach to promoting breast and cervical cancer screening among older women of color. Members of informal support networks were recruited for this health promotion intervention to empower Latina and African American women to engage in positive

  15. Joint breast and colorectal cancer screenings in medically underserved women

    PubMed Central

    Davis, Terry C; Arnold, Connie L; Wolf, Michael S; Bennett, Charles L; Liu, Dachao; Rademaker, Alfred

    2016-01-01

    Background Breast and colon cancer screening in rural community clinics is underused. Objective To evaluate the effectiveness and cost-effectiveness of alternative interventions designed to promote simultaneous screening for breast and colon cancer in community clinics. Methods A 3-arm, quasi-experimental evaluation was conducted during May 2008-August 2011 in 8 federally qualifed health clinics in predominately rural Louisiana. Baseline screening rates reported by the clinics was <10% for breast cancer (using mammography) and 1%-2% for colon cancer (using the fecal occult blood test [FOBT]). 744 women aged 50 years or older who were eligible for routine mammography and an FOBT were recruited. The combined screening efforts included: enhanced care; health literacy-informed education (education alone), or health literacy-informed education with nurse support (nurse support). Results Postintervention screening rates for completing both tests were 28.1% with enhanced care, 23.7% with education alone, and 38.7% with nurse support. After adjusting for age, race, and literacy, patients who received nurse support were 2.21 times more likely to complete both screenings than were those who received the education alone (95% confidence interval [CI], 1.12-4.38; P = .023). The incremental cost per additional woman completing both screenings was $3,987 for education with nurse support over education alone, and $5,987 over enhanced care. Limitations There were differences between the 3 arms in sociodemographic characteristics, literacy, and previous screening history. Not all variables that were significantly different between arms were adjusted for, therefore adjustments for key variables (age, race, literacy) were made in statistical analyses. Other limitations related generalizability of results. Conclusions Although joint breast and colon cancer screening rates were increased substantially over existing baseline rates in all 3 arms, the completion rate for both tests was modest. Nurse support and telephone follow-up were most effective. However, it is not likely to be cost effective or affordable in clinics with limited resources. PMID:26918252

  16. Intelligent Screening Systems for Cervical Cancer

    PubMed Central

    Ng, Siew Cheok; Abu Osman, Noor Azuan

    2014-01-01

    Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data. PMID:24955419

  17. Nanoscale/Molecular analysis of Fecal Colonocytes for Colorectal Cancer Screening | Division of Cancer Prevention

    Cancer.gov

    DESCRIPTION (provided by applicant): Existing guidelines recommend colorectal cancer (CRC) screening for all patients over age 50. However, CRC remains the second leading cause of cancer death among Americans largely because colonoscopic screening of all the >100 million Americans over age 50 is unfeasible for both patient-related (non-compliance) and societal (inadequate endoscopic capacity and funding) reasons.

  18. Nanoscale/Molecular analysis of Fecal Colonocytes for Colorectal Cancer Screening | Division of Cancer Prevention

    Cancer.gov

    DESCRIPTION (provided by applicant): Existing guidelines recommend colorectal cancer (CRC) screening for all patients over age 50. However, CRC remains the second leading cause of cancer death among Americans largely because colonoscopic screening of all the >100 million Americans over age 50 is unfeasible for both patient-related (non-compliance) and societal (inadequate endoscopic capacity and funding) reasons. |

  19. Statistical analyses in Swedish randomised trials on mammography screening and in other randomised trials on cancer screening: a systematic review

    PubMed Central

    Boniol, Mathieu; Smans, Michel; Sullivan, Richard; Boyle, Peter

    2015-01-01

    Objectives We compared calculations of relative risks of cancer death in Swedish mammography trials and in other cancer screening trials. Participants Men and women from 30 to 74 years of age. Setting Randomised trials on cancer screening. Design For each trial, we identified the intervention period, when screening was offered to screening groups and not to control groups, and the post-intervention period, when screening (or absence of screening) was the same in screening and control groups. We then examined which cancer deaths had been used for the computation of relative risk of cancer death. Main outcome measures Relative risk of cancer death. Results In 17 non-breast screening trials, deaths due to cancers diagnosed during the intervention and post-intervention periods were used for relative risk calculations. In the five Swedish trials, relative risk calculations used deaths due to breast cancers found during intervention periods, but deaths due to breast cancer found at first screening of control groups were added to these groups. After reallocation of the added breast cancer deaths to post-intervention periods of control groups, relative risks of 0.86 (0.76; 0.97) were obtained for cancers found during intervention periods and 0.83 (0.71; 0.97) for cancers found during post-intervention periods, indicating constant reduction in the risk of breast cancer death during follow-up, irrespective of screening. Conclusions The use of unconventional statistical methods in Swedish trials has led to overestimation of risk reduction in breast cancer death attributable to mammography screening. The constant risk reduction observed in screening groups was probably due to the trial design that optimised awareness and medical management of women allocated to screening groups. PMID:26152677

  20. UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening

    PubMed Central

    Field, J K; Duffy, S W; Baldwin, D R; Whynes, D K; Devaraj, A; Brain, K E; Eisen, T; Gosney, J; Green, B A; Holemans, J A; Kavanagh, T; Kerr, K M; Ledson, M; Lifford, K J; McRonald, F E; Nair, A; Page, R D; Parmar, M K B; Rassl, D M; Rintoul, R C; Screaton, N J; Wald, N J; Weller, D; Williamson, P R; Yadegarfar, G; Hansell, D M

    2016-01-01

    Background Lung cancer screening using low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial. Methods The pilot UK Lung Cancer Screening (UKLS) is a randomised controlled trial of LDCT screening for lung cancer versus usual care. A population-based questionnaire was used to identify high-risk individuals. CT screen-detected nodules were managed by a pre-specified protocol. Cost effectiveness was modelled with reference to the National Lung Cancer Screening Trial mortality reduction. Results 247 354 individuals aged 50–75 years were approached; 30.7% expressed an interest, 8729 (11.5%) were eligible and 4055 were randomised, 2028 into the CT arm (1994 underwent a CT). Forty-two participants (2.1%) had confirmed lung cancer, 34 (1.7%) at baseline and 8 (0.4%) at the 12-month scan. 28/42 (66.7%) had stage I disease, 36/42 (85.7%) had stage I or II disease. 35/42 (83.3%) had surgical resection. 536 subjects had nodules greater than 50 mm3 or 5 mm diameter and 41/536 were found to have lung cancer. One further cancer was detected by follow-up of nodules between 15 and 50 mm3 at 12 months. The baseline estimate for the incremental cost-effectiveness ratio of once-only CT screening, under the UKLS protocol, was £8466 per quality adjusted life year gained (CI £5542 to £12 569). Conclusions The UKLS pilot trial demonstrated that it is possible to detect lung cancer at an early stage and deliver potentially curative treatment in over 80% of cases. Health economic analysis suggests that the intervention would be cost effective—this needs to be confirmed using data on observed lung cancer mortality reduction. Trial registration ISRCTN 78513845. PMID:26645413

  1. Using the Cancer Risk Management Model to evaluate the health and economic impacts of cytology compared with human papillomavirus DNA testing for primary cervical cancer screening in Canada

    PubMed Central

    Popadiuk, C.; Gauvreau, C.L.; Bhavsar, M.; Nadeau, C.; Asakawa, K.; Flanagan, W.M.; Wolfson, M.C.; Coldman, A.J.; Memon, S.; Fitzgerald, N.; Lacombe, J.; Miller, A.B.

    2016-01-01

    Background In Canada, discussion about changing from cytology to human papillomavirus (hpv) dna testing for primary screening in cervical cancer is ongoing. However, the Canadian Task Force on Preventive Health Care has not yet made a recommendation, concluding that the evidence is insufficient. Methods We used the cervical cancer and hpv transmission models of the Cancer Risk Management Model to study the health and economic outcomes of primary cytology compared with hpv dna testing in 14 screening scenarios with varying screening modalities and intervals. Projected cervical cancer cases, deaths, colposcopies, screens, costs, and incremental cost-effectiveness were evaluated. We performed sensitivity analyses for hpv dna test costs. Results Compared with triennial cytology from age 25, 5-yearly hpv dna screening alone from age 30 resulted in equivalent incident cases and deaths, but 55% (82,000) fewer colposcopies and 43% (1,195,000) fewer screens. At hpv dna screening intervals of 3 years, whether alone or in an age-based sequence with cytology, screening costs are greater, but at intervals of more than 5 years, they are lower. Scenarios on the cost-effectiveness frontier were hpv dna testing alone every 10, 7.5, 5, or 3 years, and triennial cytology starting at age 21 or 25 when combined with hpv dna testing every 3 years. Conclusions Changing from cytology to hpv dna testing as the primary screening test for cervical cancer would be an acceptable strategy in Canada with respect to incidence, mortality, screening and diagnostic test volumes. PMID:26985148

  2. The 10 Pillars of Lung Cancer Screening: Rationale and Logistics of a Lung Cancer Screening Program.

    PubMed

    Fintelmann, Florian J; Bernheim, Adam; Digumarthy, Subba R; Lennes, Inga T; Kalra, Mannudeep K; Gilman, Matthew D; Sharma, Amita; Flores, Efren J; Muse, Victorine V; Shepard, Jo-Anne O

    2015-01-01

    On the basis of the National Lung Screening Trial data released in 2011, the U.S. Preventive Services Task Force made lung cancer screening (LCS) with low-dose computed tomography (CT) a public health recommendation in 2013. The Centers for Medicare and Medicaid Services (CMS) currently reimburse LCS for asymptomatic individuals aged 55-77 years who have a tobacco smoking history of at least 30 pack-years and who are either currently smoking or had quit less than 15 years earlier. Commercial insurers reimburse the cost of LCS for individuals aged 55-80 years with the same smoking history. Effective care for the millions of Americans who qualify for LCS requires an organized step-wise approach. The 10-pillar model reflects the elements required to support a successful LCS program: eligibility, education, examination ordering, image acquisition, image review, communication, referral network, quality improvement, reimbursement, and research frontiers. Examination ordering can be coupled with decision support to ensure that only eligible individuals undergo LCS. Communication of results revolves around the Lung Imaging Reporting and Data System (Lung-RADS) from the American College of Radiology. Lung-RADS is a structured decision-oriented reporting system designed to minimize the rate of false-positive screening examination results. With nodule size and morphology as discriminators, Lung-RADS links nodule management pathways to the variety of nodules present on LCS CT studies. Tracking of patient outcomes is facilitated by a CMS-approved national registry maintained by the American College of Radiology. Online supplemental material is available for this article. PMID:26495797

  3. [Screening for colorectal cancer in Italy, 2010 survey].

    PubMed

    Zorzi, Manuel; Fedato, Chiara; Grazzini, Grazia; Sassoli de' Bianchi, Priscilla; Naldoni, Carlo; Pendenza, Melania; Sassatelli, Romano; Senore, Carlo; Visioli, Carmen Beatriz; Zappa, Marco

    2012-01-01

    We present the main results of the 2010 survey of the Italian screening programmes for colorectal cancer carried out by the National centre for screening monitoring (Osservatorio nazionale screening, ONS) on behalf of the Ministry of health. By the end of 2010, 105 programmes were active, 9 of which had been activated during the year, and 65% of Italians aged 50-69 years were residing in areas covered by organised screening programmes (theoretical extension). Twelve regions had their whole population covered. In the South of Italy and Islands, 5 new programmes were activated in 2010, with a theoretical extension of 29%. The majority of programmes employed the faecal occult blood test (FIT), while some adopted flexible sigmoidoscopy (FS) once in a lifetime and FIT for non-responders to FS. Overall, about 3,404,000 subjects were invited to undergo FIT, 47.2% of those to be invited within the year. The adjusted attendance rate was 48% and approximately 1,568,796 subjects were screened. Large differences in the attendance rate were observed among regions: 10% of programmes reported values lower than 24%. Positivity rate of FIT programmes was 5.5% at first screening (range: 1.6-11.3%) and 4.3% at repeat screening (range: 3.2-6.7%). The average attendance rate to total colonoscopy (TC) was 81.4% and in one region it was lower than 70%. Completion rate for total colonoscopy (TC) was 88.7%. Among the 740,281 subjects attending screening for the first time, the detection rate (DR) per 1,000 screened subjects was 2.4 for invasive cancer and 10.3 for advanced adenomas (AA - adenomas with a diameter ≥1 cm, with villous/tubulo-villous type or with high-grade dysplasia). As expected, the corresponding figures in the 843,204 subjects at repeat screening were lower (1.2‰ and 7.6‰ for invasive cancer and AA, respectively). The DR of cancer and adenomas increased with age and was higher among males. Many programmes reported some difficulties in guaranteeing TC in the appropriate time frame to FIT+ subjects: in 16% of cases the waiting time was longer than two months. Nine programmes employed FS as the screening test: 98% of the target population (about 60,000 subjects) were invited, and 13,629 subjects were screened, with an attendance rate of 24%. Overall, 87% of FS were classified as complete. TC referral rate was 9.5% and the DR per 1,000 screened subjects was 2.8 and 40.6 for invasive cancer and AA, respectively. PMID:23293271

  4. Cervical cancer screening among Cambodian-American women.

    PubMed

    Taylor, V M; Schwartz, S M; Jackson, J C; Kuniyuki, A; Fischer, M; Yasui, Y; Tu, S P; Thompson, B

    1999-06-01

    Southeast Asian women have higher invasive cervical cancer incidence rates and lower Pap testing frequencies than most other racial/ethnic groups in the United States. However, there is little information about the cervical cancer screening behavior of Cambodian-American women. Cambodian residents of Seattle were surveyed in person during late 1997 and early 1998. The PRECEDE model was used to guide the development of items that assessed predisposing, reinforcing, and enabling factors associated with cervical cancer screening participation. The estimated overall survey response was 72%. Four hundred thirteen women completed our questionnaire. Approximately one-quarter (24%) of the respondents had never had a Pap test, and over one-half (53%) had not been screened recently. The following variables were positively associated with a history of at least one Pap smear: younger age, greater number of years since immigration, belief about Pap testing for postmenopausal women, prenatal care in the United States, and physician recommendation. Women who believed in karma were less likely to have ever been screened for cervical cancer than those who did not. Six variables independently predicted recent screening: age; beliefs about regular checkups, cervical cancer screening for sexually inactive women, and the prolongation of life; having a female doctor; and a previous physician recommendation for Pap testing. The study findings indicate that culturally specific approaches might be effective in modifying the cervical cancer screening behavior of immigrant women. Programs targeting Cambodian-Americans are likely to be more effective if they are multifaceted and simultaneously address predisposing, reinforcing, and enabling factors. PMID:10385145

  5. Will supplemental screening ultrasound increase breast cancer overdiagnosis?

    PubMed

    Molleran, Virginia M

    2015-08-01

    Overdiagnosis refers to the detection of cancers that would never come to light in a patient's lifetime and are only identified by means of screening. Exactly how much overdiagnosis currently exists with screening mammography is uncertain. Because we do not know for certain which tumors would ultimately lead to death if left untreated and which would not, we cannot directly measure overdiagnosis and how best to estimate it is a matter of controversy. A conservative estimate of overdiagnosis with mammography would be on the order of 10%, but estimates have ranged as high as 54%. We know from multiple studies that ultrasound (US) screening mostly detects small, invasive, node-negative cancers; and in the ACRIN 6666 study, there was a greater tendency for US-only-detected tumors to be low grade than those detected with mammography. However, the population of patients undergoing screening US can be expected to differ from the average screening mammography population in that they will have higher breast density, they will be younger, and they may also have higher breast cancer risk than the population undergoing screening mammography. These factors may be associated with more aggressive tumors. There is no way to know whether we will be increasing overdiagnosis without performing a large randomized controlled study with very long-term follow-up. Even if some cancers are overdiagnosed with US, there will be a greater proportion of lethal breast cancers that are successfully treated because of screening US. The more important task is to learn how to correctly diagnose and appropriately treat nonlethal cancers. PMID:26100187

  6. The role of endoscopic ultrasound in pancreatic cancer screening

    PubMed Central

    Bhutani, Manoop S.; Koduru, Pramoda; Joshi, Virendra; Saxena, Payal; Suzuki, Rei; Irisawa, Atsushi; Yamao, Kenji

    2016-01-01

    Pancreatic cancer (PC) is a highly lethal cancer. Despite a significant advancement in cancer treatment, the mortality rate of PC is nearly identical to the incidence rates. Early detection of tumor or its precursor lesions with dysplasia may be the most effective approach to improve survival. Screening strategies should include identification of the population at high risk of developing PC, and an intense application of screening tools with adequate sensitivity to detect PC at an early curable stage. Endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) seem to be the most promising modalities for PC screening based on the data so far. EUS had an additional advantage over MRI by being able to obtain tissue sample during the same examination. Several questions remain unanswered at this time regarding the age to begin screening, frequency of screening, management of asymptomatic pancreatic lesions detected on screening, timing of resection, and extent of surgery and impact of screening on survival. Novel techniques such as needle-based confocal laser endomicroscopy (nCLE), along with biomarkers, may be helpful to identify pancreatic lesions with more aggressive malignant potential. Further studies will hopefully lead to the development of strategies combining EUS with other technological/biological advancements that will be cost-effective and have an impact on survival. PMID:26879161

  7. Screening for Cervical, Prostate, and Breast Cancer: Interpreting the Evidence.

    PubMed

    Carter, Stacy M; Williams, Jane; Parker, Lisa; Pickles, Kristen; Jacklyn, Gemma; Rychetnik, Lucie; Barratt, Alexandra

    2015-08-01

    Cancer screening is an important component of prevention and early detection in public health and clinical medicine. The evidence for cancer screening, however, is often contentious. A description and explanation of disagreements over the evidence for cervical, breast, and prostate screening may assist physicians, policymakers, and citizens faced with screening decisions and suggest directions for future screening research. There are particular issues to be aware of in the evidence base for each form of screening, which are summarized in this paper. Five tensions explain existing conflicts over the evidence: (1) data from differing contexts may not be comparable; (2) screening technologies affect evidence quality, and thus evidence must evolve with changing technologies; (3) the quality of evidence of benefit varies, and the implications are contested; (4) evidence about harm is relatively new, there are gaps in that evidence, and there is disagreement over what it means; and (5) evidence about outcomes is often poorly communicated. The following principles will assist people to evaluate and use the evidence: (1) attend closely to transferability; (2) consider the influence of technologies on the evidence base; (3) query the design of meta-analyses; (4) ensure harms are defined and measured; and (5) improve risk communication practices. More fundamentally, there is a need to question the purpose of cancer screening and the values that inform that purpose, recognizing that different stakeholders may value different things. If implemented, these strategies will improve the production and interpretation of the methodologically challenging and always-growing evidence for and against cancer screening. PMID:26091929

  8. Cervical cancer prevented by screening: Long-term incidence trends by morphology in Norway.

    PubMed

    Lnnberg, Stefan; Hansen, Bo Terning; Haldorsen, Tor; Campbell, Suzanne; Schee, Kristina; Nygrd, Mari

    2015-10-01

    Both major morphologic types of cervical cancer, squamous cell carcinoma (SCC) and adenocarcinoma (AC), are causally related to persistent infection with high-risk human papillomavirus (hrHPV), but screening has primarily been effective at preventing SCC. We analysed incidence trends of cervical cancer in Norway stratified by morphologies over 55 years, and projected SCC incidence in the absence of screening by assessing the changes in the incidence rate of AC. The Cancer Registry of Norway was used to identify all 19,530 malignancies in the cervix diagnosed in the period 1956-2010. The majority of these (82.9%) were classified as SCCs, 10.5% as ACs and the remaining 6.6% were of other or undefined morphology. By joint-point analyses of a period of more than five decades, the average annual percentage change in the age-standardised incidence was -1.0 (95%CI: -2.1-0.1) for cervical SCC, 1.5 (95%CI:1.1-1.9) for cervical AC and -0.9 (95%CI: -1.4 to -0.3) for cervical cancers of other or undefined morphology. The projected age-standardised incidence rate of cervical SCC in Norway, assuming no screening, was 28.6 per 100,000 woman-years in 2010, which compared with the observed SCC rate of 7.3 corresponds to an estimated 74% reduction in SCC or a 68% reduction due to screening in the total cervical cancer burden. Cytology screening has impacted cervical cancer burden more than suggested by the overall observed cervical cancer incidence reduction since its peak in the mid-1970s. The simultaneous substantial increase in cervical adenocarcinoma in Norway is presumably indicative of an increase in exposure to HPV over time. PMID:25833121

  9. Apparatus Would Position Bright Spot On Projection Screen

    NASA Technical Reports Server (NTRS)

    Rayman, Marc D.

    1996-01-01

    Proposed apparatus aims beam of visible light at wavelength lambda(2) to create bright spot at desired position in image on projection screen. Intended to replace handheld laser and flashlight pointers lecturers sometimes use to indicate features in projected images. Beam of light cannot be inadvertently aimed toward audience.

  10. Breast cancer screening interventions for Arabic women: a literature review.

    PubMed

    Donnelly, Tam Truong; Hwang, Jasmine

    2015-06-01

    Similar to other Middle Eastern countries, breast cancer is the most common cancer among women in Qatar with increasing incidence and mortality rates. High mortality rates of breast cancer in the Middle Eastern countries are primarily due to delayed diagnosis of the disease. Thus screening and early detection of breast cancer are important in reducing cancer morbidity and mortality. With the aim of updating knowledge on existing interventions and developing effective intervention programs to promote breast cancer screening in Arabic populations in Qatar, this review addresses the question: What interventions are effective in increasing breast cancer knowledge and breast cancer screening rates in Arabic populations in Arabic countries and North America? Systematic literature review was performed to answer the proposed question. As the result of the search, six research studies were identified and appraised. From the findings, we infer several insights: (a) a language-appropriate and culturally sensitive educational program is the most important component of a successful intervention regardless of the study setting, (b) multi-level interventions that target both women, men, health care professionals, and/or larger health care system are more likely to be successful than single educational interventions or public awareness campaigns, and (c) more vigorous, personal and cognitive interventions that address psychosocial factors are likely to be more effective than less personal and informative interventions. This review has important implications for health care providers, intervention planners, and researchers. PMID:23975014

  11. Triage of HPV positive women in cervical cancer screening.

    PubMed

    Wentzensen, Nicolas; Schiffman, Mark; Palmer, Timothy; Arbyn, Marc

    2016-03-01

    Despite HPV vaccines, screening will remain central for decades to control cervical cancer. Recently, HPV testing alone or with cytology was introduced as an alternative to cytology screening. However, most HPV infections are harmless and additional tests are required to identify women with progressing infections or precancer. With three options for primary screening, and without clear strategies for triage of screen-positive women, there is great confusion about the best approach. Also, increasing HPV vaccination coverage will lead to lower disease prevalence, and force new screening approaches. Currently recommended triage strategies for primary HPV screening include HPV genotyping for HPV16 and HPV18 and cytology. Other alternatives that are currently evaluated include p16/Ki-67 dual stain cytology, host methylation, and viral methylation testing. Clinical management of women with cervical cancer screening results is moving to use risk thresholds rather than individual test results. Specific risk thresholds have been defined for return to primary screening, repeat testing, referral to colposcopy, and immediate treatment. Choice of test algorithms is based on comparison of absolute risk estimates from triage tests with established clinical thresholds. Importantly, triage tests need to be evaluated together with the primary screening test and the downstream clinical management. An optimal integrated screening and triage strategy should reassure the vast majority of women that they are at very low risk of cervical cancer, send the women at highest risk to colposcopy at the right time, when disease can be colposcopically detected, and minimize the intermediate risk group that requires continued surveillance. PMID:26643050

  12. Alcohol Consumption, Depression, Insomnia and Colorectal Cancer Screening: Racial Differences

    PubMed Central

    Owusu, Daniel; Quinn, Megan; Wang, Ke Sheng

    2015-01-01

    Background: Mortality from colorectal cancer (CRC) can be reduced drastically by early detection and early treatment. However, uptake of CRC screening is relatively low, about 50% for those whom the test is highly recommended. Objectives: We examined the influence of and racial differences in depression, insomnia, alcohol use, and tobacco use on CRC screening uptake in the US. Patients and Methods: Analysis of the 2012 National Health Information Survey data was conducted. Both weighted univariate and multiple logistic regression analyses were performed in SAS to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs). A total of 21511 participants were included in the analysis. Results: Prevalence of CRC screening in the participants was 19%. Adjusting for all factors, insomnia (OR = 1.18, 95%CI = 1.06 - 1.32), moderate alcohol drinking (OR = 1.16, 95%CI = 1.01 - 1.30), past smoking (OR = 1.17, 95%CI = 1.04 - 1.32), depression (OR = 1.37, 95%CI = 1.18 - 1.58), African American (AA) race, and cancer history were positively associated with CRC screening. Females and Single were inversely associated with CRC screening prevalence. In stratified analysis by races (White and AA), depression was associated with CRC screening in both races. Marital status, smoking, cancer history and insomnia were associated with CRC screening in Whites only; while alcohol use was associated with CRC screening in AAs only. Conclusions: We have found significant associations between lifestyle factors (alcohol consumption and smoking) and mental health problems (depression and insomnia) and CRC screening uptake. To improve overall CRC screening uptake in the US, it is important to consider racial differences in predictors and tailor appropriate interventions to each racial/ethnic group. PMID:26097837

  13. Knowledge, attitudes, and behaviours towards cancer screening in indigenous populations: a systematic review.

    PubMed

    Kolahdooz, Fariba; Jang, Se Lim; Corriveau, André; Gotay, Carolyn; Johnston, Nora; Sharma, Sangita

    2014-10-01

    Cancer mortality among indigenous peoples is increasing, but these populations commonly under use cancer-screening services. This systematic review explores knowledge, attitudes, and behaviours towards cancer screening among indigenous peoples worldwide. Searches of major bibliographic databases identified primary studies published in English up to March, 2014; of 33 eligible studies, three were cohort studies, 27 cross-sectional, and three case-control. Knowledge of and participation in screening was greater for breast cancer than for other cancers. Indigenous peoples tended to have less knowledge, less favourable attitudes, and a higher propensity to refuse screening than non-indigenous populations. The most common factors affecting knowledge, attitudes, and behaviours towards cancer screening included access to screening, knowledge about cancer and screening, educational attainment, perceived necessity of screening, and age. Greater understanding of knowledge, attitudes, and behaviours towards cancer screening in diverse indigenous cultures is needed so that culturally appropriate cancer prevention programmes can be provided. PMID:25281469

  14. Perceptual analysis of cancers missed in mammography screening

    NASA Astrophysics Data System (ADS)

    Mello-Thoms, Claudia

    2003-05-01

    Mammography screening is recommended for a large population of women, aiming at detecting the initial signs of breast cancer. However, due to the complexity of the breast parenchyma and to the low prevalence of cancer in the screening population, among other factors, a significant fraction of cancers are not initially reported, being only found in retrospect. Fault visual search, that is, not examining the area where the cancer is located, is responsible for a third of these misses, but all other unreported cancers attract some amount of visual attention, as indicated by the duration of visual gaze in the location of the lesion. Thus, perceptual and decision making mechanisms must be understood, in order to aid radiologists in detection cancer at earlier stages. We have been working on modeling these mechanisms by using spatial frequency analysis, in a process that is inspired by the one performed by the eye-brain system. In this paper we compare the spatial frequency representation of areas that contain reported cancers and that of the same area on the previous mammogram, where the cancer was either not reported or it was reported as a benign lesion. In addition, we contrast the representation of these areas containing cancerous lesions with the representation of the corresponding area in the cancer-free contra-lateral breast.

  15. Oral cancer screening usefulness: between true andperceived effectiveness.

    PubMed

    Petti, S

    2016-03-01

    Screenings, introduced in the 1920s, became rapidly popular in healthcare settings. Chance is an intrinsic screening characteristic. Roughly one half of screened subjects are correctly classified merely by chance, and in high-prevalence settings, even inaccurate screenings detect several diseased individuals by chance, thus appearing effective. The viewpoint is another variable affecting screening perceived effectiveness. For example, public health officers, who seek for mortality rate reductions, look for high sensitivity, which, in turn, is affected by disease prevalence. The relative mortality rate reduction attributable to screening may therefore be significant in high-prevalence areas and irrelevant in low-prevalence areas. This explains why oral cancer visual screening is perceived effective in high-prevalence countries and ineffective in low-prevalence countries. Patients seek for reliable outcomes. Therefore, they require screenings with high positive (PV+) and negative (PV-) predictive values. In high-prevalence areas, PV+ is high, while PV- is low. The reverse occurs in low-prevalence areas. Thus, even for accurate screenings, the perceived effectiveness due to misclassification is low among false-negative patients in high-prevalence areas, who are misclassified as unaffected by the disease, and among false-positive patients in low-prevalence areas, who are subjected to psychophysical sufferings. This article explains the reasons for these and other paradoxes engendered by screening. PMID:26575316

  16. Mortality results from a randomized prostate-cancer screening trial.

    TOXLINE Toxicology Bibliographic Information

    Andriole GL; Crawford ED; Grubb RL 3rd; Buys SS; Chia D; Church TR; Fouad MN; Gelmann EP; Kvale PA; Reding DJ; Weissfeld JL; Yokochi LA; O'Brien B; Clapp JD; Rathmell JM; Riley TL; Hayes RB; Kramer BS; Izmirlian G; Miller AB; Pinsky PF; Prorok PC; Gohagan JK; Berg CD; PLCO Project Team

    2009-03-26

    BACKGROUND: The effect of screening with prostate-specific-antigen (PSA) testing and digital rectal examination on the rate of death from prostate cancer is unknown. This is the first report from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial on prostate-cancer mortality.METHODS: From 1993 through 2001, we randomly assigned 76,693 men at 10 U.S. study centers to receive either annual screening (38,343 subjects) or usual care as the control (38,350 subjects). Men in the screening group were offered annual PSA testing for 6 years and digital rectal examination for 4 years. The subjects and health care providers received the results and decided on the type of follow-up evaluation. Usual care sometimes included screening, as some organizations have recommended. The numbers of all cancers and deaths and causes of death were ascertained.RESULTS: In the screening group, rates of compliance were 85% for PSA testing and 86% for digital rectal examination. Rates of screening in the control group increased from 40% in the first year to 52% in the sixth year for PSA testing and ranged from 41 to 46% for digital rectal examination. After 7 years of follow-up, the incidence of prostate cancer per 10,000 person-years was 116 (2820 cancers) in the screening group and 95 (2322 cancers) in the control group (rate ratio, 1.22; 95% confidence interval [CI], 1.16 to 1.29). The incidence of death per 10,000 person-years was 2.0 (50 deaths) in the screening group and 1.7 (44 deaths) in the control group (rate ratio, 1.13; 95% CI, 0.75 to 1.70). The data at 10 years were 67% complete and consistent with these overall findings.CONCLUSIONS: After 7 to 10 years of follow-up, the rate of death from prostate cancer was very low and did not differ significantly between the two study groups. (ClinicalTrials.gov number, http://clinicaltrials.gov/ct2/show/NCT00002540 target=new>NCT00002540.)

  17. Evaluating Teaching Techniques in the Hmong Breast and Cervical Cancer Health Awareness Project

    PubMed Central

    Lor, Maichou; Bowers, Barbara

    2014-01-01

    Background Cancer health disparities are a reality for Hmong women who are often diagnosed at a later stage, have low literacy, and experienced care that is not culturally appropriate. Lack of attention to cultural appropriateness and literacy levels of cancer screening materials may contribute to disproportionately low levels of cancer screening among Hmong women. Purpose To evaluate the Hmong Health Awareness Project (HHAP), a program designed to create awareness and acceptance of breast and cervical cancer screening, and to examine participants’ perceptions of the utility of the content of the workshops. Methods Hmong researchers partnered with three Midwestern Hmong community centers to implement six workshops. Three teaching techniques: pictographs, videos, and hands-on activities were utilized to teach Hmong participants about cancer screening. Participants included 150 Hmong (male=30, female = 120). Teach back method was used to assess participants’ understanding of cancer screening throughout the workshops. Qualitative data were collected in focus groups to assess the feasibility of teaching methods and participants’ perceptions of the utility of the content of the workshops. Directed content analysis was used to analyze participants’ responses. Results The three teaching techniques were helpful in increasing the Hmong people’s understanding about breast and cervical cancer screening. Nearly all participants perceived an increased in their understanding, greater acceptance of cancer screening, and increased willingness to be screened. Men expressed support for screening after the workshops. Conclusion Findings can guide future interventions to improve health communications and screening and reduce diagnostic disparities among Hmong and immigrant populations. PMID:24488558

  18. Examining the cost-effectiveness of cancer screening promotion.

    PubMed

    Andersen, M Robyn; Urban, Nicole; Ramsey, Scott; Briss, Peter A

    2004-09-01

    Cost-effectiveness analyses (CEAs) can help to quantify the contribution of the promotion of a screening program to increased participation in screening. The cost-effectiveness (C/E) of screening promotion depends in large part on the endpoints of interest. At the most fundamental level, the C/E of a strategy for promoting screening would focus on the attendance rate, or cost per person screened, and the C/E would be influenced by the costs of promotion, as well as by the size and responsiveness of the target population. In addition, the costs of screening promotion (measured as the cost per additional participant in screening) can be included in a CEA estimate of the screening technology. In this case, depending on the efficacy of the screening test and the costs and influence of the promotion, the C/E of screening may improve or become poorer. In the current study, the authors reviewed the literature on the C/E of cancer screening promotion. The following lessons were learned regarding the C/E of screening and its promotion: 1) high-quality information on the C/E of screening is increasingly available; 2) cost-effective promotion of screening is dependent on cost-effective screening strategies; 3) quality-of-life effects may be important in assessing the overall C/E of screening programs; 4) research efforts aimed at identifying cost-effective approaches to screening promotion are useful but sparse; 5) C/E studies should be better incorporated into well designed effectiveness research efforts; 6) variations in C/E according to intervention characteristics, population characteristics, and context should be evaluated in greater depth; 7) the long-term effects of screening promotion are critical to assessing C/E; 8) the effects of promotion on costs of screening must be better understood; and 9) CEA must be interpreted in light of other information. The authors showed that CEA can be a valuable tool for understanding the merits of health promotion interventions and that CEA is particularly valuable in identifying screening strategies that might be promoted most cost-effectively. PMID:15316909

  19. Offering Lung Cancer Screening to High-Risk Medicare Beneficiaries Saves Lives and Is Cost-Effective: An Actuarial Analysis

    PubMed Central

    Pyenson, Bruce S.; Henschke, Claudia I.; Yankelevitz, David F.; Yip, Rowena; Dec, Ellynne

    2014-01-01

    Background By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening. Objective To estimate the cost and cost-effectiveness (ie, cost per life-year saved) of LDCT lung cancer screening of the Medicare population at high risk for lung cancer. Methods Medicare costs, enrollment, and demographics were used for this study; they were derived from the 2012 Centers for Medicare & Medicaid Services (CMS) beneficiary files and were forecast to 2014 based on CMS and US Census Bureau projections. Standard life and health actuarial techniques were used to calculate the cost and cost-effectiveness of lung cancer screening. The cost, incidence rates, mortality rates, and other parameters chosen by the authors were taken from actual Medicare data, and the modeled screenings are consistent with Medicare processes and procedures. Results Approximately 4.9 million high-risk Medicare beneficiaries would meet criteria for lung cancer screening in 2014. Without screening, Medicare patients newly diagnosed with lung cancer have an average life expectancy of approximately 3 years. Based on our analysis, the average annual cost of LDCT lung cancer screening in Medicare is estimated to be $241 per person screened. LDCT screening for lung cancer in Medicare beneficiaries aged 55 to 80 years with a history of ≥30 pack-years of smoking and who had smoked within 15 years is low cost, at approximately $1 per member per month. This assumes that 50% of these patients were screened. Such screening is also highly cost-effective, at <$19,000 per life-year saved. Conclusion If all eligible Medicare beneficiaries had been screened and treated consistently from age 55 years, approximately 358,134 additional individuals with current or past lung cancer would be alive in 2014. LDCT screening is a low-cost and cost-effective strategy that fits well within the standard Medicare benefit, including its claims payment and quality monitoring. PMID:25237423

  20. Primary care screening for prostate cancer.

    PubMed

    O'Sullivan, J

    1998-09-01

    Prostate cancer is second only to lung cancer among killers of men in the United States. Researchers continue to develop tests that are more sensitive for diagnosing prostate cancer. At present, primary care assessment and evaluation of the disease are determined by physical evidence that may not be apparent and by laboratory values that may not be truly reflective of the underlying disease process. Men over the age of 40 need an annual evaluation for increased prostate-specific antigen (PSA) along with a digital rectal examination. Some data suggest that the digital rectal exam and PSA levels may be insensitive indicators of prostate cancer in men with low total or free testosterone levels. The synergistic effect of testosterone on PSA could mask indicators for evaluation of prostate cancer. PMID:10455574

  1. Esophageal cancer: Recent advances in screening, targeted therapy, and management

    PubMed Central

    Gaur, Puja; Kim, Min P.; Dunkin, Brian J.

    2014-01-01

    The incidence of esophageal cancer remains on the rise worldwide and despite aggressive research in the field of gastrointestinal oncology, the survival remains poor. Much remains to be defined in esophageal cancer, including the development of an effective screening tool, identifying a good tumor marker for surveillance purposes, ways to target esophageal cancer stem cells as well as circulating tumor cells, and developing minimally invasive protocols to treat early-stage disease. The goal of this chapter is to highlight some of the recent advances and ongoing research in the field of esophageal cancer. PMID:25395880

  2. Screening for colorectal cancer in Italy: 2011-2012 survey.

    PubMed

    Zorzi, Manuel; Da Re, Filippo; Mantellini, Paola; Naldoni, Carlo; Sassoli De'Bianchi, Priscilla; Senore, Carlo; Turrin, Anna; Visioli, Carmen Beatriz; Zappa, Marco

    2015-01-01

    We present the main results of the 2011-2012 survey of the Italian screening programmes for colorectal cancer carried out by the National centre for screening monitoring (Osservatorio nazionale screening, ONS) on behalf of the Ministry of Health. By the end of 2012, 112 programmes were active, of which 11 had been activated during 2012 and 4 during 2011. The national theoretical extension increased from 66% of Italians aged 50-69 years residing in areas covered by organized screening programmes in 2010 to 73.7% in 2012. The majority of programmes employ the fecal immunochemical test (FIT), while some have adopted flexible sigmoidoscopy (FS) once in a lifetime and FIT for non-responders to FS. Overall, about 7,744,000 subjects were invited to undergo FIT, 53.1% of those to be invited within the two years. The adjusted attendance rate was 47.1%and 3,531,937 subjects were screened. Large differences in the attendance rate were observed among regions. Positivity rate of FIT programmes was 5.2% at first screening (range: 1.0-12.4%) and 4.0% at repeat screening (range: 3.4-6.4%). The average attendance rate to total colonoscopy (TC) was 81.2% and in two regions (Molise and Campania) it was lower than 70%. Completion rate for total colonoscopy (TC) was 91%. Among the 1,316,327 subjects attending screening for the first time, the detection rate (DR) per 1,000 screened subjects was 2.0 for invasive cancer and 9.1 ‰ for advanced adenomas (AA, adenomas with a diameter ≥1 cm, with villous/tubulo-villous type or high-grade dysplasia). As expected, the corresponding figures in the 2,215,610 subjects at repeat screening were lower (1.0‰ and 6.8‰ for invasive cancer and AA, respectively). Many programmes reported some difficulties in guaranteeing TC in the appropriate time frame to FIT+ subjects: in 15% of cases the waiting time was longer than two months. Ten programmes in 2011 and eight in 2012 employed FS as the screening test: 24,549 subjects were screened in the two years, with an attendance rate of 24.5%. Overall, 85.9% of FSs were classified as complete. Overall, TC referral rate was 9.8% and the DR per 1,000 screened subjects was 3.0 and 48.2 for invasive cancer and AA, respectively. PMID:26405781

  3. Alternatives to colonoscopy for population-wide colorectal cancer screening.

    PubMed

    Leung, W Cy; Foo, D Cc; Chan, T T; Chiang, M F; Lam, A Hk; Chan, H Hw; Cheung, C Cl

    2016-02-01

    Colorectal cancer is one of the top three cancers in the world in terms of incidence. Colonoscopy, which many regard as the gold standard in diagnosis of colonic polyps and neoplasm, is costly, invasive and labour-intensive, and deemed an unsuitable population-wide index screening tool. Alternative modalities, including guaiac and immunohistochemical faecal occult blood tests, computed tomographic colonography, colon capsule endoscopy, flexible sigmoidoscopy, and double-contrast barium enema are available. The procedures, test characteristics, and their implications are reviewed. Immunohistochemical faecal occult blood testing appears to be the most suitable population-wide screening test for an average-risk population, with flexible sigmoidoscopy as an alternative. More evidence is needed to determine the role of computed tomographic colonography and colon capsule endoscopy in colorectal cancer screening. PMID:26744124

  4. Comprehensive cancer control programs and coalitions: partnering to launch successful colorectal cancer screening initiatives.

    PubMed

    Seeff, Laura C; Major, Anne; Townsend, Julie S; Provost, Ellen; Redwood, Diana; Espey, David; Dwyer, Diane; Villanueva, Robert; Larsen, Leslie; Rowley, Kathryn; Leonard, Banning

    2010-12-01

    Colorectal cancer control has long been a focus area for Comprehensive Cancer Control programs and their coalitions, given the high burden of disease and the availability of effective screening interventions. Colorectal cancer control has been a growing priority at the national, state, territorial, tribal, and local level. This paper summarizes several national initiatives and features several Comprehensive Cancer Control Program colorectal cancer control successes. PMID:21086035

  5. Dual Telecentric Lens System For Projection Onto Tilted Toroidal Screen

    NASA Technical Reports Server (NTRS)

    Gold, Ronald S.; Hudyma, Russell M.

    1995-01-01

    System of two optical assemblies for projecting image onto tilted toroidal screen. One projection lens optimized for red and green spectral region; other for blue. Dual-channel approach offers several advantages which include: simplified color filtering, simplified chromatic aberration corrections, less complex polarizing prism arrangement, and increased throughput of blue light energy. Used in conjunction with any source of imagery, designed especially to project images formed by reflection of light from liquid-crystal light valve (LCLV).

  6. Management of subsolid pulmonary nodules in CT lung cancer screening.

    PubMed

    Heuvelmans, Marjolein A; Oudkerk, Matthijs

    2015-07-01

    The distinct appearance and behavior of subsolid pulmonary nodules (SSNs) has resulted in separate recommendations for the management of solitary SSNs, both for incidentally detected as well as for screen detected nodules. However, these guidelines have been based primarily on expert opinion. Recently two studies were published regarding SSNs detected in low-dose computed tomography (LDCT) lung cancer screening, including management advices. PMID:26380722

  7. Management of subsolid pulmonary nodules in CT lung cancer screening

    PubMed Central

    Heuvelmans, Marjolein A.

    2015-01-01

    The distinct appearance and behavior of subsolid pulmonary nodules (SSNs) has resulted in separate recommendations for the management of solitary SSNs, both for incidentally detected as well as for screen detected nodules. However, these guidelines have been based primarily on expert opinion. Recently two studies were published regarding SSNs detected in low-dose computed tomography (LDCT) lung cancer screening, including management advices. PMID:26380722

  8. Hereditary Colorectal Cancer: Genetics and Screening.

    PubMed

    Brosens, Lodewijk A A; Offerhaus, G Johan A; Giardiello, Francis M

    2015-10-01

    Colorectal cancer (CRC) is the third most common cancer and the third leading cause of cancer death in men and women in the United States. About 30% of patients with CRC report a family history of CRC. However, only 5% of CRCs arise in the setting of a well-established mendelian inherited disorder. In addition, serrated polyposis is a clinically defined syndrome with multiple serrated polyps in the colorectum and an increased CRC risk for which the genetics are unknown. This article focuses on genetic and clinical aspects of Lynch syndrome, familial adenomatous polyposis, and MUTYH-associated polyposis. PMID:26315524

  9. Cancer Screening Among Peer-Led Community Wellness Center Enrollees.

    PubMed

    Rockson, Lois E; Swarbrick, Margaret A; Pratt, Carlos

    2016-03-01

    Growing evidence suggests health disparities exist in services for individuals with mental disorders served by the public mental health system. The current study assessed the use of cancer screening services among New Jersey residents in publicly funded mental health programs. Self-administered written surveys were completed by 148 adults using peer-led community wellness centers throughout New Jersey. Information was collected on (a) the use of breast, cervical, and colorectal cancer screening services; (b) barriers to receiving preventive services; and (c) perceptions of overall health. More males than females participated in the study, with equal participation among White and African American individuals. Schizophrenia spectrum disorders were the most common self-reported psychiatric condition. Colorectal cancers had lower screening levels compared to those of the general population. Physicians not advising patients to complete tests emerged as a main cause of low screening rates. Wellness initiatives designed by peers collaborating with health care providers may improve adherence to preventive cancer screening measures. [Journal of Psychosocial Nursing and Mental Health Services, 54(3), 36-40.]. PMID:26935189

  10. Race and colorectal cancer screening compliance among persons with a family history of cancer

    PubMed Central

    Laiyemo, Adeyinka O; Thompson, Nicole; Williams, Carla D; Idowu, Kolapo A; Bull-Henry, Kathy; Sherif, Zaki A; Lee, Edward L; Brim, Hassan; Ashktorab, Hassan; Platz, Elizabeth A; Smoot, Duane T

    2015-01-01

    AIM: To determine compliance to colorectal cancer (CRC) screening guidelines among persons with a family history of any type of cancer and investigate racial differences in screening compliance. METHODS: We used the 2007 Health Information National Trends Survey and identified 1094 (27.4%) respondents (weighted population size = 21959672) without a family history of cancer and 3138 (72.6%) respondents (weighted population size = 58201479) with a family history of cancer who were 50 years and older. We defined compliance with CRC screening as the use of fecal occult blood testing within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We compared compliance with CRC screening among those with and without a family member with a history of cancer. RESULTS: Overall, those with a family member with cancer were more likely to be compliant with CRC screening (64.9% vs 55.1%; OR = 1.45; 95%CI: 1.20-1.74). The absolute increase in screening rates associated with family history of cancer was 8.2% among whites. Hispanics had lowest screening rates among those without family history of cancer 41.9% but had highest absolute increase (14.7%) in CRC screening rate when they have a family member with cancer. Blacks had the lowest absolute increase in CRC screening (5.3%) when a family member has a known history of cancer. However, the noted increase in screening rates among blacks and Hispanics when they have a family member with cancer were not higher than whites without a family history of cancer: (54.5% vs 58.7%; OR = 1.16; 95%CI: 0.72-1.88) for blacks and (56.7% vs 58.7%; OR = 1.25; 95%CI: 0.72-2.18) for Hispanics. CONCLUSION: While adults with a family history of any cancer were more likely to be compliant with CRC screening guidelines irrespective of race/ethnicity, blacks and Hispanics with a family history of cancer were less likely to be compliant than whites without a family history. Increased burden from CRC among blacks may be related to poor uptake of screening among high-risk groups. PMID:26672497

  11. Cervical cancer worry and screening among appalachian women.

    PubMed

    Kelly, Kimberly M; Schoenberg, Nancy; Wilson, Tomorrow D; Atkins, Elvonna; Dickinson, Stephanie; Paskett, Electra

    2015-04-01

    Although many have sought to understand cervical cancer screening (CCS) behavior, little research has examined worry about cervical cancer and its relationship to CCS, particularly in the underserved, predominantly rural Appalachian region. Our mixed method investigation aimed to obtain a more complete and theoretically-informed understanding of the role of cancer worry in CCS among Appalachian women, using the Self-Regulation Model (SRM). Our quantitative analysis indicated that the perception of being at higher risk of cervical cancer and having greater distress about cancer were both associated with greater worry about cancer. In our qualitative analysis, we found that, consistent with the SRM, negative affect had a largely concrete-experiential component, with many women having first-hand experience of the physical consequences of cervical cancer. Based on the results of this manuscript, we describe a number of approaches to lessen the fear associated with CCS. Intervention in this elevated risk community is merited and may focus on decreasing feelings of worry about cervical cancer and increasing communication of objective risk and need for screening. From a policy perspective, increasing the quantity and quality of care may also improve CCS rates and decrease the burden of cancer in Appalachia. PMID:25416153

  12. Breast cancer worry and screening: some prospective data.

    PubMed

    McCaul, K D; Schroeder, D M; Reid, P A

    1996-11-01

    Breast cancer concerns were measured among 353 women, ages 40-75, from North Dakota. One year later, participants were recontacted and asked about their screening behavior during the previous year. Greater concern about breast cancer, even the highest level of concern, was related to a higher likelihood that women performed breast self-examination, had a mammography screening, and had a clinical breast examination. These data do not support the idea that worry inhibits action; instead, they suggest that nonpathological worry motivates self-protective behavior. PMID:8973922

  13. A cancer screening skills laboratory for medical students.

    PubMed

    Merlo, K B; Luketich, G F; Gilyon, K

    1987-01-01

    At St. Louis University School of Medicine a 15-hour Integrated Oncology Module is part of the required second-year Introduction to Medicine course. In place of a one-hour lecture in the module, a required one-hour laboratory was introduced to teach cancer screening as a means of secondary cancer prevention. This activity follows completion of the Introduction to Physical Diagnosis course. The laboratory utilized anatomically correct models to instruct students in fundamental screening procedures for cervical, breast, prostate, and colorectal cancer. Emphasis was placed on a professional interaction with the patient. The Cancer Prevention Laboratory sessions were conducted by registered nurses with specialized training in cancer screening. The Socratic method was employed by the instructors as each of 157 students moved through a series of stations screening appropriate models. The student described the procedure as it was performed, and answered questions pertinent to the activity. The instructors assessed performance using a checklist developed for this purpose. Questions relative to secondary cancer prevention and proper physical detection of cancer appeared on the final exam of the Integrated Oncology Module. One hundred fifty-seven students completed the screening laboratory. Four nurse instructors were employed at each session. Thirty-nine hours were required for all students to complete the lab. Student critique of the activity was overwhelmingly positive, particularly in the acceptance of the registered nurse instructors. Eighty-six percent of the 157 students reported that the teaching methodologies used by the nurses were excellent. The nurses were also perceived as knowledgeable and nonthreatening. PMID:3274979

  14. Screening for Bladder and Other Urothelial Cancers

    MedlinePLUS

    ... genes . Being exposed to paints, dyes, metals or petroleum products in the workplace. Past treatment with radiation ... cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and ...

  15. Skin cancer screening and melanoma detection: a life saved.

    PubMed

    Rajpara, Anand; Fischer, Ryan; Chandra, Joan; Aires, Daniel; Blackmon, Joseph

    2015-04-01

    Rural America spans about two-thirds of the land that composes the United States. There are major health disparities in this population including a lack of screening, a shortage in education, and limited access to health care providers. These health disparities combined with a lack of health insurance led our patient to ignore the asymptomatic melanoma on her right foot for 10 years. Although the most recent update from the US Preventive Service Task Force found insufficient evidence to recommend for or against routine melanoma and non-melanoma skin cancer screening, our patient insists that the screening she attended that day saved her life. PMID:25933086

  16. ESR/ERS white paper on lung cancer screening

    PubMed Central

    Bonomo, Lorenzo; Gaga, Mina; Nackaerts, Kristiaan; Peled, Nir; Prokop, Mathias; Remy-Jardin, Martine; von Stackelberg, Oyunbileg; Sculier, Jean-Paul

    2015-01-01

    Lung cancer is the most frequently fatal cancer, with poor survival once the disease is advanced. Annual low dose computed tomography has shown a survival benefit in screening individuals at high risk for lung cancer. Based on the available evidence, the European Society of Radiology and the European Respiratory Society recommend lung cancer screening in comprehensive, quality-assured, longitudinal programmes within a clinical trial or in routine clinical practice at certified multidisciplinary medical centres. Minimum requirements include: standardised operating procedures for low dose image acquisition, computer-assisted nodule evaluation, and positive screening results and their management; inclusion/exclusion criteria; expectation management; and smoking cessation programmes. Further refinements are recommended to increase quality, outcome and cost-effectiveness of lung cancer screening: inclusion of risk models, reduction of effective radiation dose, computer-assisted volumetric measurements and assessment of comorbidities (chronic obstructive pulmonary disease and vascular calcification). All these requirements should be adjusted to the regional infrastructure and healthcare system, in order to exactly define eligibility using a risk model, nodule management and quality assurance plan. The establishment of a central registry, including biobank and image bank, and preferably on a European level, is strongly encouraged. PMID:25929956

  17. Quality assurance of endoscopy in colorectal cancer screening.

    PubMed

    Valori, Roland; Sint Nicolaas, Jerome; de Jonge, Vincent

    2010-08-01

    This chapter explores the concept of quality assurance of colorectal cancer screening. It argues that effective quality assurance is critical to ensure that the benefits of screening outweigh the harms. The three key steps of quality assurance, definition of standards, measurement of standards and enforcement of standards, are explained. Quality is viewed from the perspective of the patient and illustrated by following the path of patients accessing endoscopy within screening services. The chapter discusses the pros and cons of programmatic versus non-programmatic screening and argues that quality assurance of screening can and should benefit symptomatic services. Finally, the chapter emphasises the importance of a culture of excellence underpinned by continuous quality improvement and effective service leadership. PMID:20833349

  18. Laser speckle reduction via colloidal-dispersion-filled projection screens.

    PubMed

    Riechert, Falko; Bastian, Georg; Lemmer, Uli

    2009-07-01

    We use projection screens filled with colloidal dispersions to reduce laser speckle in laser projection systems. Laser light is multiply scattered at the globules of the colloidal dispersion's internal phase, which do Brownian movement. The integration time of the human eye causes a perception of a reduced laser speckle contrast because of temporal averaging. As a counteracting effect, blurring of projected images occurs in the colloidal dispersion, which degrades image quality. We measure and compare speckle reduction and blurring of three different colloidal dispersions filled into transmission screens of different thicknesses. We realized a high speckle contrast reduction at simultaneously low blurring with a thin screen filled with a highly scattering colloidal dispersion with forward-peaked scattering. We realize speckle contrast values below 3% at acceptable blurring. PMID:19571932

  19. Screening adherence and cancer risk perceptions in colorectal cancer survivors with Lynch-like syndrome.

    PubMed

    Katz, L H; Burton-Chase, A M; Advani, S; Fellman, B; Polivka, K M; Yuan, Y; Lynch, P M; Peterson, S K

    2016-03-01

    Cancer screening recommendations for patients with Lynch-like syndrome (LLS) are not well defined. We evaluated adherence to Lynch syndrome (LS) screening recommendations, cancer risk perceptions, and communication within the families among colorectal cancer (CRC) survivors with LLS. Thirty-four participants with LLS completed a questionnaire about risk perception, adherence to LS screening recommendations, and communication with relatives. Clinical data were obtained from medical records. Most participants (76%) believed they should undergo colonoscopy every 1-2 years. Only 41% correctly interpreted their genetic tests as uninformative negative or as variant of unknown significance for LS. Less than half had had an upper gastrointestinal endoscopy for screening purpose. Among female participants, 86% had been screened for endometrial cancer (EC) and 71% for ovarian cancer. Most participants had informed relatives about the CRC diagnosis and advised them to undergo CRC screening, but only 50% advised female relatives to be screened for EC and only one-third advised relatives to have genetic counseling. Most CRC survivors with LLS follow the same cancer screening recommended for LS patients but do not understand the meaning of LLS. Greater care must be devoted to communicating the implications of nondiagnostic germline mutation testing among patients with LLS. PMID:26272410

  20. Colorectal Cancer Screening and State Health Insurance Mandates.

    PubMed

    Hamman, Mary K; Kapinos, Kandice A

    2016-02-01

    Colorectal cancer (CRC) is the third most deadly cancer in the USA. CRC screening is the most effective way to prevent CRC death, but compliance with recommended screenings is very low. In this study, we investigate whether CRC screening behavior changed under state mandated private insurance coverage of CRC screening in a sample of insured adults from the 1997 to 2008 Behavioral Risk Factor Surveillance Survey (BRFSS). We present difference-in-difference-in-differences (DDD) estimates that compare insured individuals age 51 to 64 to Medicare age-eligible individuals (ages 66 to 75) in mandate and non-mandate states over time. Our DDD estimates suggest endoscopic screening among men increased by 2 to 3 percentage points under mandated coverage among 51 to 64 year olds relative to their Medicare age-eligible counterparts. We find no clear evidence of changes in screening behavior among women. DD estimates suggest no evidence of a mandate effect on either type of CRC screening for men or women. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25521438

  1. AMIGAS: Building a Cervical Cancer Screening Intervention for Public Health Practice

    PubMed Central

    Smith, Judith Lee; Wilson, Katherine M.; Orians, Carlyn E.; Byrd, Theresa L.

    2015-01-01

    Background Many barriers to cervical cancer screening for Hispanic women have been documented, but few effective interventions exist. The Community Preventive Services Task Force recommends increasing cervical cancer screening through various methods. Building on this evidence, the Centers for Disease Control and Prevention funded the research and testing phases for an evidence-based and theoretically grounded intervention designed to increase cervical cancer screening among never and rarely screened Hispanic women of Mexican descent. In this article, we describe the development process of the AMIGAS (Ayudando a las Mujeres con Informacin, Gua, y Amor para su Salud) intervention, highlight the integration of scientific evidence and community-based participatory research principles, and identify opportunities for dissemination, adaptation, and implementation of this intervention. Methods The AMIGAS team was a collaboration among researchers, promotoras (community health workers), and program administrators. The multiyear, multiphase project was conducted in Houston, Texas; El Paso, Texas; and Yakima, Washington. The team completed several rounds of formative research, designed intervention materials and methodology, conducted a randomized controlled trial, created a guide for program administrators, and developed an intervention dissemination plan. Results Trial results demonstrated that AMIGAS was successful in increasing cervical cancer screening among Hispanic women. Adaptation of AMIGAS showed minimal reduction of outcomes. Dissemination efforts are underway to make AMIGAS available in a downloadable format via the Internet. Conclusions Developing a community-based intervention that is evidence-based and theoretically grounded is challenging, time-intensive, and requires collaboration among multiple disciplines. Inclusion of key stakeholdersin particular program deliverers and administratorsand planning for dissemination and translation to practice are integral components of successful intervention design. By providing explicit directions for adaptation for program deliverers, relevant information for program administrators, and access to the intervention via the Internet, AMIGAS is available to help increase cervical cancer screening among Hispanic women and other women disproportionately affected by cervical cancer. PMID:23930983

  2. Impact of awareness of cancer among acquaintances on cancer screening attendance.

    PubMed

    Eisinger, François; Blay, Jean-Yves; Morère, Jean-François; Coscas, Yvan; Calazel-Benque, Anne; Roussel, Claire; Pivot, Xavier

    2011-01-01

    Two nationwide observational surveys were carried out in France in 2005 and 2008 with the aim of assessing the impact on attitudes towards cancer screening of a positive history of cancer among a person's close circle of acquaintances (relatives, friends or colleagues). In 2005, 67% (993/1482) of people interviewed reported having someone in their close circle of acquaintances affected by cancer and in 2008, the rate was 80% (1158/1454). In 2008, having someone within a person's close circle of acquaintances affected by cancer did not increase the rate of screening for breast cancer (already high at >80%). However, it did increase the rate of screening for colorectal cancer [odds ratio (OR)=2.3; 95% confidence interval (CI)=1.6-3.3] and prostate cancer (OR=2.2; 95% CI=1.4-3.5). Knowing someone affected by cancer within the close circle of acquaintances clearly increases awareness, and thus could be an incentive for undergoing cancer screening. With regard to cancer types, such as prostate cancer, for which there is no national programme or media communication, this awareness might be the main source of information and motivation. The impact of awareness on screening behaviour seems to be greatest for the same cancer location as that in the affected acquaintance, as opposed to cancers at other sites. Increased awareness as observed in our survey, which may be attributable to less social stigma associated with a diagnosis of cancer, might increase the rate of screening attendance in the general population. PMID:21245679

  3. Screening for colorectal cancer in Italy: 2011-2012 survey.

    PubMed

    Zorzi, Manuel; Mangone, Lucia; Sassatelli, Romano; Baracco, Susanna; Budroni, Mario; Castaing, Marine; Cirilli, Claudia; Cusimano, Rosanna; Fusco, Mario; Giacomin, Adriano; Giorgi Rossi, Paolo; Naldoni, Carlo; Pannozzo, Fabio; Piffer, Silvano; Puppo, Antonella; Tisano, Francesco; Zappa, Marco

    2015-01-01

    We utilised the IMPATTO study's archives to describe the 2000-2008 colorectal cancer (CRC) incidence rate trends in Italy, once screening programmes based on the faecal immunochemical test were implemented in different areas. Data on CRCs diagnosed in Italy from 2000 to 2008 in subjects aged 40-79 years were collected by 23 cancer registries. Incidence rate trends were evaluated as a whole and by macro-area (North-Centre and South-Islands), presence of a screening programme, sex, ten-year age class, anatomic site, stage at diagnosis, and pattern of diagnosis (screen-detected, non-screen-detected). The annual percent change (APC) of incidence rate trends, with 95% confidence intervals (95%CI), were computed. The study included 46,857 CRCs diagnosed in subjects aged 40-79 years, of which 2,806 were screen-detected. The incidence rates in the North-Centre were higher than in the South and on the Islands. During the study period, screening programmes had been implemented only in the North-Centre and had a significant effect on incidence rates, with an initial sharp increase in incidence, followed by a decrease that started in the 3rd-4th years of screening. These incidence rate trends were exclusively due to modifications in the rates of stage I cases. After screening programmes started, incidence increased in all anatomic sites, particularly in the distal colon. The differential figures introduced by the implementation of screening programmes warrant a continuous surveillance of CRC incidence and mortality trends to monitor the impact of screening at a national level. PMID:26405783

  4. Sensitivity of endoscopic screening for gastric cancer by the incidence method.

    PubMed

    Hamashima, Chisato; Okamoto, Mikizo; Shabana, Michiko; Osaki, Yoneatsu; Kishimoto, Takuji

    2013-08-01

    Although radiographic screening for gastric cancer has been conducted in Japan, it is anticipated that endoscopy will become a new screening method because of its high detection rate. The sensitivities of endoscopic and radiographic screening were calculated by the detection method and the incidence method based on the results of community-based screening in Japan. There were 56,676 screenings for gastric cancer using endoscopy and radiography from April 2002 to March 2007 in Yonago, Japan. The target age group was from 40 to 79 years. Screen-detected and interval cancers were investigated based on a screening database linked to the Tottori Cancer Registry. All gastric cancers diagnosed within 1 year after a negative screen were considered interval cancers. Based on the screening history, these were divided into prevalence screening and incidence screening. Prevalence screenings included 7,388 for endoscopic screening and 5,410 for radiographic screening, whereas incidence screenings included 18,021 for endoscopic screening and 11,417 for radiographic screening. The sensitivity of prevalence screening calculated by the incidence method was 0.886 (95% confidence interval [CI] = 0.698-0.976) for endoscopic screening and 0.831 (95% CI = 0.586-0.964) for radiographic screening; however, the difference was not significant (p = 0.626). The sensitivity of incidence screening calculated by the incidence method was 0.954 (95% CI = 0.842-0.994) for endoscopic screening and 0.855 (95% CI = 0.637-0.970) for radiographic screening (p = 0.177). Endoscopic screening for gastric cancer had a higher sensitivity than radiographic screening by the incidence method in both screening rounds. However, further study is needed to evaluate mortality reduction and to estimate overdiagnosis with endoscopic screening for gastric cancer. PMID:23364866

  5. Screening in GI Cancers: The Role of Genetics.

    PubMed

    Stoffel, Elena M

    2015-06-01

    Genetic and epigenetic alterations identified in tumors of different cancer types can provide insights regarding the roles played by different cell signaling pathways in carcinogenesis. Somatic mutation profiles of GI tumors are used to guide choice of chemotherapy and can facilitate identification of individuals whose cancers arise in the setting of genetic predisposition. This review provides a framework for how clinical history, family history of cancer, and tumor genomic phenotype can be used to screen patients with colorectal, gastric, or pancreatic cancer for hereditary cancer syndromes. Early identification of individuals who carry germline mutations can affect clinical care not only for patients with cancer but also for their at-risk relatives. PMID:25918283

  6. Breast cancer screening controversy: too much or not enough?

    PubMed

    Pivot, Xavier; Viguier, Jrme; Touboul, Chantal; Morre, Jean-Franois; Blay, Jean-Yves; Coscas, Yvan; Lhomel, Christine; Eisinger, Franois

    2015-06-01

    The Cochrane analysis exploring the risk/benefit ratio of breast cancer screening resulted in a controversy worldwide spread by the mass media. Our survey sought to assess the impact of this controversy in terms of breast cancer screening awareness and attendance. A nationwide observational study, recorded in the EDIFICE iterative surveys, with a representative sample of 451 women aged 40-75 years, living in France, was carried out in the 3 months after the start of the controversy in January 2013. Of the 405 women with no personal history of cancer, 69 (17%) declared having heard of the controversy (aware group). Women remembering the controversy were more likely to belong to higher socioprofessional categories and to have a higher level of education. The most frequently remembered issues were overdiagnosis (38%), unreliability (16%) and radiation risk (9%). Compared with women who were unaware of the controversy, the aware group knew more about the limits of breast cancer screening (undiagnosed cancers, 20 vs. 7%, P<0.05 and risk of false positives, 20 vs. 2%, P<0.05) and were more likely to change their opinion for the worse over the mass media debate (8.7 vs. 1.2%, P<0.05). Nevertheless, only 1% of the aware-group declared their intention to subsequently undergo screening less frequently. The low impact of the controversy on the behaviour of women with respect to screening suggests that it should not be seen as a threat to screening attendance rates, but more as an opportunity to improve awareness. PMID:26016791

  7. Social stratification, risk factor prevalence and cancer screening attendance.

    PubMed

    Eisinger, Franois; Viguier, Jrme; Touboul, Chantal; Coscas, Yvan; Pivot, Xavier; Blay, Jean-Yves; Lhomel, Christine; Morre, Jean-Franois

    2015-06-01

    This analysis aimed to assess the extent to which exposure to cancer risk factors and attendance of screening programmes are influenced by social characteristics. The validated Evaluation of deprivation and health inequalities in public health centres (EPICES) index was used to measure social deprivation. A sample of the general population (N=1603) was assessed to search for potential correlations between screening attendance, risk factors and any components of the EPICES score. In 2011, 33% of the population studied was classified as 'vulnerable'. Sex had no significant impact on this rating (32% men, 35% women), whereas occupational status did. Vulnerable individuals were more likely already to have cancer (10 vs. 7%; nonsignificant difference; odds ratio 1.43 [0.98-2.10]). The mean BMI was 26.0?kg/m (SD 4.9) for the vulnerable population versus 24.8?kg/m (SD 3.9) in the nonvulnerable population (P<0.01). The prevalence of current smoking was higher in the vulnerable group (38 vs. 23%, odds ratio 2.03 [1.61-2.56]). In contrast, no statistically significant difference was observed between attendance rates for nationwide organized cancer screening programmes (breast and colorectal; target age group 50-74 years) by the vulnerable and nonvulnerable groups. Social indicators of vulnerable populations are associated with increased rates of risk factors for cancer, but not with screening attendance. Our data support the previously reported marked impact of organized programmes that reduce or even remove inequalities in access to cancer screening. However, although the organized programmes have indeed enabled population-wide, nonselective access to screening, primary prevention as it stands today remains inadequate in the underserved population and further improvements are warranted. PMID:26016792

  8. Cancer Molecular Analysis Project: weaving a rich cancer research tapestry.

    PubMed

    Buetow, Kenneth H; Klausner, Richard D; Fine, Howard; Kaplan, Richard; Singer, Dinah S; Strausberg, Robert L

    2002-05-01

    The Cancer Molecular Analysis Project (CMAP) of the NCI is integrating diverse cancer research data to elucidate fundamental etiologic processes, enable development of novel therapeutic approaches, and facilitate the bridging of basic and clinical science. PMID:12086845

  9. Screening of cervical cancer in Catalonia 2006–2012

    PubMed Central

    de Sanjosé, Silvia; Ibáñez, Raquel; Rodríguez-Salés, Vanesa; Peris, Mercè; Roura, Esther; Diaz, Mireia; Torné, Aureli; Costa, Dolors; Canet, Yolanda; Falguera, Gemma; Alejo, Maria; Espinàs, Josep Alfons; Bosch, F. Xavier

    2015-01-01

    The early detection of intraepithelial lesions of the cervix, through the periodic examination of cervical cells, has been fundamental for the prevention of invasive cervical cancer and its related mortality. In this report, we summarise the cervical cancer screening activities carried out in Catalonia, Spain, within the National Health System during 2008–2011. The study population covers over two million women resident in the area. The evaluation includes 758,690 cervical cytologies performed on a total of 595,868 women. The three-year coverage of cervical cytology among women aged between 25 and 65 years was 40.8%. About 50% of first screened women with negative results had not returned to the second screening round. The introduction of high-risk human papillomavirus DNA (HPV) detection, as a primary screening cotest with cytology among women over age 40 with a poor screening history, significantly improved the detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), being far superior to cytology alone. Cotesting did not improve the detection of CIN2+. The use of the HPV test for the triage of atypical squamous cell undetermined significance (ASC-US) improved the selection of women at high risk of CIN2+. Sampling (both cytology and HPV test) was largely performed by midwives (66.7%), followed by obstetricians (23.8%) and nurses (7%). Over half of the centres (54.8%) had full use of online medical records. During the study period, educational activities for professionals and for women were carried out periodically. The organisation of screening as a population activity in which women are actively called to the screening visit and the introduction of HPV testing as a primary screening tool are strongly recommended to ensure the maximum population impact in the reduction of the cervical cancer burden. PMID:25987901

  10. Screen-and-Treat Approach to Cervical Cancer Prevention Using Visual Inspection With Acetic Acid and Cryotherapy: Experiences, Perceptions, and Beliefs From Demonstration Projects in Peru, Uganda, and Vietnam

    PubMed Central

    Paul, Proma; Winkler, Jennifer L.; Bartolini, Rosario M.; Penny, Mary E.; Huong, Trinh Thu; Nga, Le Thi; Kumakech, Edward; Mugisha, Emmanuel

    2013-01-01

    Cervical cancer is preventable but continues to cause the deaths of more than 270,000 women worldwide each year, most of them in developing countries where programs to detect and treat precancerous lesions are not affordable or available. Studies have demonstrated that screening by visual inspection of the cervix using acetic acid (VIA) is a simple, affordable, and sensitive test that can identify precancerous changes of the cervix so that treatment such as cryotherapy can be provided. Government partners implemented screening and treatment using VIA and cryotherapy at demonstration sites in Peru, Uganda, and Vietnam. Evaluations were conducted in the three countries to explore the barriers and facilitating factors for the use of services and for incorporation of screen-and-treat programs using VIA and cryotherapy into routine services. Results showed that use of VIA and cryotherapy in these settings is a feasible approach to providing cervical cancer prevention services. Activities that can help ensure successful programs include mobilizing and educating communities, organizing services to meet women's schedules and needs, and strengthening systems to track clients for follow-up. Sustainability also depends on having an adequate number of trained providers and reducing staff turnover. Although some challenges were found across all sites, others varied from country to country, suggesting that careful assessments before beginning new secondary prevention programs will optimize the probability of success. PMID:24217554

  11. [Intelligent distributed system of population cancer screening].

    PubMed

    Barchuk, A A; Podolsky, M D; Gaidukov, V S; Kuznetsov, V I; Arseniev, A I; Kanaev, S V; Barchuk, A S; Levchenko, E V; Merabishvili, V M; Kostitsyn, K A; Beloglazova, O V; Filochkina, A V; Gagua, K E; Preis, V G; Tarakanov, S A

    2015-01-01

    This review summarizes data dedicated to improving the efficiency of screening of malignant tumors through the use of modern information and telecommunication technologies. It is showed that currently available software solutions in the field of medical imaging is not enough adapted for population screening. So far there is no single standard that defines checking algorithms of data processing at certain controlled conditions. The most expected result will be the organization of information centralized storage, sharing diagnostic data, providing broad access to them, automated analysis and selection of diagnostically significant results through the software. The basic requirements for the development of self-learning systems for intelligent processing array of heterogeneous data through the use of technologies of semantic networks are provided. PMID:26571818

  12. [Organization of colon-rectal cancer screening in the Provincial Health Agency of Ragusa].

    PubMed

    Blangiardi, F; Ferrera, G; Cilia, S; Aprile, E

    2012-01-01

    Cancer screening is a secondary prevention program that permits early diagnosis of neoplasias and precancerous lesions are in order to diminish mortality and morbidity for certain types of tumors (breast, colon-rectal, and cervical). In 2010, the Ragusa Provincial Health Agency began screening for colon-rectal cancer in an experimental phase that initially involved only the municipality of Ragusa but that was then extended to other municipalities of the province. Although the organizing model suffered from many managerial problems including lack of human resources and tools, there was good collaboration and involvement of the public health/hygiene offices and the general practitioners and volunteer associations. This type of networking was useful in that adhesion to screening was well above that expected. Another winning aspect of the project resulted in clear and pertinent communication to the population. PMID:22880386

  13. Gender differences in attitudes impeding colorectal cancer screening

    PubMed Central

    2013-01-01

    Background Colorectal cancer screening (CRCS) is the only type of cancer screening where both genders reduce risks by similar proportions with identical procedures. It is an important context for examining gender differences in disease-prevention, as CRCS significantly reduces mortality via early detection and prevention. In efforts to increase screening adherence, there is increasing acknowledgment that obstructive attitudes prevent CRCS uptake. Precise identification of the gender differences in obstructive attitudes is necessary to improve uptake promotion. This study randomly sampled unscreened, screening - eligible individuals in Ontario, employing semi-structured interviews to elicit key differences in attitudinal obstructions towards colorectal cancer screening with the aim of deriving informative differences useful in planning promotions of screening uptake. Methods N = 81 participants (49 females, 32 males), 50 years and above, with no prior CRCS, were contacted via random-digit telephone dialing, and consented via phone-mail contact. Altogether, N = 4,459 calls were made to yield N = 85 participants (1.9% response rate) of which N = 4 participants did not complete interviews. All subjects were eligible for free-of-charge CRCS in Ontario, and each was classified, via standard interview by CRCS screening decision-stage. Telephone-based, semi-structured interviews (SSIs) were employed to investigate gender differences in CRCS attitudes, using questions focused on 5 attitudinal domains: 1) Screening experience at the time of interview; 2) Barriers to adherence; 3) Predictors of Adherence; 4) Pain-anxiety experiences related to CRCS; 5) Gender-specific experiences re: CRCS, addressing all three modalities accessible through Ontarios program: a) fecal occult blood testing; b) flexible sigmoidoscopy; c) colonoscopy. Results Interview transcript analyses indicated divergent themes related to CRCS for each gender: 1) bodily intrusion, 2) perforation anxiety, and 3) embarrassment for females and; 1) avoidant procrastination with underlying fatalism, 2) unnecessary health care and 3) uncomfortable vulnerability for males. Respondents adopted similar attitudes towards fecal occult blood testing, flexible sigmoidoscopy and colonoscopy, and were comparable in decision stage across tests. Gender differences were neither closely tied to screening stage nor modality. Women had more consistent physician relationships, were more screening-knowledgeable and better able to articulate views on screening. Men reported less consistent physician relationships, were less knowledgeable and kept decision-making processes vague and emotionally distanced (i.e. at arms length). Conclusions Marked differences were observed in obstructive CRCS attitudes per gender. Females articulated reservations about CRCS-associated distress and males suppressed negative views while ambiguously procrastinating about the task of completing screening. Future interventions could seek to reduce CRCS-related stress (females) and address the need to overcome procrastination (males). PMID:23706029

  14. Cervical Cancer Screening: Defining the Need for Research

    PubMed Central

    Simoes, E.; Brucker, S.; Beckmann, M. W.; Ortmann, O.; Albring, C.; Wallwiener, D.

    2013-01-01

    With the development of a National Cancer Plan published in 2012, Germany has followed the recommendations of the WHO and the EU. The first area of action listed in Germanyʼs National Cancer Plan is improving the early detection of cancer. Both citizens and medical specialists are encouraged to take responsibility themselves and contribute to the efforts being made to meet the challenge of cancer. Screening for cervical cancer has long been an integral part of the German Directive for the Early Detection of Cancer and now – following the recommendations given in the European Guideline – an organised screening approach shall be developed to maximise the benefits and minimise the risks through a partial reorganisation of existing structures. Before this can be rolled out nationwide, it will be necessary to check the feasibility and suitability of new contents and organisational structures. The Federal Joint Committee which is largely responsible for the process according to the draft law on the implementation of the National Cancer Plan has emphasised the importance of evidence-based medicine and of collaboration between the autonomous governing bodies within the healthcare system to obtain viable results. For medical specialists, the follow-on question is which areas will need more research in future. New process steps need to be developed and verified to see whether they offer evidence which will support defined approaches or whether such evidence needs to be newly compiled, e.g. by testing invitation procedures for screening in trial schemes. The experience gained during the implementation of the existing directive on early detection of cancer should be integrated into the new process. Research initiated by specialists could encourage the development of a new version of the Directive for the Early Detection of Cancer suitable for the Germanyʼs healthcare system. PMID:26633900

  15. Colorectal cancer screening with odour material by canine scent detection

    PubMed Central

    Kohnoe, Shunji; Yamazato, Tetsuro; Satoh, Yuji; Morizono, Gouki; Shikata, Kentaro; Morita, Makoto; Watanabe, Akihiro; Morita, Masaru; Kakeji, Yoshihiro; Inoue, Fumio; Maehara, Yoshihiko

    2011-01-01

    Objective Early detection and early treatment are of vital importance to the successful treatment of various cancers. The development of a novel screening method that is as economical and non-invasive as the faecal occult blood test (FOBT) for early detection of colorectal cancer (CRC) is needed. A study was undertaken using canine scent detection to determine whether odour material can become an effective tool in CRC screening. Design Exhaled breath and watery stool samples were obtained from patients with CRC and from healthy controls prior to colonoscopy. Each test group consisted of one sample from a patient with CRC and four control samples from volunteers without cancer. These five samples were randomly and separately placed into five boxes. A Labrador retriever specially trained in scent detection of cancer and a handler cooperated in the tests. The dog first smelled a standard breath sample from a patient with CRC, then smelled each sample station and sat down in front of the station in which a cancer scent was detected. Results 33 and 37 groups of breath and watery stool samples, respectively, were tested. Among patients with CRC and controls, the sensitivity of canine scent detection of breath samples compared with conventional diagnosis by colonoscopy was 0.91 and the specificity was 0.99. The sensitivity of canine scent detection of stool samples was 0.97 and the specificity was 0.99. The accuracy of canine scent detection was high even for early cancer. Canine scent detection was not confounded by current smoking, benign colorectal disease or inflammatory disease. Conclusions This study shows that a specific cancer scent does indeed exist and that cancer-specific chemical compounds may be circulating throughout the body. These odour materials may become effective tools in CRC screening. In the future, studies designed to identify cancer-specific volatile organic compounds will be important for the development of new methods for early detection of CRC. PMID:21282130

  16. Knowledge and Attitudes about Colon Cancer Screening among African Americans

    ERIC Educational Resources Information Center

    James, Aimee S.; Daley, Christine M.; Greiner, K. Allen

    2011-01-01

    Objectives: To explore knowledge and attitudes about colorectal cancer (CRC) screening among African American patients age 45 and older at a community health center serving low-income and uninsured patients. Methods: We conducted 7 focus groups and 17 additional semistructured interviews. Sessions were audio-recorded, transcribed, and analyzed…

  17. Cervical Cancer Screening Among Chinese Immigrants in Seattle, Washington

    PubMed Central

    Do, H. Hoai; Taylor, Victoria M.; Yasui, Yutaka; Jackson, J. Carey; Tu, Shin-Ping

    2006-01-01

    Introduction Chinese American women have high rates of invasive cervical cancer, compared to the general population. However, little is known about the Pap testing behavior of ethnic Chinese immigrants. Methods We conducted a community-based survey of Chinese immigrants living in Seattle, Washington, during 1999. Two indicators of cervical cancer screening participation were examined: at least one previous Pap smear and Pap testing in the last 2 years. Results The overall estimated response rate was 64%, and the cooperation rate was 72%. Our study sample for this analysis included 647 women. Nearly one quarter (24%) of the respondents had never had a Pap test, and only 60% had been screened recently. Factors independently associated with cervical cancer screening use included marital status, housing type, and age at immigration. Conclusion Our findings confirm low levels of cervical cancer screening among Chinese immigrants to North America. Culturally and linguistically appropriate Pap testing intervention programs for less acculturated Chinese women should be developed, implemented, and evaluated. PMID:16228798

  18. Cervical cancer screening in Belgium and overscreening of adolescents.

    PubMed

    Van Kerrebroeck, Helena; Makar, Amin

    2016-03-01

    There has been a marked decrease in the incidence of cervical cancer thanks to cytological screening with the Pap smear test. In Belgium, this screening is rather opportunistic. Over 39% of Belgian women between 25 and 64 years of age are never or only rarely screened by cytological tests. Moreover, there is an excess use of Pap smears because of women who rely on their yearly cervical smear and because many Pap smears are obtained from women beyond the target age range of 25 to 64 years. Sexually active adolescents are increasingly being recognized as a population distinct from adult women. They are at a high risk of acquiring the human papillomavirus (HPV), but most infections and cervical intraepithelial lesions caused by HPV are efficiently cleared by the immune system. We present a description of cervical cancer screening in Belgium using the database of the National Health Insurance Institute (RIZIV/INAMI) and the Belgian Health Care Knowledge Centre (KCE). We describe why elimination of Pap testing in the adolescent population reduces costs and harms without increasing cervical cancer rates. Expectant management, education on the risk factors for cervical cancer and HPV persistence, and HPV vaccination are very important in adolescents and young adults. PMID:25812038

  19. Knowledge and Attitudes about Colon Cancer Screening among African Americans

    ERIC Educational Resources Information Center

    James, Aimee S.; Daley, Christine M.; Greiner, K. Allen

    2011-01-01

    Objectives: To explore knowledge and attitudes about colorectal cancer (CRC) screening among African American patients age 45 and older at a community health center serving low-income and uninsured patients. Methods: We conducted 7 focus groups and 17 additional semistructured interviews. Sessions were audio-recorded, transcribed, and analyzed

  20. The history of colorectal cancer screening: a personal perspective.

    PubMed

    Winawer, Sidney J

    2015-03-01

    The present explosive interest in screening for colorectal cancer (CRC), one of the most prevalent and preventable cancers, had its beginnings at a hospital in London and an Internist's office in Ohio. Demonstrated there were the concepts that CRC did not occur de-novo but arose from a premalignant polyp, that detection of the resultant cancer at an earlier stage was associated with better survival and that cancer could be detected at an early presymptomatic stage by screening. Many years later, the introduction of colonoscopy and colonoscopic polypectomy provided the opportunity for randomized trials to prove that these concepts were true. The sequence of rigorous science followed by guidelines consensus and then multilevel national efforts of screening implementation has resulted in a decline in the CRC incidence and mortality worldwide, most significantly in the USA. Campaigns have been initiated to maximize population screening and further investigate its optimal approach. Some historical details of this success story and many of the key participants are presented in this paper. PMID:25599958

  1. Breast Cancer Screening: Cultural Beliefs and Diverse Populations

    ERIC Educational Resources Information Center

    Simon, Cassandra E.

    2006-01-01

    This article addresses the role of culture in breast cancer screening behavior among African American, American Indian/Alaskan Native, Asian American/Pacific Islander, and Hispanic/Latina women. It reviews cultural beliefs, attitudes, and knowledge and their relative influence on women's decisions regarding health tests. The article explores how

  2. Molecular biomarkers for future screening of lung cancer.

    PubMed

    Hensing, Thomas A; Salgia, Ravi

    2013-10-01

    The Landmark National Lung Screening Trial established the potential for low dose CT screening (LDCT) to reduce lung cancer-specific mortality in high-risk patients as defined by smoking history and age. However, the prevalence of lung cancer in asymptomatic smokers selected based on the NLST criteria is low. Recent advances have facilitated biomarker discovery for early diagnosis of lung cancer through the analysis of surrogate tissues, including airway epithelium, sputum, exhaled breath, and blood. Although a number of candidate diagnostic biomarkers have been described, none have been validated for use in the clinical setting. The NLST ACRIN biomarker repository is a valuable resource of annotated biological specimens that were collected during the NLST trial, which has the potential to facilitate validation of candidate biomarkers for early diagnosis identified in discovery trials. It will be important to perform retrospective and prospective analysis of biomarkers to screen for lung cancer. The review below summarizes some of our understanding of biomarkers in screening. PMID:23893423

  3. Fatalistic Beliefs and Cervical Cancer Screening Among Mexican Women.

    PubMed

    Marvn, Ma Luisa; Ehrenzweig, Yamilet; Catillo-Lpez, Rosa Lilia

    2016-01-01

    Fatalistic beliefs about cervical cancer were studied in 464 Mexican women, and how such beliefs relate to participation in cervical cancer screening was evaluated. Rural women were less likely than urban women to have had a Pap test and more likely to believe that the illness is due to bad luck or fate. These were also the beliefs most associated with nonscreening among rural women, whereas for urban women the belief most associated with nonscreening was "there is not much I can do to prevent cervical cancer." PMID:25256106

  4. Enhancing the use and quality of colorectal cancer screening.

    PubMed Central

    Holden, Debra J; Harris, Russell; Porterfield, Deborah S; Jonas, Daniel E; Morgan, Laura C; Reuland, Daniel; Gilchrist, Michael; Viswanathan, Meera; Lohr, Kathleen N; Lyda-McDonald, Brieanne

    2010-01-01

    OBJECTIVES To conduct a systematic review of the use and quality (including underuse, overuse, and misuse) of appropriate colorectal cancer (CRC) screening, including factors associated with screening, effective interventions to improve screening rates, current capacity, and monitoring and tracking the use and quality. Trends in the use and quality of CRC screening tests is also presented. DATA SOURCES We searched MEDLINE, the Cochrane Library, and the Cochrane Central Trials Registry, supplemented by handsearches, for studies published in English from January 1998 through September 2009. REVIEW METHODS We used standard Evidence-based Practice Center methods of dual review of abstracts, full text articles, abstractions, quality rating, and quality grading. We resolved disagreements by consensus. RESULTS We found multiple problems of underuse, overuse, and misuse of CRC screening. We identified a total of 116 articles for inclusion into the systematic review, including a total of 72 studies qualified for inclusion for key question (KQ) 2, 21 for KQ 3, 12 for KQ 4, and 8 for KQ 5. A number of patient-level factors are associated with lower screening rates, including having low income or less education, being uninsured or of Hispanic or Asian descent, not being acculturated into the United States, and having less or reduced access to care. Being insured, of higher income or education, and non-Hispanic white, participating in other cancer screenings, having a family history of CRC or personal history of another cancer, as well as receiving a physician recommendation to be screened, are associated with higher screening rates. Interventions that effectively increased CRC screening with high strength of evidence include patient reminders, one-on-one interactions, eliminating structural barriers, and system-level changes. The largest magnitude of improvement came from one-on-one interactions and eliminating barriers. Purely educational small-media interventions do not improve screening rates. Evidence is mixed for decision aids, although certain designs may be effective. No studies tested interventions to reduce overuse or misuse of CRC screening. We found no studies that assessed monitoring systems for underuse, overuse, and misuse of CRC screening. Modeling studies, using various assumptions, show that if the United States were to adopt a colonoscopy-only approach to CRC screening and everyone were to agree to be screened in this way, it is likely that colonoscopy capacity would need to be substantially increased. CONCLUSIONS Both CRC screening and patient-physician discussions of CRC screening are underused, and important problems of overuse and misuse also exist. Some interventions hold promise for improvement. The research priority is to design and test interventions to increase screening and CRC screening discussions, building on the effective approaches identified in this review, and tailored to specific population needs. In addition, new interventions to reduce overuse and misuse should be designed and tested, along with studies of ongoing monitoring systems that are linked to feedback and continued improvement efforts. PMID:20726624

  5. CT Lung Cancer Screening Program Development: Part 2.

    PubMed

    Yates, Teri

    2015-01-01

    Radiology administrators must use innovative strategies around clinical collaboration and marketing to ensure that patients access the service in sufficient numbers. Radiology Associates of South Florida in collaboration with Baptist Health South Florida have developed a successful lung cancer screening program. The biggest factors in their success have been the affordability of their service and the quality of the program. Like mammography, lung cancer screening programs serve as an entry point to other services that generate revenue for the hospital. Patients may require further evaluation in the form of more imaging or surgical services for biopsy. Part 1 provided background and laid out fundamentals for starting a program. Part 2 focuses on building patient volume, marketing, and issues related to patient management after the screen is performed. PMID:26314180

  6. Ovarian Cancer Screening Method Fails to Reduce Deaths from the Disease

    Cancer.gov

    New results from the NCI-sponsored PLCO Cancer Screening Trial show that screening for ovarian cancer with transvaginal ultrasound (TVU) and the CA-125 blood test did not result in fewer deaths from the disease compared with usual care.

  7. Racial and ethnic disparities in U.S. cancer screening rates

    Cancer.gov

    The percentage of U.S. citizens screened for cancer remains below national targets, with significant disparities among racial and ethnic populations, according to the first federal study to identify cancer screening disparities among Asian and Hispanic gr

  8. Racial Differences in Knowledge, Attitudes, and Cancer Screening Practices among a Triracial Rural Population

    PubMed Central

    Paskett, Electra D.; Tatum, Cathy; Rushing, Julia; Michielutte, Robert; Bell, Ronny; Foley, Kristie Long; Bittoni, Marisa; Dickinson, Stephanie

    2015-01-01

    BACKGROUND Low-income, minority, and rural women face a greater burden with regard to cancer-related morbidity and mortality and are usually underrepresented in cancer control research. The Robeson County Outreach, Screening and Education Project sought to increase mammography use among low-income, minority, and rural women age > 40 years. The current article reports on racial disparities and barriers to screening, especially those related to knowledge, attitudes, and behaviors. METHODS A baseline survey was administered to 897 women age > 40 years who lived in rural Robeson County in North Carolina. The sample consisted of three principal racial groups: whites, African Americans, and Native Americans. Survey comparisons were made among racial groups with respect to knowledge, attitudes, and behaviors regarding breast and cervical carcinoma screening. RESULTS Overall, Native American and African-American women had lower levels of knowledge, more inaccurate beliefs, and more barriers to screening compared with white women. Among the notable findings were that 43% of the patient population did not mention mammograms and 53% did not mention Pap smears as breast and cervical carcinoma screening tests, respectively; furthermore, compared with white women, significantly fewer African-American and Native American women mentioned these tests (P < 0.001). Sixty-seven percent of all women reported that a physician had never encouraged them to receive a mammogram, although 75% reported having received a regular checkup in the preceding year. CONCLUSIONS Although all low-income rural women experienced significant barriers to receiving cancer screening tests, these barriers were more common for minority women compared with white women. More research is needed to identify ways to overcome such barriers, especially among Native American women. The results of the current study have important implications with respect to the designing of interventions aimed at improving cancer screening for all women. PMID:15505784

  9. Cervical cancer screening in a rural population of Zimbabwe.

    PubMed

    Thistle, P J; Chirenje, Z M

    1997-09-01

    In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s at family planning clinics, various central and district government hospitals, and in private practice. The initial results of a cervical cancer screening program introduced in a district hospital (Salvation Army Howard Hospital) in the Chiweshe rural community in 1994 were investigated. The aim is for every mother to receive a Pap smear at her 6-week postpartum visit. By May 1996, a total of 419 Pap smears--representing less than 20% of the hospital's postnatal population--had been performed at this facility. If all postnatal visits included a Pap smear, there would have been 2500 screenings. 58.7% of smears were classified as inadequate, primarily because of the coexistence of sexually transmitted infections. A total of 173 slides (41.3%) were normal. Of the abnormal smears, 158 (37.7%) had inflammation. Abnormal cytology was reported in 65 cases (15.5%); 15 of these cases (3.6%) were high-grade squamous intraepithelial lesions. Factors contributing to the low number of Pap smears actually performed included a high default rate for the postpartum visit, shortages of test-related supplies, and the rapid turnover of trained staff. Cervical cancer screening efforts in Zimbabwe require physical resources to perform smears, well-trained personnel, transport and laboratory services, and adequate patient follow up and treatment. Finally, since cervical cancer primarily affects older women, young women of reproductive age may not be the most appropriate target population for screening efforts. PMID:9509642

  10. Screening for Viral Hepatitis and Hepatocellular Cancer.

    PubMed

    Cameron, Andrew M

    2015-10-01

    Accurate tests for at-risk populations are available for hepatitis B virus, hepatitis C virus (HCV), and hepatocellular carcinoma (HCC). Effective treatments for all three diseases exist if diagnosed early. New antivirals are making a significant impact on HCV. Liver transplant is curative for early HCC and is prioritized by the United Network for Organ Sharing in the United States. Screening and surveillance for deadly disease only makes sense if there are identifiable populations at risk for the condition, there are sensitive and specific low-cost tests available for the condition, and there are effective treatments for the condition. PMID:26315520

  11. Diagnostic evaluation following a positive lung screening chest radiograph in the Prostate, Lung, Colorectal, Ovarian (PLCO) Cancer Screening Trial

    PubMed Central

    Hocking, William G.; Tammemagi, Martin C.; Commins, John; Oken, Martin M.; Kvale, Paul A.; Hu, Ping; Ragard, Lawrence R.; Riley, Tom L.; Pinsky, Paul; Beck, Thomas M.; Prorok, Philip C.

    2013-01-01

    Lung cancer is the major cause of cancer mortality. One of the aims of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) was to determine if annual screening chest radiographs reduce lung cancer mortality. We enrolled 154,900 individuals, aged 5574 years; 77,445 were randomized to the intervention arm and received an annual chest radiograph for 3 or 4 years. Participants with a positive screen underwent diagnostic evaluation under guidance of their primary physician. Methods of diagnosis or exclusion of cancer, interval from screen to diagnosis, and factors predicting diagnostic testing were evaluated. One or more positive screens occurred in 17% of participants. Positive screens resulted in biopsy in 3%, with 54% positive for cancer. Biopsy likelihood was associated with a mass, smoking, age, and family history of lung cancer. Diagnostic testing stopped after a chest radiograph or computed tomography/magnetic resonance imaging in over half. After a second or subsequent positive screen, evaluation stopped after comparison to prior radiographs in over half. Of 308 screen-detected cancers, the diagnosis was established by thoracotomy/thoracoscopy in 47.7%, needle biopsy in 27.6%, bronchoscopy in 20.1% and mediastinoscopy in 2.9%. Eighty-four percent of screen-detected lung cancers were diagnosed within 6 months. Diagnostic evaluations following a positive screen were conducted in a timely fashion. Lung cancer was diagnosed by tissue biopsy or cytology in all cases. Lung cancer was excluded during evaluation of positive screening examinations by clinical or radiographic evaluation in all but 1.4% who required a tissue biopsy. PMID:23993734

  12. Diagnostic evaluation following a positive lung screening chest radiograph in the Prostate, Lung, Colorectal, Ovarian (PLCO) Cancer Screening Trial.

    PubMed

    Hocking, William G; Tammemagi, Martin C; Commins, John; Oken, Martin M; Kvale, Paul A; Hu, Ping; Ragard, Lawrence R; Riley, Tom L; Pinsky, Paul; Beck, Thomas M; Prorok, Philip C

    2013-11-01

    Lung cancer is the major cause of cancer mortality. One of the aims of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) was to determine if annual screening chest radiographs reduce lung cancer mortality. We enrolled 154,900 individuals, aged 55-74 years; 77,445 were randomized to the intervention arm and received an annual chest radiograph for 3 or 4 years. Participants with a positive screen underwent diagnostic evaluation under guidance of their primary physician. Methods of diagnosis or exclusion of cancer, interval from screen to diagnosis, and factors predicting diagnostic testing were evaluated. One or more positive screens occurred in 17% of participants. Positive screens resulted in biopsy in 3%, with 54% positive for cancer. Biopsy likelihood was associated with a mass, smoking, age, and family history of lung cancer. Diagnostic testing stopped after a chest radiograph or computed tomography/magnetic resonance imaging in over half. After a second or subsequent positive screen, evaluation stopped after comparison to prior radiographs in over half. Of 308 screen-detected cancers, the diagnosis was established by thoracotomy/thoracoscopy in 47.7%, needle biopsy in 27.6%, bronchoscopy in 20.1% and mediastinoscopy in 2.9%. Eighty-four percent of screen-detected lung cancers were diagnosed within 6 months. Diagnostic evaluations following a positive screen were conducted in a timely fashion. Lung cancer was diagnosed by tissue biopsy or cytology in all cases. Lung cancer was excluded during evaluation of positive screening examinations by clinical or radiographic evaluation in all but 1.4% who required a tissue biopsy. PMID:23993734

  13. Cancer Screening and Genetics: A Tale of Two Paradigms

    PubMed Central

    Hamilton, Jada G.; Edwards, Heather M.; Khoury, Muin J.; Taplin, Stephen H.

    2014-01-01

    The long-standing medical tradition to first do no harm is reflected in population-wide evidence-based recommendations for cancer screening tests that focus primarily on reducing morbidity and mortality. The conventional cancer screening process is predicated on finding early-stage disease that can be treated effectively; yet emerging genetic and genomic testing technologies have moved the target earlier in the disease development process to identify a probabilistic predisposition to disease. Genetic risk information can have varying implications for the health and well-being of patients and their relatives, and has raised important questions about the evaluation and value of risk information. This paper explores the paradigms that are being applied to the evaluation of conventional cancer screening tests and emerging genetic and genomic tests of cancer susceptibility, and how these perspectives are shifting and evolving in response to advances in our ability to detect cancer risks. We consider several challenges germane to the evaluation of both categories of tests including defining benefits and harms in terms of personal and clinical utility, addressing healthcare consumers information preferences, and managing scientific uncertainty. We encourage research and dialogue aimed at developing a better understanding of the value of all risk information, non-genetic and genetic, to peoples lives. PMID:24706727

  14. What implementation interventions increase cancer screening rates? a systematic review

    PubMed Central

    2011-01-01

    Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as the evidentiary foundation for an implementation guideline. Poor reporting, lack of precision and consistency in defining operational elements, and insufficient consideration of context and differences among populations are areas for additional research. PMID:21958556

  15. Medical Student Response to a Class Lipid-Screening Project.

    ERIC Educational Resources Information Center

    Lum, Gifford; And Others

    1982-01-01

    Medical students at the State University of New York's Downstate Medical Center initiated and carried out a voluntary project to screen lipids (cholesterol) to identify known coronary risk factors. The incidence of coronary disease factors among these students and the response of students with high cholesterol levels are reported. (Authors/PP)

  16. A transparent projection screen based on plasmonic Ag nanocubes

    NASA Astrophysics Data System (ADS)

    Saito, Koichiro; Tatsuma, Tetsu

    2015-12-01

    A transparent and colourless projection screen is fabricated by depositing a silver nanocube sub-monolayer on a titania thin film. Backward scattering of the silver nanocubes is enhanced by titania in the blue and red regions, to which human eyes are less sensitive. As a result, this screen, which is cost-effective even for large areas, allows projection of full colour images.A transparent and colourless projection screen is fabricated by depositing a silver nanocube sub-monolayer on a titania thin film. Backward scattering of the silver nanocubes is enhanced by titania in the blue and red regions, to which human eyes are less sensitive. As a result, this screen, which is cost-effective even for large areas, allows projection of full colour images. Electronic supplementary information (ESI) available: Preparation of Ag nanocubes, calculated values for a Ag nanocube on TiO2 (Tables S1 and S2). See DOI: 10.1039/c5nr06766a

  17. Cervical Cancer Screening in an Early Diagnosis and Screening Center in Mersin, Turkey.

    PubMed

    Nayir, Tufan; Okyay, Ramazan Azim; Nazlican, Ersin; Yesilyurt, Hakki; Akbaba, Muhsin; Ilhan, Berrin; Kemik, Aytekin

    2015-01-01

    Cancer is a major public health problem due to the jeavy disease burden, fatality and tendency for increased incidence. Of all cancer types, cervical cancer is reported to be the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases worldwide in 2012. It features a long preclinical phase with slowly progressing precancerous lesions such as CIN 2 and 3 and adenocarcinoma in situ. Therefore, screening programs such as with Pap smear tests may play an important role in cervical cancer prevention. The purpose of this study was to present results of a Pap smear screening survey for cervical cancer targeting women living in an urban area in the province of Mersin, located in the Mediterranean region of Turkey. This community- based descriptive study included women living at Akdeniz county of Mersin province. A total of 1,032 screened women between 30 and 65 ages within the routine screening programme constituted the study population. The mean age of the participants was 43.88.6 (min. 30, max. 65) years. The percentage of the participants who had previously undergone smears was 40.6%. Epithelial cell changes were found in 26 (2.5%) participants, with ASC-US in 18 (1.7%), ASC-H in 2 (0.2%), LSIL in 5 (0.5%) and HSIL in 1 (0.1%). The most common clinical presentation together with epithelial changes was abnormal vaginal discharge. Taking into account the presence of women who had never undergone Pap test; it should be offered at primary level of health care in the form of a community-based service to achieve reduced morbidity and mortality rates. PMID:26514466

  18. DNA probes for papillomavirus strains readied for cervical cancer screening

    SciTech Connect

    Merz, B.

    1988-11-18

    New Papillomavirus tests are ready to come to the aid of the standard Papanicolauo test in screening for cervical cancer. The new tests, which detect the strains of human papillomavirus (HPV) most commonly associated with human cervical cancer, are designed to be used as an adjunct to rather than as a replacement for the Papanicolaou smears. Their developers say that they can be used to indicated a risk of developing cancer in women whose Papanicolaou smears indicate mild cervical dysplasia, and, eventually, to detect papillomavirus infection in normal Papanicolaou smears. The rationale for HPV testing is derived from a growing body of evidence that HPV is a major factor in the etiology of cervical cancer. Three HPV tests were described recently in Chicago at the Third International Conference on Human Papillomavirus and Squamous Cervical Cancer. Each relies on DNA probes to detect the presence of papillomavirus in cervical cells and/or to distinguish the strain of papillomavirus present.

  19. Molecular breast imaging: an emerging modality for breast cancer screening

    PubMed Central

    O’Connor, Michael K

    2015-01-01

    SUMMARY Screening mammography is recognized as an imperfect imaging tool that performs poorly in women with dense breast tissue – a limitation which has driven demand for supplemental screening techniques. One potential supplemental technique is molecular breast imaging (MBI). Significant improvements in gamma camera technology allow MBI to be performed at low radiation doses, comparable with those of tomosynthesis and mammography. A recent screening trial in women with dense breast tissue yielded a cancer detection rate of 3.2 per 1000 for mammography alone and 12.0 per 1000 for the combination of mammography and MBI. MBI also demonstrated a lower recall rate than that of mammography. MBI is a promising supplemental screening technique in women with dense breast tissue. PMID:25621015

  20. Familial colorectal cancer screening: When and what to do?

    PubMed Central

    Del Vecchio Blanco, Giovanna; Paoluzi, Omero Alessandro; Sileri, Pierpaolo; Rossi, Piero; Sica, Giuseppe; Pallone, Francesco

    2015-01-01

    Colorectal cancer (CRC) is the third leading cause of death worldwide and represents a clinical challenge. Family members of patients affected by CRC have an increased risk of CRC development. In these individuals, screening is strongly recommended and should be started earlier than in the population with average risk, in order to detect neoplastic precursors, such as adenoma, advanced adenoma, and nonpolypoid adenomatous lesions of the colon. Fecal occult blood test (FOBT) is a non invasive, widespread screening method that can reduce CRC-related mortality. Sigmoidoscopy, alone or in addition to FOBT, represents another screening strategy that reduces CRC mortality. Colonoscopy is the best choice for screening high-risk populations, as it allows simultaneous detection and removal of preneoplastic lesions. The choice of test depends on local health policy and varies among countries. PMID:26185367

  1. Teledermatology protocol for screening of Skin Cancer*

    PubMed Central

    Piccoli, Maria Fernanda; Amorim, Bruna Dücker Bastos; Wagner, Harley Miguel; Nunes, Daniel Holthausen

    2015-01-01

    BACKGROUND Telemedicine refers to the use of technology as improvement of healthcare delivery to places where distance becomes an obstacle. Its use represents a great potential for dermatology, a specialty whose visual analysis phase is essential in diagnosis. OBJECTIVES To analyze the compatibility index of skin cancer diagnoses between primary care and teledermatology, and to validate a protocol for standardization of digital imaging to obtain the reports in teledermatology. METHODS An observational cross-sectional study developed through the census of 333 examination requests, received between January/2012 and July/2012, in the Center for Telemedicine and Telehealth of SES-SC. We used a protocol for photographic lesion standardization, consisting of three steps (panoramic photo, close-up with ruler and dermoscopy). After collection, the data were sent to a virtual site on the Internet, and recorded with the use of an electronic health record containing the images, the skin phototype and demographic characteristics. RESULTS The level of compatibility between the diagnosis of skin cancer in Santa Catarina's primary care and the diagnosis proposed by teledermatology was 19.02%. Proportionally, it was 21.21% for BCC, 44.44% for SCC and 6.98% for MM. The protocol was statistically significant (p <0.05), with an OR of 38.77. CONCLUSION The rate of diagnostic compatibility of skin cancer was low and the use of the protocol optimized the chance of validating requests for examination. PMID:25830990

  2. Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) | Division of Cancer Prevention

    Cancer.gov

    The PLCO Cancer Screening Trial was a population-based randomized trial to determine the effects of screening on cancer-related mortality and secondary endpoints in more than 150,000 men and women aged 55 to 74.  The PLCO Biorepository, accessible by the Cancer Data Access System (CDAS) web portal, contains about 2.7 million biologic specimens from intervention participants during their six trial screening years, and buccal cell specimens from control participants. The Etiology and Early Marker Studies (EEMS) component has biologic materials and risk factor information from trial participants before diagnosis of disease.  | A repository of data from a large randomized trial on the effects of screening on cancer-related mortality and secondary endpoints in men and women aged 55 to 74.

  3. Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) | Division of Cancer Prevention

    Cancer.gov

    The PLCO Cancer Screening Trial was a population-based randomized trial to determine the effects of screening on cancer-related mortality and secondary endpoints in more than 150,000 men and women aged 55 to 74. The PLCO Biorepository, accessible by the Cancer Data Access System (CDAS) web portal, contains about 2.7 million biologic specimens from intervention participants during their six trial screening years, and buccal cell specimens from control participants. The Etiology and Early Marker Studies (EEMS) component has biologic materials and risk factor information from trial participants before diagnosis of disease. | A repository of data from a large randomized trial on the effects of screening on cancer-related mortality and secondary endpoints in men and women aged 55 to 74.

  4. Participation in Biomedical Research Studies and Cancer Screenings: Perceptions of Risks to Minorities Compared With Whites

    PubMed Central

    Katz, Ralph V.; Wang, Min Qi; Green, B. Lee; Kressin, Nancy R.; Claudio, Cristina; Russell, Stefanie Luise; Sommervil, Christelle

    2009-01-01

    Background This analysis was conducted to determine whether there is a difference among blacks, Hispanics, and whites in their perception of risks associated with participating in either a biomedical study or a cancer screening. Methods The Tuskegee Legacy Project Questionnaire, which focused on research subject participation, was administered in two different surveys (1999-2000 and 2003) in seven cities. The Cancer Screening Questionnaire was administered in 2003 in three cities. Results The study sample across the three surveys consisted of 1,064 blacks, 781 Hispanics, and 1,598 non-Hispanic whites. Response rates ranged from 44% to 70% by city. Logistic regression analyses, adjusted for age, sex, education, income, and city, revealed that blacks and Hispanics each self-reported that minorities, compared with whites, are more likely to be taken advantage of in biomedical studies and much less likely to get a thorough and careful examination in a cancer screening (odds ratios ranged from 3.6 to 14.2). Conclusions Blacks and Hispanics perceive equally high levels of risk for participating in cancer screening examinations and for volunteering to become research subjects in biomedical studies. This perception provides a strong message about the need to overtly address this critical health disparities issue. PMID:18813202

  5. Engaging Health Systems to Increase Colorectal Cancer Screening: CommunityClinical Outreach in Underserved Areas of Wisconsin

    PubMed Central

    Weeth-Feinstein, Lauren; Conlon, Amy; Scott, Sheryl

    2013-01-01

    Background Colorectal cancer is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related death in Wisconsin. Incidence and mortality rates for colorectal cancer vary by age, race/ethnicity, geography, and socioeconomic status. From 2010 through 2012, the Wisconsin Comprehensive Cancer Control Program awarded grants to 5 regional health systems for the purpose of planning and implementing events to increase colorectal cancer screening rates in underserved communities. Community Context Grantees were chosen for their ability to engage community partners in reaching underserved groups including African American, Hispanic/Latino, Hmong, rural, and uninsured populations in their service areas. Methods Grantees identified target populations for proposed screening events, designated institutional planning teams, engaged appropriate local partner organizations, and created plans for follow-up. All grantees implemented 1 or more colorectal cancer screening events within 6 months of receiving their awards. Events were conducted in 2 phases. Outcomes Participating health systems organized 36 screening events and distributed 633 individual test kits; 506 kits were returned, of which 57 (9%) tested positive for colorectal abnormalities. Of attendees who received screening, 63% were uninsured or underinsured, 55% had no previous screening, 46% were of a racial/ethnic minority group, 22% had a family history of cancer, and 13% were rural residents. This project strengthened partnerships between health systems and local organizations. Interpretation An effective strategy for improving colorectal cancer screening rates, particularly among underserved populations, is to award health systems grants for implementing community-based screening events in conjunction with community partners. PMID:24262024

  6. 42 CFR 410.37 - Colorectal cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Colorectal cancer screening tests: Conditions for...) BENEFITS Medical and Other Health Services § 410.37 Colorectal cancer screening tests: Conditions for and...) Colorectal cancer screening tests means any of the following procedures furnished to an individual for...

  7. Body Mass Index and Cancer Screening in Older American Indian and Alaska Native Men

    ERIC Educational Resources Information Center

    Muus, Kyle J.; Baker-Demaray, Twyla; McDonald, Leander R.; Ludtke, Richard L.; Allery, Alan J.; Bogart, T. Andy; Goldberg, Jack; Ramsey, Scott D.; Buchwald, Dedra S.

    2009-01-01

    Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancer screening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancer screening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the

  8. Body Mass Index and Cancer Screening in Older American Indian and Alaska Native Men

    ERIC Educational Resources Information Center

    Muus, Kyle J.; Baker-Demaray, Twyla; McDonald, Leander R.; Ludtke, Richard L.; Allery, Alan J.; Bogart, T. Andy; Goldberg, Jack; Ramsey, Scott D.; Buchwald, Dedra S.

    2009-01-01

    Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancer screening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancer screening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the…

  9. 42 CFR 410.39 - Prostate cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Prostate cancer screening tests: Conditions for and... Medical and Other Health Services § 410.39 Prostate cancer screening tests: Conditions for and limitations... of early detection of prostate cancer: (i) A screening digital rectal examination. (ii) A...

  10. 42 CFR 410.39 - Prostate cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Prostate cancer screening tests: Conditions for and... Medical and Other Health Services § 410.39 Prostate cancer screening tests: Conditions for and limitations... cancer screening tests means any of the following procedures furnished to an individual for the...

  11. 42 CFR 410.39 - Prostate cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Prostate cancer screening tests: Conditions for and... Medical and Other Health Services § 410.39 Prostate cancer screening tests: Conditions for and limitations... cancer screening tests means any of the following procedures furnished to an individual for the...

  12. 42 CFR 410.37 - Colorectal cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Colorectal cancer screening tests: Conditions for...) BENEFITS Medical and Other Health Services § 410.37 Colorectal cancer screening tests: Conditions for and...) Colorectal cancer screening tests means any of the following procedures furnished to an individual for...

  13. 42 CFR 410.37 - Colorectal cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Colorectal cancer screening tests: Conditions for...) BENEFITS Medical and Other Health Services § 410.37 Colorectal cancer screening tests: Conditions for and...) Colorectal cancer screening tests means any of the following procedures furnished to an individual for...

  14. 42 CFR 410.39 - Prostate cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Prostate cancer screening tests: Conditions for and... Medical and Other Health Services § 410.39 Prostate cancer screening tests: Conditions for and limitations... cancer screening tests means any of the following procedures furnished to an individual for the...

  15. 42 CFR 410.37 - Colorectal cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Colorectal cancer screening tests: Conditions for...) BENEFITS Medical and Other Health Services § 410.37 Colorectal cancer screening tests: Conditions for and...) Colorectal cancer screening tests means any of the following procedures furnished to an individual for...

  16. 42 CFR 410.39 - Prostate cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Prostate cancer screening tests: Conditions for and... Medical and Other Health Services § 410.39 Prostate cancer screening tests: Conditions for and limitations... cancer screening tests means any of the following procedures furnished to an individual for the...

  17. 42 CFR 410.37 - Colorectal cancer screening tests: Conditions for and limitations on coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Colorectal cancer screening tests: Conditions for...) BENEFITS Medical and Other Health Services § 410.37 Colorectal cancer screening tests: Conditions for and...) Colorectal cancer screening tests means any of the following procedures furnished to an individual for...

  18. INTERVAL LUNG CANCERS NOT DETECTED ON SCREENING CHEST X-RAYS: HOW ARE THEY DIFFERENT?

    PubMed Central

    Kvale, Paul A.; Johnson, Christine Cole; Tammemägi, Martin; Marcus, Pamela M.; Zylak, Carl J.; Spizarny, David L.; Hocking, William; Oken, Martin; Commins, John; Ragard, Lawrence; Hu, Ping; Berg, Christine; Prorok, Philip

    2014-01-01

    Background The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial provides us an opportunity to describe interval lung cancers not detected by screening chest x-ray (CXR) compared to screen-detected cancers. Methods Participants were screened for lung cancer with CXR at baseline and annually for two (never smokers) or three (ever smokers) more years. Screen-detected cancers were those with a positive CXR and diagnosed within 12 months. Putative interval cancers were those with a negative CXR screen but with a diagnosis of lung cancer within 12 months. Potential interval cancers were re-reviewed to determine whether lung cancer was missed and probably present during the initial interpretation or whether the lesion was a “true interval” cancer. Results 77,445 participants were randomized to the intervention arm with 70,633 screened. Of 5,227 positive screens from any screening round, 299 resulted in screen-detected lung cancers; 151 had potential interval cancers with 127 CXR available for re-review. Cancer was probably present in 45/127 (35.4%) at time of screening; 82 (64.6%) were “true interval” cancers. Compared to screen-detected cancers, true interval cancers were more common among males, persons with <12 years education and those with a history of smoking. True interval lung cancers were more often small cell, 28.1% vs. 7.4%, and less often adenocarcinoma, 25.6% vs. 56.2% (p<0.001), more advanced stage IV (30.5% vs. 16.6%, p<0.02), and less likely to be in the right upper lobe, 17.1% vs. 36.1% (p<0.02). Conclusion True interval lung cancers differ from CXR-screen-detected cancers with regard to demographic variables, stage, cell type and location. PMID:25123333

  19. Detection rates of high-grade prostate cancer during subsequent screening visits. Results of the European Randomized Screening Study for Prostate Cancer.

    PubMed

    van der Kwast, Theodorus H; Ciatto, Stefano; Martikainen, Paula M; Hoedemaeker, Robert; Laurila, Marita; Pihl, Carl-Gustaph; Hugosson, Jonas; Neetens, Ingrid; Nelen, Vera; Di Lollo, Simonetta; Roobol, Monique J; Mtnen, Liisa; Santonja, Carlos; Moss, Sue; Schrder, Fritz H

    2006-05-15

    Screening for prostate cancer using prostate-specific antigen (PSA) tests has led to a stage and grade shift as compared to the pre-PSA era. Effectiveness of screening for prostate cancer should be manifested by a reduction in detection rate of aggressive cancers during subsequent screening. In 6 centers of the European Randomized Screening study for Prostate Cancer, a total of 58,710 men were tested for prostate cancer. Screening centers differed with regard to age-range, screening interval and biopsy indications. During the 2nd visit, the proportion of Gleason score 6 cancers increased from 62.5 to 75%, mainly at the expense of Gleason score 7 cancers. High-grade (Gleason score 8-10) cancer detection rates varied per screening center during the 1st visit from 5.1 to 41.1, and during the 2nd visit from 6.4 to 29.3/10,000 men. The overall detection rate of high-grade cancers showed a reduction during the 2nd visit from 26 to 12/10,000 men, an effect mainly attributable to the screening center with the highest cancer detection rate (i.e. 507/10,000 men). Variations in detection rates among screening centers related among others to biopsy compliance and age range. PMID:16353141

  20. [Breast cancer screening: a better anamnesis and an informed choice].

    PubMed

    Fauquert, B

    2015-09-01

    The goal of this article is to compare breast cancer screening national and international guidelines for defining a pragmatic and evidence-based attitude for primary care professionals in Belgium. A literature review was made in the main guidelines databases and in the belgian epidemiological and reimbursement databases. The decrease in breast cancer mortality this last decade reduce the screening efficiency by the same extent. Finally, it is recommended to propose systematically mammotest screening between 50 and 70 and to inform the patients by messages developed for this purpose by the KCE. Based on a simple family history, we can define three risk groups (KCE - strong recommendation, moderate evidence level). Start this anamnesis from 30 years old, seems to be logical regards to the exams which have to be done if the risk is very elevated. If the risk is elevated, it is recommended to propose annual mammography between 40 and 49 (KCE - weak recommendation - very low evidence level). If the risk is very elevated, refer to the secondary care. Supplementary data are needed to appreciate the influence of social health determinant on the breast cancer morbidity and mortality and to improve our vision of the screening benefice-risk trade-off. PMID:26591308

  1. Breast cancer screening: stages of adoption among Cambodian American women

    PubMed Central

    Tu, Shin-Ping; Yasui, Yutaka; Kuniyuki, Alan; Schwartz, Stephen M.; Jackson, J. Carey; Taylor, Vicky M.

    2006-01-01

    Background Little information is available on the breast cancer screening behavior of Cambodian American women. Methods We identified households from multiple sources using Cambodian surnames and conducted a cross-sectional survey, administered by bilingual and bicultural interviewers. Breast cancer screening stages of adoption were examined based on concepts from the transtheoretical model of behavioral change. Results Our response rate was 73% (398 women in clinical breast exam (CBE) analysis, and 248 in mammography analysis) with approximately 25% each in the maintenance stage. We found significant associations between screening stage with physician characteristics. Asian American female physician increased the likelihood of being in the maintenance stage (CBE, OR = 10.1, 95% CI 2.837.1; mammogram, OR = 74.7, 95% CI 8.3674.6), compared to Asian American male physician with precontemplation/contemplation stage as our referent outcome. Conclusion Results from this study support the need to promote regular breast cancer screening among Cambodian American women. 2002 International Society for Preventive Oncology. Published by Elsevier Science Ltd. All rights reserved. PMID:12088201

  2. Usefulness of Immunohistochemistry for Microsatellite Instability Screening in Gastric Cancer

    PubMed Central

    Bae, Yoon Sung; Kim, Hoguen; Noh, Sung Hoon; Kim, Hyunki

    2015-01-01

    Background/Aims The usefulness of immunohistochemistry to screen for the microsatellite instability (MSI) phenotype in gastric cancer remains unclear. Moreover, the prognostic value of MSI phenotypes in gastric cancer has been debated. Methods The clinicopathologic parameters and survival outcomes of 203 MSI-high (MSI-H) and 261 microsatellite-stable (MSS) advanced gastric cancers (AGCs) were compared. Next, we compared the immunohistochemistry results for hMLH1 and hMSH2 with those of a polymerase chain reaction (PCR)-based method. Kaplan-Meier curves and a Cox proportional hazard regression model were used to conduct survival analyses. Results The MSI-H AGCs were correlated with older age (p<0.001), female gender (p=0.018), distal location (p<0.001), larger size (p=0.016), and intestinal type (p<0.001). Multivariate analysis revealed that the MSI-H phenotype was an independent favorable factor that was related to overall survival in patients with AGC (p<0.001). Compared with the PCR-based analysis, immunohistochemistry exhibited high sensitivity (91.1%) and specificity (98.5%) in the detection of MSI phenotypes. Conclusions MSI-H gastric cancers have distinct clinicopathologic features and better prognoses, which suggests the necessity of MSI analysis in gastric cancer. Immunohistochemistry can be a useful and reliable screening method in the assessment of MSI status in gastric cancer. PMID:26343070

  3. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening

    PubMed Central

    Ka‘opua, Lana Sue I.; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L.; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2015-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai‘i-based project on anal cancer screening tools. Krueger’s focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being “on the radar” of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through “real talk” (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai‘i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

  4. Addressing Risk and Reluctance at the Nexus of HIV and Anal Cancer Screening.

    PubMed

    Ka'opua, Lana Sue I; Cassel, Kevin; Shiramizu, Bruce; Stotzer, Rebecca L; Robles, Andrew; Kapua, Cathy; Orton, Malulani; Milne, Cris; Sesepasara, Maddalynn

    2016-01-01

    Anal cancer disproportionately burdens persons living with human immunodeficiency virus (PLHIV) regardless of natal sex, sexual orientation, gender expression, and ethnic identity. Culturally competent communications are recommended to address health disparities, with sociocultural relevance ensured through constituent dialogic processes. Results are presented from six provider focus groups conducted to inform the promotion/education component of a Hawai'i-based project on anal cancer screening tools. Krueger's focus group methodology guided discussion queries. Verbatim transcripts of digitally recorded discussions were analyzed using grounded theory and PEN-3 procedures. Adherence to an audit trail ensured analytic rigor. Grounded theory analysis detected the overall theme of risk and reluctance to anal cancer screening, characterized by anal cancer not being "on the radar" of PLHIV, conflicting attributions of the anus and anal sex, fear of sex-shaming/-blaming, and other interrelated conceptual categories. PEN-3 analysis revealed strategies for destigmatizing anal cancer, through "real talk" (proactive, candid, nonjudgmental discussion) nested in a framework of sexual health and overall well-being, with additional tailoring for relevance to Native Hawaiians/Pacific Islanders, transgender persons, and other marginalized groups. Application of strategies for health practice are specific to the Hawai'i context, yet may offer considerations for developing strengths-based, culturally relevant screening promotion/education with diverse PLHIV in other locales. PMID:26630979

  5. A novel multitarget stool DNA test for colorectal cancer screening.

    PubMed

    Malik, Pramod

    2016-03-01

    Review of: Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, Ahlquist DA, Berger BM. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med 2014;370(14):1287-97. This Practice Pearl reviews the results of a prospective, multicenter, cross-sectional clinical study that evaluated the performance of a new multitarget stool DNA (or mt-sDNA) screening test for colorectal cancer (CRC) and compared it with a fecal immunochemical test (FIT) in individuals at average risk for CRC. The potential impact of this test on the future of CRC screening is also discussed in a brief commentary. mt-sDNA testing is a noninvasive screening test designed to detect DNA biomarkers associated with colorectal neoplasia and occult hemoglobin in the stool. The sensitivity of mt-sDNA testing for detection of CRC was 92.3%, compared with 73.8% for FIT (p = 0.002). Sensitivity for detecting advanced precancerous lesions was 42.4% for mt-sDNA testing and 23.8% for FIT (p < 0.001). The specificities of mt-sDNA testing and FIT were 86.6% and 94.9%, respectively (p < 0.001). mt-sDNA testing thus may be a first-line screening option for asymptomatic individuals at average risk for CRC who do not want to have a colonoscopy. PMID:26753807

  6. Colorectal Cancer in Iran: Molecular Epidemiology and Screening Strategies

    PubMed Central

    Dolatkhah, Roya; Somi, Mohammad Hossein; Bonyadi, Mortaza Jabbarpour; Asvadi Kermani, Iraj; Farassati, Faris; Dastgiri, Saeed

    2015-01-01

    Purpose. The increasing incidence of colorectal cancer (CRC) in the past three decades in Iran has made it a major public health burden. This study aimed to report its epidemiologic features, molecular genetic aspects, survival, heredity, and screening pattern in Iran. Methods. A comprehensive literature review was conducted to identify the relevant published articles. We used medical subject headings, including colorectal cancer, molecular genetics, KRAS and BRAF mutations, screening, survival, epidemiologic study, and Iran. Results. Age standardized incidence rate of Iranian CRCs was 11.6 and 10.5 for men and women, respectively. Overall five-year survival rate was 41%, and the proportion of CRC among the younger age group was higher than that of western countries. Depending on ethnicity, geographical region, dietary, and genetic predisposition, mutation genes were considerably diverse and distinct among CRCs across Iran. The high occurrence of CRC in records of relatives of CRC patients showed that family history of CRC was more common among young CRCs. Conclusion. Appropriate screening strategies for CRC which is amenable to early detection through screening, especially in relatives of CRCs, should be considered as the first step in CRC screening programs. PMID:25685149

  7. Cervical cancer screening coverage in a high-incidence region

    PubMed Central

    Navarro, Cibelli; da Fonseca, Allex Jardim; Sibajev, Alexander; Souza, Camila Iasmim de Andrade; Arajo, Daniela Souza; Teles, Daniele Aparecida de Freitas; de Carvalho, Stphanie Gomes Lins; Cavalcante, Kyldery Wendell Moura; Rabelo, Wendell Lima

    2015-01-01

    OBJECTIVE To analyze the coverage of a cervical cancer screening program in a city with a high incidence of the disease in addition to the factors associated with non-adherence to the current preventive program. METHODS A cross-sectional study based on household surveys was conducted. The sample was composed of women between 25 and 59 years of age of the city of Boa Vista, RR, Northern Brazil who were covered by the cervical cancer screening program. The cluster sampling method was used. The dependent variable was participation in a womens health program, defined as undergoing at least one Pap smear in the 36 months prior to the interview; the explanatory variables were extracted from individual data. A generalized linear model was used. RESULTS 603 women were analyzed, with an mean age of 38.2 years (SD = 10.2). Five hundred and seventeen women underwent the screening test, and the prevalence of adherence in the last three years was up to 85.7% (95%CI 82.5;88.5). A high per capita household income and recent medical consultation were associated with the lower rate of not being tested in multivariate analysis. Disease ignorance, causes, and prevention methods were correlated with chances of non-adherence to the screening system; 20.0% of the women were reported to have undergone opportunistic and non-routine screening. CONCLUSIONS The informed level of coverage is high, exceeding the level recommended for the control of cervical cancer. The preventive program appears to be opportunistic in nature, particularly for the most vulnerable women (with low income and little information on the disease). Studies on the diagnostic quality of cervicovaginal cytology and therapeutic schedules for positive cases are necessary for understanding the barriers to the control of cervical cancer. PMID:25741655

  8. Knowledge of Cervical Cancer Screening among Women across Different Socio-Economic Regions of China

    PubMed Central

    Di, Jiangli; Rutherford, Shannon; Wu, Jiuling; Song, Bo; Ma, Lan; Chen, Jingyi; Chu, Cordia

    2015-01-01

    Background and Objective China has a high burden of cervical cancer (CC) and wide disparities in CC burden exist among different socio-economic regions. In order to reduce these disparities, China’s government launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Understanding the factors associated with underutilization of CC screening among target populations is important to improve the screening participation rate, and a high participation rate is key to achieving the goals of a screening program. However, data on the knowledge of CC among target populations in program areas is lacking in China. This study will investigate the knowledge of CC prevention and control among women in specific project counties to develop a better understanding of factors that might influence CC screening participation in order to improve the implementation of the NCCSPRA. Materials and Methods A cross-sectional survey was conducted and face-to-face interview questionnaires were completed by 308 women who received CC screening services in 6 project counties of NCCSPRA across different socio-economic regions of China. ANOVA and Chi-square tests were used to compare the knowledge rates and scores across the different subgroups. Logistic regression was conducted to examine factors associated with knowledge level. Results The overall CC knowledge rate of the target population was only 19.5%. Regional socio-economic level, advice from doctors, age, and educational status were strong predictors of knowledge level of CC screening. Significantly lower knowledge rates and scores were identified in older women (55–64 years old), less educated women (with primary school or illiterate), women in less developed regions and women who did not receive any advice about screening results from doctors. Conclusion The knowledge of CC screening among women in the project counties of NCCSPRA was found to be very poor. Given the importance of knowledge in encouraging women to participate in screening is key to reducing CC burden in rural women in China, it is urgent that a targeted health promotion intervention is developed and implemented in project counties, especially targeting older women, women with less education and women in less developed regions, and focus on improving their CC knowledge and encouraging them to communicate with health care providers. The health promotion intervention targeting health care providers is also important to improve their knowledge of CC and provide best advice to women. PMID:26657110

  9. variantGPS: SNP500Cancer Project

    Cancer.gov

    The SNP500Cancer is part of the Cancer Genome Anatomy Project and is specifically designed to generate resources for the identification and characterization of genetic variation in genes important in cancer. CGAP is dedicated to the development of technology, including both assays and utilization of technical platforms.

  10. Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study.

    PubMed

    Crawford, Joanne; Ahmad, Farah; Beaton, Dorcas; Bierman, Arlene S

    2016-03-01

    South Asian (SA) immigrants settled in the United Kingdom (UK) and North America [United States (US) and Canada] have low screening rates for breast, cervical and colorectal cancers. Incidence rates of these cancers increase among SA immigrants after migration, becoming similar to rates in non-Asian native populations. However, there are disparities in cancer screening, with low cancer screening uptake in this population. We conducted a scoping study using Arksey & O'Malley's framework to examine cancer screening literature on SA immigrants residing in the UK, US and Canada. Eight electronic databases, key journals and reference lists were searched for English language studies and reports. Of 1465 identified references, 70 studies from 1994 to November 2014 were included: 63% on breast or cervical cancer screening or both; 10% examined colorectal cancer screening only; 16% explored health promotion/service provision; 8% studied breast, cervical and colorectal cancer screening; and 3% examined breast and colorectal cancer screening. A thematic analysis uncovered four dominant themes: (i) beliefs and attitudes towards cancer and screening included centrality of family, holistic healthcare, fatalism, screening as unnecessary and emotion-laden perceptions; (ii) lack of knowledge of cancer and screening related to not having heard about cancer and its causes, or lack of awareness of screening, its rationale and/or how to access services; (iii) barriers to access including individual and structural barriers; and (iv) gender differences in screening uptake and their associated factors. Findings offer insights that can be used to develop culturally sensitive interventions to minimise barriers and increase cancer screening uptake in these communities, while recognising the diversity within the SA culture. Further research is required to address the gap in colorectal cancer screening literature to more fully understand SA immigrants' perspectives, as well as research to better understand gender-specific factors that influence screening uptake. PMID:25721339

  11. Screening for Breast Cancer: Current Attitudes and Practice

    PubMed Central

    Noulty, Elizabeth J.

    1989-01-01

    In a survey of selected Ontario physicians, 21% reported following the suggestion of the Canadian Task Force on the Periodic Health Examination that all women 50 to 59 years of age have annual mammographic and physical examination of the breast. Concern about screening continues to centre on the issue of effectiveness and cost-effectiveness of mammography. In comparison to previous studies, fewer physicians report concern about radiation risk. The only characteristic distinguishing between physicians who report regularly screening for breast cancer and those who do not is their agreement with the Task Force suggestion. PMID:21249022

  12. Psychosocial Predictors of Adherence to Risk-appropriate Cervical Cancer Screening Guidelines: a cross sectional study of women in Ohio Appalachia participating in the Community Awareness Resources and Education (CARE) project

    PubMed Central

    Paskett, Electra D.; McLaughlin, John M.; Reiter, Paul L.; Lehman, Amy M.; Rhoda, Dale A.; Katz, Mira L.; Hade, Erinn M.; Post, Douglas M.; Ruffin, Mack T.

    2009-01-01

    Objective We describe factors, in the context of the Social Determinants of Health model, associated with receiving Pap smears within risk-appropriate guidelines (i.e., guidelines that specify screening intervals based upon a womans individual risk of developing cervical cancer). Methods Completed in June 2006, we conducted a cross-sectional survey of women from 14 health clinics in Ohio Appalachia pertaining to psychosocial, demographic, biological, and health-related factors. A logistic regression model was constructed to predict whether or not a woman was within risk-appropriate cervical cancer screening guidelines. Results Of 562 women with a date of last Pap smear, 380 (68%) were within risk-appropriate guidelines. Logistic regression showed that, compared to women with low-level SES, women with middle- and high-level SES had 3.39 [1.85, 6.21] and 3.86 [2.03, 7.34] times the odds, respectively, of being within risk-appropriate guidelines. Odds of being within guidelines increased 1.09 [1.04, 1.15] fold for each decrease of one major life event. Additionally, women that were financially better off or financially worse off than their parents at the same age had lower odds (0.41 [0.23, 0.73] and 0.49 [0.24, 0.98], respectively) of being within guidelines than women who reported their finances were the same as their parents. Results also showed an interaction between marital status and age at first intercourse (p=0.001). Conclusion The results suggest an impact of psychosocial factors on Pap smear testing behaviors, and illustrate the need to examine risk-appropriate interventions to improve screening. PMID:19744509

  13. Cervical cancer screening: A never-ending developing program.

    PubMed

    Comparetto, Ciro; Borruto, Franco

    2015-07-16

    With the term "oncological screening", we define the overall performances made to detect early onset of tumors. These tests are conducted on a population that does not have any signs or symptoms related to a neoplasm. The whole population above a certain age, only one sex, only subjects with a high risk of developing cancer due to genetic, professional, discretionary reasons may be involved. Screening campaigns should be associated, when risk factors that can be avoided are known, with campaigns for the prevention of cancer by means of suitable behavior. The goal of cancer screening cannot however be limited to the diagnosis of a greater number of neoplasms. Screening will be useful only if it leads to a reduction in overall mortality or at least in mortality related to the tumor. Screening should then allow the diagnosis of the disease at a stage when there is a possibility of healing, possibility that is instead difficult when the disease is diagnosed at the appearance of signs or symptoms. This is the reason why not all campaigns of cancer screening have the same effectiveness. In Italy, every year there are about 150000 deaths due to cancer. Some of these tumors can be cured with a very high percentage of success if diagnosed in time. Cervical cancer can be diagnosed with non-invasive tests. The screening test used all over the world is Papanicolaou (Pap) test. This test may be carried out over the entire healthy population potentially exposed to the risk of contracting cancer. Public health has begun the screening campaigns in the hope of saving many of the approximately 270000 new cases of cancer reported each year. Screening is done following protocols that guarantee quality at the national level: these protocols are subject to change over time to reflect new realities or to correct any errors in the system. A simplified sketch of a possible route of cancer screening is as follows: (1) after selecting the target population, for example all women between 25 and 64 years (in the case of monitoring of cervical cancer), an invitation letter with the date and time of the appointment, planned according to the acceptance capacity of the hospital, is sent to all individuals; (2) an examination, which depending on the individual and the type of cancer to be monitored, for example, can be a Pap smear, is performed and the patient can go home; (3) once available the results of examinations, if negative, they shall be communicated to the person concerned that will be notified by mail and will be recalled for a second test at a few years of distance, in the case of non-negativity, instead, the patient is contacted by telephone and informed of the need to carry out further examinations: it is said that the patient is in the "phase two" of the screening pathway; (4) in phase two, reached by only a small portion of the interested parties (usually less than 3%-5%), more in-depth tests are carried out, which, depending on the individual and the type of cancer, can be: cytological and colposcopic examinations, the removal of a fragment of tissue (biopsy) and subsequent histological examination, additional tests such as ultrasound, radiography, or others such as computerized tomography, magnetic resonance imaging, positron emission tomography, etc., in case of negativity, the concerned person will be called for new control tests at a a few years of distance, in case of non-negativity, it will be proposed instead an oncologic therapeutic plan and/or surgery to treat the diagnosed tumor; and (5) once the treatment plan is completed, the individual enters the follow-up protocol, which is monitored over time to see if the tumor has been completely removed or if instead it is still developing. Cervical cancer is undoubtedly the most successful example of a cancer screening campaign. Paradoxically, its effectiveness is one of the strongest reasons to criticize the usefulness of vaccination against human papillomavirus (HPV) in countries where the screening service with Pap test is organized in an efficient manner. Cervi

  14. Cervical cancer screening: A never-ending developing program

    PubMed Central

    Comparetto, Ciro; Borruto, Franco

    2015-01-01

    With the term oncological screening, we define the overall performances made to detect early onset of tumors. These tests are conducted on a population that does not have any signs or symptoms related to a neoplasm. The whole population above a certain age, only one sex, only subjects with a high risk of developing cancer due to genetic, professional, discretionary reasons may be involved. Screening campaigns should be associated, when risk factors that can be avoided are known, with campaigns for the prevention of cancer by means of suitable behavior. The goal of cancer screening cannot however be limited to the diagnosis of a greater number of neoplasms. Screening will be useful only if it leads to a reduction in overall mortality or at least in mortality related to the tumor. Screening should then allow the diagnosis of the disease at a stage when there is a possibility of healing, possibility that is instead difficult when the disease is diagnosed at the appearance of signs or symptoms. This is the reason why not all campaigns of cancer screening have the same effectiveness. In Italy, every year there are about 150000 deaths due to cancer. Some of these tumors can be cured with a very high percentage of success if diagnosed in time. Cervical cancer can be diagnosed with non-invasive tests. The screening test used all over the world is Papanicolaou (Pap) test. This test may be carried out over the entire healthy population potentially exposed to the risk of contracting cancer. Public health has begun the screening campaigns in the hope of saving many of the approximately 270000 new cases of cancer reported each year. Screening is done following protocols that guarantee quality at the national level: these protocols are subject to change over time to reflect new realities or to correct any errors in the system. A simplified sketch of a possible route of cancer screening is as follows: (1) after selecting the target population, for example all women between 25 and 64 years (in the case of monitoring of cervical cancer), an invitation letter with the date and time of the appointment, planned according to the acceptance capacity of the hospital, is sent to all individuals; (2) an examination, which depending on the individual and the type of cancer to be monitored, for example, can be a Pap smear, is performed and the patient can go home; (3) once available the results of examinations, if negative, they shall be communicated to the person concerned that will be notified by mail and will be recalled for a second test at a few years of distance, in the case of non-negativity, instead, the patient is contacted by telephone and informed of the need to carry out further examinations: it is said that the patient is in the phase two of the screening pathway; (4) in phase two, reached by only a small portion of the interested parties (usually less than 3%-5%), more in-depth tests are carried out, which, depending on the individual and the type of cancer, can be: cytological and colposcopic examinations, the removal of a fragment of tissue (biopsy) and subsequent histological examination, additional tests such as ultrasound, radiography, or others such as computerized tomography, magnetic resonance imaging, positron emission tomography, etc., in case of negativity, the concerned person will be called for new control tests at a a few years of distance, in case of non-negativity, it will be proposed instead an oncologic therapeutic plan and/or surgery to treat the diagnosed tumor; and (5) once the treatment plan is completed, the individual enters the follow-up protocol, which is monitored over time to see if the tumor has been completely removed or if instead it is still developing. Cervical cancer is undoubtedly the most successful example of a cancer screening campaign. Paradoxically, its effectiveness is one of the strongest reasons to criticize the usefulness of vaccination against human papillomavirus (HPV) in countries where the screening service with Pap test is organized in an efficient manne

  15. Mapping International Cancer Activities Global Cancer Project Map Launch

    Cancer.gov

    CGHs Dr. Sudha Sivaram, Dr. Makeda Williams, and Ms. Kalina Duncan have partnered with Drs. Ami Bhatt and Franklin Huang at Global Oncology, Inc. (GO) to develop a web-based tool designed to facilitate cancer research and control activity planning. This tool, the Global Cancer Project Map (GCPM), is a database that allows users locate and learn more about international cancer projects and research programs through the use of an interactive world map.

  16. Gastric Cancer: Descriptive Epidemiology, Risk Factors, Screening, and Prevention

    PubMed Central

    Karimi, Parisa; Islami, Farhad; Anandasabapathy, Sharmila; Freedman, Neal D.; Kamangar, Farin

    2014-01-01

    Less than a century ago, gastric cancer (GC) was the most common cancer in the United States and perhaps throughout the world. Despite its worldwide decline in incidence over the past century, GC remains a major killer across the globe. This article reviews the epidemiology, screening, and prevention of gastric cancer. We first discuss the descriptive epidemiology of GC, including its incidence, survival, and mortality, including trends over time. Next, we characterize the risk factors for gastric cancer, both environmental and genetic. Serological markers and histological precursor lesions of GC and early detection of GC of using these markers is reviewed. Finally, we discuss prevention strategies and provide suggestions for further research. PMID:24618998

  17. Towards personalized screening: Cumulative risk of breast cancer screening outcomes in women with and without a first-degree relative with a history of breast cancer.

    PubMed

    Ripping, Theodora Maria; Hubbard, Rebecca A; Otten, Johannes D M; den Heeten, Gerard J; Verbeek, André L M; Broeders, Mireille J M

    2016-04-01

    Several reviews have estimated the balance of benefits and harms of mammographic screening in the general population. The balance may, however, differ between individuals with and without family history. Therefore, our aim is to assess the cumulative risk of screening outcomes; screen-detected breast cancer, interval cancer, and false-positive results, in women screenees aged 50-75 and 40-75, with and without a first-degree relative with a history of breast cancer at the start of screening. Data on screening attendance, recall and breast cancer detection were collected for each woman living in Nijmegen (The Netherlands) since 1975. We used a discrete time survival model to calculate the cumulative probability of each major screening outcome over 19 screening rounds. Women with a family history of breast cancer had a higher risk of all screening outcomes. For women screened from age 50-75, the cumulative risk of screen-detected breast cancer, interval cancer and false-positive results were 9.0, 4.4 and 11.1% for women with a family history and 6.3, 2.7 and 7.3% for women without a family history, respectively. The results for women 40-75 followed the same pattern for women screened 50-75 for cancer outcomes, but were almost doubled for false-positive results. To conclude, women with a first-degree relative with a history of breast cancer are more likely to experience benefits and harms of screening than women without a family history. To complete the balance and provide risk-based screening recommendations, the breast cancer mortality reduction and overdiagnosis should be estimated for family history subgroups. PMID:26537645

  18. The Influence of Time Perspective on Cervical Cancer Screening among Latinas in the United States

    PubMed Central

    Roncancio, Angelica M.; Ward, Kristy K.; Fernandez, Maria E.

    2014-01-01

    To develop effective interventions to increase cervical cancer screening among Latinas, we should understand the role of cultural factors, such as time perspective, in the decision to be screened. We examined the relation between present time orientation, future time orientation and self-reported cervical cancer screening among Latinas. A group of 206 Latinas completed a survey measuring factors associated with screening. Logistic regression analyses revealed that future time orientation was significantly associated with self-reported screening. Understanding the influence of time orientation on cervical cancer screening will assist us in developing interventions that effectively target time perspective and screening. PMID:23928988

  19. Impact of Changes to Breast Cancer Screening Guidelines on Healthcare Providers and Patients.

    PubMed

    Hartnett, Erin

    2016-04-01

    In October 2015, the American Cancer Society (ACS) updated its evidence-based breast cancer screening guidelines for women at average risk for breast cancer. These guidelines introduced significant changes to the age to begin breast cancer screening, as well as the frequency between screenings and duration of screening. Not long afterward, in January 2016, the U.S. Preventive Services Task Force released its updated breast cancer screening guidelines, which differ from those of the ACS. The varying guidelines present challenges for healthcare providers and patients, particularly women aged 40-49 years. PMID:26991715

  20. Strategies for expanding colorectal cancer screening at community health centers.

    PubMed

    Sarfaty, Mona; Doroshenk, Mary; Hotz, James; Brooks, Durado; Hayashi, Seiji; Davis, Terry C; Joseph, Djenaba; Stevens, David; Weaver, Donald L; Potter, Michael B; Wender, Richard

    2013-01-01

    Community health centers are uniquely positioned to address disparities in colorectal cancer (CRC) screening as they have addressed other disparities. In 2012, the federal Health Resources and Services Administration, which is the funding agency for the health center program, added a requirement that health centers report CRC screening rates as a standard performance measure. These annually reported, publically available data are a major strategic opportunity to improve screening rates for CRC. The Patient Protection and Affordable Care Act enacted provisions to expand the capacity of the federal health center program. The recent report of the Institute of Medicine on integrating public health and primary care included an entire section devoted to CRC screening as a target for joint work. These developments make this the ideal time to integrate lifesaving CRC screening into the preventive care already offered by health centers. This article offers 5 strategies that address the challenges health centers face in increasing CRC screening rates. The first 2 strategies focus on improving the processes of primary care. The third emphasizes working productively with other medical providers and institutions. The fourth strategy is about aligning leadership. The final strategy is focused on using tools that have been derived from models that work. PMID:23818334

  1. Screening for Chemical Contributions to Breast Cancer Risk: A Case Study for Chemical Safety Evaluation

    PubMed Central

    Ackerman, Janet M.; Dairkee, Shanaz H.; Fenton, Suzanne E.; Johnson, Dale; Navarro, Kathleen M.; Osborne, Gwendolyn; Rudel, Ruthann A.; Solomon, Gina M.; Zeise, Lauren; Janssen, Sarah

    2015-01-01

    Background Current approaches to chemical screening, prioritization, and assessment are being reenvisioned, driven by innovations in chemical safety testing, new chemical regulations, and demand for information on human and environmental impacts of chemicals. To conceptualize these changes through the lens of a prevalent disease, the Breast Cancer and Chemicals Policy project convened an interdisciplinary expert panel to investigate methods for identifying chemicals that may increase breast cancer risk. Methods Based on a review of current evidence, the panel identified key biological processes whose perturbation may alter breast cancer risk. We identified corresponding assays to develop the Hazard Identification Approach for Breast Carcinogens (HIA-BC), a method for detecting chemicals that may raise breast cancer risk. Finally, we conducted a literature-based pilot test of the HIA-BC. Results The HIA-BC identifies assays capable of detecting alterations to biological processes relevant to breast cancer, including cellular and molecular events, tissue changes, and factors that alter susceptibility. In the pilot test of the HIA-BC, chemicals associated with breast cancer all demonstrated genotoxic or endocrine activity, but not necessarily both. Significant data gaps persist. Conclusions This approach could inform the development of toxicity testing that targets mechanisms relevant to breast cancer, providing a basis for identifying safer chemicals. The study identified important end points not currently evaluated by federal testing programs, including altered mammary gland development, Her2 activation, progesterone receptor activity, prolactin effects, and aspects of estrogen receptor β activity. This approach could be extended to identify the biological processes and screening methods relevant for other common diseases. Citation Schwarzman MR, Ackerman JM, Dairkee SH, Fenton SE, Johnson D, Navarro KM, Osborne G, Rudel RA, Solomon GM, Zeise L, Janssen S. 2015. Screening for chemical contributions to breast cancer risk: a case study for chemical safety evaluation. Environ Health Perspect 123:1255–1264; http://dx.doi.org/10.1289/ehp.1408337 PMID:26032647

  2. Screening for Vitamin D Insufficiency in Pediatric Cancer Survivors

    PubMed Central

    Esbenshade, Adam J.; Sopfe, Jenna; Zhao, Zhiguo; Li, Zeda; Campbell, Kristin; Simmons, Jill H.; Friedman, Debra L.

    2013-01-01

    Background Corticosteroids increase risk for decreased bone mineral density, which can be worsened by vitamin D insufficiency (VDI) or deficiency (VDD). Procedure In the Vanderbilt cancer survivorship clinic, we obtained screening total 25-hydroxy vitamin D levels (VDL) in 171 cancer survivors <23 years old who were treated with prolonged corticosteroids for their cancer, and compared this group to a control group of 97 healthy pediatric patients. Results VDD was diagnosed in 15.8% and VDI in 34.5% of cancer survivors and VDD/VDI combined was associated with body mass index (BMI) >85th percentile (Odds ratio (OR) = 5.4; p<0.001), older age (OR = 2.2; p=0.012), non-Caucasian or Hispanic race (OR = 4.5 p = 0.008) and summer versus winter season (OR= 0.12, p<0.001). In multivariable analysis, VDI/VDD prevalence did not differ from the control group (VDI/VDD (43.3%). In the combined survivor/control group multivariable analysis, cancer diagnosis did not increase VDI/VDD risk, but significant associations persisted with elevated BMI (p <0.001), age (p=0.004), non-Caucasian or Hispanic race (p<0.001), and seasonality (p<0.001). Conclusion VDD/VDI is equally common in pediatric cancer survivors treated with corticosteroids and healthy children. The impact of VDD/VDI in cancer survivors may be greater due to risk for impaired bone health superimposed on that conferred from corticosteroid exposure. Thus, screening VDLs should be obtained in pediatric cancer survivors treated with corticosteroids, particularly in those with elevated BMI, older age, or non-Caucasian race. Prospective studies evaluating the impact of interventions to minimize VDD/VDI on long-term bone health in survivors are required. PMID:24194420

  3. SGO White Paper on ovarian cancer: etiology, screening and surveillance.

    PubMed

    Schorge, John O; Modesitt, Susan C; Coleman, Robert L; Cohn, David E; Kauff, Noah D; Duska, Linda R; Herzog, Thomas J

    2010-10-01

    Ovarian cancer is a heterogeneous, rapidly progressive, highly lethal disease of low prevalence. The etiology remains poorly understood. Numerous risk factors have been identified, the most prominent involving an inherited predisposition in 10% of cases. Women with germline mutations associated with Hereditary Breast/Ovarian Cancer and Lynch syndromes have dramatically elevated risks (up to 46% and 12%, respectively). Risk-reducing salpingo-oophorectomy is the best method to prevent ovarian cancer in these high-risk women. Significant risk reduction is also seen in the general population who use oral contraceptives. Since up to 89% patients with early-stage disease have symptoms prior to diagnosis, increased awareness of the medical community may facilitate further workup in patients who otherwise would have had a delay. Despite enormous effort, there is no proof that routine screening for ovarian cancer in either the high-risk or general populations with serum markers, sonograms, or pelvic examinations decreases mortality. Further evaluation is needed to determine whether any novel biomarkers, or panels of markers, have clinical utility in early detection. Prospective clinical trials have to be designed and completed prior to offering of any of these new diagnostic tests. CA125 is currently the only biomarker recommended for monitoring of therapy as well as detection of recurrence. This commentary provides an overview on the background, screening and surveillance of ovarian cancer. PMID:20692025

  4. Screening for Ovarian Cancer: U.S. Preventive Services Task Force Reaffirmation Recommendation

    MedlinePLUS

    ... cancer marker called cancer antigen–125 or transvaginal ultrasonography (examination of the ovaries done with an ultrasound ... find? Studies show that annual screening with transvaginal ultrasonography or cancer antigen– 125 measurement does not reduce ...

  5. African American Men and Prostate Cancer: Be Your Own Advocate and Understand Screening

    MedlinePLUS

    AFRICAN AMERICAN MEN AND PROSTATE CANCER: BE YOUR OWN ADVOCATE AND UNDERSTAND SCREENING By the National Cancer Institute September is National ... most commonly diagnosed type of cancer among American men. For reasons that are still unknown, African American ...

  6. Unifying screening processes within the PROSPR consortium: a conceptual model for breast, cervical, and colorectal cancer screening.

    PubMed

    Beaber, Elisabeth F; Kim, Jane J; Schapira, Marilyn M; Tosteson, Anna N A; Zauber, Ann G; Geiger, Ann M; Kamineni, Aruna; Weaver, Donald L; Tiro, Jasmin A

    2015-06-01

    General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute-funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast, cervical, and colorectal cancer and includes seven research centers and a statistical coordinating center. Given current health care reform initiatives in the United States, this conceptual model can facilitate the development of comprehensive quality metrics for cancer screening and promote trans-organ comparative cancer screening research. PROSPR findings will support the design of interventions that improve screening outcomes across multiple cancer sites. PMID:25957378

  7. Cancer Screening on the Hopi Reservation: A Model for Success in a Native American Community

    PubMed Central

    Joshweseoma, Lori; Saboda, Kathylynn; Sanderson, Priscilla; Ami, Delores; Harris, Robin

    2015-01-01

    American Indian women have lower cancer survival rates compared to non-Hispanic White women. Increased cancer screening fostered by culturally sensitive education and community programs may help decrease this disparity. This study assesses the effectiveness of Hopi Cancer Support Services (HCSS) in maintaining high rates of breast and cervical cancer screening among Hopi women and evaluates the impact of participation in HCSS programs on colorectal cancer (CRC) screening. A population-based survey was conducted on the Hopi reservation in 2012 (n = 252 women). Frequency of breast, cervical, and colorectal cancer screenings, participation in HCSS programs and barriers to screening were evaluated. Unconditional multiple logistic regression estimated the independent effect of the HCSS program on CRC screening. Approximately 88 % of Hopi women 40+ reported ever having had a mammogram; 71 % did so within the past 2 years. Approximately 66 % of women 50+ were ever screened for colorectal cancer (FOBT and/or colonoscopy). Women who had their last mammogram through HCSS were 2.81 (95 % CI 1.12, 7.07) times more likely to have been screened for CRC. Breast and cervical cancer screening continues at a high rate among Hopi women and is substantially greater than that reported prior to the inception of HCSS. Furthermore, participation in programs offered by HCSS is strongly associated with increased colorectal cancer screening. This tribal health program (HCSS) has strongly influenced cancer screening among Hopi women and is a model of a tribally run cancer prevention program. PMID:26091896

  8. Cancer Screening on the Hopi Reservation: A Model for Success in a Native American Community.

    PubMed

    Brown, Sylvia R; Joshweseoma, Lori; Saboda, Kathylynn; Sanderson, Priscilla; Ami, Delores; Harris, Robin

    2015-12-01

    American Indian women have lower cancer survival rates compared to non-Hispanic White women. Increased cancer screening fostered by culturally sensitive education and community programs may help decrease this disparity. This study assesses the effectiveness of Hopi Cancer Support Services (HCSS) in maintaining high rates of breast and cervical cancer screening among Hopi women and evaluates the impact of participation in HCSS programs on colorectal cancer (CRC) screening. A population-based survey was conducted on the Hopi reservation in 2012 (n = 252 women). Frequency of breast, cervical, and colorectal cancer screenings, participation in HCSS programs and barriers to screening were evaluated. Unconditional multiple logistic regression estimated the independent effect of the HCSS program on CRC screening. Approximately 88 % of Hopi women 40+ reported ever having had a mammogram; 71 % did so within the past 2 years. Approximately 66 % of women 50+ were ever screened for colorectal cancer (FOBT and/or colonoscopy). Women who had their last mammogram through HCSS were 2.81 (95 % CI 1.12, 7.07) times more likely to have been screened for CRC. Breast and cervical cancer screening continues at a high rate among Hopi women and is substantially greater than that reported prior to the inception of HCSS. Furthermore, participation in programs offered by HCSS is strongly associated with increased colorectal cancer screening. This tribal health program (HCSS) has strongly influenced cancer screening among Hopi women and is a model of a tribally run cancer prevention program. PMID:26091896

  9. Lung cancer screening guidelines. The nurse's role in patient education and advocacy.

    PubMed

    Lehto, Rebecca H

    2014-06-01

    Although the third leading cancer in incidence following breast and prostate, lung cancer is the principal cause of cancer death in the United States. The majority of lung cancer cases are detected at an advanced stage when surgical resection is no longer an option. Recent research has concluded that lung cancer screening with low-dose computed tomography for specific high-risk groups may reduce lung cancer mortality. Public awareness and the need for current information are growing regarding the state of the science relative to lung cancer screening for individuals at high risk for lung cancer. This article provides a historical perspective on the topic of lung cancer screening. The risks and benefits of screening are discussed, and current clinical practice guidelines are reviewed. Oncology nurses will need to be cognizant of the risks, benefits, and current guidelines related to lung cancer screening as they support patients and their families making informed decisions about personal health care. PMID:24867114

  10. CT screening for lung cancer: Is the evidence strong enough?

    PubMed

    Field, J K; Devaraj, A; Duffy, S W; Baldwin, D R

    2016-01-01

    The prevailing questions at this time in both the public mind and the clinical establishment is, do we have sufficient evidence to implement lung cancer Computed Tomography (CT) screening in Europe? If not, what is outstanding? This review addresses the twelve major areas, which are critical to any decision to implement CT screening and where we need to assess whether we have sufficient evidence to proceed to a recommendation for implementation in Europe. The readiness level of these twelve categories in 2015 have been with colour coded, where green indicates we have sufficient evidence, amber is borderline evidence and red requires further evidence. Recruitment from the 'Hard to Reach' community still remains at red, while mortality data, cost effectiveness and screening interval are all categorised as amber. The integration of smoking cessation into CT screening programmes is still considered to be category amber. The US Preventive Services Task Force have recommended that CT screening is implemented in the USA utilising the NLST criteria, apart from continuing screening to 80 years of age. The cost effectiveness of the NLST was calculated to be $81,000/QALY, however, its well recognised that the costs of medical care in the USA, is far higher than that of Europe. Medicare have agreed to cover the cost of screening but have stipulated a number of stringent requirements for inclusion. To date we do not have good CT screening mortality data available in Europe and eagerly await the publication of the NELSON trial data in 2016 and then the pooled UKLS and NELSON data thereafter. However in the meantime we should start planning for implementation in Europe, especially in the areas of the radiological service provision and accreditation, as well as identifying novel mechanisms to recruit from the hardest to reach communities. PMID:26711931

  11. Perspectives of colorectal cancer risk and screening among Dominicans and Puerto Ricans: stigma and misperceptions.

    PubMed

    Goldman, Roberta E; Diaz, Joseph A; Kim, Ivone

    2009-11-01

    Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were "bad food," digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening. PMID:19776255

  12. Perspectives of Colorectal Cancer Risk and Screening among Dominicans and Puerto Ricans: Stigma and Misperceptions

    PubMed Central

    Goldman, Roberta E.; Diaz, Joseph A.; Kim, Ivone

    2013-01-01

    Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were “bad food,” digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening. PMID:19776255

  13. Substantial Family History of Prostate Cancer in Black Men Recruited for Prostate Cancer Screening

    PubMed Central

    Mastalski, Kathleen; Coups, Elliot J.; Ruth, Karen; Raysor, Susan; Giri, Veda N.

    2008-01-01

    Background Black men are at increased risk for prostate cancer (PCA), particularly with a family history (FH) of the disease. Previous reports have raised concern for suboptimal screening of Black men with a FH of PCA. We report on the extent of FH of PCA from a prospective, longitudinal PCA screening program for high-risk men. Methods Black men ages 35-69 are eligible for PCA screening through the Prostate Cancer Risk Assessment Program (PRAP) regardless of FH. Rates of self-reported FH of PCA, breast, and colon cancer at baseline were compared with an age-matched sample of Black men from the 2005 National Health Interview Survey (NHIS) using standard statistical methods. Results As of January 2007, 332 Black men with pedigree information were enrolled in PRAP and FH of PCA was compared to 838 Black men from the 2005 NHIS. Black men in PRAP reported significantly more first-degree relatives with PCA compared to Black men in the 2005 NHIS (34.3%, 95% CI 29.2-39.7 vs. 5.7%, 95% CI 3.9-7.4). Black men in PRAP also had more FH of breast cancer compared to the 2005 NHIS (11.5%, 95% CI 8.2-15.4 vs 6.3%, 95% CI 4.6-8.0). Conclusions FH of PCA appears to be a motivating factor for Black men seeking PCA screening. Targeted recruitment and education among Black families should improve PCA screening rates. Efforts to recruit Black men without a FH of PCA are also needed. Condensed Abstract Black men seeking prostate cancer screening have a substantial burden of family history of prostate cancer. Targeted education and enhancing discussion in Black families should increase prostate cancer screening and adherence. PMID:18816608

  14. Understanding Cervical Cancer Prevention and Screening in Chuukese Women in Hawai‘i

    PubMed Central

    Kawamoto, Crissy T

    2010-01-01

    Background Cervical cancer is the primary cause of death due to cancer in women in Chuuk State, Federated States of Micronesia. The Chuukese population is the fastest growing segment of the Micronesian community in Hawai‘i. Little is known about the health beliefs or practices of this population in Hawai‘i. The purpose of this project was to describe the knowledge, attitudes, and beliefs of Chuukese women in Hawai‘i regarding cervical cancer prevention and screening. Methods Research assistants from the Chuukese community were recruited and trained as members of the research team. A culturally sensitive survey tool was developed and piloted by the research team and used to interview ten key informants from the Chuukese community in Honolulu, Hawai‘i. Results There is limited knowledge about cervical cancer, especially the association with human papillomavirus (HPV). This may be indicative of a lack of health information in general. Fear, privacy concerns, lack of awareness and cultural beliefs represent the main barriers mentioned when discussing cervical cancer. Education, done in a group setting with other women, is the most recommended method of informing this community and improving preventive and screening services for cervical cancer in these women. PMID:20539995

  15. Colorectal Cancer Screening Activities in ICSN Countries, June 2006

    Cancer.gov

    Following the successful pilot program that ran from 2002-2004, the Australian government has allocated funding to phase in a National Bowel Cancer Screening Program, using an immunochemical FOBT, followed by colonoscopy if indicated. The first phase of the program (2006-2008) will target people turning 55 or 65 years of age between 1 May 2006 and 30 June 2008 and those who participated in the Pilot Program.

  16. Familial nonmedullary thyroid cancer: screening, clinical, molecular and genetic findings.

    PubMed

    Navas-Carrillo, Diana; Ros, Antonio; Rodrguez, Jos Manuel; Parrilla, Pascual; Orenes-Piero, Esteban

    2014-12-01

    Thyroid cancer, the commonest of endocrine malignancies, continues increasing in incidence being the 5th more prevalent cancer among women in the United States in 2012. Familial thyroid cancer has become a well-recognized, unique, clinical entity in patients with thyroid cancer originating from follicular cells, that is, nonmedullary thyroid carcinoma. Hereditary nonmedullary thyroid cancer may occur as a minor component of familial cancer syndromes (familial adenomatous polyposis, Gardner's syndrome, Cowden's disease, Carney's complex type 1, Werner's syndrome, and papillary renal neoplasia) or as a primary feature (familial nonmedullary thyroid cancer [FNMTC]). Although there is some controversy, some epidemiologic and clinical kindred studies have shown that FNMTC is associated with more aggressive disease than sporadic cases, with higher rates of multicentric tumours, lymph node metastasis, extrathyroidal invasion, and shorter disease-free survival. This way, preventing screening will allow earlier detection, more timely intervention, and hopefully improved outcomes for patients and their families. On the other hand, in the last years, an important number of genetic studies on FNMTC have been published, trying to determine its genetic contribution. However, the genetic inheritance of FNMTC remains unclear; but it is believed to be autosomal dominant with incomplete penetrance and variable expressivity. This paper provides an extensive overview of FNMTC from several points of view. Firstly, the impact of early detection on prognosis, secondly, the management and follow-up of FNMTC patients, and finally, the role of susceptibility loci, microRNAs (miRNAs) and telomerases in recently identified isolated cases of FNMTC. PMID:25218916

  17. Upward Communication About Cancer ScreeningAdolescent Daughter to Mother

    PubMed Central

    MOSAVEL, MAGHBOEBA; PORTS, KATIE A.

    2015-01-01

    Substantial breast and cervical cancer disparities exist in the United States, particularly among African American women with low social economic status. There is considerable potential for discussions about cancer prevention between mothers and daughters. However, upward communication, from child to parent, remains a relatively novel research area, and it remains unclear how receptive mothers would be to messages from their daughter about cancer, a topic that may be considered culturally inappropriate for daughters to initiate. In this study, we simulated cancer message delivery to daughters and then conducted direct observation of daughters as they recalled and shared the message with their mother or female elder. We found that daughters were able to successfully recall and deliver a cancer appeal to their mother and mothers were generally receptive to this message. Not only did mothers listen to their daughters appeals, but also daughters knowledge of cancer was considerably improved by the opportunity to educate her female elder. Moreover, daughters nonverbal communication suggested a surprisingly relaxed demeanor. The potential of young people to impact the screening behavior of their female elders is very promising in terms of reducing cancer disparities. PMID:25848895

  18. [Knowledge co-production and local transfer to reduce inequalities of access to breast cancer screening].

    PubMed

    Viot, Marianne; Vaillant, Zo; Harel, Lucile; Rican, Stphane; Dauchez, Mlanie Boulland; Baron, Marie; Ndiaye, El Hadji Malik Lam; Delpech, Eva; Brchenade, Sylvie; El Ghozi, Laurent; Salem, Grard

    2015-01-01

    This paper describes a knowledge transfer experiment that has been conducted since September 2012 in Argenteuil (Val d'Oise, France). This experiment is part of an interventional research project called DeCL/C: "Knowledge translation on social and spatial inequalities: a tool to raise local awareness and mobilization to lessen cancer screening participation rate disparities': The project is carried out by health geographers from Paris Ouest University (UPO) and the National Association of Cities for Public Health (Elus, Sante Publique et Territoires, ESPT). It encompasses two main components: intervention designed to implement a knowledge co-production and transfer process among researchers, stakeholders and decision makers at various levels. This knowledge concerns social and spatial determinants of inequalities of access to breast cancer screening programmes in cities. The research is multidisciplinary (geography, sociology, political science, epistemology) and is designed to measure the impact of this knowledge co-production and transfer in terms of actions in the targeted cities (six cities in the Paris region) as well as the reduction of inequalities of access to breast cancer screening programmes. This article, based on knowledge transfer literature and an empirical experiment in Argenteuil, describes the ongoing knowledge transfer process. It also highlights Argenteuil stakeholders' and decision makers' interest in action and research. The analysis of the knowledge co-production, sharing and ownership process by local actors a e both "strategic" and "profound': PMID:26414133

  19. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial

    PubMed Central

    Jacobs, Ian J; Menon, Usha; Ryan, Andy; Gentry-Maharaj, Aleksandra; Burnell, Matthew; Kalsi, Jatinderpal K; Amso, Nazar N; Apostolidou, Sophia; Benjamin, Elizabeth; Cruickshank, Derek; Crump, Danielle N; Davies, Susan K; Dawnay, Anne; Dobbs, Stephen; Fletcher, Gwendolen; Ford, Jeremy; Godfrey, Keith; Gunu, Richard; Habib, Mariam; Hallett, Rachel; Herod, Jonathan; Jenkins, Howard; Karpinskyj, Chloe; Leeson, Simon; Lewis, Sara J; Liston, William R; Lopes, Alberto; Mould, Tim; Murdoch, John; Oram, David; Rabideau, Dustin J; Reynolds, Karina; Scott, Ian; Seif, Mourad W; Sharma, Aarti; Singh, Naveena; Taylor, Julie; Warburton, Fiona; Widschwendter, Martin; Williamson, Karin; Woolas, Robert; Fallowfield, Lesley; McGuire, Alistair J; Campbell, Stuart; Parmar, Mahesh; Skates, Steven J

    2016-01-01

    Summary Background Ovarian cancer has a poor prognosis, with just 40% of patients surviving 5 years. We designed this trial to establish the effect of early detection by screening on ovarian cancer mortality. Methods In this randomised controlled trial, we recruited postmenopausal women aged 50–74 years from 13 centres in National Health Service Trusts in England, Wales, and Northern Ireland. Exclusion criteria were previous bilateral oophorectomy or ovarian malignancy, increased risk of familial ovarian cancer, and active non-ovarian malignancy. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer-generated random numbers to annual multimodal screening (MMS) with serum CA125 interpreted with use of the risk of ovarian cancer algorithm, annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The primary outcome was death due to ovarian cancer by Dec 31, 2014, comparing MMS and USS separately with no screening, ascertained by an outcomes committee masked to randomisation group. All analyses were by modified intention to screen, excluding the small number of women we discovered after randomisation to have a bilateral oophorectomy, have ovarian cancer, or had exited the registry before recruitment. Investigators and participants were aware of screening type. This trial is registered with ClinicalTrials.gov, number NCT00058032. Findings Between June 1, 2001, and Oct 21, 2005, we randomly allocated 202 638 women: 50 640 (25·0%) to MMS, 50 639 (25·0%) to USS, and 101 359 (50·0%) to no screening. 202 546 (>99·9%) women were eligible for analysis: 50 624 (>99·9%) women in the MMS group, 50 623 (>99·9%) in the USS group, and 101 299 (>99·9%) in the no screening group. Screening ended on Dec 31, 2011, and included 345 570 MMS and 327 775 USS annual screening episodes. At a median follow-up of 11·1 years (IQR 10·0–12·0), we diagnosed ovarian cancer in 1282 (0·6%) women: 338 (0·7%) in the MMS group, 314 (0·6%) in the USS group, and 630 (0·6%) in the no screening group. Of these women, 148 (0·29%) women in the MMS group, 154 (0·30%) in the USS group, and 347 (0·34%) in the no screening group had died of ovarian cancer. The primary analysis using a Cox proportional hazards model gave a mortality reduction over years 0–14 of 15% (95% CI −3 to 30; p=0·10) with MMS and 11% (−7 to 27; p=0·21) with USS. The Royston-Parmar flexible parametric model showed that in the MMS group, this mortality effect was made up of 8% (−20 to 31) in years 0–7 and 23% (1–46) in years 7–14, and in the USS group, of 2% (−27 to 26) in years 0–7 and 21% (−2 to 42) in years 7–14. A prespecified analysis of death from ovarian cancer of MMS versus no screening with exclusion of prevalent cases showed significantly different death rates (p=0·021), with an overall average mortality reduction of 20% (−2 to 40) and a reduction of 8% (−27 to 43) in years 0–7 and 28% (−3 to 49) in years 7–14 in favour of MMS. Interpretation Although the mortality reduction was not significant in the primary analysis, we noted a significant mortality reduction with MMS when prevalent cases were excluded. We noted encouraging evidence of a mortality reduction in years 7–14, but further follow-up is needed before firm conclusions can be reached on the efficacy and cost-effectiveness of ovarian cancer screening. Funding Medical Research Council, Cancer Research UK, Department of Health, The Eve Appeal. PMID:26707054

  20. Problems in screening colorectal cancer in the elderly

    PubMed Central

    Mladen, Davidovic M.; Dragoslav, Milosevic P.; Sanja, Zdravkovic; Bozidar, Bojic; Snezana, Djurica

    2003-01-01

    AIM: To explore the problems in the screening of colorectal carcinoma in the elderly. METHODS: Three models of colorectal cancer prevention were examined: standard screening, active check-up of suspected cases and summons to have endoscopic check-up for previously diagnosed colorectal polyps. The study was performed among three groups of elderly individuals: Group 1 (167 cases), hospitalized asymptomatic individuals without symptoms in large intestines. Group 2 (612 cases): old individuals at home for the aged, out of which 32 showed symptoms of colon disorders; Group 3 (44 cases): elderly people with diagnosed polyps. As a result of 1788 rectosigmoidoscopies, we identified 61 individuals with polyps, out of which 44 patients were over 65 years old. However, only 9 of these 44 individuals agreed to have the endoscopy performed again. RESULTS: One cancer and 13 polyps were detected in Group 1, and two polyps in Group 2. However, it should be noted that only eleven individuals from Group 2 agreed to have the endoscopy. In Group 3, there were no relapses of the polyps among the nine individuals who came back for the endoscopy. CONCLUSION: Poor understanding of the screening procedures is one of the greatest problems in early detection of the cancer in the aged. Paradoxically, the cooperation is better with hospitalized patients, than with successfully old persons. PMID:14562405

  1. Lessons from state mandates of preventive cancer screenings.

    PubMed

    Xu, Wendy Yi; Dowd, Bryan; Abraham, Jean

    2016-03-01

    We use the 1997-2008 Medical Expenditure Panel Survey (MEPS) and variation in the timing of state mandates for coverage of colorectal, cervical, and prostate cancer screenings to investigate the behavioral and financial effects of mandates on privately insured adults. We find that state mandates did not result in increased rates of cancer screening. However, coverage of preventive care, whether mandated or not, moves the cost of care from the consumer's out-of-pocket expense to the premium, resulting in a cross-subsidy of users of the service by non-users. While some cross-subsidies are intentional, others may be unintentional. We find that users of cancer screening have higher levels of income and education, while non-users tend to be racial minorities, lack a usual source of care, and live in communities with fewer physicians per capita. These results suggest that coverage of preventive care may transfer resources from more advantaged individuals to less advantaged individuals. PMID:25773049

  2. Prostate cancer screening: what general practitioners and patients need to know.

    PubMed

    Boyden, A

    1996-09-01

    Much controversy surrounds the appropriateness of screening for prostate cancer. The individual benefit from screening is unproven. Screening may result in many men being unnecessarily treated for prostate cancer with the associated risks of developing treatment related side effects, including impotence and incontinence. Men requesting screening need to be informed of these issues before they decide whether to proceed. This article reviews the current position in relation to screening, critically appraising current thinking in order to clarify the issues. PMID:8854414

  3. Body mass index and colon cancer screening: The road ahead

    PubMed Central

    Tandon, Kanwarpreet; Imam, Mohamad; Ismail, Bahaa Eldeen Senousy; Castro, Fernando

    2015-01-01

    Screening for colorectal cancer (CRC) has been associated with a decreased incidence and mortality from CRC. However, patient adherence to screening is less than desirable and resources are limited even in developed countries. Better identification of individuals at a higher risk could result in improved screening efforts. Over the past few years, formulas have been developed to predict the likelihood of developing advanced colonic neoplasia in susceptible individuals but have yet to be utilized in mass screening practices. These models use a number of clinical factors that have been associated with colonic neoplasia including the body mass index (BMI). Advances in our understanding of the mechanisms by which obesity contributes to colonic neoplasia as well as clinical studies on this subject have proven the association between BMI and colonic neoplasia. However, there are still controversies on this subject as some studies have arrived at different conclusions on the influence of BMI by gender. Future studies should aim at resolving these discrepancies in order to improve the efficiency of screening strategies. PMID:25663756

  4. Predictive features of breast cancer on Mexican screening mammography patients

    NASA Astrophysics Data System (ADS)

    Rodriguez-Rojas, Juan; Garza-Montemayor, Margarita; Trevino-Alvarado, Victor; Tamez-Pena, Jos Gerardo

    2013-02-01

    Breast cancer is the most common type of cancer worldwide. In response, breast cancer screening programs are becoming common around the world and public programs now serve millions of women worldwide. These programs are expensive, requiring many specialized radiologists to examine all images. Nevertheless, there is a lack of trained radiologists in many countries as in Mexico, which is a barrier towards decreasing breast cancer mortality, pointing at the need of a triaging system that prioritizes high risk cases for prompt interpretation. Therefore we explored in an image database of Mexican patients whether high risk cases can be distinguished using image features. We collected a set of 200 digital screening mammography cases from a hospital in Mexico, and assigned low or high risk labels according to its BIRADS score. Breast tissue segmentation was performed using an automatic procedure. Image features were obtained considering only the segmented region on each view and comparing the bilateral di erences of the obtained features. Predictive combinations of features were chosen using a genetic algorithms based feature selection procedure. The best model found was able to classify low-risk and high-risk cases with an area under the ROC curve of 0.88 on a 150-fold cross-validation test. The features selected were associated to the differences of signal distribution and tissue shape on bilateral views. The model found can be used to automatically identify high risk cases and trigger the necessary measures to provide prompt treatment.

  5. Colonoscopic screening for colorectal cancer improves quality of life measures: a population-based screening study

    PubMed Central

    Taupin, Doug; Chambers, Sharon L; Corbett, Mike; Shadbolt, Bruce

    2006-01-01

    Background Screening asymptomatic individuals for neoplasia can have adverse consequences on quality of life. Colon cancer screening is widespread but the quality of life (QOL) consequences are unknown. This study determined the impact of screening colonoscopy on QOL measures in asymptomatic average-risk participants. Methods Asymptomatic male and female participants aged 5574 years were randomly selected from the Australian Electoral Roll or six primary care physicians' databases. Participants completed the Short-Form (SF-36) Quality of Life Assessment at baseline and at a mean of 39 days after colonoscopy. Outcome measures were (i) significant changes in raw scores in any of the eight SF-36 domains assessed following colonoscopic screening and (ii) improvements or declines in previously validated categories, representing clinically significant changes, within any of the eight SF-36 domains. Results Baseline QOL measures were similar to those of a matched general population sample. Role Limitations due to Emotions, Mental Health and Vitality raw scores significantly improved following colonoscopy (P < 0.05, 2-tailed t-test). Health ratings according to Category were similar (same clinical status) in the majority of participants. However, 30% participants recorded clinically significant improvement in the Mental Health and Vitality domains (P < 0.05, Wilcoxon Signed-Ranks test). This improvement was not offset by declines in other domains or in other participants. Improvement in QOL was not related to colonoscopy results. Conclusion Average-risk persons benefit significantly from colon cancer screening with colonoscopy, improving in Mental Health and Vitality domains of Quality of Life. This improvement is not offset by declines in other domains. PMID:17044941

  6. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    PubMed Central

    Das, Soumen; Chatterjee, Jyotirmoy

    2015-01-01

    Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cytosensors over a frequency range offers instantaneous and quantitative means to monitor cellular events and is an upcoming technique in real time to classify cells as normal and abnormal ones. This technology is exploited for label-free detection of diseases by identifying and measuring nonbiological parameters of the cell which may carry the disease signature.

  7. Implementing lung cancer screening in the real world: opportunity, challenges and solutions

    PubMed Central

    Optican, Robert J.

    2015-01-01

    The World Health Organization estimates that, in 2012, there were 1,589,925 deaths from lung cancer worldwide. Screening for lung cancer with low-dose computed tomography (LDCT) has the potential to significantly alter this statistic, by identifying lung cancers in earlier stages, enabling curative treatment. Challenges remain, however, in replicating the 20% mortality benefit demonstrated by the National Lung Screening Trial (NLST), in populations outside the confines of a research trial, not only in the US but around the world. We review the history of lung cancer screening, the current evidence for LDCT screening, and the key elements needed for a successful screening program. PMID:26380176

  8. Developing Screening Services for Colorectal Cancer on Android Smartphones

    PubMed Central

    Wu, Hui-Ching; Chang, Chiao-Jung; Lin, Chun-Che; Tsai, Ming-Chang; Chang, Che-Chia

    2014-01-01

    Abstract Introduction: Colorectal cancer (CRC) is an important health problem in Western countries and also in Asia. It is the third leading cause of cancer deaths in both men and women in Taiwan. According to the well-known adenoma-to-carcinoma sequence, the majority of CRC develops from colorectal adenomatous polyps. This concept provides the rationale for screening and prevention of CRC. Removal of colorectal adenoma could reduce the mortality and incidence of CRC. Mobile phones are now playing an ever more crucial role in people's daily lives. The latest generation of smartphones is increasingly viewed as hand-held computers rather than as phones, because of their powerful on-board computing capability, capacious memories, large screens, and open operating systems that encourage development of applications (apps). Subjects and Methods: If we can detect the potential CRC patients early and offer them appropriate treatments and services, this would not only promote the quality of life, but also reduce the possible serious complications and medical costs. In this study, an intelligent CRC screening app on Android (Google, Mountain View, CA) smartphones has been developed based on a data mining approach using decision tree algorithms. For comparison, the stepwise backward multivariate logistic regression model and the fecal occult blood test were also used. Results: Compared with the stepwise backward multivariate logistic regression model and the fecal occult blood test, the proposed app system not only provides an easy and efficient way to quickly detect high-risk groups of potential CRC patients, but also brings more information about CRC to customer-oriented services. Conclusions: We developed and implemented an app system on Android platforms for ubiquitous healthcare services for CRC screening. It can assist people in achieving early screening, diagnosis, and treatment purposes, prevent the occurrence of complications, and thus reach the goal of preventive medicine. PMID:24848873

  9. Understanding Barriers to Colorectal Cancer Screening in Kentucky

    PubMed Central

    Kanotra, Sarojini; Siameh, Seth; Jones, Jessica; Thompson, Becki; Thomas-Cox, Sue

    2015-01-01

    Introduction Colorectal cancer screening rates have increased significantly in Kentucky, from 35% in 1999 to 66% in 2012. A continued improvement in screening requires identification of existing barriers and implementation of interventions to address barriers. Methods The state of Kentucky added a question to the 2012 Kentucky Behavioral Risk Factor Surveillance System survey for respondents aged 50 years or older who answered no to ever having been screened for colorectal cancer by colonoscopy or sigmoidoscopy to assess the reasons why respondents had not been screened. Combined responses constituted 4 categories: attitudes and beliefs, health care provider and health care systems barriers, cost, and other. Prevalence estimates for barriers were calculated by using raking weights and were stratified by race/ethnicity, sex, education, income, and health insurance coverage. Logistic regression estimated odds ratios for barriers to screening. Results The most common barriers in all areas were related to attitudes and beliefs, followed by health care provider and systems, and cost. Non-Hispanic whites and respondents with more than a high school education were more likely to choose attitudes and beliefs as a barrier than were non-Hispanic blacks and those with less than a high school education. Respondents with low incomes and with no insurance were significantly more likely to select cost as a barrier. No significant associations were observed between demographic variables and the selection of a health care provider and a health care system. Conclusion Barriers related to education, race/ethnicity, income, and insurance coverage should be considered when designing interventions. Expansion of Medicaid and implementation of the Affordable Care Act in Kentucky could have an impact on reducing these barriers. PMID:26086608

  10. Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004-2013

    PubMed Central

    Suh, Mina; Choi, Kui Son; Park, Boyoung; Lee, Yoon Young; Jun, Jae Kwan; Lee, Duk-Hyoung; Kim, Yeol

    2016-01-01

    Purpose The Korean National Cancer Screening Survey (KNCSS), a nationwide cross-sectional survey, has been conducted annually since 2004. The current study was conducted to report on the trends in screening rates among Korean men and women, and to evaluate policies regarding cancer screening programs implemented to reduce the burden of cancer. Materials and Methods The current study used KNCSS data. The eligible study population included men aged 40-74 years and women aged 30-74 years with no cancer history. The lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated for five major cancers (i.e., stomach, liver, colorectal, breast, and cervix uteri). Results The screening rates with recommendation increased by 4.2% (95% confidence interval [CI], 3.7% to 4.8%) annually for stomach cancer, 1.2% (95% CI, 0.1% to 2.4%) for liver cancer, 3.0% (95% CI, 1.8% to 4.1%) for colorectal cancer, 3.7% (95% CI, 2.7% to 4.8%) for breast cancer, and 1.3% (95% CI, 0.8% to 1.8%) for cervical cancer. In 2013, the screening rates with recommendation for stomach, liver, colorectal, breast, and cervical cancers were 73.6%, 33.6%, 55.6%, 59.7%, and 67.0%, respectively. Conclusion Both the lifetime screening rates and screening rates with recommendation for the five above-mentioned cancers increased annually from 2004 to 2013. PMID:25943324

  11. Projection type transparent 3D display using active screen

    NASA Astrophysics Data System (ADS)

    Kamoshita, Hiroki; Yendo, Tomohiro

    2015-05-01

    Equipment to enjoy a 3D image, such as a movie theater, television and so on have been developed many. So 3D video are widely known as a familiar image of technology now. The display representing the 3D image are there such as eyewear, naked-eye, the HMD-type, etc. They has been used for different applications and location. But have not been widely studied for the transparent 3D display. If transparent large 3D display is realized, it is useful to display 3D image overlaid on real scene in some applications such as road sign, shop window, screen in the conference room etc. As a previous study, to produce a transparent 3D display by using a special transparent screen and number of projectors is proposed. However, for smooth motion parallax, many projectors are required. In this paper, we propose a display that has transparency and large display area by time multiplexing projection image in time-division from one or small number of projectors to active screen. The active screen is composed of a number of vertically-long small rotate mirrors. It is possible to realize the stereoscopic viewing by changing the image of the projector in synchronism with the scanning of the beam.3D vision can be realized by light is scanned. Also, the display has transparency, because it is possible to see through the display when the mirror becomes perpendicular to the viewer. We confirmed the validity of the proposed method by using simulation.

  12. The Association of Perceived Provider-Patient Communication and Relationship Quality with Colorectal Cancer Screening

    ERIC Educational Resources Information Center

    Underhill, Meghan L.; Kiviniemi, Marc T.

    2012-01-01

    Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening

  13. Annual Screening with Chest X-Ray Does Not Reduce Lung Cancer Deaths

    Cancer.gov

    Annual screening for lung cancer using a standard chest x-ray does not reduce the risk of dying from lung cancer when compared with no annual screening, according to findings from the NCI-led Prostate, Lung, Colorectal, and Ovarian (PLCO) screening trial.

  14. Using an Ocean of Data, Researchers Model Real-Life Benefits of Cancer Screening

    Cancer.gov

    Using the results of screening trials, the NCI Cancer Intervention and Surveillance Modeling Network is trying to estimate the true benefit of cancer screening in the general population and identify the optimal way to implement screening within the health care system.

  15. Self-Reported Willingness to Have Cancer Screening and the Effects of Sociodemographic Factors

    PubMed Central

    Kressin, Nancy R.; Manze, Meredith; Russell, Stefanie L.; Katz, Ralph V.; Claudio, Cristina; Lee Green, B.; Wang, Min Qi

    2010-01-01

    Background The relative effects of race/ethnicity and other sociodemographic factors, compared to those of attitudes and beliefs on willingness to have cancer screening, are not well understood. Methods We conducted telephone interviews with 1148 adults (31% African American, 27% Puerto Rican American, 43% white) from 3 cities in mainland United States and Puerto Rico. Respondents reported their sociodemographic characteristics, attitudes about barriers and facilitators of cancer screening, and willingness to have cancer screening under 4 scenarios: when done in the community vs ones doctors office, and whether or not one had symptoms. Results Racial/ethnic minority status, age, and lower income were frequently associated with increased willingness to have cancer screening, even after including attitudes and beliefs about screening. Having screening nearby was important for community screening, and anticipation of embarrassment from screening for when there were no cancer symptoms. Associations varied across 4 screening scenarios, with the fewest predictors for screening by ones doctor when there were symptoms. Conclusions Sociodemographic characteristics not only were related to willingness to have cancer screenings in almost all cases, but were generally much stronger factors than attitudinal barriers and facilitators. Cancer screening campaigns should affect attitudinal change where possible, but should also recognize that targeting screening to specific population groups may be necessary. PMID:20355351

  16. Factors related to health practices: cervical cancer screening among Filipino women.

    PubMed

    Ayres, Cynthia G; Atkins, Robert; Lee, Ji H

    2010-01-01

    This correlational study developed and tested theory to better understand health practices, including cervical cancer screening, among young Filipino women. It tested theoretical relationships postulated among (a) positive health practices, (b) cervical cancer screening, (c) social support, (d) acculturation, and (e) optimism. A convenience sample of 89 young Filipino women in an urban setting was obtained. Participants completed a demographic sheet and five instruments. Significant positive correlations were found between PHP and social support (r = .169, p <.05) and previous cervical cancer screening behavior (r = .285, p <.01) and cervical cancer screening frequency (r = .33, p <.01). Social support was not significantly related to cervical cancer screening. Previous cervical cancer screening behavior was significantly related to optimism (r = .285, p <.01) and screening frequency (r = .924, p <.01). Optimism was significantly related to positive health practices (r = .209, p <.05) and cervical cancer screening knowledge (r = .224, p <.05) but not significantly related to previous cervical cancer screening behavior or screening frequency. Findings contribute to a more comprehensive knowledge base regarding positive health practices, including cervical cancer screenings, among young Filipino women. PMID:20949836

  17. Breast and cervical cancer screening in Great Britain: Dynamic interrelated processes.

    PubMed

    Labeit, Alexander; Peinemann, Frank

    2015-12-01

    No previous analysis has investigated the determinants of screening uptake for breast and cervical cancer screening for possible spillover effects from one type of screening examination to the other type of screening examination with a dynamic bivariate panel probit model. For our analysis, we used a dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) and dependent variables were the participation of breast and cervical cancer screening in the recent year. The balanced panel sample consisted of 844 women from the British Household Panel Survey (BHPS) from the time period 1992 to 2008. Our analysis showed the high relevance of past screening behaviour and the importance of state dependency for the same and the other type of cancer screening examinations even after controlling for covariates and unobserved heterogeneity. The uptake for breast and cervical cancer screening was higher when the same screening examination was done one or three years earlier. This result is in accordance with the medical screening programmes in Great Britain. With regard to breast and cervical cancer screening positive spillover effects existed between screening examinations in the third order lags. Women with a previous visit to a general practitioner and individuals in the recommended age groups had a higher uptake for breast and cervical cancer screening. Other socioeconomic and health related variables had non-uniform results in both screening examinations. Promoting the uptake of one female prevention activity could also enhance the uptake of the other prevention activity. PMID:26487452

  18. The molecular pathogenesis of colorectal cancer and its potential application to colorectal cancer screening

    PubMed Central

    Grady, William M.; Markowitz, Sanford D.

    2016-01-01

    Advances in our understanding of the molecular genetics and epigenetics of colorectal cancer has led to novel insights into the pathogenesis of this common cancer. These advances have revealed that there are molecular subtypes of colon polyps and colon cancer and that these molecular subclasses have unique and discrete clinical and pathological features. Although the molecular characterization of these subgroups of colorectal polyps and cancer is only partially understood at this time, it does appear likely that classifying colon polyps and cancers based on their genomic instability and/or epigenomic instability status will eventually be useful for informing approaches for the prevention and early detection of colon polyps and colorectal cancer. In this review, we will discuss our current understanding of the molecular pathogenesis of the polyp to cancer sequence and the potential to use this information to direct screening and prevention programs. PMID:25492499

  19. Examining breast cancer screening barriers among Central American and Mexican immigrant women: fatalistic beliefs or structural factors?

    PubMed

    De Jesus, Maria; Miller, Eva B

    2015-01-01

    Researchers have examined "cancer fatalism" (the belief that cancer is predetermined, beyond individual control, and necessarily fatal) as a major barrier to breast cancer screening among Latinas. The authors examine perceptions of breast cancer, its causes, and experiences with screening among Salvadoran, Guatemalan, Mexican, and Bolivian immigrant women in Washington, DC. Two salient themes emerged: (a) perceptions of breast cancer causes and breast cancer screening; and (b) structural factors are the real barriers to breast cancer screening. Findings demonstrate participants' awareness and motivation to get screened and elucidate structural barriers that are obscured by the discourse of fatalism and hinder breast cancer screening. PMID:25383565

  20. How African American Men decide Whether or Not to Get Prostate Cancer Screening

    PubMed Central

    Jones, Randy A.; Steeves, Richard; Williams, Ishan

    2009-01-01

    Prostate cancer is the most commonly diagnosed cancer in men in the U.S. and affects African Americans disproportionately when compared to other ethnic groups. There are unclear reasons for this disparity, but several factors may include race, nutrition, family history of cancer, and screening. With early detection of prostate cancer, survival is much better; thus screening may be helpful, especially for high-risk individuals. Prostate cancer screening continues to be controversial. A paucity of data exist on what prostate cancer screening means to African Americans, particularly in rural areas, and how they make the decision to undergo prostate cancer screening or not. This study interviewed 17 African American men to explore how and when they decided about prostate cancer screening. The majority of the men (n = 9) said that they had prostate cancer screening. Three themes emerged from the data: 1) these men had information on prostate cancer; 2) family and friends played an important role in the men’s decision-making process; and 3) for screening, it was necessary for the men to have a trusting relationship with their healthcare provider. These findings confirm that the decision-making process is not a simple process. The study’s results can help healthcare providers understand some of the important decision-making factors in prostate cancer screening for African American men. PMID:19258830

  1. [Screening for colorectal cancer: even with virtual colography?].

    PubMed

    Layer, G; Riemann, J F

    2013-09-01

    Colorectal cancer (CRC) is responsible for 27,000 deaths and 65,000 new cancers in Germany each year, although this should be unnecessary as CRC is preventable because it is possible to remove the precursors, harmless polyps and adenomas. However, only 2.5?% of people in health insurance make use of screening colonoscopy annually so that it becomes necessary to check out other screening tests. The most commonly used test is the Guaiak-based test for fecal occult blood (gFOBT) which is highly specific but not very sensitive (only approximately 10?%). New immunological stool tests are more sensitive but the specificity is reduced from 90?% to approximately 80?%. Virtual colonoscopy based on computed tomography (CT) or magnetic resonance imaging (MRI) is comparable to endoscopy for diagnostics with overall accuracy rates of approximately 80-90?% for polyps larger than 5mm but for radiation protection reasons CT is not usable in Germany and MRI is internationally not adequately established by large study trials. For the future there is much hope in molecular blood tests. It is of great importance that every physician is aware of the different tests, their strengths and weaknesses and advises all patients to use the different screening possibilities. PMID:23933636

  2. Network-based reading system for lung cancer screening CT

    NASA Astrophysics Data System (ADS)

    Fujino, Yuichi; Fujimura, Kaori; Nomura, Shin-ichiro; Kawashima, Harumi; Tsuchikawa, Megumu; Matsumoto, Toru; Nagao, Kei-ichi; Uruma, Takahiro; Yamamoto, Shinji; Takizawa, Hotaka; Kuroda, Chikazumi; Nakayama, Tomio

    2006-03-01

    This research aims to support chest computed tomography (CT) medical checkups to decrease the death rate by lung cancer. We have developed a remote cooperative reading system for lung cancer screening over the Internet, a secure transmission function, and a cooperative reading environment. It is called the Network-based Reading System. A telemedicine system involves many issues, such as network costs and data security if we use it over the Internet, which is an open network. In Japan, broadband access is widespread and its cost is the lowest in the world. We developed our system considering human machine interface and security. It consists of data entry terminals, a database server, a computer aided diagnosis (CAD) system, and some reading terminals. It uses a secure Digital Imaging and Communication in Medicine (DICOM) encrypting method and Public Key Infrastructure (PKI) based secure DICOM image data distribution. We carried out an experimental trial over the Japan Gigabit Network (JGN), which is the testbed for the Japanese next-generation network, and conducted verification experiments of secure screening image distribution, some kinds of data addition, and remote cooperative reading. We found that network bandwidth of about 1.5 Mbps enabled distribution of screening images and cooperative reading and that the encryption and image distribution methods we proposed were applicable to the encryption and distribution of general DICOM images via the Internet.

  3. Cancer Genome Anatomy Project | Office of Cancer Genomics

    Cancer.gov

    The National Cancer Institute (NCI) Cancer Genome Anatomy Project (CGAP) is an online resource designed to provide the research community access to biological tissue characterization data. Request a free copy of the CGAP Website Virtual Tour CD from ocg@mail.nih.gov.

  4. Blinded Validation of Breath Biomarkers of Lung Cancer, a Potential Ancillary to Chest CT Screening

    PubMed Central

    Phillips, Michael; Bauer, Thomas L.; Cataneo, Renee N.; Lebauer, Cassie; Mundada, Mayur; Pass, Harvey I.; Ramakrishna, Naren; Rom, William N.; Vallières, Eric

    2015-01-01

    Background Breath volatile organic compounds (VOCs) have been reported as biomarkers of lung cancer, but it is not known if biomarkers identified in one group can identify disease in a separate independent cohort. Also, it is not known if combining breath biomarkers with chest CT has the potential to improve the sensitivity and specificity of lung cancer screening. Methods Model-building phase (unblinded): Breath VOCs were analyzed with gas chromatography mass spectrometry in 82 asymptomatic smokers having screening chest CT, 84 symptomatic high-risk subjects with a tissue diagnosis, 100 without a tissue diagnosis, and 35 healthy subjects. Multiple Monte Carlo simulations identified breath VOC mass ions with greater than random diagnostic accuracy for lung cancer, and these were combined in a multivariate predictive algorithm. Model-testing phase (blinded validation): We analyzed breath VOCs in an independent cohort of similar subjects (n = 70, 51, 75 and 19 respectively). The algorithm predicted discriminant function (DF) values in blinded replicate breath VOC samples analyzed independently at two laboratories (A and B). Outcome modeling: We modeled the expected effects of combining breath biomarkers with chest CT on the sensitivity and specificity of lung cancer screening. Results Unblinded model-building phase. The algorithm identified lung cancer with sensitivity 74.0%, specificity 70.7% and C-statistic 0.78. Blinded model-testing phase: The algorithm identified lung cancer at Laboratory A with sensitivity 68.0%, specificity 68.4%, C-statistic 0.71; and at Laboratory B with sensitivity 70.1%, specificity 68.0%, C-statistic 0.70, with linear correlation between replicates (r = 0.88). In a projected outcome model, breath biomarkers increased the sensitivity, specificity, and positive and negative predictive values of chest CT for lung cancer when the tests were combined in series or parallel. Conclusions Breath VOC mass ion biomarkers identified lung cancer in a separate independent cohort, in a blinded replicated study. Combining breath biomarkers with chest CT could potentially improve the sensitivity and specificity of lung cancer screening. Trial Registration ClinicalTrials.gov NCT00639067 PMID:26698306

  5. Thermographic image analysis as a pre-screening tool for the detection of canine bone cancer

    NASA Astrophysics Data System (ADS)

    Subedi, Samrat; Umbaugh, Scott E.; Fu, Jiyuan; Marino, Dominic J.; Loughin, Catherine A.; Sackman, Joseph

    2014-09-01

    Canine bone cancer is a common type of cancer that grows fast and may be fatal. It usually appears in the limbs which is called "appendicular bone cancer." Diagnostic imaging methods such as X-rays, computed tomography (CT scan), and magnetic resonance imaging (MRI) are more common methods in bone cancer detection than invasive physical examination such as biopsy. These imaging methods have some disadvantages; including high expense, high dose of radiation, and keeping the patient (canine) motionless during the imaging procedures. This project study identifies the possibility of using thermographic images as a pre-screening tool for diagnosis of bone cancer in dogs. Experiments were performed with thermographic images from 40 dogs exhibiting the disease bone cancer. Experiments were performed with color normalization using temperature data provided by the Long Island Veterinary Specialists. The images were first divided into four groups according to body parts (Elbow/Knee, Full Limb, Shoulder/Hip and Wrist). Each of the groups was then further divided into three sub-groups according to views (Anterior, Lateral and Posterior). Thermographic pattern of normal and abnormal dogs were analyzed using feature extraction and pattern classification tools. Texture features, spectral feature and histogram features were extracted from the thermograms and were used for pattern classification. The best classification success rate in canine bone cancer detection is 90% with sensitivity of 100% and specificity of 80% produced by anterior view of full-limb region with nearest neighbor classification method and normRGB-lum color normalization method. Our results show that it is possible to use thermographic imaging as a pre-screening tool for detection of canine bone cancer.

  6. Clinical Perspectives on Colorectal Cancer Screening at Latino-Serving Federally Qualified Health Centers

    ERIC Educational Resources Information Center

    Coronado, Gloria D.; Petrik, Amanda F.; Spofford, Mark; Talbot, Jocelyn; Do, Huyen Hoai; Taylor, Victoria M.

    2015-01-01

    Purpose: Colorectal cancer is the second most common cause of cancer death in the United States, and rates of screening for colorectal cancer are low. We sought to gather the perceptions of clinic personnel at Latino-serving Federally Qualified Health Centers (operating 17 clinics) about barriers to utilization of screening services for colorectal

  7. 77 FR 41791 - Proposed Collection; Comment Request; Prostate, Lung, Colorectal and Ovarian Cancer Screening...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-16

    ... designed to determine if cancer screening for prostate, lung, colorectal, and ovarian cancer can reduce... approximately 94,000 participants being actively followed up. The reports on cancer screening and prostate, lung... HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request; Prostate,...

  8. Clinical Perspectives on Colorectal Cancer Screening at Latino-Serving Federally Qualified Health Centers

    ERIC Educational Resources Information Center

    Coronado, Gloria D.; Petrik, Amanda F.; Spofford, Mark; Talbot, Jocelyn; Do, Huyen Hoai; Taylor, Victoria M.

    2015-01-01

    Purpose: Colorectal cancer is the second most common cause of cancer death in the United States, and rates of screening for colorectal cancer are low. We sought to gather the perceptions of clinic personnel at Latino-serving Federally Qualified Health Centers (operating 17 clinics) about barriers to utilization of screening services for colorectal…

  9. Reducing cancer screening disparities in medicare beneficiaries through cancer patient navigation.

    PubMed

    Braun, Kathryn L; Thomas, William L; Domingo, Jermy-Leigh B; Allison, Amanda L; Ponce, Avette; Haunani Kamakana, P; Brazzel, Sandra S; Emmett Aluli, N; Tsark, JoAnn U

    2015-02-01

    Significant racial disparities in cancer mortality are seen between Medicare beneficiaries. A randomized controlled trial tested the use of lay navigators (care managers) to increase cancer screening of Asian and Pacific Islander Medicare beneficiaries. The study setting was Moloka'i General Hospital on the island of Moloka'i, Hawai'i, which was one of six sites participating in the Cancer Prevention and Treatment Demonstration sponsored by the Centers for Medicare and Medicaid Services. Between 2006 and 2009, 488 Medicare beneficiaries (45% Hawaiian, 35% Filipino, 11% Japanese, 8% other) were randomized to have a navigator help them access cancer screening services (experimental condition, n = 242) or cancer education (control condition, n = 246). Self-reported data on screening participation were collected at baseline and exit from the study, and differences were tested using chi-square. Groups were similar in demographic characteristics and baseline screening prevalence of breast, cervical, prostate, and colorectal cancers. At study exit, 57.0% of women in the experimental arm and 36.4% of controls had had a Papanicolaou test in the past 24 months (P = .001), 61.7% of women in the experimental arm and 42.4% of controls had had a mammogram in the past 12 months (P = .003), 54.4% of men in the experimental arm and 36.0% of controls had had a prostate-specific antigen test in the past 12 months (P = .008), and 43.0% of both sexes in the experimental arm and 27.2% of controls had had a flexible sigmoidoscopy or colonoscopy in the past 5 years (P < .001). Findings suggest that navigation services can increase cancer screening in Medicare beneficiaries in groups with significant disparities. PMID:25640884

  10. Helicobacter pylori Antibody Titer and Gastric Cancer Screening

    PubMed Central

    Kishikawa, Hiroshi; Kimura, Kayoko; Takarabe, Sakiko; Kaida, Shogo; Nishida, Jiro

    2015-01-01

    The ABC method is a serum gastric cancer screening method, and the subjects were divided based on H. pylori serology and atrophic gastritis as detected by serum pepsinogen (PG): Group A [H. pylori (?) PG (?)], Group B [H. pylori (+) PG (?)], Group C [H. pylori (+) PG (+)], and Group D [H. pylori (?) PG (+)]. The risk of gastric cancer is highest in Group D, followed by Groups C, B, and A. Groups B, C, and D are advised to undergo endoscopy, and the recommended surveillance is every three years, every two years, and annually, respectively. In this report, the reported results with respect to further risk stratification by anti-H. pylori antibody titer in each subgroup are reviewed: (1) high-negative antibody titer subjects in Group A, representing posteradicated individuals with high risk for intestinal-type cancer; (2) high-positive antibody titer subjects in Group B, representing active inflammation with high risk for diffuse-type cancer; and (3) low-positive antibody titer subjects in Group C, representing advanced atrophy with increased risk for intestinal-type cancer. In these subjects, careful follow-up with intervals of surveillance of every three years in (1), every two years in (2), and annually in (3) should be considered. PMID:26494936

  11. Screening for colorectal cancer: established and emerging modalities.

    PubMed

    Pawa, Nikhil; Arulampalam, Tan; Norton, John D

    2011-12-01

    It has been estimated that >95% of cases of colorectal cancer (CRC) would benefit from curative surgery if diagnosis was made at an early or premalignant polyp stage of disease. Over the past 10 years, most developed nation states have implemented mass population screening programs, which are typically targeted at the older (at-risk) age group (>50-60 years old). Conventional screening largely relies on periodic patient-centric investigation, particularly involving colonoscopy and flexible sigmoidoscopy, or else on the fecal occult blood test. These methods are compromised by either low cost-effectiveness or limited diagnostic accuracy. Advances in the development of diagnostic molecular markers for CRC have yielded an expanding list of potential new screening modalities based on investigations of patient stool (for colonocyte DNA mutations, epigenetic changes or microRNA expression) or blood specimens (for plasma DNA mutations, epigenetic changes, heteroplasmic mitochondrial DNA mutations, leukocyte transcriptome profile, plasma microRNA expression or protein and autoantibody expression). In this Review, we present a critical evaluation of the performance data and relative merits of these various new potential methods. None of these molecular diagnostic methods have yet been evaluated beyond the proof-of-principle and pilot-scale study stage and it could be some years before they replace existing methods for population screening in CRC. PMID:22045159

  12. [Assessment of screening in women cancers and in 75 years older in Loire department].

    PubMed

    Swalduz, Aurlie; Guibert, Cyril; Trone, Jane-Chlo; Guichard, Jean-Baptiste; Rivoirard, Romain; Pacaut, Ccile; Mry, Benote; Guy, Jean-Baptiste; Eddekkaoui, Houda; Fournel, Pierre; de Laroche, Guy; Merrouche, Yacine; Magn, Nicolas

    2014-09-01

    In France, there is an important interregional disparity concerning participation to cancer screening programs. The aim of this study was to assess oncologic screening practices in Loire, a French rural department, in women and in the elderly (over age 74 years). For this, two surveys were conducted. The first one was regarding screening for breast, cervical and colorectal cancer in women over age 18 years living in Loire. The second survey was regarding onco-geriatric screening through two questionnaires: one for the elderly and the other for general practitioner (GP) of the department, evaluating screening for breast, colorectal, prostate, cervical and lung cancer. One hundred sixty six women were included in the first investigation mean age of 47.6 years. Ninety three point six per cent were screening for breast cancer, 19% received Human Papilloma virus vaccine, 83.1% were screening by Papanicolau smear for cervical cancer and finally, 51.7% were screening for colorectal cancer, among the one entering screening program criteria. In the second survey, 44 patients and 28 GP were included. Thirty-eight point six per cent of patients over 74 years continue screening. Only 11.4% were reluctant to screening and in 80% because of anxiety du to the results. Among GP, 50% continued screening on two major criteria: life expectancy and performans status. The present study shows heterogeneity of screening in this department both rural and working class and gives us a societo-medical photography. PMID:25229392

  13. Experiences and unmet needs of women undergoing Pap smear cervical cancer screening: impact on uptake of cervical cancer screening in south eastern Nigeria.

    PubMed

    Chigbu, Chibuike O; Onyebuchi, Azubuike K; Egbuji, Chuma C; Ezugwu, Eusebus C

    2015-03-01

    The burden of cervical cancer is on the increase in sub-Saharan Africa mainly due to inadequate provision and utilisation of cervical cancer prevention services. Several evidence-based strategies have been deployed to improve cervical cancer screening uptake without much success. However, patients' experiences and satisfaction with service provision has not been adequately studied. Inefficiencies in service delivery and less fulfilling experiences by women who attend cervical cancer screening could have considerable impact in future voluntary uptake of cervical cancer screening. Six hundred and eighty women who underwent Pap smear screening in three health care facilities in two states in south eastern Nigeria were interviewed to evaluate their satisfaction, willingness to undertake future voluntary screening, unmet needs and correlation between satisfaction level and willingness to undergo future screening. Satisfaction with Pap smear screening correlated positively with willingness to undertake future voluntary screening (Pearson's correlation coefficient = 0.78, P = 0.001). The mean satisfaction score was significantly higher among participants handled by nurses than those handled by the physicians (3.16 ± 0.94 vs 2.52 ± 0.77, P = 0.001). 'Scrapping discomfort' of the spatula was reported as the most dissatisfying aspect of Pap smear experience. The need for less invasive screening procedures was the most unmet need. It was concluded that improving the Pap smear screening experience of women and providing less invasive methods of cervical cancer screening with immediate results could improve uptake of cervical cancer screening in south eastern Nigeria. PMID:24980966

  14. A new approach to digital breast tomosynthesis for breast cancer screening

    NASA Astrophysics Data System (ADS)

    Nishikawa, Robert M.; Reiser, Ingrid; Seifi, Payam; Vyborny, Carl J.

    2007-03-01

    Digital breast tomosynthesis (DBT) is being proposed as a replacement for conventional mammography for breast cancer screening. However, there are limitations to DBT that reduce its effectiveness for screening, principally, difficulty in imaging microcalcifications and increased reading times by radiologists. We propose a method to overcome these limitations. Our proposed method is to divide the total dose given to the patient unequally such that one projection uses at least half of the dose and the remaining dose is divided over the remaining projections. We assume that in screening with DBT, only a single view is obtained using twice the dose of a conventional mammogram. All the projection images are used in the reconstruction. The 2D projection image that received the highest dose is analyzed by a computer-aided detection (CADe) scheme for microcalcifications. The radiologist views the 3D image set, with mass CADe, principally to search for masses and the 2D image to search for clustered microcalcifications with CADe. Since the 3D image set is for mass detection, the image can be reconstructed using larger sized pixels. This will reduce computation time and image noise. In principle, radiologists can review the tomosynthesis slices faster since they do not have to search for microcalcifications. We believe that by producing both a high resolution, "standard" dose 2D image and a lower resolution 3D image set, both calcifications and masses can be optimally imaged and detected in a time efficient manner.

  15. Breast cancer racial differences before age 40--implications for screening.

    PubMed Central

    Johnson, Edwin T.

    2002-01-01

    BACKGROUND: Most authorities advocate mammogram screening for breast cancer beginning at age 40 based on the age-specific distribution and incidence of breast cancer in the general population. This policy has been bolstered by studies that demonstrate that, for the general population, mammography in the 40-49 age bracket reduces mortality. However, it also has been reported that African-American breast cancer patients are diagnosed more often than white patients below the age of 40. Young African-American women are also more likely to have advanced disease at the time of diagnosis with predictably higher mortality. The purpose of this investigation is to explore the question, whether a subset of African-American women, age 30-39, by virtue of increased vulnerability, would benefit from early mammogram screening. STUDY DESIGN: The age-specific distribution (age 30-84) of African-American and white breast cancer patients in five State cancer registries were compared. Prognostic indicators (tumor size and nodal status) in two of the five registries in African-American and white breast cancer cases below the age of 40 were compared. Age-specific incidence in the 30-39 age group and the relative populations of black and white women in the United States were noted in the Surveillance Epidemiology and End Report (SEER) (1994-1998) and The U.S. Census 2000. RESULTS: The differences of age-specific distribution and age-specific incidence of African-American and white breast cancer patients were found to be significant. More than 10% of African-American women with breast cancer were diagnosed before age 40 compared to 5% of white patients. The incidence of breast cancer (SEER Report 1994-1998) in the 30-39-age bracket for African-American and white women was 48.9 and 40.2 at the 95% confidence level, while the proportion of African-American and white women reported by the Census Bureau was not too dissimilar, 15.8% and 14.6% respectively. Prognostic indicators (tumor size and nodal status) support the notion that young African-American women are more likely to have advanced disease at diagnosis. CONCLUSIONS: African-American women in the 30-39 age group have twice the age-specific distribution, have a higher incidence compared to their white counterparts, and exhibit more ominous prognostic signs. This study provides evidence that African-American women in the 30-39 age category represent a high-risk group that may benefit from efforts at earlier detection. Although mammography remains the preferred screening modality, investigators have pointed out difficulties encountered when using mammography in young women, including low sensitivity, high breast density, cost/benefit concerns, and low positive predictive value. Nevertheless, the increasing mortality and persistent racial incidence gap in young African-American women, age 30-39, argue for considering early screening mammography in spite of recognized concerns. PMID:11918384

  16. Psychological Barriers and Facilitators of Colorectal Cancer Screening: A French Qualitative Study

    PubMed Central

    Bridou, Morgiane; Aguerre, Colette; Gimenes, Guillaume; Kubiszewski, Violaine; Le Gall, Armel; Potard, Catherine; Sorel, Olivier; Reveillere, Christian

    2013-01-01

    The aim of this qualitative study was to explore the psychological barriers to and facilitators of undergoing the Hemoccult-II® colorectal cancer screening test in France. Sixty-nine French people aged 50 to 74 years were divided into seven qualitative focus groups. Three issues were discussed with participants: knowledge and beliefs about colorectal cancer screening; facilitators of colorectal cancer screening by Hemoccult-II®; barriers to colorectal cancer screening by Hemoccult-II®. All the discussions were led by two psychologists and were recorded, transcribed verbatim and analyzed using qualitative data analysis software. Correspondence factor analyses identified three dimensions for each topic. The main psychological facilitators of colorectal cancer screening were: information about colorectal cancer screening, perceived simplicity of using Hemoccult-II®, and perception of risk. Uncertainty about the reliability of Hemoccult-II®, health anxiety, and embarrassment emerged as the main barriers to colorectal cancer screening. Cross-sectional analyses identified the differences between the views expressed by women and men. Women appeared more embarrassed about Hemoccult-II® and men seemed to be more worried about colorectal cancer. This preliminary study suggests that psychological factors play an important role in colorectal cancer screening by Hemoccult-II®. This finding may help health organizations to conceive better awareness campaigns to promote colorectal cancer screening in order to reduce the related mortality rate by taking into account psychological determinants. PMID:26973907

  17. Willingness to Participate in Cancer Screenings: Blacks vs Whites vs Puerto Rican Hispanics

    PubMed Central

    Katz, Ralph V.; Claudio, Cristina; Kressin, Nancy R.; Green, B. Lee; Wang, Min Qi; Russell, Stefanie Luise

    2009-01-01

    Background In the United States, blacks and Hispanics have lower cancer screening rates than whites have. Studies on the screening behaviors of minorities are increasing, but few focus on the factors that contribute to this discrepancy. This study presents the self-reported willingness by blacks, Puerto Rican Hispanics, and non-Hispanic whites to participate in cancer screenings in differing cancer screening situations. Methods The Cancer Screening Questionnaire (CSQ), a 60-item questionnaire, was administered via random-digit-dial telephone interviews to adults in three cities: Baltimore, Maryland; New York, New York; and, San Juan, Puerto Rico. Results The 1,148 participants in the CSQ study sample consisted of 355 blacks, 311 Puerto Rican Hispanics, and 482 non-Hispanic whites. Response rates ranged from 45% to 58% by city. Multivariable logistic regression analyses revealed that blacks and Puerto Ricans were often more likely (OR 2.0-3.0) and never less likely than whites to self-report willingness to participate in cancer screenings regardless of who conducted the cancer screening, what one was asked to do in the cancer screening, or what type of cancer was involved (with the exception of skin cancer where blacks, compared with whites, had an OR of 0.5). Conclusions The findings from this study provide evidence that blacks and Hispanics self-report that they are either as willing or more willing than whites to participate in cancer screening programs. PMID:18813201

  18. Long-Term Trial Results Show No Mortality Benefit from Annual Prostate Cancer Screening

    Cancer.gov

    Thirteen year follow-up data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial show higher incidence but similar mortality among men screened annually with the prostate-specific antigen (PSA) test and digital rectal examination

  19. Which screening method is appropriate for older cancer patients at risk for malnutrition?

    PubMed

    Isenring, Elizabeth; Elia, Marinos

    2015-04-01

    The risk for malnutrition increases with age and presence of cancer, and it is particularly common in older cancer patients. A range of simple and validated nutrition screening tools can be used to identify malnutrition risk in cancer patients (e.g., Malnutrition Screening Tool, Mini Nutritional Assessment Short Form Revised, Nutrition Risk Screening, and the Malnutrition Universal Screening Tool). Unintentional weight loss and current body mass index are common components of screening tools. Patients with cancer should be screened at diagnosis, on admission to hospitals or care homes, and during follow-up at outpatient or general practitioner clinics, at regular intervals depending on clinical status. Nutritional assessment is a comprehensive assessment of dietary intake, anthropometrics, and physical examination often conducted by dietitians or geriatricians after simple screening has identified at-risk patients. The result of nutritional screening, assessment and the associated care plans should be documented, and communicated, within and between care settings for best patient outcomes. PMID:25770324

  20. Barriers and Facilitators of Prostate Cancer Screening among Filipino Men in Hawaii

    PubMed Central

    Conde, Francisco A.; Landier, Wendy; Ishida, Dianne; Bell, Rose; Cuaresma, Charlene F.; Misola, Jane

    2013-01-01

    Purpose/Objectives To examine perceptions, attitudes, and beliefs regarding barriers and facilitators to prostate cancer screening, and to identify potential interventional strategies to promote prostate cancer screening among Filipino men in Hawaii. Design Exploratory, qualitative. Setting Community-based settings in Hawaii. Sample 20 Filipino men, 40 years old or older Methods Focus group discussions were tape-recorded, transcribed, and content analysis performed for emergent themes. Main Research Variables Perceptions regarding prostate cancer, barriers and facilitators to prostate cancer screening, and culturally-relevant interventional strategies Findings Perceptions of prostate cancer included fatalism, hopelessness, and dread. Misconceptions regarding causes of prostate cancer, such as frequency of sexual activity, were identified. Barriers to prostate cancer screening included lack of awareness of the need for screening, reticence to seek healthcare when feeling well, fear of cancer diagnosis, financial issues, time constraints, and embarrassment. Presence of urinary symptoms, personal experience with family or friend who had cancer, and receiving recommendations from a healthcare provider regarding screening were facilitators for screening. Potential culturally-relevant interventional strategies to promote prostate cancer screening included screening recommendations from health professionals and cancer survivors; radio/television commercials and newspaper articles targeted to the Filipino community; informational brochures in Tagalog, Ilocano and/or English; and interactive, educational forums facilitated by Filipino multilingual, male healthcare professionals. Conclusions Culturally-relevant interventions are needed that address barriers to prostate cancer screening participation and misconceptions about causes of prostate cancer. Implications for Nursing Findings provide a foundation for future research regarding development of interventional strategies to promote prostate cancer screening among Filipino men. PMID:21356660

  1. Ethical issues evolving from patients’ perspectives on compulsory screening for syphilis and voluntary screening for cervical cancer in Kenya

    PubMed Central

    2014-01-01

    Background Public health aims to provide universal safety and progressive opportunities to populations to realise their highest level of health through prevention of disease, its progression or transmission. Screening asymptomatic individuals to detect early unapparent conditions is an important public health intervention strategy. It may be designed to be compulsory or voluntary depending on the epidemiological characteristics of the disease. Integrated screening, including for both syphilis and cancer of the cervix, is a core component of the national reproductive health program in Kenya. Screening for syphilis is compulsory while it is voluntary for cervical cancer. Participants’ perspectives of either form of screening approach provide the necessary contextual information that clarifies mundane community concerns. Methods Focus group discussions with female clients screened for syphilis and cancer of the cervix were conducted to elicit their perspectives of compulsory and voluntary screening. The discussions were audiotaped, transcribed and thematic content analysis performed manually to explore emerging ethics issues. Results The results indicate that real ethical challenges exist in either of the approaches. Also, participants were more concerned about the benefits of the procedure and whether their dignity is respected than the compulsoriness of screening per se. The implication is for the policy makers to clarify in the guidelines how to manage ethical challenges, while at the operational level, providers need to be judicious to minimize potential harms participants and families when screening for disease in women. Conclusions The context for mounting screening as a public health intervention and attendant ethical issues may be more complex than hitherto perceived. Interpreting emerging ethics issues in screening requires more nuanced considerations of individuals’ contextual experiences since these may be contradictory to the policy position. In considering mounting screening for Syphilis and cervical cancer as a public heal intervention, the community interests and perspectives should be inculcated into the program. Population lack of information on procedures may influence adversely the demand for screening services by the individuals at risk or the community as a collective agent. PMID:24678613

  2. How protective is cervical cancer screening against cervical cancer mortality in developing countries? The Colombian case

    PubMed Central

    2010-01-01

    Background Cervical cancer is one of the top causes of cancer morbidity and mortality in Colombia despite the existence of a national preventive program. Screening coverage with cervical cytology does not explain the lack of success of the program in reducing incidence and mortality rates by cervical cancer. To address this problem an ecological analysis, at department level, was carried out in Colombia to assess the relationship between cervical screening characteristics and cervical cancer mortality rates. Methods Mortality rates by cervical cancer were estimated at the department level for the period 2000-2005. Levels of mortality rates were compared to cervical screening coverage and other characteristics of the program. A Poisson regression was used to estimate the effect of different dimensions of program performance on mortality by cervical cancer. Results Screening coverage ranged from 28.7% to 65.6% by department but increases on this variable were not related to decreases in mortality rates. A significant reduction in mortality was found in departments where a higher proportion of women looked for medical advice when abnormal findings were reported in Pap smears. Geographic areas where a higher proportion of women lack health insurance had higher rates of mortality by cervical cancer. Conclusions These results suggest that coverage is not adequate to prevent mortality due to cervical cancer if women with abnormal results are not provided with adequate follow up and treatment. The role of different dimensions of health care such as insurance coverage, quality of care, and barriers for accessing health care needs to be evaluated and addressed in future studies. PMID:20846446

  3. ACR CT Accreditation Program and the Lung Cancer Screening Program Designation.

    PubMed

    Kazerooni, Ella A; Armstrong, Mark R; Amorosa, Judith K; Hernandez, Dina; Liebscher, Lawrence A; Nath, Hrudaya; McNitt-Gray, Michael F; Stern, Eric J; Wilcox, Pamela A

    2016-02-01

    The ACR recognizes that low-dose CT for lung cancer screening has the potential to significantly reduce mortality from lung cancer in the appropriate high-risk population. The ACR supports the recommendations of the US Preventive Services Task Force and the National Comprehensive Cancer Network for screening patients. To be effective, lung cancer screening should be performed at sites providing high-quality low-dose CT examinations overseen and interpreted by qualified physicians using a structured reporting and management system. The ACR has developed a set of tools necessary for radiologists to take the lead on the front lines of lung cancer screening. The ACR Lung Cancer Screening Center designation is built upon the ACR CT accreditation program and requires use of Lung-RADS or a similar structured reporting and management system. This designation provides patients and referring providers with the assurance that they will receive high-quality screening with appropriate follow-up care. PMID:26846533

  4. Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.

    PubMed

    Houssami, Nehmat; Lång, Kristina; Bernardi, Daniela; Tagliafico, Alberto; Zackrisson, Sophia; Skaane, Per

    2016-04-01

    This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening. PMID:27017251

  5. Korean women's attitudes toward breast cancer screening tests.

    PubMed

    Im, Eun-Ok; Park, Young Sook; Lee, Eun Ok; Yun, Soon Nyung

    2004-08-01

    The purpose of the study was to explore Korean women's attitudes toward breast cancer screening tests from a feminist perspective. Twenty Korean women working in Dong-Dae-Moon Market in Seoul, South Korea were recruited using a convenience sampling method. Semi-structured in-depth interviews were conducted using an interview guideline that was developed for the study. The data were analyzed using a thematic analysis. The themes emerged from the analysis process included: "importance of breasts to women", "fearful, but not related to me", "bad previous experience", and "no need for a breast exam." Based on the findings, implications for nursing practice are proposed. PMID:15240081

  6. Perceptions of Colorectal Cancer Screening in Urban African American Clinic Patients: Differences by Gender and Screening Status

    PubMed Central

    Gordon, Thomas F.; Ruzek, Sheryl Burt; Wolak, Caitlin; Ward, Stephanie; Paranjape, Anuradha; Lin, Karen; Meyer, Brian; Ruggieri, Dominique G.

    2010-01-01

    African Americans have higher colorectal cancer (CRC) morbidity and mortality than whites, yet have low rates of CRC screening. Few studies have explored African Americans own perceptions of barriers to CRC screening or elucidated gender differences in screening status. Focus groups were conducted with 23 African American patients between 50 and 70 years of age who were patients in a general internal medicine clinic in a large urban teaching hospital. Focus groups were delimited by gender and CRC screening status. Focus group transcripts were analyzed using an iterative coding process with consensus and triangulation to develop thematic categories. Results indicated key thematic differences in perceptions of screening by gender and CRC screening status. While both men and women who had never been screened had a general lack of knowledge about CRC and screening modalities, women had an overall sense that health screenings were needed and indicated a stronger need to have a positive relationship with their doctor. Women also reported that African American men do not get colonoscopy because of the perceived sexual connotation. Men who had never been screened, compared to those who had been screened, had less trust of their doctors and the health care system and indicated an overall fear of going to the doctor. They also reiterated the sexual connotation of having a colonoscopy and were apprehensive about being sedated during the procedure. Overall, men expressed more fear and were more reluctant to undergo CRC screening than women, but among those who had undergone CRC screening, particularly colonoscopy, men expressed advantages of having the screening. All groups were also found to have a negative attitude about the use of fecal occult blood testing and felt colonoscopy was the superior screening modality. Results suggest that messages and education about CRC screening, particularly colonoscopy, might place more emphasis on accuracy and might be more effective in increasing screening rates among African Americans if tailored to gender and screening status. PMID:20443096

  7. Structuring Lecture Videos by Automatic Projection Screen Localization and Analysis.

    PubMed

    Li, Kai; Wang, Jue; Wang, Haoqian; Dai, Qionghai

    2015-06-01

    We present a fully automatic system for extracting the semantic structure of a typical academic presentation video, which captures the whole presentation stage with abundant camera motions such as panning, tilting, and zooming. Our system automatically detects and tracks both the projection screen and the presenter whenever they are visible in the video. By analyzing the image content of the tracked screen region, our system is able to detect slide progressions and extract a high-quality, non-occluded, geometrically-compensated image for each slide, resulting in a list of representative images that reconstruct the main presentation structure. Afterwards, our system recognizes text content and extracts keywords from the slides, which can be used for keyword-based video retrieval and browsing. Experimental results show that our system is able to generate more stable and accurate screen localization results than commonly-used object tracking methods. Our system also extracts more accurate presentation structures than general video summarization methods, for this specific type of video. PMID:26357345

  8. Effective screening for early diagnosis of pancreatic cancer.

    PubMed

    Hanada, Keiji; Okazaki, Akihito; Hirano, Naomichi; Izumi, Yoshihiro; Minami, Tomoyuki; Ikemoto, Juri; Kanemitsu, Kozue; Hino, Fumiaki

    2015-12-01

    Diagnosis of pancreatic cancer (PC) at an early stage with curative surgery should improve long-term patient outcome. At present, improving survival should lie in identifying those cases with high-risk factors or precursor lesions through an effective screening including ultrasonography, some biological markers, or national familial pancreatic cancer registration. Recently, cases with PC < 10 mm with a favorable prognosis have been reported. For the diagnoses of cases with PC < 10 mm, the rate of tumor detection was higher on endoscopic ultrasonography (EUS) than on CT or other modalities, and EUS-guided fine needle aspiration was helpful in confirming the histologic diagnosis. Additionally, for the diagnosis of cases with PC in situ, EUS and magnetic resonance cholangiopancreatography (MRCP) may play important roles in detecting the local irregular stenosis of the pancreatic duct. Cytodiagnosis of pancreatic juice using endoscopic nasopancreatic drainage multiple times may be useful in the final diagnosis. PMID:26651254

  9. Medical screening for lung cancer: perspective and strategy

    SciTech Connect

    Kilburn, K.H.

    1986-08-01

    Strategies to prevent or reverse cancer promotion are described. One strategy, involving the screening and prompt treatment of small lung cancers, is proposed as a study to be tested in occupational groups with very high risk, specifically asbestos-exposed shipyard workers who smoke cigarettes. The relative risk can be assigned on the basis of (1) age, (2) years since first asbestos exposure, and (3) cigarette smoking amount, recency of cessation and age at onset. Proposed surveillance would be chest x-ray films at 4-month intervals and sputum cytology in current smokers and those within 10 years of cessation. Means of detection, such as monoclonal antibody tests for adenocarcinoma and other marker molecules, would be explored. Prompt conventional treatment would be assured. Other inquiries would be directed at new treatment, such as using targeted molecules directed at surface antigens.

  10. The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial: Questions and Answers

    Cancer.gov

    The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial is a large, randomized study to determine whether the use of certain screening tests will reduce the risk of dying of those four cancers. In addition to answering questions about the screening tests, the PLCO asked questions about many aspects of the study participants health and collected biospecimens (blood and some tissues) to answer many other questions about cancer.

  11. Resected Lung Cancer Patients Who Would and Would Not Have Met Screening Criteria

    PubMed Central

    Farjah, Farhood; Wood, Douglas E.; Zadworny, Megan E.; Rusch, Valerie W.; Rizk, Nabil P.

    2016-01-01

    Background Current eligibility criteria for lung cancer screening may underestimate the risk of malignancy for some individuals. We compared the predicted risk of lung cancer among patients who would have met screening criteria to those who would not have despite being at moderate-risk. Methods A retrospective cohort study was performed of resected lung cancer patients. The screen eligible group was based on criteria provided by the United States Preventive Services Task Forceage 5580 and a ?30 pack-year smoking history. The screen ineligible group was based on criteria provided by the National Comprehensive Cancer Network for a moderate-risk individual not recommended screeningage >50 years, >20 pack-year smoking history, and no history of asbestos exposure or chronic obstructive pulmonary disease. A recently validated risk-prediction model was used to compare the risk of lung cancer across eligibility groups based on measured and imputed patient-level variables. Results Screen ineligible patients (n=88) had a lower estimated probability of lung cancer than screen eligible patients (n=419)1.3% versus 3.1%, p<0.001. However, 20% of screen ineligible patients had a predicted probability of lung cancer greater than or equal to the prevalence of lung cancer (3.7%) among National Lung Screening Trial participants; 17% of screen ineligible patients had a predicted probability of lung cancer greater than or equal to the American Association for Thoracic Surgery threshold (5%) defining high-risk individuals. Conclusions Current eligibility criteria for lung cancer screening underestimate the risk of lung cancer for some individuals who might benefit from lung cancer screening. PMID:26298169

  12. Personalizing Age of Cancer Screening Cessation Based on Comorbidity: Model estimates of harms and benefits

    PubMed Central

    Lansdorp-Vogelaar, Iris; Gulati, Roman; Mariotto, Angela B; Schechter, Clyde B; de Carvalho, Tiago M; Knudsen, Amy B; van Ravesteyn, Nicolien T; Heijnsdijk, Eveline AM; Pabiniak, Chester; van Ballegooijen, Marjolein; Rutter, Carolyn M; Kuntz, Karen M; Feuer, Eric J; Etzioni, Ruth; de Koning, Harry J; Zauber, Ann G; Mandelblatt, Jeanne S

    2014-01-01

    Background Harms and benefits of cancer screening depend on age and comorbidity, yet reliable estimates are lacking. Objective To estimate the harms and benefits of cancer screening by age and comorbidity to inform decisions about screening cessation. Design Collaborative modeling with seven well-established cancer simulation models and common data on average and comorbidity level-specific life expectancy from SEER-Medicare. Setting US population. Patients US cohorts aged 6690 years in 2010 with average health or one of four comorbidity levels (linked to specific conditions): none, mild, moderate, or severe. Intervention Mammography, prostate-specific antigen testing, or fecal immunochemical testing. Measurements Lifetime cancer deaths prevented and life-years gained (benefits); false-positive tests and overdiagnosed cancers (harms). For each comorbidity level: the age at which harms and benefits of screening were similar to that for individuals with average health undergoing screening at age 74. Results Screening 1000 women with average life expectancy at age 74 for breast cancer resulted in 7996 (range across models) false-positives, 0.50.8 overdiagnosed cancers, and 0.70.9 breast cancer deaths prevented. While absolute numbers of harms and benefits differed across cancer sites, the ages at which to cease screening were highly consistent across models and cancer sites when based on harm-benefit ratios comparable to screening average-health individuals at age 74. For individuals with no, mild, moderate, and severe comorbidities, screening until ages of 76, 74, 72, and 66, respectively, resulted in similar harms and benefits as for average-health individuals. Limitations Comorbidity only influenced life expectancy. Conclusion Comorbidity is an important determinant of harms and benefits of screening. Estimates of screening benefits and harms by comorbidity can inform discussions between providers and their older patients about personalizing decisions about when to stop cancer screening. Primary Funding Source National Cancer Institute at the National Institutes of Health PMID:25023249

  13. Literacy Barriers to Colorectal Cancer Screening in Community Clinics

    PubMed Central

    ARNOLD, CONNIE L.; RADEMAKER, ALFRED; BAILEY, STACY COOPER; ESPARZA, JULIA M.; REYNOLDS, CRISTALYN; LIU, DACHAO; PLATT, DACI; DAVIS, TERRY C.

    2013-01-01

    This article examines the relationship between literacy and colorectal cancer (CRC) screening knowledge, beliefs, and experiences, with a focus on fecal occult blood tests (FOBTs). Participants were 975 patients in 8 Louisiana federally qualified health centers. Participants were 50 years of age or older and not up to date with CRC screening; approximately half (52%) had low literacy (less than a 9th-grade level). Participants with low literacy were less likely than were those with adequate literacy to be aware of advertisements promoting CRC screening (58.7% vs. 76.3%, p < .0001) or to believe it was very helpful to find CRC early (74.5% vs. 91.9%, p < .0001). The majority of participants had positive beliefs about the benefits of CRC screening using FOBTs. Participants with low literacy had more perceived barriers to FOBT completion and were more likely to strongly agree or agree that FOBTs would be confusing, embarrassing, or a lot of trouble; however, none of these remained significant in multivariate analyses controlling for relevant covariates. Confidence in being able to obtain an FOBT kit was high among those with low and adequate literacy (89.8% vs. 93.1%, respectively, p = .20); yet multivariate analyses revealed a significant difference in regard to literacy (p = .04) with low-literacy participants indicating less confidence. There was no significant difference by literacy in ever receiving a physician recommendation for CRC screening (38.4% low vs. 39.0% adequate, p = .79); however, multivariate analyses revealed significant differences in FOBT completion by literacy (p = .036). Overall, findings suggest that literacy is a factor in patients CRC knowledge, beliefs, and confidence in obtaining a FOBT. PMID:23030574

  14. Efficacy of an Educational Material on Second Primary Cancer Screening Practice for Cancer Survivors: A Randomized Controlled Trial

    PubMed Central

    Shin, Dong Wook; Cho, Juhee; Kim, Young Woo; Oh, Jae Hwan; Kim, Seok Won; Chung, Ki-Wook; Lee, Woo-Yong; Lee, Jeong Eon; Guallar, Eliseo; Lee, Won-Chul

    2012-01-01

    Background Cancer surivors have limited knowledge about second primary cancer (SPC) screening and suboptimal rates of completion of screening practices for SPC. Our objective was to test the efficacy of an educational material on the knowledge, attitudes, and screening practices for SPC among cancer survivors. Methods Randomized, controlled trial among 326 cancer survivors from 6 oncology care outpatient clinics in Korea. Patients were randomized to an intervention or an attention control group. The intervention was a photo-novel, culturally tailored to increase knowledge about SPC screening. Knowledge and attitudes regarding SPC screening were assessed two weeks after the intervention, and screening practices were assessed after one year. Results At two weeks post-intervention, the average knowledge score was significantly higher in the intervention compared to the control group (0.81 vs. 0.75, P<0.01), with no significant difference in their attitude scores (2.64 vs. 2.57, P?=?0.18). After 1 year of follow-up, the completion rate of all appropriate cancer screening was 47.2% in both intervention and control groups. Conclusion While the educatinal material was effective for increasing knowledge of SPC screening, it did not promote cancer screening practice among cancer survivors. More effective interventions are needed to increase SPC screening rates in this population. Trial Registration ClinicalTrial.gov NCT00948337 PMID:22479375

  15. Phenotype Recognition for RNAi Screening by Random Projection Forest

    NASA Astrophysics Data System (ADS)

    Zhang, Bailing

    2011-06-01

    High-content screening is important in drug discovery. The use of images of living cells as the basic unit for molecule discovery can aid the identification of small compounds altering cellular phenotypes. As such, efficient computational methods are required for the rate limiting task of cellular phenotype identification. In this paper we first investigate the effectiveness of a feature description approach by combining Haralick texture analysis with Curvelet transform and then propose a new ensemble approach for classification. The ensemble contains a set of base classifiers which are trained using random projection (RP) of original features onto higher-dimensional spaces. With Classification and Regression Tree (CART) as the base classifier, it has been empirically demonstrated that the proposed Random Projection Forest ensemble gives better classification results than those achieved by the Boosting, Bagging and Rotation Forest algorithms, offering a classification rate 88% with smallest standard deviation, which compares sharply with the published result of 82%.

  16. Increased breast cancer screening and downstaging in Colombian women: A randomized trial of opportunistic breast-screening.

    PubMed

    Murillo, Ral; Daz, Sandra; Perry, Fernando; Poveda, Csar; Pieros, Marion; Snchez, Oswaldo; Buitrago, Lina; Gamboa, Oscar; Lozano, Tefilo; Yu, Hsiang; Wang, Ching-Yun; Duggan, Catherine; Thomas, David B; Anderson, Benjamin O

    2016-02-01

    The lack of breast cancer screening in low and middle-income countries results in later stage diagnosis and worsened outcomes for women. A cluster randomized trial was performed in Bogot, Colombia between 2008 and 2012 to evaluate effects of opportunistic breast cancer screening. Thirteen clinics were randomized to an intervention arm and 13 to a control arm. Physicians in intervention clinics were instructed to perform clinical breast examination on all women aged 50-69 years attending clinics for non-breast health issues, and then refer them for mammographic screening. Physicians in control clinics were not explicitly instructed to perform breast screening or mammography referrals, but could do so if they thought it indicated ("usual care"). Women were followed for 2-years postrandomization. 7,436 women were enrolled and 7,419 (99.8%) screened in intervention clinics, versus 8,419 enrolled and 1,108 (13.1%) screened in control clinics. Incidence ratios (IR) of early, advanced and all breast cancers were 2.9 (95% CI 1.1-9.2), 1.0 (0.3-3.5) and 1.9 (0.9-4.1) in the first (screening) year of the trial, and the cumulative IR for all breast cancers converged to 1.4 (0.7-2.8) by the end of follow-up (Year 2). Eighteen (69.2%) of 26 women with early stage disease had breast conservation surgery (BCS) versus 6 (42.5%) of 14 women with late-stage disease (p?=?0.02). Fifteen (68.2%) of 22 women with breast cancer in the intervention group had BCS versus nine (50.0%) of 18 women in the control group (p?=?0.34). Well-designed opportunistic clinic-based breast cancer screening programs may be useful for early breast cancer detection in LMICs. PMID:26264446

  17. Factors Associated with the Uptake of Cervical Cancer Screening Among Women in Portland, Jamaica

    PubMed Central

    Ncube, Butho; Bey, Amita; Knight, Jeremy; Bessler, Patricia; Jolly, Pauline E.

    2015-01-01

    Background: Cervical cancer is the second most common cancer among women worldwide and is the leading cause of deaths in developing countries. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, the uptake for cervical screening among Jamaican women remains low. Aims: This study was carried out to identify factors associated with Jamaican women's decisions to screen for cervical cancer. Materials and Methods: Cross-sectional descriptive study of 403 women aged 19 years and older from Portland, Jamaica. An interviewer-administered questionnaire assessed the women's cervical cancer screening history, as well as their knowledge, attitudes, and practices regarding the disease and screening. Results: Of the 403 women interviewed, 66% had a Papanicolaou (Pap) smear and only 16% had a Pap test within the past year. Significant predicators of uptake of screening were being married, age, parity, discussing cancer with health provider, perception of consequences of not having a Pap smear, and knowing a person with cervical cancer. Women who did not know where to go for a Pap smear were 85% less likely to have been screened (prevalence odds ratio (POR): 0.15, 95% confidence interval (CI): 0.04, 0.52). Conclusions: This study showed suboptimal uptake of cervical cancer screening among Jamaican women. Multipronged approaches are needed to address barriers to screening, as well as identify and support conditions that encourage women's use of reproductive health services, thereby reducing incidence and mortality rates from cervical cancer. PMID:25839002

  18. Depression screening and management practices at a tertiary care cancer centre.

    PubMed

    Breau, Geneviève

    2014-01-01

    Depression in cancer patients reduces patient survival and quality of life, though clinicians may not screen for depression, as part of routine practice. The current study examined depression screening and management behaviour at a tertiary care cancer centre by interviewing 10 oncologists and 10 nurses. The Theory of Planned Behaviour was applied to better understand screening behaviour. Results indicated clinicians screened for depression and managed depression by consulting other health professionals. This study found that depression is screened for and managed appropriately in patients, and certain components of the Theory of Planned Behaviour may be useful in understanding screening behaviour. PMID:24707703

  19. Knowledge, attitudes, and practices regarding cervical cancer and screening among Ethiopian health care workers

    PubMed Central

    Kress, Catherine M; Sharling, Lisa; Owen-Smith, Ashli A; Desalegn, Dawit; Blumberg, Henry M; Goedken, Jennifer

    2015-01-01

    Background Though cervical cancer incidence has dramatically decreased in resource rich regions due to the implementation of universal screening programs, it remains one of the most common cancers affecting women worldwide and has one of the highest mortality rates. The vast majority of cervical cancer-related deaths are among women that have never been screened. Prior to implementation of a screening program in Addis Ababa University-affiliated hospitals in Ethiopia, a survey was conducted to assess knowledge of cervical cancer etiology, risk factors, and screening, as well as attitudes and practices regarding cervical cancer screening among womens health care providers. Methods Between February and March 2012 an anonymous, self-administered survey to assess knowledge, attitudes, and practices related to cervical cancer and its prevention was distributed to 334 health care providers at three government hospitals in Addis Ababa, Ethiopia and three Family Guidance Association clinics in Awassa, Adama, and Bahir Dar. Data were analyzed using SPSS software and chi-square test was used to test differences in knowledge, attitudes, and practices across provider type. Results Overall knowledge surrounding cervical cancer was high, although awareness of etiology and risk factors was low among nurses and midwives. Providers had no experience performing cervical cancer screening on a routine basis with <40% having performed any type of cervical cancer screening. Reported barriers to performing screening were lack of training (52%) and resources (53%); however the majority (97%) of providers indicated cervical cancer screening is an essential part of womens health care. Conclusion There is a clear need among womens health care providers for education regarding cervical cancer etiology, risk factors and for training in low-tech, low-cost screening methods. Meeting these needs and improving the infrastructure necessary to implement appropriate screening programs is essential to reduce the burden of cervical cancer in Ethiopia. PMID:26261427

  20. Breath testing as potential colorectal cancer screening tool.

    PubMed

    Amal, Haitham; Leja, Marcis; Funka, Konrads; Lasina, Ieva; Skapars, Roberts; Sivins, Armands; Ancans, Guntis; Kikuste, Ilze; Vanags, Aigars; Tolmanis, Ivars; Kirsners, Arnis; Kupcinskas, Limas; Haick, Hossam

    2016-01-01

    Although colorectal cancer (CRC) screening is included in organized programs of many countries worldwide, there is still a place for better screening tools. In this study, 418 breath samples were collected from 65 patients with CRC, 22 with advanced or nonadvanced adenomas, and 122 control cases. All patients, including the controls, had undergone colonoscopy. The samples were analysed with two different techniques. The first technique relied on gas chromatography coupled with mass spectrometry (GC-MS) for identification and quantification of volatile organic compounds (VOCs). The T-test was used to identify significant VOCs (p values < 0.017). The second technique relied on sensor analysis with a pattern recognition method for building a breath pattern to identify different groups. Blind analysis or leave-one-out cross validation was conducted for validation. The GC-MS analysis revealed four significant VOCs that identified the tested groups; these were acetone and ethyl acetate (higher in CRC), ethanol and 4-methyl octane (lower in CRC). The sensor-analysis distinguished CRC from the control group with 85% sensitivity, 94% specificity and 91% accuracy. The performance of the sensors in identifying the advanced adenoma group from the non-advanced adenomas was 88% sensitivity, 100% specificity, and 94% accuracy. The performance of the sensors in identifying the advanced adenoma group was distinguished from the control group was 100% sensitivity, 88% specificity, and 94% accuracy. For summary, volatile marker testing by using sensor analysis is a promising noninvasive approach for CRC screening. PMID:26212114

  1. Fecal DNA testing for Colorectal Cancer Screening: the ColoSure test

    PubMed Central

    Ned, Rene M.; Melillo, Stephanie; Marrone, Michael

    2011-01-01

    Colorectal cancer is the third most common cancer and the second leading cause of cancer-related deaths in the United States. Screening has been shown to be effective in reducing colorectal cancer incidence and mortality. Colonoscopy, sigmoidoscopy, and fecal occult blood tests are all recommended screening tests that have widespread availability. Nevertheless, many people do not receive the evidence-based recommended screening for colorectal cancer. Additional stool-based methods have been developed that offer more options for colorectal cancer screening, including a variety of fecal DNA tests. The only fecal DNA test that is currently available commercially in the United States is ColoSure(TM), which is marketed as a non-invasive test that detects an epigenetic marker (methylated vimentin) associated with colorectal cancer and pre-cancerous adenomas. We examined the published literature on the analytic validity, clinical validity, and clinical utility of ColoSure and we briefly summarized the current colorectal cancer screening guidelines regarding fecal DNA testing. We also addressed the public health implications of the test and contextual issues surrounding the integration of fecal DNA testing into current colorectal cancer screening strategies. The primary goal was to provide a basic overview of ColoSure and identify gaps in knowledge and evidence that affect the recommendation and adoption of the test in colorectal cancer screening strategies. PMID:21487548

  2. Factors influencing Breast Cancer Screening in Low-Income African Americans in Tennessee

    PubMed Central

    Patel, Kushal; Kanu, Mohamed; Liu, Jianguo; Bond, Brea; Brown, Elizabeth; Williams, Elizabeth; Theriot, Rosemary; Bailey, Stephanie; Sanderson, Maureen; Hargreaves, Margaret

    2014-01-01

    This study examined demographic and lifestyle factors that influenced decisions and obstacles to being screened for breast cancer in low-income African Americans in three urban Tennessee cities. As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, health care access and utilization, and screening practices for various cancers in low-income African Americans. For this study, only African American women 40 years and older (n=334) were selected from the Meharry CNP community survey database. There were several predictors of breast cancer screening such as marital status and having health insurance (P< .05). Additionally, there were associations between obstacles to screening and geographic region such as transportation and not having enough information about screenings (P< .05). Educational interventions aimed at improving breast cancer knowledge and screening rates should incorporate information about obstacles and predictors to screening. PMID:24554393

  3. A systematic review of patient acceptance of screening for oral cancer outside of dental care settings.

    PubMed

    Paudyal, Priyamvada; Flohr, Francesca D; Llewellyn, Carrie D

    2014-10-01

    This systematic review summarised the literature on patient acceptability of screening for oral cancer outside dental care settings. A comprehensive search of relevant literature was performed in EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, CINAHAL, psycINFO, CANCERLIT and BNI to identify relevant articles published between 1975 and Dec 2013. Studies reporting acceptability of oral cancer screening to undiagnosed individuals attending non-dental settings were eligible for inclusion. A total of 2935 references were initially identified from the computerised search but 2217 were excluded after screening the titles. From the abstracts of the remaining 178 articles, 47 full text articles were retrieved for further scrutiny, and 12 studies were found to be eligible for inclusion. In these studies, knowledge about oral cancer, anxiety related to the screening process, preference for care provision, and financial cost were influencing factors for the acceptance of screening. Written information provided to patients in primary care was reported to boost immediate knowledge levels of oral cancer, lessen anxiety, and increase intentions for screening. The majority of screening methods were entirely acceptable to patients; lack of acceptability from the patients' viewpoint was not a significant barrier to carrying out opportunistic screening of high-risk populations. In conclusion, the available evidence suggests that acceptance of, and satisfaction with oral cancer screening is high, particularly where patients have previously been educated about oral cancer. Further research focusing on patient's preferences would enable streamlining of the approach to oral cancer screening taken by any national programme. PMID:25127201

  4. Determinants of Breast, Cervical and Colorectal Cancer Screening Adherence in Mexican American Women

    PubMed Central

    Gonzalez, Patricia; Castaneda, Sheila F.; Mills, Paul J.; Talavera, Gregory A.; Elder, John P.; Gallo, Linda C.

    2012-01-01

    Despite the effectiveness of cancer screening procedures, its utilization among Latinas remains low. Guided, in part, by the Behavioral Model for Vulnerable Populations, this study examined the associations between predisposing, enabling, and need factors with self-reported breast, cervical, and colorectal cancer screening adherence. Participants were 319 Mexican American women, from a range of socioeconomic (SES) backgrounds, living near the United States-Mexico border. Women were adherent with breast cancer (BC) screening (?42 years) if they had received at least one mammogram within the last two years, with cervical cancer (CC) screening (?40 years) if they had received at least one Pap exam in the last three years, and with colorectal cancer (CRC) screening (?52 years) if they had undergone one or more of the following: Fecal Occult Blood Test (FOBT) within the last year, or sigmoidoscopy in the last 5 years, or colonoscopy within the last 10 years. BC and CC screenings were higher in the current sample compared to national and state figures: 82% with mammography and 86% adherent with Pap exam screening. However, only 43% were adherent with CRC screening recommendations. Characteristics associated with mammography adherence included CC adherence and usual source of care. BC adherence was associated to CC adherence. Characteristics associated with CRC adherence included BC adherence, being premenopausal, and insurance coverage. A key correlate of cancer screening adherence was adherence to other preventive services. Results underscore the need for continued efforts to ensure that Latinas of all SES levels obtain regular and timely cancer screenings. PMID:21874364

  5. China national lung cancer screening guideline with low-dose computed tomography (2015 version)

    PubMed Central

    Zhou, Qing-hua; Fan, Ya-guang; Bu, Hong; Wang, Ying; Wu, Ning; Huang, Yun-chao; Wang, Guiqi; Wang, Xin-yun; Qiao, You-lin

    2015-01-01

    Background Lung cancer is the leading cause of cancer-related death in China. Results from a randomized controlled trial using annual low-dose computed tomography (LDCT) in specific high-risk groups demonstrated a 20% reduction in lung cancer mortality. Methods A China national lung cancer screening guideline was developed by lung cancer early detection and treatment expert group appointed by the National Health and Family Planning Commission, based on results of the National Lung Screening Trial, systematic review of evidence related to LDCT screening, and protocol of lung cancer screening program conducted in rural China. Results Annual lung cancer screening with LDCT is recommended for high risk individuals aged 50–74 years who have at least a 20 pack-year smoking history and who currently smoke or have quit within the past five years. Individualized decision making should be conducted before LDCT screening. LDCT screening also represents an opportunity to educate patients as to the health risks of smoking; thus, education should be integrated into the screening process in order to assist smoking cessation. Conclusions A lung cancer screening guideline is provided for the high-risk population in China. PMID:26557925

  6. Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans

    PubMed Central

    Thompson, Caroline A.; Gomez, Scarlett Lin; Chan, Albert; Chan, John K.; McClellan, Sean R.; Chung, Sukyung; Olson, Cliff; Nimbal, Vani; Palaniappan, Latha P.

    2014-01-01

    BACKGROUND Routinely recommended screening for breast, cervical, and colorectal cancers can significantly reduce mortality from these types of cancer, yet screening is underutilized among Asians. Surveys rely on self-report and often are underpowered for analysis by Asian ethnicities. Electronic health records include validated (as opposed to recall-based) rates of cancer screening. In this paper we seek to better understand cancer screening patterns in a population of insured Asian Americans. METHODS We calculated rates of compliance with cervical, breast, and colorectal cancer screening among Asians from an EHR population, and compared them to non-Hispanic whites. We performed multivariable modeling to evaluate potential predictors (at the provider- and patient- level) of screening completion among Asian patients. RESULTS Aggregation of Asian subgroups masked heterogeneity in screening rates. Asian Indians and Native Hawaiians and Pacific Islanders had the lowest rates of screening in our sample, well below that of non-Hispanic whites. In multivariable analyses, screening completion was negatively associated with patient-physician language discordance for mammography (OR:0.81 95% CI:0.71–0.92) and colorectal cancer screening (OR:0.79 CI:0.72–0.87) and positively associated with patient-provider gender concordance for mammography (OR:1.16 CI:1.00–1.34) and cervical cancer screening (OR:1.66 CI:1.51–1.82). Additionally, patient enrollment in online health services increased mammography (OR:1.32 CI:1.20–1.46) and cervical cancer screening (OR:1.31 CI:1.24–1.37). CONCLUSIONS Language- and gender- concordant primary care providers, and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations. IMPACT This study demonstrates how use of EHR data can inform investigations of primary prevention practices within the healthcare delivery setting. PMID:25368396

  7. Stated Preference for Cancer Screening: A Systematic Review of the Literature, 1990–2013

    PubMed Central

    Mansfield, Carol; Ekwueme, Donatus U.; Smith, Judith Lee; Guy, Gery P.; Li, Chunyu; Hauber, A. Brett

    2016-01-01

    Introduction Stated-preference methods provide a systematic approach to quantitatively assess the relative preferences for features of cancer screening tests. We reviewed stated-preference studies for breast, cervical, and colorectal cancer screening to identify the types of attributes included, the use of questions to assess uptake, and whether gaps exist in these areas. The goal of our review is to inform research on the design and promotion of public health programs to increase cancer screening. Methods Using the PubMed and EconLit databases, we identified studies published in English from January 1990 through July 2013 that measured preferences for breast, cervical, and colorectal cancer screening test attributes using conjoint analysis or a discrete-choice experiment. We extracted data on study characteristics and results. We categorized studies by whether attributes evaluated included screening test, health care delivery characteristics, or both. Results Twenty-two studies met the search criteria. Colorectal cancer was the most commonly studied cancer of the 3. Fifteen studies examined only screening test attributes (efficacy, process, test characteristics, and cost). Two studies included only health care delivery attributes (information provided, staff characteristics, waiting time, and distance to facility). Five studies examined both screening test and health care delivery attributes. Overall, cancer screening test attributes had a significant effect on a patient’s selection of a cancer screening test, and health care delivery attributes had mixed effects on choice. Conclusion A growing number of studies examine preferences for cancer screening tests. These studies consistently find that screening test attributes, such as efficacy, process, and cost, are significant determinants of choice. Fewer studies have examined the effect of health care delivery attributes on choice, and the results from these studies are mixed. There is a need for additional studies on the barriers to cancer screening uptake, including health care delivery attributes, and the effect of education materials on preferences. PMID:26916898

  8. Updates and Controversies in the Rapidly Evolving Field of Lung Cancer Screening, Early Detection, and Chemoprevention

    PubMed Central

    Kathuria, Hasmeena; Gesthalter, Yaron; Spira, Avrum; Brody, Jerome S.; Steiling, Katrina

    2014-01-01

    Lung cancer remains the leading cause of cancer-related death in the United States. Cigarette smoking is a well-recognized risk factor for lung cancer, and a sustained elevation of lung cancer risk persists even after smoking cessation. Despite identifiable risk factors, there has been minimal improvement in mortality for patients with lung cancer primarily stemming from diagnosis at a late stage when there are few effective therapeutic options. Early detection of lung cancer and effective screening of high-risk individuals may help improve lung cancer mortality. While low dose computerized tomography (LDCT) screening of high risk smokers has been shown to reduce lung cancer mortality, the high rates of false positives and potential for over-diagnosis have raised questions on how to best implement lung cancer screening. The rapidly evolving field of lung cancer screening and early-detection biomarkers may ultimately improve the ability to diagnose lung cancer in its early stages, identify smokers at highest-risk for this disease, and target chemoprevention strategies. This review aims to provide an overview of the opportunities and challenges related to lung cancer screening, the field of biomarker development for early lung cancer detection, and the future of lung cancer chemoprevention. PMID:24840047

  9. Cost-effectiveness of Prostate Cancer Screening: A Simulation Study Based on ERSPC Data

    PubMed Central

    de Carvalho, T. M.; Auvinen, A.; Zappa, M.; Nelen, V.; Kwiatkowski, M.; Villers, A.; Pez, A.; Moss, S. M.; Tammela, T. L. J.; Recker, F.; Denis, L.; Carlsson, S.V.; Wever, E. M.; Bangma, C. H.; Schrder, F. H.; Roobol, M. J.; Hugosson, J.; de Koning, H. J.

    2015-01-01

    Background: The results of the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial showed a statistically significant 29% prostate cancer mortality reduction for the men screened in the intervention arm and a 23% negative impact on the life-years gained because of quality of life. However, alternative prostate-specific antigen (PSA) screening strategies for the population may exist, optimizing the effects on mortality reduction, quality of life, overdiagnosis, and costs. Methods: Based on data of the ERSPC trial, we predicted the numbers of prostate cancers diagnosed, prostate cancer deaths averted, life-years and quality-adjusted life-years (QALY) gained, and cost-effectiveness of 68 screening strategies starting at age 55 years, with a PSA threshold of 3, using microsimulation modeling. The screening strategies varied by age to stop screening and screening interval (one to 14 years or once in a lifetime screens), and therefore number of tests. Results: Screening at short intervals of three years or less was more cost-effective than using longer intervals. Screening at ages 55 to 59 years with two-year intervals had an incremental cost-effectiveness ratio of $73000 per QALY gained and was considered optimal. With this strategy, lifetime prostate cancer mortality reduction was predicted as 13%, and 33% of the screen-detected cancers were overdiagnosed. When better quality of life for the post-treatment period could be achieved, an older age of 65 to 72 years for ending screening was obtained. Conclusion: Prostate cancer screening can be cost-effectiv