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The listing includes projects involved with the screening, detection, and diagnosis of gastrointestinal, hepatic, and pancreatic cancer; lung cancer; bladder and prostate cancer; leukemia and lymphoma; thyroid, oral, and other head and neck cancer; other ...
Cancerscreening is a complicated science. Each screening intervention must be carefully assessed before it is widely implemented. A screening test can falsely appear useful as it finds disease at an early stage and leads to intervention and cure. Such a test can be harmful to the population screened if it commonly finds disease that fulfills the pathologic criteria of
Table 3 provides a summary of key recommendations for each cancer site discussed in this chapter. One of the unifying principles of cancerscreening is that every clinician or group practice needs to define an explicit screening policy. Resources must then be devoted to implementing this policy, evaluating adherence, and improving performance. PMID:12529905
Cancerscreening is a complicated science. Each screening intervention must be carefully assessed before it is widely implemented. A screening test can falsely appear useful as it finds disease at an early stage and leads to intervention and cure. Such a test can be harmful to the population screened if it commonly finds disease that fulfills the pathologic criteria of cancer but behaves indolently (meaning it would never harm the host). Such "pseudo-disease" or "overdiagnosed disease" has been demonstrated in many malignancies including cancers of the lung, breast, and especially the prostate. The nature of each specific screening test and each disease is such that some screened patients may receive unnecessary treatment with all its complications and risk. Alternatively, some screening technologies have been proven useful providing net benefit to the population screened. Often these beneficial technologies are underused. These screening technologies if widely implemented have the potential of saving countless lives. Many available screening tests have tremendous potential in terms of benefit, but have yet to be fully assessed. At the minimum, patients should be informed of what is known, what is not known, and what is believed about these tests. PMID:15124134
Abstract Objectives We explored self-reported rates of individual on-schedule breast, cervical, and colorectal cancerscreenings, as well as an aggregate measure of comprehensive screenings, among unmarried women aged 40–75 years. We compared women who partner with women (WPW) or with women and men (WPWM) to women who partner exclusively with men (WPM). We also compared barriers to on-schedule cancerscreenings between WPW/WPWM and WPM. Methods Comparable targeted and respondent-driven sampling methods were used to enroll 213 WPW/WPWM and 417 WPM (n?=?630). Logistic regression models were computed to determine if partner gender was associated with each measure of on-schedule screening after controlling for demographic characteristics, health behaviors, and cancer-related experiences. Results Overall, 74.3% of women reported on-schedule breast screening, 78.3% reported on-schedule cervical screening, 66.5% reported on-schedule colorectal screening, and 56.7% reported being on-schedule for comprehensive screening. Partner gender was not associated with any of the measures of on-schedule screening in multivariable analyses. However, women who reported ever putting off, avoiding, or changing the place of screenings because of sexual orientation were less likely to be on-schedule for comprehensive screening. Women who reported barriers associated with taking time from work and body image concerns were also less likely to be on-schedule for comprehensive screening. Conclusions Barriers to cancerscreening were comparable across types of examinations as well as between WPW/WPWM and WPM. Developing health promotion programs for unmarried women that address concomitant detection and prevention behaviors may improve the efficiency and effectiveness of healthcare delivery and ultimately assist in reducing multiple disease risks.
Rogers, Michelle L.; Armstrong, Gene F.; Rakowski, William; Bowen, Deborah J.; Hughes, Tonda; McGarry, Kelly A.
What is cervical cancerscreening? Cervical cancerscreening is used to find changes in the cells of the cervix that could lead ... includes the FAQ Human Papillomavirus Infection]. How is cervical cancerscreening done? Cervical cancerscreening is simple and ...
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.
STUDY OBJECTIVE--The aim was to demonstrate the benefits of breast cancerscreening on mortality. DESIGN--The study was an evaluation of a breast cancerscreening programme by means of different approaches: (1) a case-control study, breast cancer deaths being the cases; (2) comparing the numbers of breast cancer deaths in screened and unscreened women; (3) comparing breast cancer mortality before and
H J Collette; F de Waard; J J Rombach; C Collette; N E Day
... These are called diagnostic tests . General Information About Cervical Cancer Cervical cancer is a disease in which malignant (cancer) cells ... Cervical Cancer Prevention Cervical Cancer Treatment Screening for cervical cancer using the Pap test has decreased the number ...
... of Interventions to Increase CancerScreeningCancerScreening in the United States Physician Practices Regarding Genetic Testing Cancers Diagnosed at Late Stages African American Women and Mass Media Campaign Public Service Announcements Public Service Announcements Transcripts ...
Although colorectal cancer is the third leading cause of cancer-related deaths in the United States, 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 50 years. However, the myriad screening options and slight differences in screening recommendations between guidelines
Prostate cancer is the most common cancer and the second leading cause of cancer-related deaths in American men. Although\\u000a the use of the prostate-specific antigen (PSA) test for prostate cancerscreening since the 1990s has led to increased early\\u000a diagnoses, the most recent studies are in conflict about the risks and benefits of routine prostate cancerscreening. Recently,\\u000a evidence has
... ongoing clinical trials is available from the NCI Web site . Three tests are used by health care providers to screen ... ongoing clinical trials is available from the NCI Web site . Risks of Breast CancerScreeningScreening tests have risks. Decisions about screening tests can be ...
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 cancerscreening services through the Breast and Cervical Cancer Program in Savannah and Macon, Georgia. PMID:23072329
Hall, Ingrid J; Rim, Sun Hee; Johnson-Turbes, C Ashani; Vanderpool, Robin; Kamalu, Ngozi N
Context Breast cancerscreening in community practices may be different from that in randomized controlled trials. New screening modalities are becoming available. Objectives To review breast cancerscreening, especially in the community and to examine evidence about new screening modalities. Data Sources and Study Selection English-language articles of randomized controlled trials assessing effectiveness of breast cancerscreening were reviewed, as well as meta-analyses, systematic reviews, studies of breast cancerscreening in the community, and guidelines. Also, studies of newer screening modalities were assessed. Data Synthesis All major US medical organizations recommend screening mammography for women aged 40 years and older. Screening mammography reduces breast cancer mortality by about 20% to 35% in women aged 50 to 69 years and slightly less in women aged 40 to 49 years at 14 years of follow-up. Approximately 95% of women with abnormalities on screening mammograms do not have breast cancer with variability based on such factors as age of the woman and assessment category assigned by the radiologist. Studies comparing full-field digital mammography to screen film have not shown statistically significant differences in cancer detection while the impact on recall rates (percentage of screening mammograms considered to have positive results) was unclear. One study suggested that computer-aided detection increases cancer detection rates and recall rates while a second larger study did not find any significant differences. Screening clinical breast examination detects some cancers missed by mammography, but the sensitivity reported in the community is lower (28% to 36%) than in randomized trials (about 54%). Breast self-examination has not been shown to be effective in reducing breast cancer mortality, but it does increase the number of breast biopsies performed because of false-positives. Magnetic resonance imaging and ultrasound are being studied for screening women at high risk for breast cancer but are not recommended for screening the general population. Sensitivity of magnetic resonance imaging in high-risk women has been found to be much higher than that of mammography but specificity is generally lower. Effect of the magnetic resonance imaging on breast cancer mortality is not known. A balanced discussion of possible benefits and harms of screening should be undertaken with each woman. Conclusions In the community, mammography remains the main screening tool while the effectiveness of clinical breast examination and self-examination are less. New screening modalities are unlikely to replace mammography in the near future for screening the general population.
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 Case–control and prospective cohort study. Setting Europe and North America. Patients Participants in the European Early Lung Cancer (EUELC) and Harvard case–control 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 cancerscreening. Primary Funding Source Roy Castle Lung Cancer Foundation.
Raji, Olaide Y.; Duffy, Stephen W.; Agbaje, Olorunshola F.; Baker, Stuart G.; Christiani, David C.; Cassidy, Adrian; Field, John K.
This article is the first phase in the Gateways to CancerScreeningproject – a user?driven participatory research project that examines barriers and facilitators to preventive cancerscreening for women with physical mobility disabilities. Through a systematic review of the existing literature on this subject we discover that, despite the fact that women with disabilities have the same biological risk
Julie Devaney; Lisa Seto; Nancy Barry; Fran Odette; Linda Muraca; Sharmini Fernando; Samira Chandani; Jan Angus
ObjectiveTo project long-term estimates of the number needed to screen (NNS) and the additional number needed to treat (NNT) to prevent one prostate cancer death with prostate-specific antigen (PSA) screening in Europe and in the United States.
Roman Gulati; Angela B. Mariotto; Shu Chen; John L. Gore; Ruth Etzioni
One of the most common cancers, colorectal cancer is a leading cause of cancer deaths worldwide. The vast majority of colorectal carcinomas develop slowly from easily-removed precursors (adenomas), and in contrast to most other types of cancer, chances of prevention and early detection are very good. Tests for fecal occult blood, sigmoidoscopy and colonoscopy are frequently recommended and widely used. Most western countries have initiated population-wide screening programs for colorectal cancer, with the goal of greatly reducing incidence and mortality. Various models for screening programs and different screening examinations have been proposed and implemented. Evidence from a range of countries shows that the highest participation rates are obtained when programs are designed to invite eligible individuals to come in for screening. PMID:23535550
Brenner, Hermann; Stock, Christian; Hoffmeister, Michael
... service covered? Search Medicare.gov for covered items Prostate cancerscreenings How often is it covered? Medicare ... covers: Digital rectal exam: Once every 12 months Prostate Specific Antigen (PSA) test: Once every 12 months ...
Although primary prevention of human papillomavirus (HPV) infections that are causally associated with invasive cervical cancer\\u000a may be within our grasp, it is unlikely that these approaches will replace existing cervical cancerscreening strategies for\\u000a many years. Experts agree and data support periodic cytology screening for young-adult women using one of several technologies.\\u000a Recent analyses of cost-effectiveness suggest that the
Dorothy J. Wiley; Bradley J. Monk; Emmanuel Masongsong; Kristina Morgan
Breast cancer is the most common non-skin cancer and the second leading cause of cancer death in North American women. Mammography is the only screening test shown to reduce breast cancer-related mortality. There is general agreement that screening should be offered at least biennially to women 50 to 74 years of age. For women 40 to 49 years of age, the risks and benefits of screening should be discussed, and the decision to perform screening should take into consideration the individual patient risk, values, and comfort level of the patient and physician. Information is lacking about the effectiveness of screening in women 75 years and older. The decision to screen women in this age group should be individualized, keeping the patient's life expectancy, functional status, and goals of care in mind. For women with an estimated lifetime breast cancer risk of more than 20 percent or who have a BRCA mutation, screening should begin at 25 years of age or at the age that is five to 10 years younger than the earliest age that breast cancer was diagnosed in the family. Screening with magnetic resonance imaging may be considered in high-risk women, but its impact on breast cancer mortality is uncertain. Clinical breast examination plus mammography seems to be no more effective than mammography alone at reducing breast cancer mortality. Teaching breast self-examination does not improve mortality and is not recommended; however, women should be aware of any changes in their breasts and report them promptly. PMID:23418799
Since 1989, several breast cancerscreening mammography programs have been established. The purpose of this chapter is to provide the history and the main results of the previous programs. Furthermore, special attention is given to the new rules established in 2001 with emphasis of the general principles as well as the ethical principles of breast screening. PMID:12075156
The feasibility of mass population screening for breast cancer by clinical examination and x-ray mammography was studied. The results indicate that such a programme could be conducted effectively by non-medical staff and be safe from the dangers of irradiation. The response rate of women invited for screening suggests that such a service is acceptable to the general public. The additional work load produced by screening would not overburden the existing surgical services.
George, W D; Gleave, E N; England, P C; Wilson, M C; Sellwood, R A; Asbury, D; Hartley, G; Barker, P G; Hobbs, P; Wakefield, J
... Over time, some polyps can turn into cancer. Colon Polyp • Screening tests can find polyps, so they can ... longer, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and • Blood in or on your stool (bowel movement). the entire colon. During the test, the doctor can • Stomach pain, ...
Prostate cancer is a serious health care problem in the United States. Whether or not to screen for it has become a timely issue. Although a large number of men have clinically important, asymptomatic, undetected prostate cancer, an even larger number have clinically unimportant cancer. To justify screening programs, not only must we avoid detecting biologically unimportant cancers, we must also detect and effectively treat that subset of tumors that, if undiagnosed, would progress, produce symptoms, and reduce life expectancy. Serum prostate-specific antigen (PSA) assay, or its variations such as PSA density, PSA velocity, and age-specific reference ranges, and the digital rectal examination are the best tests for detecting clinically important, asymptomatic, curable tumors. Recent data suggest that using serum PSA levels does not result in an overdetection of unimportant tumors. Highly effective, curative treatment of localized prostate cancer is available. These factors promote optimism that screening for prostate cancer will ultimately prove beneficial. Nonetheless, men should be informed regarding the benefits and possible risks before being screened for prostate cancer.
Colorectal cancer (CRC) is the most common cancer in the Nordic countries after breast and prostate cancer. About 15,000 new cancers are diagnosed and more than 7000 patients will die from CRC in 2005. CRC fulfils most of the criteria for applying screening; the natural history is well known compared with many other cancers. CRC may be cured by detection at an early stage and even prevented by removal of possible precursors like adenomas. Faecal occult blood test is the only CRC screening modality that has been subjected to adequately sized randomised controlled trials (RCT) with long-term follow-up results, using Hemoccult-II. Sensitivity for strictly asymptomatic CRC is less than 30% for a single screening round, but programme sensitivity has been estimated to be more. Biennial screening with un-rehydrated Hemoccult-II slides has shown a CRC mortality reduction of 15-18% after approximately 10 years of follow-up in those targeted for screening. For those attending, the mortality reduction has been estimated at 23%. Denmark has decided to do feasibility studies to try to evaluate whether a population-based screening run by the community will have the same effect as has been demonstrated in the randomised trials. In Norway the government has accepted no formal population-based screening. In Finland, the Ministry of Social Affairs and Health made a recommendation in 2003 to the municipalities to run a randomised feasibility study with FOBT screening for colorectal cancer as a public health policy that is repeated every second year. In 2004 the first municipalities started. It has been claimed that today Sweden cannot afford CRC screening despite the potential mortality benefit. There is sufficient evidence for the efficacy of screening for colorectal cancer with fecal occult blood test every second year. There is, however, only little evidence on the effectiveness of screening when run as a public health service and there is insufficient knowledge of harmful effects and costs, even in RCTs. PMID:16118076
Hakama, Matti; Hoff, Geir; Kronborg, Ole; Pĺhlman, Lars
Colorectal carcinoma represents a major cause of cancer deaths in the United Kingdom. Tumours detected at an early or even premalignant stage have a better prognosis. In this review we consider the argument for screening for colorectal carcinomas and discuss the means available and the implications of implementing screening programmes using some of these methods. A suggestion is made for the more rational use of limited resources to target those at greatest risk.
\\u000a In the randomized controlled trials carried out in the late 1970s and the 1980s, mammographic screening was demonstrated to\\u000a have an impact in decreasing mortality from breast cancer. The evaluation of mammographic service screening programmes implemented\\u000a in several Western European countries in the late 1980s and the 1990s demonstrated that these programmes may have an even\\u000a higher effect on breast
In the United Kingdom there are almost 31,000 new cases of colorectal cancer each year and nearly 20,000 deaths. It is the second most common cause of all deaths from cancer in the United Kingdom. The efficacy of screening with faecal occult blood tests to detect and treat tumours at an early stage, and thereby to reduce mortality, is currently being assessed in several randomised controlled trials. In general, faecal occult blood tests have a low sensitivity and only moderate levels of uptake among the population invited for screening. Until the studies in Denmark, Sweden, and Nottingham report their findings, there is no case for providing such screening routinely to an asymptomatic population. Detecting and removing premalignant adenomas by flexible sigmoidoscopy could be more effective than detecting early localised, asymptomatic cancers in reducing deaths from colorectal cancer. It is estimated that screening people at about the age of 60 by a single flexible sigmoidoscopy examination with appropriate colonoscopic surveillance could prevent 5500 cases of colorectal cancer and 3500 deaths in the United Kingdom each year. A randomised controlled trial to confirm these observations should be seen as a priority.
The specific aims of the research project were: To evaluate screening for breast cancer in relation to mortality, particularly focusing on older women and the interval between screens; To determine the efficacy of sigmoidoscopic screening for prevention o...
To be successful, screening procedures must have certain properties: simplicity, acceptability, reasonable costs, and adequate sensitivity. The evolution of mammography over the past 10 years has allowed the examination to fall within accepted standards for these properties, and it has become a widely accepted procedure. Its expanded use has resulted in an increase in the detection of early stage disease with a profound effect upon the treatment of the disease. Survival continues to correlate with cancer size and nodal involvement, and the increase in the number of early cases diagnosed eventually should be reflected in a decreasing mortality rate. Though the efficacy of screening mammography for women between the ages of 50 and 69 is well-established, its usefulness in women aged 40-49 has provoked considerable debate. Despite the disagreements concerning appropriate screening thresholds and intervals, the American Cancer Society and the American College of Radiology have concluded that sufficient evidence exists to maintain published guidelines. PMID:8334656
The purpose of this paper is to clarify the objectives of screening programs, particularly for cancer, characteristics of diseases suitable for screening, features of suitable screening tests, levels of program evaluation, and evidence on the advantages and disadvantages of screening. Diseases suitable for screening are those leading to serious morbidity and high mortality, those with a prolonged preclinical phase in their natural course, and those for which effective therapy is available following early diagnosis. Useful screening procedures have documented validity, acceptability, and safety and are performed with relative ease and modest cost. These generic issues in cancerscreening are examined in the context of screening for cervical, breast, and lung cancer. Each of these cancers illustrates how to weigh different kinds of evidence when advocating or rejecting screening. PMID:3746492
Abstract Objective To describe cancerscreening rates for cancer survivors and compare them with those for matched controls. Design Population-based, retrospective study with individuals linked across administrative databases. Setting Ontario. Participants Survivors of breast (n = 11 219), colorectal (n = 4348), or endometrial (n = 3473) cancer, or Hodgkin lymphoma (HL) (n = 2071) matched to general population controls. Survivors were those who had completed primary treatment and were on “well” follow-up. The study period was 4 years (1 to 5 years from the date of cancer diagnosis). Main outcome measures Never versus ever screened (in the 4-year study period) for breast cancer, colorectal cancer (CRC), and cervical cancer and never versus ever received (during the study period) a periodic health examination; rates were compared between cancer survivors and controls. Random effects models were used to estimate odds ratios and 95% CIs. Results Sixty-five percent of breast cancer survivors were never screened for CRC and 40% were never screened for cervical cancer. Approximately 50% of CRC survivors were never screened for breast or cervical cancer. Thirty-two percent of endometrial cancer survivors were never screened for breast cancer and 66% were never screened for CRC. Forty-four percent of HL survivors were never screened for breast cancer, 77% were never screened for CRC, and 32% were never screened for cervical cancer. Comparison with matched controls showed a mixed picture, with breast and endometrial cancer survivors more likely, and CRC and HL survivors less likely, than controls to be screened. Conclusion There is concern about the preventive care of cancer survivors despite frequent visits to both oncology specialists and family physicians during the “well” follow-up period.
Grunfeld, Eva; Moineddin, Rahim; Gunraj, Nadia; Del Giudice, M. Elisabeth; Hodgson, David C.; Kwon, Janice S.; Elit, Laurie
Early Detection and Screening: Screening for Colorectal Cancer Colorectal cancer--currently the second leading cause of cancer death in this country--is frequently preventable and highly treatable if detected early. NCI's Division of Cancer Control and
Findings from the National Cancer Institute's 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 cancerscreening 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 cancerscreening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancerscreening 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 cancerscreening. 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
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
This chapter focuses on the special issues that need to be considered when making decisions to screen older persons for cancer.\\u000a Specifically, while there is substantial evidence that screening for colorectal, breast, and cervical cancer reduces cancer\\u000a mortality among persons in their 50s and 60s [1–6], few screening trials included persons over age 70. Therefore, clinicians\\u000a must assess whether to
... cases of stomach cancer has greatly decreased since 1930. The reasons for this are not clear, but ... will decrease the risk of dying from cancer. Scientists study screening tests to find those with the ...
An apparatus and method for improving the contrast between incident projected light and ambient light reflected from a projectionscreen are described. The efficiency of the projectionscreen for reflection of the projected light remains high, while permitting the projectionscreen to be utilized in a brightly lighted room. Light power requirements from the projection system utilized may be reduced.
... a challenge for resource managers as they review current management practices. Adaptation is a critical means of addressing climate change in the near ... greenhouse gases will be felt for decades even if effective mitigation begins now. ... a joint project of the three western Forest Service research stations whose goal ...
Lung cancer is the leading cause of cancer-related death in men and the second leading cause in women. Smoking cessation is the most effective measure to prevent development of lung cancer. Early detection trials with chest x-ray and sputum cytology failed to show reduction lung cancer mortality, despite the larger proportion of early-stage lung cancer diagnosed in the screened arm. The advent of low-dose chest computed tomography disclosed new perspectives. In 2011 an innovative, large prospective randomized controlled trial called "Reduced lung-cancer mortality with low-dose computed tomographic screening" was published and revealed reduced lung-cancer and overall mortality when persons at risk were annually screened by low-dose computed tomography compared to annually chest x-rays. At the moment, lung cancerscreening cannot be recommended in general. It is uncertain for which duration screening should be continued, which screening modality is most appropriate and cost effective and what the psychological impact in case of indeterminate findings is. To avoid lung cancerscreening programs being started imprudently, the Swiss healthcare system needs a provider independent commission mandated to continuously monitor ongoing screening trials, evaluate the results as well as the economical aspects, and make evidence based recommendations. PMID:22753286
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.
There is growing enthusiasm for community-academic partnerships to promote health in underserved communities. Drawing upon resources available at a comprehensive cancer center, we developed the ACCESS program to guide community based organizations through a flexible program planning process. Over a three-year period, ACCESS partnered with 67 agencies serving various medically underserved populations. Organizations included hospitals, parishes, senior centers, harm reduction
Bruce D. Rapkin; Mary Jane Massie; Elizabeth J. Jansky; David W. Lounsbury; Paulette D. Murphy; Shemeeakah Powell
The aim of this study was to describe the state of the art in cervical cancerscreening in Greece by presenting the two regionally organised screening programmes that currently operate in the country. Both programmes were initiated in 1991 and are partly funded by the European Union. The Ormylia screening programme covers the population of Halkidiki (Northern Greece), a predominantly
E Riza; P Kyriakogianni-Psaropoulou; E Koumantakis; H Symiakaki; I Garas; A Linos
Much progress has been made in cancerscreening over the past decade, but a great deal more needs to be done if screening is to make a major impact on worldwide cancer mortality. Where fully implemented, cytological screening for cervical precursor lesions has had a major impact on mortality. However, the cost and required infrastructure levels are high, and new approaches are needed if screening is to be effective in the developing world. Testing for the human papillomavirus and automated liquid based cytology offer great promise to improve quality, reduce overall cost and make screening more viable generally. Breast screening has been less successful, although useful mortality benefits have been achieved in women aged over 50 years. Full implementation in countries that can afford it will save lives, but radical new approaches will be needed to conquer breast cancer. Colorectal cancerscreening offers the best hope of a major reduction in cancer mortality over the next decade. Less certainty exists about screening for other major cancers such as lung, prostate and ovary, but a range of potential approaches merit investigation.
Much progress has been made in cancerscreening over the past decade, but a great deal more needs to be done if screening is to make a major impact on worldwide cancer mortality. Where fully implemented, cytological screening for cervical precursor lesions has had a major impact on mortality. However, the cost and required infrastructure levels are high, and new approaches are needed if screening is to be effective in the developing world. Testing for the human papillomavirus and automated liquid based cytology offer great promise to improve quality, reduce overall cost and make screening more viable generally. Breast screening has been less successful, although useful mortality benefits have been achieved in women aged over 50 years. Full implementation in countries that can afford it will save lives, but radical new approaches will be needed to conquer breast cancer. Colorectal cancerscreening offers the best hope of a major reduction in cancer mortality over the next decade. Less certainty exists about screening for other major cancers such as lung, prostate and ovary, but a range of potential approaches merit investigation. PMID:10711235
Much progress has been made in cancerscreening over the past decade, but a great deal more needs to be done if screening is to make a major impact on worldwide cancer mortality. Where fully implemented, cytological screening for cervical precursor lesions has had a major impact on mortality. However, the cost and required infrastructure levels are high, and new approaches are needed if screening is to be effective in the developing world. Testing for the human papillomavirus and automated liquid based cytology offer great promise to improve quality, reduce overall cost and make screening more viable generally. Breast screening has been less successful, although useful mortality benefits have been achieved in women aged over 50 years. Full implementation in countries that can afford it will save lives, but radical new approaches will be needed to conquer breast cancer. Colorectal cancerscreening offers the best hope of a major reduction in cancer mortality over the next decade. Less certainty exists about screening for other major cancers such as lung, prostate and ovary, but a range of potential approaches merit investigation. PMID:10505025
In recent years medical ethics has become an undisputed part of medical studies. Many people believe that modern advances in medical technology - such as the development of dialysis machines, respirators, magnetic resonance imaging and genetic testing and types of cancerscreenings - have created bioethical dilemmas that confront physicians in the 21st century. Debates over research and screening ethics have until recently revolved around two related questions: the voluntary, informed consent of subjects, and the appropriate relationship between risk and benefit to subjects. Every patient has a right to full and accurate information about his or her medical condition. This legal principle arose primarily through court decisions concerning informed consent, but over time physicians recognized that most patients prefer to learn the truth about their condition and use the information well. To screen is to search for disease in the absence of symptoms or, in other words, to attempt to find disease in someone not thought to have a disease. Examples of screening include routine mammography to detect breast cancer, routine pap smears to detect cervical cancer, and routine Prostate Specific Antigen (PSA) testing to detect prostate cancer. Ethical principles to be followed in cancerscreening programmes are intended mainly to minimize unnecessary harm for the participating individuals. Numerous ethical questions can be raised about the practice of screening for disease. Here, we examine four leading cancer killers worldwide and we review the screening of protocols of these cancer types and their possible ethics. PMID:14728598
...Prostate, Lung, Colorectal and Ovarian CancerScreening Trial SUMMARY: In compliance...data collection projects, the National Cancer Institute (NCI), the National Institutes...Prostate, Lung, Colorectal and Ovarian CancerScreening Trial. Type of...
...Prostate, Lung, Colorectal and Ovarian CancerScreening Trial (PLCO) (NCI) SUMMARY...data collection projects, the National Cancer Institute (NCI), the National Institutes...Prostate, Lung, Colorectal and Ovarian CancerScreening Trial (PLCO). Type of...
Begun in the latter half of the sixties, mass screening for uterine cancer received a fresh impetus with the implementation in February of 1983 of the Health of the Aged Act. Under the latter law, a certain number of problems were also encountered, since autonomous municipalities were newly involved. This report is a description of the Pap test under the new screening system and methods of the uterine cancer mass screening approach or the screening system advanced by Japan Society of obstetrics & gynecology, committee on uterine cancerscreening. It covers the primary screening, the secondary screening and detailed screening, their roles and manner in which they are implemented in terms of the local situation. Also, the points deserving the greatest care up through the detailed screening are presented. The importance in particular of the results of the Pap test at the stage of the primary screening, the histological findings, and the reliable transaction of the specimens therefrom, are emphasized. For the mass screening for uterine cancer to result in lower cancer mortality, it is necessary that there be at least 30% of the women aged 30 and over who reside in a given district submitting to the mass screening judging from the results garnered both at home and abroad. The measures needed to reach this goal are introduced. The steps conventionally employed to attain this objective of a higher proportion of women being examined, as well as the mass media propaganda, have their limits. The role of the committees for supervising administration of the screening must be amplified as a concrete means to implement the Health of the Aged Act; the role of the municipalities, which support this realization, must be stressed, the importance of administration policy in the form of periodical examinations, examinations focused on the women of certain ages and the plans for testing with due balance in responsibility between mobile and stationary facility examinations, must be upgraded. Communications with the local medical association and related organizations is also crucial. PMID:4073921
... These are called diagnostic tests . General Information About Lung Cancer Lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung. The lungs are a pair of cone-shaped ...
... Colorectal cancer is the second leading cause of death from cancer in the United States. The number ... for colorectal cancer helps decrease the number of deaths from the disease. Four tests are used to ...
... These are called diagnostic tests . General Information About Prostate Cancer Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male ...
The scattered, inconsistent and incomplete data in the literature have prompted a comprehensive study of the physical and optical properties of projectionscreens. A large sample number of front and rear projectionscreens was obtained, representing the i...
In recent years medical ethics has become an undisputed part of medical studies. Many people believe that modern advances in medical technology - such as the development of dialysis machines, respirators, magnetic resonance imaging and genetic testing and types of cancerscreenings - have created bioethical dilemmas that confront physicians in the 21st century. Debates over research and screening ethics
Prostate cancer is a major healthcare problem worldwide, especially in the industrialized countries of the Western world.\\u000a Prostate cancer has become the most common type of cancer among men and is the second leading cause of years of life lost\\u000a from cancer in males . Incidence estimates for the year 2000 indicate prostate cancer newly affected 542,990 men worldwide\\u000a that
In 2005, there were 9264 deaths from prostate cancer, accounting for 4.7% of the total number of cancer deaths in Japan. As the population continues to age, interest in prostate cancerscreening has increased, and opportunistic screening for prostate cancer has been conducted worldwide. The guideline for prostate cancerscreening was developed based on the established method. The efficacies of
The International CancerScreening Network (ICSN) is a voluntary consortium of countries that have active population-based cancerscreening programs and active efforts to evaluate and improve the processes and outcomes from cancerscreening in practice. The ICSN includes efforts to evaluate cancerscreening for a number of cancers where screening has been demonstrated to be effective, including breast, colorectal, cervical, and lung. These programs can be national or subnational in scope, and established or pilot-based.
The purpose of this document is to compare cancerscreening for colon, prostate, breast and cervical cancer between adults with and without obesity and examine whether differences occur by sex and race. Previous studies suggest cancerscreening may differ...
... Cancer that forms in squamous cells is called squamous cell carcinoma . Basal cells : Round cells under the squamous cells. ... in the United States. Basal cell carcinoma and squamous cell carcinoma are also called nonmelanoma skin cancer and are ...
... 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 ...
A 44-year-old woman who is a new patient has no known current health problems and no family history of breast or ovarian cancer. Eighteen months ago, she had a normal screening mammogram. She recently read that mammograms may not help to prevent death from breast cancer and that “the patient should decide.” But she does not think she knows enough. She worries that there is a breast-cancer epidemic. What should her physician advise?
\\u000a Cancer is a devastating and debilitating disease. Each year more than 1.4 million people are diagnosed with non-skin cancers\\u000a and 565,650 lives are lost in the United States . Primary prevention of cancer through behavioral modifications in risk\\u000a factors such as tobacco use, sun exposure, obesity, physical inactivity, unhealthy diet, and alcohol consumption can reduce\\u000a the burden of cancer tremendously
Colorectal cancer (CRC) remains a cancer in a disappointing location. However, its location clearly has an advantage that\\u000a could theoretically permit efficient secondary prevention: the preceding of the cancer by a benign lesion, ie, the adenoma.\\u000a Complete colonoscopy and its substitute, the double-contrast barium enema, and their specific limitations, must be reserved\\u000a for high-risk patients: hereditary cancers and ulcerative colitis.
\\u000a The large bowel is world-wide the fourth commonest site for cancer after lung, stomach and breast and the fourth cause of\\u000a cancer death after lung, stomach and liver cancer. There were 943,000 new cases diagnosed and 510,000 large bowel cancer deaths\\u000a in 2000 (Parkin et al. 2001). Highest incidence rates occur in North America, Northern Europe and Australasia where the
STUDY OBJECTIVE--The aim was to make projections of the likely costs and yield resulting from the implementation of a faecal occult blood screening programme for colorectal cancer. DESIGN--Cost and clinical data were derived from the MRC colorectal screening trial currently in progress in Nottingham, UK. SETTING--The above data were used as the basis for modelling the likely implications were the trial to be reproduced as a screening programme within a "typical" family practitioner committee area. MAIN RESULTS--For an average family practitioner committee area with a target population of 75,000 subjects aged 50-74 years, the initial screening round might be expected to detect 85 cancers at a total cost of approximately 250,000 pounds. This represents a cost per cancer detected of 2700 pounds and a cost per person screened of approximately 5 pounds. For subsequent screening rounds, total costs might be expected to fall although average costs are likely to remain approximately constant. CONCLUSIONS--The model is successful in generating "order of magnitude" estimates for the costs of implementation of a screening programme for colorectal cancer. As benefit estimates are not yet available, however, no cost-effectiveness analysis can be undertaken at this stage. In general, sensitivity analyses reveal that programme costs are more sensitive to changes in clinical variables, especially detection and compliance rates, than they are to variations in the costs of resource inputs. A screening programme with a more elaborate protocol than that currently employed in the Nottingham trial will entail considerable cost increases.
Walker, A; Whynes, D K; Chamberlain, J O; Hardcastle, J D
... This method checks your bowel movements for blood. Polyps in the colon and smaller cancers often cause small amounts of ... RISK PEOPLE People with certain risk factors for colon cancer may need ... This usually means first-degree relatives (parent, sibling, ...
Screening for cancer has become extremely common. The evidence supporting screening for breast, colon, and cervix cancer is\\u000a strong, but it is unclear for skin cancer, problematic for prostate cancer, and ineffective for lung cancer. Despite the problems\\u000a associated with many screening approaches for cancer, enthusiasm by the medical profession and the public remains high. The\\u000a objective analysis for the
Dr. Barry Kramer summaries the results of the Prostate, Lung, Colorectal and Ovarian CancerScreening Trial. Dr. Christine Berg discuss the results of the colorectal cancer arm of the Prostate, Lung, Colorectal and Ovarian CancerScreening Trial.
Researchers are working on developing effective methods to screen for prostate cancer. However, it has not yet been shown that screening for prostate cancer decreases the chances of dying from prostate cancer.
Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Many, if not most, cases arise from premalignant lesions (adenomas) which may be identified and removed prior to becoming frankly malignant. For over a decade, colonoscopy has been the preferred modality for both CRC screening and prevention in the US. Early reports suggested that colonoscopic screening imparted a 90% risk reduction for colorectal cancer. Subsequent studies showed that estimate to be overly optimistic. While still an outstanding CRC screening and detection tool, colonoscopy has several important limitations. Some of these limitations relate to the mechanics of the procedure such as the risk of colonic perforation, bleeding, adverse consequences of sedation, and the inability to detect all colonic polyps. Other limitations reflect issues with patient perception regarding colonoscopy which, at least in part, drive patient non-adherence to recommended testing. This review examines the literature to address several important issues. First, we analyze the effect of colonoscopy on CRC incidence and mortality. Second, we consider the patient-based, periprocedural, and intraprocedural factors which may limit colonoscopy as a screening modality. Third, we explore new techniques and technologies which may enhance the efficacy of colonoscopy for adenoma detection. Finally, we discuss the short and long-term future of colonoscopy for CRC screening and the factors which may affect this future.
Objectives: Investigate the relationship between the dependent variable health outcome (perceived health status) and the independent variables population characteristics, (predisposing, which includes age, acculturation, months in the United States; enabling, which includes availability of medical insurance) and health behavior (personal health practices, which includes engaging in cancerscreening of mammography, Pap smear, and breast self-exam) among immigrant women from the
Screening for Colorectal Cancer: A Guidance Statement From the American College of Physicians Summaries for Patients are a service provided by Annals ... medicine. The full report is titled “Screening for Colorectal Cancer: A Guidance Statement From the American College of ...
Mortality from breast cancer is decreasing partly owing to early detection. In Mersin province in our country, local health authorities launched an education program on sexual diseases and breast cancer early detection for women over 15 years of age. After the educational session, clinical breast examination was offered by a nurse or physician, and if suspicious they were recommended to apply a specialist for further examination. Here, we report the results on those women with abnormal clinical breast examination. In this second project, socio-demographic variables were investigated such as educational level and place of living,parameters to measure the success of previous project, whether they followed the recommendation themselves, whether mammograms were reported in accordance with Breast Imaging Reporting and Data System (BIRADS). Of 3,793 women recruited, mean age was 42.2 years, 42.3%were younger than 40.0 years. Majority (88.5%) were married, graduate of primary school (60.6%), without a job(91.2%), and inhabiting in the province (38.7%). Of the population, 98.1% believe in the importance of screening in the treatment of breast cancer. According to 70.3%,monthly breast self-examination enables early detection, 33.5% believe that clinical breast examination detects cancer early, and 35.5% think that annual mammography can detect it early. Among 2,183 women 40 years of age or over, 41.5% had mammography at once before participating in the first project. Breast self-examination was being carried out by 56.6% on a monthly basis. After an abnormal breast examination, 86.4% applied to hospitals for specialist examination. Reasons for declining to seek for further examination among 410 women answering were as follows:42.0% did not accept, 27.0% did not know it was important, 16.6% because of economical reasons, and 5.0% were too shy to be examined. Being older, being married, being the graduate of primary and secondary school, residing in rural areas, having a mammogram positively affected the decision in univariate analyses (p<0.05). All but educational level (p=0.059) remained significant in multivariate analysis. Mammography was reported in accordance with BIRADS in only 45 (1.2%). Awareness of population on breast cancer early detection can be raised through education. Generally, women follow professional recommendation from professionals. Mammography reporting among radiologist in accordance with BIRADS is rare. Successful early detection of breast cancer may be obtained by public education together with improving detection methods. PMID:21976034
Background Despite evidence that several colorectal cancer (CRC) screening strategies can reduce CRC mortality, screening rates remain low. This study aimed to determine whether the approach by which screening is recommended influences adherence. Methods We used a cluster randomization design with clinic time block as the unit of randomization. Persons at average risk for development of CRC in a racially/ethnically diverse urban setting were randomized to receive recommendation for screening by fecal occult blood testing (FOBT), colonoscopy, or their choice of FOBT or colonoscopy. The primary outcome was completion of CRC screening within 12 months after enrollment, defined as performance of colonoscopy, or 3 FOBT cards plus colonoscopy for any positive FOBT result. Secondary analyses evaluated sociodemographic factors associated with completion of screening. Results A total of 997 participants were enrolled; 58% completed the CRC screening strategy they were assigned or chose. However, participants who were recommended colonoscopy completed screening at a significantly lower rate (38%) than participants who were recommended FOBT (67%) (P< .001) or given a choice between FOBT or colonoscopy (69%) (P< .001). Latinos and Asians (primarily Chinese) completed screening more often than African Americans. Moreover, non-white participants adhered more often to FOBT, while white participants adhered more often to colonoscopy. Conclusions The common practice of universally recommending colonoscopy may reduce adherence to CRC screening, especially among racial/ethnic minorities. Significant variation in overall and strategy-specific adherence exists between racial/ethnic groups; however, this may be a proxy for health beliefs and/or language. These results suggest that patient preferences should be considered when making CRC screening recommendations. Trial Registration clinicals.gov Identifier: NCT00705731
Inadomi, John M.; Vijan, Sandeep; Janz, Nancy K.; Fagerlin, Angela; Thomas, Jennifer P.; Lin, Yunghui V.; Munoz, Roxana; Lau, Chim; Somsouk, Ma; El-Nachef, Najwa; Hayward, Rodney A.
Colorectal cancer is the third leading type of cancer, and the second leading cause of cancer-related death in the United States. Prevention of colorectal cancer should be achievable by screening programs that detect adenomas in asymptomatic patients and lead to their removal. In this manuscript, we review the major screening modalities, the advantages and disadvantages of each approach, the data
Christopher S. Huang; Subodh K. Lal; Francis A. Farraye
Colorectal cancer is the third most common cancer in the United States. Although mortality and incidence rates are declining in the United States, colorectal cancerscreening remains underused. In addition, recent data suggest that colonoscopy, which is often considered the gold standard for colorectal cancerscreening, is less protective for right-sided tumors, which are more likely to be flat or
OBJECTIVES To provide an overview of the status of lung cancerscreening. DATA SOURCES Published articles, book chapters, websites, and research studies on lung cancerscreening. CONCLUSION Screening with chest x-ray and sputum cytology has not been shown to be effective in reducing lung cancer mortality. Although screening with helical CT is currently under investigation in randomized clinical trials, observational studies have not shown evidence that it can detect lung cancer that is curable. IMPLICATION FOR NURSING PRACTICE As healthcare educators and caregivers, nurses should be informed of the status and current controversies associated with lung cancerscreening.
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Non–AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancerscreening is now an important component\\u000a of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an\\u000a assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the\\u000a screening test and its potential outcome.
Keith Sigel; Robert Dubrow; Michael Silverberg; Kristina Crothers; Scott Braithwaite; Amy Justice
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.
Colorectal cancer is the second commonest cause of cancer death in the UK. An effective national screening programme is urgently required to reduce the substantial morbidity and mortality from the disease. The success of any screening programme will depend on the screening test detecting early Dukes's A carcinomas and adenomatous polyps. Prognosis is directly related to tumour staging and a
Objectives: Sigmoidoscopy screening and fecal occult blood (FOB) tests have been demonstrated as effective ways to reduce mortality from colorectal cancer. However, most studies of colorectal cancerscreening and cancer mortality have not taken into consideration lifestyle factors that could account for the observed associations. The purpose of this study was to determine the association between screening and incidence of
Martha L. Slattery; Sandra L. Edwards; Khe Ni Ma; Gary D. Friedman
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 articles calling for screening. Implications of broadly implemented screening for all patients across treatment settings are discussed. PMID:22492662
Kazak, Anne E; Brier, Moriah; Alderfer, Melissa A; Reilly, Anne; Fooks Parker, Stephanie; Rogerwick, Stephanie; Ditaranto, Susan; Barakat, Lamia P
In 2006, an estimated 275,000 women in the United States were diagnosed with breast cancer and 41,000 patients died of this disease. 1 Because breast cancer is a common disease and early stage cancers detected by mammography are more successfully treated, mam- mogram screening programs have been instrumental in reducing breast cancer mortality. The morbidity of breast cancer treatment has
The cost-effectiveness of a series of mutually exclusive colorectal cancerscreening programmes with varying screening interval and target group are analysed. Costs and effects for 60 possible screening programmes are simulated on the basis of data collected from a randomized trial initiated in 1985 in Funen County, Denmark. The screening test applied is the unhydrated Hemoccult-II. The analysis identifies six
Of all colorectal cancerscreening methods, colonoscopy used as a primary screening tool is both the most promising and the most discussed in the current literature. Several countries have introduced colonoscopic screening on a national scale, but many issues still require further research. The practicality of using colonoscopic screening can be questionable given the huge target population, which requires a
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
Background: This study examines socio-demographic determinants of participation in a population-based randomized controlled trial that proved that oral visual inspection was effective in reducing oral cancer mortality in high-risk individuals in India. Methods: Multivariate logistic regression was used to establish socio-demographic characteristics of participants versus non-participants in the intervention arm. Compliance with referral was analysed according to the socio-demographic characteristics
K. Ramadas; S. Arrossi; S. Thara; G. Thomas; V. Jissa; J. M. Fayette; B. Mathew; R. Sankaranarayanan
BACKGROUND: Compared to normal weight women, women with obesity have higher mortality from breast cancer but are less often screened.\\u000a \\u000a \\u000a OBJECTIVES: To examine the relation between mammography use and weight category and to examine the influence of race, illness burden,\\u000a and other factors on this relationship.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN AND SETTING: The 1998 National Health Interview Survey, a U.S. civilian population-based survey.
Christina C. Wee; Ellen P. McCarthy; Roger B. Davis; Russell S. Phillips
Background Prostate cancerscreening rates are higher than colorectal cancerscreening rates, despite the established benefit of screening in reducing colorectal cancer incidence and mortality. Methods We used data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS) to identify correlates of colorectal cancerscreening among men who have undergone prostate cancerscreening. Results Our sample included 41,781 men aged 50 years and older who reported undergoing prostate cancerscreening in the last year. More than two-thirds (69.2%) of the men were up to date with colorectal cancerscreening. On multivariable analysis, men who were younger, Hispanic, less educated, not married or partnered, employed, not a veteran, did not have a personal doctor, lacked a recent medical checkup, smoked, or were sedentary were less likely to be adherent to colorectal cancerscreening. Conclusion Tailored interventions targeted towards men who have already undergone prostate cancerscreening may improve rates of colorectal cancerscreening in a group that may be already aware of, and interested in, the benefits of cancer risk prevention. The prostate cancerscreening encounter may represent a “teachable moment” to increase colorectal cancerscreening rates.
Prostate cancerscreening rates are higher than colorectal cancer (CRC) screening rates, despite the established benefit of\\u000a screening in reducing CRC incidence and mortality. We used data from the 2006 Behavioral Risk Factor Surveillance System to\\u000a identify correlates of CRC screening among men who have undergone prostate cancerscreening. Our sample included 41,781 men\\u000a aged 50 years and older who reported
The Prostate, Lung, Colorectal and Ovarian (PLCO) CancerScreening Trial, sponsored by the National Cancer Institute (NCI), reached a significant milestone last month with the enrollment of its final participant
Cancerscreening guidelines are developed by numerous agencies. These guidelines are often conflicting leaving the primary care physician in a difficult position. He (she) is requested to choose the best test for his or her patients taking into consideration the principles of screening, the test cost and most importantly the patient's emotional and physical well-being. Screening for some cancers, like lung cancer, has been considered of no benefit. Other cancers, like breast, colon, cervix and prostate, have been the subject of numerous recommendations: For breast cancer, clinical examination and mammography are recommended every 1-2 years for women between 50 to 70 years. For cervical cancer, PAP smear is suggested every 1-3 years and for colorectal cancer, a yearly fecal occult blood, sigmoidoscopy or colonoscopy every 5-10 years. Annual serum prostate specific antigen (PSA) and digital rectal examination screening for prostate cancer are still controversial. PMID:12243426
Ashkar, K; Bulbul, M; Sharara, A; Hourani, M; Hamadeh, G N
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 dis...
Organised breast cancerscreening targets women aged between 50 and 74. Beyond this age group, the risk persists and cancer professionals notice inequalities in access to diagnosis linked to age. With the aim of improving early detection of these cancers in women over 75, an oncogeriatric nurse at the Léon-Bérard cancer centre in Lyon has carried out a study to find out if modesty could represent a hindrance to screening. PMID:22891464
Prostate cancer is the most common cancer in men in the United States. In 2003, 221,000 men were newly diagnosed with prostate cancer and 28,000 died of the disease. 1 Since 1989 prostate specific antigen (PSA) has been accepted and used as a key tumor marker in regard to screening for prostate cancer and monitoring for progression or recurrence in
In modern healthcare, one of the most public, most important, and at the same time complicated and scientifically demanding topics is screening for a cancer. Mammographic screening for breast cancer has been, in the last few years, a particularly hotly disputed topic in scientific and public policy circles, with similar confusion and frustration widely reported and thus disseminated by the mass media. Most remarkably, this debacle has taken place against the backdrop of, and despite,a truly enormous amount of completed research designed to address the usefulness of such screening. To avoid a "mammography" debacle for lung cancer, the fundamental principles of screening need to be presented as we have come to think of them. Although it is generally accepted that low-dose computed tomography (CT) screening leads to early diagnosis of lung cancer in a high percentage of the cases, the logical consequence of the current knowledge is that annual CT screening prevents death from lung cancer. Thus, it is not whether CT screening is effective, rather the magnitude of its benefit which needs to be determined. We will illustrate our approach by discussing the Early Lung Cancer Action Project and its New York and International sequels. PMID:16000600
Non-AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancerscreening is now an important component of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the screening test and its potential outcome. HIV-infected patients are at enhanced risk of several cancers compared to the general population; anal cancer, hepatocellular carcinoma, Hodgkin's lymphoma, and lung cancer all have good evidence demonstrating an enhanced risk in HIV-infected persons. A number of cancerscreening interventions have shown benefit for specific cancers in the general population, but data on the application of these tests to HIV-infected persons are limited. Here we review the epidemiology and background literature relating to cancerscreening interventions in HIV-infected persons. We then use these data to inform a conceptual model for evaluating HIV-infected patients for cancerscreening. PMID:21695529
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).
Abd El All, Howayda S; Refaat, Amany; Dandash, Khadiga
and in many countries attempts are be- ing made to apply this lesson to breast cancerscreening. 2 However, organization is only one of the require- ments for effective screening programs. The others include a valid and acceptable screening test, earlier and efficient diag- nosis of the disease, minimal diagnosis of nonprogressive dis- ease, effective therapy for the detected disease
The increasing use of rear projectionscreens has brought about the need for a better understanding of their performance limits based on an analytical model which relates the physical and optical properties of the screen. A theoretical model is developed based on the Mie theory of light scattering, and a general discussion is given of the optical and viewing properties of rear projectionscreens, using an operational terminology. Basic light scattering data are used to calculate relations between such optical properties as screen brightness, axial gain, uniformity, efficiency, color fidelity, and ambient light sensitivity from such physical parameters as scattering particle size and number density, and relative refractive index of the scattering particles. Data from experimental investigations of volume scattering materials fabricated by Corning Glass Works are found to be in good agreement with the theoretical calculations. PMID:20068680
Breast cancerscreening is a highly complex and more recently a controversial topic. Conventional screening includes breast self-examination, clinical breast examination, and screening mammography. Several newer imaging modalities have been introduced into the screening armamentarium including breast magnetic resonance imaging and whole-breast automated ultrasound. Novel imaging techniques like positron emission mammography are currently under clinical investigation in the hopes of improving the sensitivity of breast cancerscreening. In addition, the development of biochemical assays, which employ minimally invasive sampling are also promising. PMID:22828098
Feldman, Elizabeth D; Oppong, Bridget A; Willey, Shawna C
Problem: Fetal Alcohol Syndrome (FAS) is preventa- ble, under-diagnosed, and under-reported. Wisconsin rates for alcohol use and binge drinking in childbear- ing-age women exceed the national average. FAS preva- lence in Wisconsin has not previously been systemati- cally evaluated. Methods: The Wisconsin Fetal Alcohol Syndrome ScreeningProject (WFASSP) used a multi-stage, multi- source prospective population-based screening meth- odology to identify
Marianne Weiss; Christine E. Cronk; Sandra Mahkorn; Randall Glysch; Sara Zirbel
OBJECTIVE--To assess the value of ultrasonography in a screening procedure for early ovarian cancer. DESIGN--Prospective study of at least 5000 self referred women without symptoms of ovarian cancer. Each woman was scheduled to undergo three annual screenings (consisting of one or more scans) to detect grossly abnormal ovaries or non-regressing masses. SETTING--The ovarian screening clinic at King's College Hospital, London.
S. Campbell; V. Bhan; P. Royston; M. I. Whitehead; W. P. Collins
In most psychological and medical research, patients are assumed to have difficulties with health statistics but clinicians not. However, studies indicate that most doctors have problems in understanding health statistics, including those of their own speciality. For example, only two out of 20 urologists knew the information relevant for a patient to make an informed decision about whether to take PSA screening for prostate cancer, just 14 out of 65 physicians in internal medicine understood that 5-year survival rates do not tell anything about screening's benefit, and merely 34 out of 160 gynecologists were able to interpret the meaning of a positive test result. This statistical illiteracy has a direct effect on patients understanding and interpretation of medical issues. Not rarely their own limited health literacy and their doctors' misinformation make them suffer through a time of emotional distress and unnecessary anxiety. The main reasons for doctors' statistical illiteracy are medical schools that ignore the importance of teaching risk communication. With little effort doctors could taught the simple techniques of risk communication, which would make most of their statistical confusion disappear. PMID:23535552
Quality assurance is a key issue in colorectal cancerscreening, because effective screening is able to improve primary prevention of the cancer. The quality measure may be described in terms: how well the screening test tells who truly has a disease (sensitivity) and who truly does not have a disease (specificity). This paper raises concerns about identification of the optimal screening test for colorectal cancer. Colonoscopy vs flexible sigmoidoscopy in colorectal cancerscreening has been a source of ongoing debate. A multicentre randomised controlled trial comparing flexible sigmoidoscopy with usual care showed that flexible sigmoidoscopy screening is able to diminish the incidence of distal and proximal colorectal cancer, and also mortality related to the distal colorectal cancer. However, colonoscopy provides a more complete examination and remains the more sensitive exam than flexible sigmoidoscopy. Moreover, colonoscopy with polypectomy significantly reduces colorectal cancer incidence and colorectal cancer-related mortality in the general population. The article considers the relative merits of both methods and stresses an ethical aspect of patient’s involvement in decision-making. Patients should be informed not only about tests tolerability and risk of endoscopy complications, but also that different screening tests for bowel cancer have different strength to exclude colonic cancer and polyps. The authorities calculate effectiveness and costs of the screening tests, but patients may not be interested in statistics regarding flexible sigmoidoscopy screening and from an ethical point of view, they have the right to chose colonoscopy, which is able to exclude a cancer and precancerous lesions in the whole large bowel.
Worldwide, cervical cancer is a leading cause of cancer related morbidity and mortality. For over 50 years, cervical cytology has been the gold standard for cervical cancerscreening. Because of its profound effect on cervical cancer mortality in nations that have adopted screening programs, the Pap smear is widely accepted as the model screening test. Since its introduction, many studies have analyzed the Pap smear and found that it is not without its shortcomings including low sensitivity for detection of cervical intraepithelial neoplasia 2/3. Additionally, the discovery of infection with the human papillomavirus (HPV) as a necessary step in the development of cervical cancer has led to the development of HPV testing as an adjunct to cytology screening. More recently, researchers have compared HPV testing and cytology in the primary screening of cervical cancer. In this review, we will discuss cytologic testing limitations, the role of HPV DNA testing as an alternative screening tool, the impact of the HPV vaccine on screening, and future directions in cervical cancerscreening.
This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet. The project is in 3 phases: (1) hardware/software ...
B. A. Crothers D. C. Wilbur J. A. Gelfand J. H. Eichhorn M. S. Ro
Following the demonstration of the superior validity of human papillomavirus (HPV) tests in screening for cervical cancer and the arrival of highly efficacious HPV 16 and 18 vaccines, cervical cancer prevention enters a time of sustainable introduction in developing countries. Multidisciplinary efforts and novel protocols are being developed, and challenging situations are being faced to make cervical cancer, still the
Cervical cancer is a major cause of mortality and premature death among women in their most productive years in low- and medium-resourced countries in Asia, Africa and Latin America, despite the fact that it is an eminently preventable cancer. While cytology screening programmes have resulted in a substantial reduction of cervical cancer mortality in developed countries, they have been shown
In a prospective study we determined the frequency and causes of delay in the diagnosis of breast cancer after suspicious screening mammography. We included all women aged 50–75 years who underwent biennial screening mammography in the southern breast cancerscreening region of the Netherlands between 1 January 1996 and 1 January 2002. Clinical data, breast imaging reports, biopsy results and
L E M Duijm; J H Groenewoud; F H Jansen; J Fracheboud; M van Beek; H J de Koning; LEM Duijm
Despite the efficacy of mammography and the widespread promotion of screening programmes, a significant number of eligible women still do not attend for regular breast screening. An integrative review methodology was considered the most appropriate means to critically analyse the available literature pertaining to factors which influence participation in breast cancerscreening. From the extensive literature search, 12 selected core research papers met the inclusion criteria and were incorporated in the literature review. Four themes emerged from the literature which impact on participation in mammography screening: psychological and practical issues, ethnicity issues, influence of socioeconomic status and issues related to screening programmes. The recent Independent Review Panel on Breast CancerScreening endorsed the importance of access to information which clearly communicates the harms and benefits of breast screening to enable women to make informed decisions about their health. The recommendations from the panel and others have been included in this review. PMID:24067312
Edgar, Lynne; Glackin, Marie; Mary Ann Rogers, Katherine; Hughes, Caroline
Screening and early diagnosis of colorectal cancer Colorectal cancer, major health problem in industrialised countries, fulfils the conditions required for mass screening. Data from controlled studies indicate that it is possible to reduce colorectal cancer mortality at a population level using faecal occult blood testing. Population-based studies rely on biennial testing in subjects between 50 and 74 and total colonoscopy in case of positive test. The colorectal cancer mortality decrease in this case varies between 15 and 28% in the general population, 33 and 39% among participants to screening. In order to decrease significantly colorectal cancer mortality compliance has to be over 50%. On the basis of available data, the European Commission recommended to organise colorectal cancerscreening in the EU. Epidemiological studies allow us to define subjects at high risk for colorectal cancer. Colonoscopy screening is recommended in first degree relatives of patients with colorectal cancer diagnosed before 60 or 65 or with two affected first-degree relatives, in subjects with an extended ulcerative colitis or Crohn disease or with a personal history of large bowel cancer or large adenoma. PMID:20225558
Recent advances in the understanding of prostate cancer pathology, screening methods, and epidemiology were discussed at the 11th International Prostate Cancer Update. Regarding pathology, Dr. Gary Miller enumerated several factors that lead to the perception of prostate cancer as “unpredictable.” These include the disease’s multifocal nature, variable progression rates, and the uncertainty regarding the point at which carcinomas metastasize. Screening methods have been the subject of research by the Laval University Prostate CancerScreening Program since 1988. Dr. Fernand Labrie presented the results of this 10-year study. Dr. Daisaku Hirano presented data from his studies of prostate cancer epidemiology in Japan as compared to the United States. The role of environmental factors, particularly diet, in prostate cancer pathogenesis and development is supported by the increase of the disease in Japan, concurrent with the “westernization” of diet there. Finally, useful information was presented on new computer- and Internet-based diagnostic and research tools.
Crawford, E. David; Miller, Gary J; Labrie, Fernand; Hirano, Daisaku; Batuello, Joseph; Glode, L Michael
BackgroundTo estimate the benefits of prostate-specific antigen (PSA) screening on prostate cancer (Pca) metastasis and Pca-specific mortality, we compared two populations with a well-defined difference in intensity of screening.
Pim J. van Leeuwen; David Connolly; Anna Gavin; Monique J. Roobol; Amanda Black; Chris H. Bangma; Fritz H. Schröder
Background This study examines variations in breast cancerscreening among primary care clinicians by geographic location of clinical practice. Methods A cross-sectional survey design was used to examine approaches to breast cancerscreening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about breast cancerscreening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location. Results Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four breast cancerscreening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written breast cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas. Conclusion Development of an evidence-based consensus statement regarding breast cancerscreening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how breast cancerscreening is approached across varied clinical settings.
Santora, Lisa M; Mahoney, Martin C; Lawvere, Silvana; Englert, Jessica J; Symons, Andrew B; Mirand, Amy L
In this video excerpt from NOVA, learn about the advantages, disadvantages, and ethical implications of screening for genes associated with diseases, including those linked to breast and ovarian cancers.
... ensure coverage of cervical cancerscreening for private health insurance Twenty-six states and the District of Columbia ... large employers. Women who have self-insured based health insurance should check with their health plans to see ...
Diagnosing breast cancer early and efficiently is a critical component of any strategy aimed at decreasing breast cancer mortality in developing countries. In this chapter, I evaluate the evidence behind screening strategies and its controversies. The effect of breast-cancerscreening has never been formally evaluated in developing countries, and data from the major screening trials need to be viewed in this context. Screening asymptomatic women by means of breast self-examination, clinical examination or mammography can play a significant role in decreasing breast-cancer mortality in developing countries. Major programmes should not be implemented, however, until adequate diagnostic and therapeutic facilities are in place. The most fundamental interventions in early detection, diagnosis, surgery, radiation therapy, and drug therapy must be integrated, organised and resourced appropriately within existing healthcare structures. PMID:22222136
Scope and purposeTo address the benefits and limitations of oral cancerscreening and the use of adjunctive screening aids to visualise and detect potentially malignant and malignant oral lesions. Squamous cell carcinomas of the lips and cancers of the oropharynx (including the posterior one-third of the base of the tongue and the tonsils were excluded.MethodologyA specially convened expert panel evaluated
The most rigorous and valid approach to evaluating cancerscreening modalities is the randomized controlled trial, or RCT. RCTs are major undertakings and the intricacies of trial design, operations, and management are generally under appreciated by the typical researcher. The purpose of this chapter is to inform the reader of the “nuts and bolts” of designing and conducting cancerscreening 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 between the screened and control arms of cause-specific mortality rates 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 cancerscreening RCTs and provide recommendations for future trials. Throughout the chapter we illustrate topics with examples from completed or on-going RCTs, including the Prostate, Lung, Colorectal and Ovarian (PLCO) CancerScreening Trial and the National Lung Screening Trial (NLST).
Using spiral computed tomography (CT) to screen people at increased risk for lung cancer can detect the disease at an early stage and may increase the number of people who can be cured, according to the Oct. 26, 2006, New England Journal of Medicine. However, it is too soon to say whether such screening actually helps people live longer.
Our goal was to examine colorectal cancer (CRC) screening, referral, and follow-up practices in a population of Chinese and Latino immigrant patients. We conducted a nested cohort study within a larger randomized trial in a primary care clinic of a large municipal hospital. Participants were patients born in China and Latin America, new to the clinic and eligible for screening
The Michigan Dermatological Society sponsors free skin cancer detection clinics annually. In 1985, fifty-four volunteer dermatologists screened 1,909 patient-participants. In 1986, following establishment of the program and structure discussed here, 102 volunteer dermatologists screened 4,431 patient-participants. PMID:3819099
OBJECTIVES:Inclusion of colorectal cancerscreening as a performance measure in the Veterans Health Administration (VHA) health system appears to have improved screening rates but may have also increased inappropriate screening. Our aim was to ascertain whether the fecal occult blood test (FOBT) was being ordered appropriately.METHODS:We examined records of 500 consecutive primary care patients at a single VHA facility for
Background. Little is known about breast cancerscreening practices or predictors of age-specific screening for Samoan women.Methods. Through systematic, random sampling procedures, we identified and interviewed 720 adult (?30 years) Samoan women residing in American Samoa, Hawaii, and Los Angeles. Multivariate logistic regressions were performed to determine independent predictors for recent age-specific screening.Results. Only 55.6% of women (?30 years) had
ContextDespite the substantive societal impact of prostate cancer, the medical community is currently divided on the balance between benefit and harm of screening for prostate cancer using prostate-specific antigen (PSA).
In 1995, there will be 244,000 new cases of prostate cancer, and 40,400 deaths from prostate cancer, among men in the United States. The American Cancer Society reports that the incidence rate of prostate cancer is increasing at an accelerated pace, and was 21 percent higher in 1994 than in 1993. The major reason for this steep rise is likely
Lung cancerscreening has been the focus of intense interest since the publication in 2011 of the NLST trial (National Lung Screening Trial) showing a mortality reduction in smokers undergoing 3-year screening by chest computed tomography. Although these data appear promising, many issues remain to be resolved, such as high rate of false positive cases, risk of overdiagnosis, optimal intervals between screens, duration of the screening process, feasibility, and cost. Structured screening programs appear crucial to guarantee patient information, technical quality, and multidisciplinary management. Despite these uncertainties, several guidelines already state that screening should be performed in patients at risk, whereas investigators stress that more data are needed. How should the primary care physician deal with individual patients requests? This review provides some clues on this complex issue. PMID:23240295
... you love): What Women Need to Know about Colon CancerScreening 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 ...
Abstract Objective To evaluate cervical cancerscreening practices and barriers to screening in a sample of lesbians. Methods Cross-sectional survey data were collected from 225 self-identified lesbians who completed an online questionnaire. Results Of the respondents, 71% reported receiving a Pap screening test in the past 24 months (routine screeners), and 29% reported receiving a Pap screening test >24 months ago or never (nonroutine screeners). Routine screeners were more likely to be older (p?0.01), white (p?=?0.04), and college graduates (p?0.01) than nonroutine screeners. Nonroutine screeners were more likely to delay seeking healthcare because of fear of discrimination (p?0.01) and were less likely than routine screeners to disclose orientation to their primary care physician (p?0.01). After adjusting for age, race, and education, nonroutine screeners perceived fewer benefits from (p?0.01) and more barriers (p?0.01) to Pap screening tests and were less knowledgeable about screening guidelines (p?0.01) than routine screeners, but there was no difference in perceived susceptibility (p?=?0.68), perceived seriousness (p?=?0.68), or risk factor knowledge (p?=?0.35) of cervical cancer. Conclusions Many lesbians do not screen for cervical cancer at recommended rates. Nonroutine screeners perceive fewer benefits, more barriers, and more discrimination and are less knowledgeable about screening guidelines than routine screeners.
Lung Cancer is known as one of the most difficult cancers to cure. The detection of lung cancer in its early stage can be helpful for medical treatment to danger. However, mass screening based on helical CT images brings a considerable number of images to diagnosis, the time-consuming fact makes it difficult to be used in the clinic. To increase the efficiency of the mass screening process, we developed a Computer-aided diagnosis (CAD) system, which can detect nodules at high speed. It takes 17 seconds per case (35 images) to detect nodules. In this paper, we describe the development of this CAD system and specifications.
Lung Cancer is know as one fo the most difficult cancers to cure. The detection of lung cancer in its early stage can be helpful for medical treatment to danger. However, mass screening based on helical CT images brings a considerable number of images to diagnosis, the time-consuming fact makes it difficult to be used in the clinic. To increase the efficiency of the mass screening process, we developed a Computer-Aided Diagnosis (CAD) system, which can detect nodules at high speed. It takes 17 seconds per case (35 images) to detect nodules. In this paper, we describe the development of this CAD system and specifications.
The incidence of breast cancer in developing countries is rapidly on the rise, and cancers are generally detected at advanced stages when a cure is not possible. If advanced cancers could be down-staged by earlier detection, many lives can be saved. However, can a screening program be successfully implemented in these countries? A high level of compliance at every level of a screening program is essential for its success. In the absence of a high level of awareness, compounded by a fatalistic attitude to life, the necessary level compliance may not be achieved. Furthermore, in view of a relatively low incidence, many women will have to be screened to detect a breast cancer; and hence a screening program may not be cost effective. It is not clear which is the best screening test to be employed; although clinical breast examination would seem appropriate, there is currently no randomized evidence that it would lead to mortality reduction. The most reasonable approach to breast cancer control in developing countries would be to provide the minimal level of cancer care that will reduce mortality and suffering, as well as to enlighten the population about the benefits of early detection using innovative approaches. PMID:21712052
Colon cancerscreening rates in women are low. Whether screening for breast and cervical cancer is associated with colon cancer\\u000a screening behavior is unknown but could provide linkage opportunities. To identify the extent to which both breast and cervical\\u000a cancerscreening increases uptake of colon cancerscreening among women in New York City. Women at least 50 years old completed\\u000a questionnaires
Rafael Guerrero-Preston; Christina Chan; David Vlahov; Maria K. Mitchell; Stephen B. Johnson; Harold Freeman
The purpose of this four-year project is to develop a comprehensive stochastic simulation model of the effectiveness and cost-effectiveness of breast cancerscreening, including efforts to promote breast cancerscreening. Emphasis in the first year was on...
This article assessed the relationship between breast and cervical cancerscreening rates and health beliefs in African American women participating in Witness Project of Harlem (WPH) education sessions. WPH is a culturally sensitive, faith-based breast and cervical cancerscreening education program targeting African American women in medically underserved New York City communities. A questionnaire administered to women participating for the
Lisa Ochoa-Frongia; Hayley S. Thompson; Yulinda Lewis-Kelly; Terri Deans-McFarlane; Lina Jandorf
Importance Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancerscreening too frequently, there is little information about patients’ perceptions regarding cessation of cancerscreening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening. Objective To obtain a deeper understanding of older adults’ perspectives on screening cessation and their experiences communicating with clinicians about this topic. Design Semistructured interview study. Setting Senior health center affiliated with an urban hospital. Participants We interviewed 33 older adults presenting to a senior health center. Their median age was 76 years (range, 63–91 years). Of the 33 participants, 27 were women; 15 were African American, 16 were white, 1 was Asian, and 1 was American Indian. Main Outcome Measures We transcribed audio recordings of interviews and analyzed them using methods of grounded theory to identify themes and illustrative quotes. Results Undergoing screening tests was perceived by participants as morally obligatory. Although many saw continued screening as a habit or custom not involving any decision, cessation of screening would require a major decision. Many asserted that they had never discussed screening cessation with their physicians or considered stopping on their own; some reported being upset when their physician recommended stopping. Although some would accept a physician’s strong recommendation to stop, others thought that such a physician’s recommendation would threaten trust or lead them to get another opinion. Participants were skeptical about the role of statistics and the recommendations of government panels in screening decisions but were more favorable toward stopping because of the balance of risks and benefits, complications, or test burdens. Conclusions and Relevance For many older adults, stopping screening is a major decision, but continuing screening is not. A physician’s recommendation to stop may threaten patient trust. Effective strategies to reduce nonbeneficial screening may include discussion of the balance of risks and benefits, complications, or burdens.
Torke, Alexia M.; Schwartz, Peter H.; Holtz, Laura R.; Montz, Kianna; Sachs, Greg A.
Background: Mortality associated with colorectal cancer can be reduced by early detection. However, the participation of eligible people in colorectal cancerscreening is thought to be inadequate. We examined the frequency of colorectal cancerscreening in 4 Canadian provinces and the influence of patient contact with a family physician on the uptake of cancerscreening. Methods: We performed analyses using
Ryan Zarychanski; Yue Chen; Charles N. Bernstein; Paul C. Hébert
It is considered that Helicobacter pylori (Hp) infection is a requirement of the gastric cancer development, and that the atrophy of gastric mucosa is a high risk group of gastric cancer among Hp infected people. We can judge a super low risk group as well as a high risk group of the gastric cancer using the ABC classification by concomitant measurement of serum pepsinogen and serum Hp antibodies. We expect that the ABC classification contributes in population-based screening of gastric cancer. We can decide the method and the distance of the imaging examination by the ABC classification. However, it is necessary to use the ABC classification appropriately. PMID:23198563
Increased cancer risk is well established in the renal transplant population. Little, however, is known about the benefits and harms of cancerscreening, treatment effectiveness, and the overall cancer prognosis in renal transplant recipients. In this study, we critically appraised guidelines for cancerscreening in the renal transplant and general populations using standard criteria for an evidence-based screening program. Guidelines
Germaine Wong; Jeremy R. Chapman; Jonathan C. Craig
Background: The incidence of skin cancers is increasing at an alarming rate, and there is currently no consensus by major health policy organizations regarding skin cancerscreening. It has previously been shown that primary care physicians do not screen a majority of patients for skin cancer. Objective: This study was undertaken to determine the prevalence of skin cancerscreening among
Daniel G. Federman; Jeffrey D. Kravetz; Robert S. Kirsner
Colorectal cancer (CRC) is the second most common cancer among Latinos; screening can reduce mortality from CRC. The aims of this study are; to assess the current compliance with free colorectal cancerscreening among Hispanic women who are participating in a national breast and cervical cancerscreening program (NBCCEDP), and to examine the effects of a set of key constructs
Although screening for prostate cancer with prostate-specific antigen (PSA) or digital rectal exam (DRE) is commonly done, evidence is currently lacking to show a benefit of such testing on survival. The current study used a nested case-control design to assess the impact of screening with PSA (with or without DRE) on mortality.Among 71,661 patients receiving ambulatory care during 1989–1990 at
J Concato; CK Wells; D Penson; RI Horwitz; P Peduzzi
The Chicago Cancer Navigation Project will conduct a concerted intervention and evaluation of a patient navigation team consisting of a nurse, social worker, and lay navigator at a Veterans Affairs (VA) facility and five Federally Qualified Health Center (FQHC) clinics. Navigation will be provided to eligible patients with prostate, colorectal, breast or cervix abnormalities.
Screening for prostate cancer has been the subject of a new controversy in 2012, because of the updated and contradictory results of the two large randomized trials of prostate cancer and while the United States Preventive Services Task Force (USPSTF) recommended not use PSA in screening, because of the risk of overdiagnosis and overtreatment especially. However, this new thinking about PSA and screening may mislead the public and create a health risk. Media pressure must be an opportunity to remind the individual screening recommendations, but also to encourage innovation for better detection and better assess prostate cancer stage. New biomarkers and MRI are promising to improve screening with the PSA and DRE. The assessment of the value of PSA around 50 years is a predictor of the risk of prostate cancer and rhythm monitoring depends on the initial value and the velocity of PSA. The challenge of the coming years will be to identify patients to be treated regarding age, life expectancy and tumor aggressiveness and to identify clearly those who can benefit of active surveillance. PMID:23682467
OBJECTIVE To examine patient and physician preferences in regard to 5 colorectal cancerscreening alternatives endorsed by a 1997 expert panel, determine the impact of patient and physician values regarding certain test features on screening preference, and assess physicians' perceptions of patients' values. DESIGN Cross-sectional survey. SETTING A general internal medicine practice at an academic medical center in 1998. PARTICIPANTS Patients (N = 217; 76% response rate) and physicians (N = 39; 87% response rate) at the study setting. MEASUREMENTS AND MAIN RESULTS Patients preferred fecal occult blood testing (43%) or colonoscopy (40%). In patients for whom accuracy was the most important test feature, colonoscopy (62%) was the preferred screening method. Patients for whom invasive test features were more important preferred fecal occult blood testing (76%; P < .001). Patients and physicians were similar in their values regarding the various test features. However, there was a significant difference between physicians' perceptions of which test features were important to patients compared with the patients' actual responses (P < .001). The largest discrepancy was for accuracy (patient actual 54% vs physician opinion 15%) and discomfort (patient actual 15% vs physician opinion 64%). CONCLUSIONS Patients have distinct preferences for colorectal cancerscreening tests that are associated with the importance placed on certain test features. Physicians incorrectly perceive those factors that are important to patients. Physicians should incorporate patient values in regard to certain test features when discussing colorectal cancerscreening with their patients and when eliciting their screening preferences.
Ling, Bruce S; Moskowitz, Mark A; Wachs, David; Pearson, Brad; Schroy, Paul C
Colorectal cancer (CRC) is still one of the leading causes of cancer-related death in Western countries, despite major improvements in its treatment. The dramatically high social and economic impact of CRC on human health makes the identification of a reliable screening tool of paramount importance. Current screening methods, such as the fecal occult blood test and colonoscopy do not adequately meet the ideal requisites of a screening test because, even if they are effective, they are limited first by too low specificity and sensitivity, or second by high invasiveness, costs and risk. Nowadays extended efforts are made by researchers to look for more reliable and effective screening tests based on a systems biology approach, using biological samples easily available, such as urine, breath, serum and feces. The effectiveness and reliability of several new attempts to screen these patients by non-invasive analysis of their biological samples using genomic (genetic and epigenetic alteration), transcriptomic (miRNA), proteomic (cancer-related antigens, new antibodies against tumor-associated antigens, mutated proteins) and metabolomic (volatile organic metabolites) methods are discussed in this review. Among the most interesting new screening tools, fecal fluorescent long-DNA, fecal miRNA and metabolomic evaluation in breath and/or serum seem to be most promising. PMID:23569331
Di Lena, Maria; Travaglio, Elisabetta; Altomare, Donato F
BACKGROUND: Colorectal cancer (CRC) screening is underutilized despite evidence that screening reduces mortality.\\u000a \\u000a \\u000a OBJECTIVE: To assess the effect of an intervention targeting physicians and their patients on rates of CRC screening.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN: A randomized clinical trial of community physicians and their patients.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS: Ninety-four community primary care physicians randomly assigned to an intervention consisting of academic detailing and direct\\u000a mailings
Judith M. E. Walsh; René Salazar; Jonathan P. Terdiman; Ginny Gildengorin
Colorectal cancer (CRC) is a major health problem worldwide. Although population-based CRC screening is strongly recommended in average-risk population, compliance rates are still far from the desirable rates. High levels of screening uptake are necessary for the success of any screening program. Therefore, the investigation of factors influencing participation is crucial prior to design and launches a population-based organized screening campaign. Several studies have identified screening behaviour factors related to potential participants, providers, or health care system. These influencing factors can also be classified in non-modifiable (i.e., demographic factors, education, health insurance, or income) and modifiable factors (i.e., knowledge about CRC and screening, patient and provider attitudes or structural barriers for screening). Modifiable determinants are of great interest as they are plausible targets for interventions. Interventions at different levels (patient, providers or health care system) have been tested across the studies with different results. This paper analyzes factors related to CRC screening behaviour and potential interventions designed to improve screening uptake.
The St. Jude Children’s Research Hospital–Washington University Pediatric Cancer Genome Project (PCGP) is participating in the international effort to identify somatic mutations that drive cancer. These cancer genome sequencing efforts will not only yield an unparalleled view of the altered signaling pathways in cancer but should also identify new targets against which novel therapeutics can be developed. Although these projects are still deep in the phase of generating primary DNA sequence data, important results are emerging and valuable community resources are being generated that should catalyze future cancer research. We describe here the rationale for conducting the PCGP, present some of the early results of this project and discuss the major lessons learned and how these will affect the application of genomic sequencing in the clinic.
Downing, James R; Wilson, Richard K; Zhang, Jinghui; Mardis, Elaine R; Pui, Ching-Hon; Ding, Li; Ley, Timothy J; Evans, William E
On the other hand, there are some downsides. There can be false positives. That happens quite commonly with a variety of screening tests. So the person without cancer actually has a positive test, and therefore they have to go through the fear, the false alarm, and the anxiety of going through workups in the fear that they may actually have cancer when they don’t.
A certified method for lung cancerscreening in Japan is the combination of chest X-ray and sputum cytology. The chest Xray examination is intended primarily for the detection of peripheral-type lung cancer. Interpretation of the films should be performed by two different physicians, and the films of screenees suspected to have abnormal shadow should be compared to the same screenee's films from previous screening visits. Sputum cytology is conducted for heavy smokers, and is useful for early detection of central lung cancer. The efficacy of this lung cancerscreening method has been shown in several case control studies. There are some problems to solve i. e., a low rate of attendance and inadequate quality control. Low-dose thoracic CT screening is performed with an exposure within a single breath hold, and its interpretation can be conducted with films, CRT, or a LCD monitor. Even when taken at low doses, the radiation exposure dose is large compared to a chest X-ray, being about 3-10 times greater than the absorbed dose and 20-40 times greater than the effective dose. Since the radiation dose in a usual clinical condition is much higher, the clinical condition is not recommended for screening. Concerning the efficacy of low-dose CT screening for heavy-smokers, a positive result was reported in June 2011, and further detailed analyses are required. There are still some problems to solve i. e., the management of undiagnosed shadows, harm caused by the screening, quality control, and efficacy in non-smokers. PMID:22241348
The selection of a rear projectionscreen 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…
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.
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…
|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…
Purpose: To identify women's sources of information about cervical cancerscreening, 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…
Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark
Certain mutations in the epidermal growth factor receptor (EGFR) gene confer hypersensitivity to the tyrosine kinase inhibitors gefitinib and erlotinib in patients with advanced non-small cell lung cancer. Large-scale screening for EGFR mutations in such patients is feasible for predicting response to TKIs and thus guiding treatment. PMID:20040267
Molina-Vila, Miguel A; Bertran-Alamillo, Jordi; Mayo, Clara; Rosell, Rafael
... come to the doctor's office." SOURCE: http://bit.ly/KEPNSw JAMA Internal Medicine, online October 21, 2013. Reuters Health (c) Copyright Thomson Reuters 2013. Check for restrictions at: http://about.reuters.com/fulllegal.asp More Health News on: Cancer Health Screening Talking With Your Doctor ...
|Purpose: To identify women's sources of information about cervical cancerscreening, 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…
Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark
This article assessed the relationship between breast and cervical cancerscreening rates and health beliefs in African American women participating in Witness Project of Harlem (WPH) education sessions. WPH is a culturally sensitive, faith-based breast and cervical cancerscreening education program targeting African American women in medically underserved New York City communities. A questionnaire administered to women participating for the first time in a Witness Project education session collected demographics, adherence to breast and cervical cancerscreening, and information about health beliefs related to cancer worry, medical mistrust, and religious faith. Screening adherence guidelines applied were as per the American Cancer Society recommendations. No statistically significant relationship was found between worry about getting breast or cervical cancer and screening adherence, or between screening adherence and agreement with statements about medical mistrust and religious beliefs. The low screening mammography and monthly breast self-exam rates emphasize the utility of programs like WPH that teach the importance of screening mammography and breast self-exam and point to the need for increased access to quality health care and cancerscreening in underserved populations. PMID:21451008
To enable more patients and physicians to participate in clinical studies that advance cancer care, the National Cancer Institute (NCI) is conducting a pilot project, the Expanded Participation Project (EPP), to speed cancer research by broadening access to clinical trials
The homeless population is a medically vulnerable patient population in our communities. Of particular concern to dermatologists is the risk for the development of skin cancer in the homeless, in light of their chronic sun exposure and suboptimal sun protection behaviors. Two free skin cancerscreenings conducted at the Fourth Street Clinic in Salt Lake City, Utah, in 2011 and 2012, resulted in the diagnosis of 13 skin cancers in 62 patients. These events also highlighted that many homeless patients had suboptimal skin cancer prevention behaviors. We believe that education, awareness, and disease prevention can be relatively easily accomplished by local homeless clinics as a first line of defense against skin cancer in the homeless population. PMID:23374956
Wilde, Megan; Jones, Benjamin; Lewis, Bethany K; Hull, Christopher M
This document is the first update of the American College of Gastroenterology (ACG) colorectal cancer (CRC) screening recommendations since 2000. The CRC screening tests are now grouped into cancer prevention tests and cancer detection tests. Colonoscopy every 10 years, beginning at age 50, remains the preferred CRC screening strategy. It is recognized that colonoscopy is not available in every clinical
Douglas K Rex; David A Johnson; Joseph C Anderson; Phillip S Schoenfeld; Carol A Burke; John M Inadomi
Cancerscreening is commonly offered in order to detect tumors at an early, treatable stage. These efforts are highly advocated\\u000a and widely accepted by the general public. However, there is conflicting evidence about the benefits of screening for breast\\u000a cancer in pre-menopausal women, prostate cancer in older men, and colorectal cancer for both sexes. This paper examines cancer\\u000a screening in
Background Native Americans from the Northern Plains have the highest age-adjusted cancer mortality compared to Native Americans from any other region in the U.S. Purpose This study examined the utilization and determinants of cancerscreening in a large sample of Native Americans from the Northern Plains. Methods A survey was administered orally to 975 individuals in 2004â2006 from three reservations and among the urban Native American community in the service region of the Rapid City Regional Hospital. Data analysis was conducted in 2007â2008. Results Forty-four percent of individuals reported ever receiving any cancerscreening. Particularly low levels were found in breast, cervical, prostate, and colon cancerscreening. In multivariate analyses, the strongest determinant of receiving cancerscreening overall or cancerscreening for a specific cancer site was recommendation for screening by a doctor or nurse. Other determinants associated with increased likelihood of ever having cancerscreening included older age, female gender, and receiving physical exams more than once a year. Increased age was a determinant of breast cancerscreening and receiving physical exams was associated with cervical cancerscreening. Conclusions Cancerscreening was markedly underutilized in this sample of Native Americans from the Northern Plains. Future research should evaluate the potential for improving cancerscreening.
Pandhi, Nancy; Guadagnolo, B. Ashleigh; Kanekar, Shalini; Petereit, Daniel G.; Smith, Maureen A.
Study subjects were participants in the Breast Cancer Detection Demonstration Project (BCDDP), a breast cancerscreening program conducted between 1973 and 1980. Sponsored by the American Cancer Society and the NCI, the BCDDP provided up to five annual breast examinations to 283,222 women at 29 screening centers in 27 cities throughout the United States.
OBJECTIVE: To examine patient and physician preferences in regard to 5 colorectal cancerscreening alternatives endorsed by a 1997 expert\\u000a panel, determine the impact of patient and physician values regarding certain test features on screening preference, and assess\\u000a physicians’ perceptions of patients’ values.\\u000a \\u000a \\u000a DESIGN: Cross-sectional survey.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: A general internal medicine practice at an academic medical center in 1998.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS:
Bruce S. Ling; Mark A. Moskowitz; David Wachs; Brad Pearson; Paul C. Schroy
To determine the optimal strategy for prostate cancerscreening, the cost-effectiveness of screening was analyzed using a medical decision model. One hundred thousand asymptomatic males between the ages of 40 and 69 were modeled with and without screening. The subjects were divided into three 10-year age groups. We used a 5-year survival rate as an effectiveness point and assumed after 5 year survival free from prostate cancer. We considered three potential programs: 1) screening with digital rectal examination (DRE), 2) screening with prostate specific antigen (PSA), and 3) screening with a combination of DRE and PSA. The study was analyzed from the payer's perspective, and only direct medical costs were included. For each of the three age groups, PSA screening was more cost-effective than either DRE screening or a combination of DRE and PSA screening. The cost-effectiveness ratio for the combination of DRE and PSA screening was 1.1-2.3 times more expensive dian that of PSA screening. If the compliance rate for work-up exams is 80%, the cost-effectiveness of prostate cancerscreening is approximate to that of gastric cancerscreening. In conclusion, PSA screening is the most cost-effective strategy for prostate cancerscreening when compared with both DRE and the combination of DRE and PSA screening. But prostate cancerscreening should be carefully conducted, taking the cost-effectiveness of the different strategies and target groups into consideration. PMID:21432194
Aim In 2005 the National Screening Unit of the Ministry of Health appointed a Colorectal Screening Advisory Group to provide independent strategic advice and recommendations on population screening for colorectal cancer (CRC) in New Zealand. Method Evidence-based review of relevant literature and assessment of CRC screening using the New Zealand Criteria to Assess Screening Programmes. Results Guaiac faecal occult blood
Susan Parry; Ann Richardson; Terri Green; Betsy Marshall; Ian Bissett; Ashley Bloomfield; Vinton Chadwick; Chris Cunningham; Michael Findlay; Barbara Greer; John McMenamin; Judi Strid; Greg Robertson; Clinton Teague
|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…
Prostate cancer (PCa) is the leading cancer diagnosis among men and the second leading cause of male cancer death. However, screening asymptomatic men remains controversial, as early diagnosis and treatment of PCa has not yet demonstrated reduced disease-...
...for Disease Control and Prevention Colorectal CancerScreening Demonstration Program Announcement...July 8, 2005. Executive Summary: Colorectal Cancer (CRC) is the second leading cause of cancer-related deaths in the United States,...
... REFERENCES GRAPHICS FIGURES Diagram colon rectum PI PICTURES Polyp colonoscopy PI COLON CANCERSCREENING OVERVIEW Colorectal cancer is a cancer ... well as about particular conditions (see "Patient information: Colon polyps (Beyond the Basics)" and "Patient information: Crohn disease ( ...
BACKGROUND: Comprehensive analyses have shown that screening for cancer\\u000a usually induces net costs. In this study, the possible costs and savings\\u000a of endoscopic colorectal cancerscreening are explored to investigate\\u000a whether the induced savings may compensate for the costs of screening.\\u000a METHODS: A simulation model for evaluation of colorectal cancerscreening,\\u000a MISCAN-COLON, is used to predict costs and savings for
Franka Loeve; Martin L. Brown; Rob Boer; Marjolein van Ballegooijen; Oortmarssen van G. J; J. D. F. Habbema
Despite multiple screening techniques, including colonoscopy, flexible sigmoidoscopy, radiological imaging, and fecal occult blood testing, colorectal cancer remains a leading cause of death. As these techniques improve, their sensitivity to detect malignant lesions is increasing; however, detection of precursor lesions remains problematic and has generated a lack of general acceptance for their widespread usage. Early detection by an accurate, noninvasive, cost-effective, simple-to-use screening technique is central to decreasing the incidence and mortality of this disease. Recent advances in the development of molecular markers in faecal specimens are encouraging for its use as a screening tool. Genetic mutations and epigenetic alterations that result from the carcinogenetic process can be detected by coprocytobiology in the colonocytes exfoliated from the lesion into the fecal matter. These markers have shown promising sensitivity and specificity in the detection of both malignant and premalignant lesions and are gaining popularity as a noninvasive technique that is representative of the entire colon. In this paper, we summarize the genetic and epigenetic fecal molecular markers that have been identified as potential targets in the screening of colorectal cancer.
With the publication of the long-term results of two randomized screening trials and updates to screening guidelines from many organizations, the past 2 years have been eventful in the field of prostate cancerscreening. Both the Prostate, Lung, Colorectal and Ovarian CancerScreening Trial—which failed to identify a benefit of screening in a community setting—and the European Randomized Study of
From December 1987 to December 1993, 6470 women underwent screening with transvaginal sonography (TVS) as part of the University of Kentucky Ovarian CancerScreeningProject. Two groups of women were eligible to participate in this investigation: (i) asymptomatic postmenopausal patients or patients >50 years of age, and (ii) asymptomatic women >30 years of age with a family history of ovarian
P. D. Depriest; H. H. Gallion; E. J. Pavlik; R. J. Kryscio; J. R. van Nagell
This paper extends the previous probability model for the distribution of lead time in periodic cancerscreening exams, namely, in that the lifetime T is treated as a random variable, instead of a fixed value. Hence the number of screens for a given individual is a random variable as well. We use the actuarial life table from the Social Security Administration to obtain the lifetime distribution, and then use this information to project the lead time distribution for someone with a future screening schedule. Simulation studies using the HIP study group data provide estimates of the lead time under different screening frequencies. The projected lead time has two components: a point mass at zero (corresponding to interval cases detected between screening exams) and a continuous probability density. We present estimates of the projected lead time for participants in a breast cancerscreening program. The model is more realistic and can inform optimal screening frequency. This study focuses on breast cancerscreening, but is applicable to other kinds of cancerscreening also. PMID:22611589
Wu, Dongfeng; Kafadar, Karen; Rosner, Gary L; Broemeling, Lyle D
Colorectal cancer is a worldwide problem having global increases in the number of cases and deaths because of the expanding and aging of the population in both developing and developed countries. Screening methods are available which can reduce the incidence by removal of adenomas and can reduce deaths in diagnosed cancer cases by earlier stage detection. Faecal occult blood testing has the strongest proof of effectiveness based on randomised control trials; sigmoidoscopy has lesser proof based on case control studies, and barium enema the weakest proof of effectiveness. Screening colonoscopy has not been subjected to a randomised trial but there is now considerable evidence of its performance and safety and it has the ability to screen, diagnose, and treat (polypectomy) in one test and it is becoming increasingly offered. Many guidelines are now in place, all with positive a position on the effectiveness of screening. However, screening rates are low and many barriers are present that need to be overcome in order to make a major global impact on colorectal cancer incidence and mortality. PMID:18070702
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in Canada. Screening guidelines recommend that first-time screening should occur at 50 years of age for average-risk individuals and at 40 years of age for those with a family history of CRC. OBJECTIVE: To examine whether persons with a positive CRC family history were achieving screening at 40 years of age and whether average-risk persons were achieving screening at 50 years of age. METHODS: The present study was a cross-sectional analysis of subjects who entered a colon cancerscreening program and were undergoing CRC screening for the first time. RESULTS: A total of 778 individuals were enrolled in the present study: 340 (174 males) with no family history of CRC, and 438 (189 males) with a positive family history of CRC. For the group with a positive family history, the mean (± SD) age for primary screening was 54.4±8.5 years, compared with 58.2±6.4 years for the group with no family history. On average, those with a positive family history initiated screening 3.8 years (95% CI 2.8 to 4.8; P<0.05) earlier than those without. Adenoma polyp detection rate for the positive family history group was 20.8% (n=91) compared with 23.5 % (n=80) for the group with no family history. CONCLUSIONS: Individuals with a positive CRC family history are initiating screening approximately four years earlier than those without a family history; nevertheless, both groups are undergoing screening well past current guideline recommendations.
Wang, Haili; Gies, Nicholas; Wong, Clarence; Sadowski, Dan; Moysey, Barbara; Fedorak, Richard N
Background Few studies have been published regarding the practice of breast cancerscreening in Asian countries. Aims The present study illustrates how the health policy for breast cancerscreening has evolved in Taiwan from selective mammographic screening within a high-risk group, firstly to a programme of physical examination by public health nurses, and finally to a two-stage breast cancerscreening
Screening makes it possible to detect cancer before the disease gives rise to symptoms. A more effective treatment could thus be offered, and patients would then have a better prognosis. If screening works, mortality from a given cancer disease should decline in the screened population. At present three screening tests meet this requirement: 1) Pap smears for cervical dysplasia, with screening started at the latest at the age of 30 and not before the age of 20; 2) Mammography screening for breast cancer in women aged 50-69; and 3) faecal occult blood testing for colorectal cancer in men and women aged 50-74. But screening means the testing of healthy persons for cancer, and it therefore has a number of negative side effects, such as false positive and false negative tests. Whether or not screening is preferable in a given situation therefore depends on how the advantages are weighted against the disadvantages. PMID:12082817
The incidence of breast cancer in US women remains disturbingly high, and unfortunately primary care physicians still frequently encounter patients in whom the disease is suspected or, even worse, confirmed. Fortunately, however, the body of knowledge surrounding the disease has grown dramatically during the past decade, and major advances have been made in the understanding of breast cancer risk, prevention, diagnosis, and treatment. Controversies persist, particularly those concerning the screening of younger women, but consensus now exists regarding many clinical issues relevant to primary care practice. Although multidisciplinary subspecialty expertise must be made available to all women with known or suspected breast cancer, the primary care physician has an important role to play when dealing with patients with this condition. The following article focuses on what primary care practitioners need to know to expertly contribute to the diagnosis, counseling, and initial treatment of women with this disease. PMID:10513286
Background and objective: Most economic evaluations of chlamydia screening do not include costs incurred by patients. The objective of this study was to estimate both the health service and private costs of patients who participated in proactive chlamydia screening, using mailed home-collected specimens as part of the Chlamydia Screening Studies project.Methods: Data were collected on the administrative costs of the
Suzanne Robinson; Tracy Roberts; Pelham Barton; Stirling Bryan; John Macleod; Anne McCarthy; Matthias Egger; Emma Sanford; Nicola Low
BACKGROUND: Data comparison between SEER and EUROCARE database provided evidence that colorectal cancer survival in USA is higher than in European countries. Since adjustment for stage at diagnosis markedly reduces the survival differences, a screening bias was hypothesized. Considering the important role of primary care in screening activities, the purpose of the study was to investigate the colorectal cancerscreening
Utilization of colorectal cancerscreening tests is suboptimal. Knowledge of colorectal cancerscreening has been associated with completion of screening. Thus, increasing awareness of colorectal cancerscreening may lead to significant improvements in screening rates. We assessed for the association among provider–patient interaction, information-seeking patterns, sources of information, trust in cancer information, and Internet usage on colorectal cancerscreening behavior
Background Cancerscreening rates in Korea for five cancer types have increased steadily since 2002. With regard to the life-time cancerscreening rates in 2009 according to cancer sites, the second highest was breast cancer (78.1%) and the third highest was cervical cancer (76.1%). Despite overall increases in the screening rate, disparities in breast and cervical cancerscreening, based on sociodemographic characteristics, still exist. Methods Data from 4,139 women aged 40 to74 years from the 2005 to 2009 Korea National CancerScreening Survey were used to analyze the relationship between sociodemographic characteristics and receiving mammograms and Pap smears. The main outcome measures were ever having had a mammogram and ever having had a Pap smear. Using these items of information, we classified women into those who had had both types of screening, only one screening type, and neither screening type. We used logistic regression to investigate relationships between screening history and sociodemographic characteristics of the women. Results Being married, having a higher education, a rural residence, and private health insurance were significantly associated with higher rates of breast and cervical cancerscreening after adjusting for age and sociodemographic factors. Household income was not significantly associated with mammograms or Pap smears after adjusting for age and sociodemographic factors. Conclusions Disparities in breast and cervical cancerscreening associated with low sociodemographic status persist in Korea.
ObjectivesA survey to determine prostate cancer-related knowledge, beliefs, and prior screening behavior was administered to men participating in prostate cancerscreening events at nine major sites in the southeast. Since prostate cancer disproportionately affects blacks, a primary focus of the analysis was to determine if differences in responses exist between racial groups.
Wendy Demark-Wahnefried; Tara Strigo; Karen Catoe; Mark Conaway; Mary Brunetti; Barbara K. Rimer; Cary N. Robertson
Objective The American Congress of Obstetricians and Gynecologists (ACOG) recently recommended that cervical cancerscreening begin at 21 years of age and occur biennially for low-risk women younger than 30 years. Earlier studies suggested that women may have limited understanding of the differences between cervical cancerscreening and chlamydia screening. This study assessed the knowledge of chlamydia and cervical cancerscreening tests and schedules in younger women. Methods A survey regarding knowledge of chlamydia and cervical cancerscreening was administered to 60 younger women aged 18–25 years in an obstetrics and gynaecology clinic at an urban community health centre. Results The majority of respondents recalled having had a Pap smear (93.3%) or chlamydia test (75.0%). Although many respondents understood that a Pap smear checks for cervical cancer (88.3%) and human papillomavirus (68.3%), 71.7% mistakenly believed that a Pap smear screens for chlamydia. No respondent correctly identified the revised cervical cancerscreening schedule, and 83.3% selected annual screening. Few respondents (23.3%) identified the annual chlamydia screening schedule and 26.7% were unsure. Conclusion Many younger women in an urban community health centre believed that cervical cancerscreening also screens for chlamydia and were confused about chlamydia screening schedules. As there is limited knowledge of the revised ACOG cervical cancerscreening guidelines, there is a risk that currently low chlamydia screening rates may decrease further after these new guidelines are better known. Obstetrician gynaecologists and primary care providers should educate younger women about the differences between chlamydia and cervical cancerscreening and encourage sexually active younger women to have annual chlamydia screening.
Ogbechie, Oluwatobi Awele; Hacker, Michele R; Dodge, Laura E; Patil, Mitalee Milan; Ricciotti, Hope A
Methods: The purpose of this study was to assess the effect of screening for colorectal cancer on life expectancy and estimate the number of colonoscopies needed per life year saved. The declining exponential approximation of life expectancy was used to calculate the effect of colorectal cancerscreening on expected remaining lifetime. The annual number of deaths from colorectal cancer and
The prevalence of colorectal cancerscreening is not what it needs to be. Whether screening takes place according to a medical practice model or a public health model, we need to systematically evaluate interventions to increase screening adherence, identify predictors of screening uptake, and identify the reasons for nonadherence. A largely untapped opportunity exists for gastroenterologists to collaborate with behavioral
In the early 1990s, breast cancer advocates petitioned the United States Congress to investigate the high rates of breast cancer on Long Island in the state of New York. The resulting law led to the Long Island Breast Cancer Study Project (LIBCSP) — more than ten research projects designed to study the possible causes of this increased incidence of cancer.
OBJECTIVE: To measure patient preferences for four different screening strategies: annual fecal occult blood testing (FOBT) alone; flexible\\u000a sigmoidoscopy (FSIG) every 5 years alone; both annual FOBT and FSIG every 5 years; or no screening.\\u000a \\u000a \\u000a DESIGN: Survey.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: University internal medicine clinic.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS: Convenience sample of 146 adults (aged 50–75 years) with no previous history of colon cancer.\\u000a \\u000a \\u000a \\u000a \\u000a INTERVENTION: Three-part
The purpose of this paper is to clarify the short-term and long-term objectives of screening for various cancers, and to indicate the kinds of data that are needed to determine whether or not the objectives are met. Cancers at various sites differ with respect to their innate suitability for screening. Criteria that enhance screening suitability include the potential for serious complications and a high rate of mortality (applicable to most cancers), a prolonged preclinical phase, and an existing therapy that is simpler and more effective in reducing the mortality rate when applied to preclinical disease than to clinically evident cancer. Tests and procedures suitable for screening are simple to perform, inexpensive, acceptable to patients and physicians, safe, relatively painless, and accurate, as measured by the test's sensitivity and specificity. The actual yield of previously undiagnosed cancer arising from a screening program will depend heavily on prevalence of disease in the screened population, specificity of the screening test, and successful follow-up of screen-positive patients with diagnosis and treatment. These issues are discussed in the context of four cancers and their respective screening modalities: cervical cancer and cytologic studies, breast cancer and mammography, colon cancer and fecal occult blood tests, and lung cancer and sputum cytologic studies. The quality of data on which screening decisions have been made for each of these cancers and tests varies. The cancers vary in terms of their relevant biologic characteristics and treatment effectiveness. Similarly, each screening procedure has its own particular advantages and disadvantages. Current American Cancer Society Guidelines for early detection of three of the cancers are presented. PMID:3048638
In the past few years the microdisplay-based projection television market has been quickly spreading over what used to be the domain of CRT technology. The demand for larger display sizes and improved image quality, together with more accessible pricing is aggressively driving the transition to microdisplays. The screen is the component of the projection system that directly conveys the visual information to the user, responsible for distributing the luminous energy from the light engine. However, the projectionscreen is far from a simple diffuser and today's performance requirements for display systems require sophisticated screens to meet the resolution, transmission efficiency, and contrast required by visual displays.
Morris, G. Michael; Sales, Tasso R. M.; Chakmakjian, S.; Schertler, Donald J.
Objective. To review screening rates and factors impacting patient utilization of colorectal cancerscreening tests.Methods. We searched Medline, CancerLit, and PsycInfo for articles on colorectal cancerscreening adherence. US studies on average-risk individuals were reviewed to identify: (1) utilization\\/adherence rates, (2) predictors of patient adherence, (3) correlation between long-term adherence and type of test selected, (4) predictors of physician recommendation
Sujha Subramanian; Michelle Klosterman; Mayur M Amonkar; Timothy L Hunt
Prostate cancer is the most common non-skin cancer in America, and while many benefits exist associated with routine prostate-specific antigen (PSA) screening, there is a lack of research evidence to support this behavior. This column will describe the state of the science of prostate screening outcomes and present the possible impact medications that prevent prostate cancer may have on screening activities. PMID:20088236
Background Breast cancerscreening in Denmark is organised by the health services in the five regions. Although general practitioners (GPs) are not directly involved in the screening process, they are often the first point of contact to the health care system and thus play an important advisory role. No previous studies, in a health care setting like the Danish system, have investigated the association between GPs’ attitudes towards breast cancerscreening and women’s participation in the screening programme. Methods Data on women’s screening participation was obtained from the regional screening authorities. Data on GPs’ attitudes towards breast cancerscreening was taken from a previous survey among GPs in the Central Denmark Region. This study included women aged 50-69 years who were registered with a singlehanded GP who had participated in the survey. Results The survey involved 67 singlehanded GPs with a total of 13,288 women on their lists. Five GPs (7%) had a negative attitude towards breast cancerscreening. Among registered women, 81% participated in the first screening round. Multivariate analyses revealed that women registered with a GP with a negative attitude towards breast cancerscreening were 17% (95% CI: 2-34%) more likely to be non-participants compared with women registered with a GP with a positive attitude towards breast cancerscreening. Conclusion The GPs' attitudes may influence the participation rate even in a system where GPs are not directly involved in the screening process. However, further studies are needed to investigate this association.
Using bi-convex cylinder lens with matrix structure, the transmissive projection display screen with high contrast and wider viewing angle has been widely used in large rear projection TV and video projectors, it obtained a inhere color shift and puzzled the designer of display screen for RGB projection tube in-line adjustment. Based on the method of light beam racing, the general
Describes program committed to early identification of children in low incidence areas of exceptionality, and development of specialized services for them. Focus here is on visual screening. (Author/CJ)
At the Heavy Ion Research Institute GSI in Darmstadt an experimental cancer treatment program with a five years duration has been initiated; the first patient treatments are scheduled for this year. A new method for cancer treatment with ions will be applied, using raster-scan method in addition to an active pulse to pulse variations of ion beam properties from the synchrotron, including the energy, intensity and focusing. An overview of this Cancer Therapy Project is presented, that covers both accelerator aspects to provide the required beam variations within a short time and the installations at the treatment place for raster-scan control. In addition to a description of the technical design (control hard- and software) experimental results will be shown, containing the achieved beam properties and measurements of raster-scan performance.
Eickhoff, H.; Haberer, Th.; Kraft, G.; Krause, U.; Poppensieker, K.; Richter, M.; Steiner, R.
Background.Despite the importance of breast cancerscreening to reduce morbidity and mortality, limited information is available on screening practices among African American women with a family history that is suggestive of hereditary breast cancer.
Chanita Hughes Halbert; Lisa Kessler; E. Paul Wileyto; Benita Weathers; Jill Stopfer; Susan Domchek; Aliya Collier; Kiyona Brewster
Studies that examine colorectal cancerscreening (CRCS) behaviors and correlates rely on self-reports of screening status.\\u000a Self-reports of CRCS may be more biased than other self-reported cancerscreening because of multiple screening options, tests\\u000a may be offered in combination, and screening schedules differ for each test. The National Cancer Institute (NCI) sponsored\\u000a the development of a core set of questions
Sula Hood; Vetta L. Sanders Thompson; Salimah Cogbill; Lauren D. Arnold; Michael Talley; Nicole M. Caito
Aims To investigate the impact of the national breast cancerscreening programme, BreastScreen Aotearoa, on breast cancer registrations in New Zealand. Methods Age-specific breast cancer incidence rates for women aged 50-64 years were compared before and after the establishment of BreastScreen Aotearoa. The degree of spread of breast cancers diagnosed at screening was compared with the degree of spread of
Ann Richardson; Brian Cox; Thelma Brown; Paul Smale
A major limitation of existing projection display sys- tems is that they rely on a high quality screen for pro- jecting images. We believe that relaxing this restriction will make projectors more useful and widely applicable. The fundamental problem with using an arbitrary sur- face for a screen is that the surface is bound to have its own colors and
Shree K. Nayar; Harish Peri; Michael D. Grossberg; Peter N. Belhumeur
Cervical cancer is one of the most preventable forms of cancer and the Pap smear test is one of the most widely accessible\\u000a forms of cancerscreening. An important public health issue is the extent to which Canadian women are engaging in regular\\u000a screening for cervical cancer, particularly potentially at-risk groups such as recent immigrants and women from minority ethnic
The incidence of cervical cancer is high among Southeast Asian American women, but their participation in preventive cervical\\u000a cancerscreening is alarmingly low. This paper reviews the literature on factors associated with participation in cervical\\u000a cancerscreening among women of Vietnamese, Cambodian and Hmong descent in the United States. These factors include acculturation,\\u000a age, marital status, knowledge about cervical cancer,
BACKGROUND: Obesity is associated with a higher incidence of colorectal cancer and increased colorectal cancer mortality. Obese women\\u000a are less likely to undergo breast and cervical cancerscreening than nonobese women. It is not known whether obesity is associated\\u000a with a lower likelihood of colorectal cancerscreening.\\u000a \\u000a \\u000a OBJECTIVE: To evaluate whether there is an association between body mass index (BMI)
Objective Since screening for cancer has been advocated, funded, and promoted in France, it is important to evaluate the attitudes of subjects in the general population and general practitioners (GPs) toward cancerscreening strategies. Methods EDIFICE is a nationwide opinion poll that was carried out by telephone among a representative sample of 1,504 subjects living in France and aged between 40 and 75 years and among a representative sample of 600 GPs. The questionnaire administered to subjects queried about previous screening for cancer. Results Ninety-three percent of women stated that they had undergone at least one mammography. Although rated “A” recommendation—strongly recommended—by the US Preventive Services Task Force, screening for colorectal cancer received less attention than prostate cancerscreening which is rated “I”—insufficient evidence—(reported screening rates of 25% and 36%, respectively). Six percent of subjects stated that they had undergone lung cancerscreening. GPs’ attitudes toward cancerscreening showed similar inconsistencies. Conclusions It thus appears that understanding of cancerscreening practices in the French general population does not match scientific evidence. To a lesser extent, this also holds for GPs.
Although the third largest Asian subgroup in the U.S., South Asians have rarely been included in cancer research. The purpose of this study was to assess rates and correlates of cancerscreening in a community sample of South Asians. This study was a collaboration between the UCLA School of Public Health and South Asian Network (SAN), a social service organization in Southern California. Data were collected from 344 adults including a substantial portion of immigrants and individuals with low income and education. Few participants received screening within guidelines for colorectal (25%), breast (34%), cervical (57%) and prostate cancer (10%). Health insurance, younger age and increased length of stay in the U.S. predicted a higher likelihood of cancerscreening. Women were significantly less likely to have received colorectal cancerscreening compared to men. These results will guide SAN's program planning efforts. Future interventions should focus on increasing cancerscreening in this population. PMID:19145482
The news media are a primary source of cancer prevention and detection information for the general public, but little is known about the content of cancer prevention and detection messages in mainstream media. This study examines how cancer prevention and screening efficacy messages are presented in cancer news media coverage. Efficacy messages provide in- formation about skills related to prevention
... service covered? Search Medicare.gov for covered items Cervical & vaginal cancerscreenings How often is it covered? Medicare Part ... doctor accepts assignment . Related resources National Cancer Institute—cervical cancer information CDC—cervical cancer information U.S. Preventive Services ...
BC Cancer Agency CARE & RESEARCH Breast Cancer Mortality After Screening Mammography in British Columbia Women Andrew J. Coldman, Ph.D. Norm Phillips, M.Sc. Lisa Kan, M.Sc. Linda Warren, M.D. Population & Preventive Oncology BC Cancer Agency BC Cancer
This paper is concerned with understanding why some women accept their invitation for free screening mammography and others do not. Free screening mammography is offered to women aged 50-64 in Britain. Uptake of invitations is about twice as high in leafy suburbs than in inner-city areas. Low uptake in inner-city areas has been attributed to "problems" of black and minority ethnic women. The research reported here was carried out in Hackney, an inner city London borough with an ethnically diverse and socially deprived population. Hackney also has the lowest uptake of screening mammography in the country. Twenty focus groups were held. Participants included white, black and minority ethnic women. Eight focus groups were conducted in English; 12 in other languages. Some methodological issues raised by undertaking qualitative research in several languages are considered. The research demonstrates how the inclusion of white women in research which operationalises ethnicity minimizes the risk of developing an analysis focusing on "problems" of black and minority ethnic women and encourages the development of general themes which may apply to all women. The analysis focuses on candidacy, that is, women's assessment of risk of their disease, and compliance, that is, the explanations respondents volunteered for accepting or refusing an invitation to attend for mammography. Candidacy and ethnicity emerge as similar constructs, manipulated by women to make claims about their risk of breast cancer. Other, non-medical reasons were given for compliance which serve as a warning about assuming that, when women accept their invitation, they do so for same the reasons the architects of the National Health Service Breast Screening Programme had in mind. PMID:14572928
Asian Americans experience disproportionate incidence and mortality rates of certain cancers, compared to other racial/ethnic groups. Primary care physicians are a critical source for cancerscreening recommendations and play a significant role in increasing cancerscreening of their patients. This study assessed primary care physicians’ perceptions of cancer risk in Asians and screening recommendation practices. Primary care physicians practicing in New Jersey and New York City (n=100) completed a 30-question survey on medical practice characteristics, Asian patient communication, cancerscreening guidelines, and Asian cancer risk. Liver cancer and stomach cancer were perceived as higher cancer risks among Asian Americans than among the general population, and breast and prostate cancer were perceived as lower risks. Physicians are integral public health liaisons who can be both influential and resourceful toward educating Asian Americans about specific cancer awareness and screening information.
Kwon, Harry T; Ma, Grace X; Gold, Robert S; Atkinson, Nancy L; Wang, Min Qi
Background Lung cancerscreening could present a “teachable moment” for promoting smoking cessation and relapse prevention. Understanding\\u000a the risk perceptions of older individuals who undergo screening will guide these efforts.\\u000a \\u000a \\u000a \\u000a Purpose This paper examines National Lung Screening Trial (NLST) participants' perceptions of risk for lung cancer and other smoking-related\\u000a diseases. We investigated (1) whether risk perceptions of lung cancerscreening participants differed
Elyse R. Park; Jamie S. Ostroff; William Rakowski; Ilana F. Gareen; Michael A. Diefenbach; Sandra Feibelmann; Nancy A. Rigotti
Objective The purpose of this community-based study was to develop a structural equation model for factors contributing to breast cancerscreening among Chinese American women. Methods A cross-sectional design included a sample of 440 Chinese American women aged 40 years and older. The initial step involved use of confirmatory factor analysis, which included the following variables: access/satisfaction with health care, enabling, predisposing, and cultural and health belief factors. Structural equation model analyses were conducted to evaluate factors related to breast cancerscreening in Chinese American women. Results Initial univariate analyses indicated that women without health insurance were significantly more likely to report being never-screened compared to women with health insurance. Structural equation modeling techniques were used to evaluate the utility of the Sociocultural Health Behavior model in understanding breast cancerscreening among Chinese American women. Results indicated that enabling and predisposing factors were significantly and positively related to breast cancerscreening. Cultural factors were significantly associated with enabling factors and satisfaction with healthcare. Overall, the proposed model explained 34% of the variance in breast cancerscreening among Chinese American women. Conclusions The model highlights the significance of enabling and predisposing factors in understanding breast cancerscreening behaviors among Chinese American women. In addition, cultural factors were associated with enabling factors, reinforcing the importance of providing translation assistance to Chinese women with poor English fluency and increasing awareness of the critical role of breast cancerscreening. Partnering with community organizations may help to facilitate and enhance the screening rates.
Ma, Grace X; Fang, Carolyn; Wang, Min Qi; Shive, Steven E; Ma, Xiang S
This study examined differences between Asian and non-Asian Americans in sources of health information and cancerscreening. A nationally representative sample of 6,722 adults in the US, including those who speak, Spanish, Chinese, Vietnamese and Korean was selected. Questionnaire items included demographic variables, health status, cancerscreening, health care experiences, health information sources, and use of an interpreter in the
Steven E. Shive; Grace X. Ma; Yin Tan; Jamil I. Toubbeh; Lalitha Parameswaran; Joseph Halowich
The National Cancer Institute (NCI) announced today that it has launched a study to understand how screening for colorectal cancer is being conducted in the United States and to help identify barriers to screening for this common disease and appropriate follow-up.
Used social marketing to identify factors influencing women's breast cancerscreening 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…
The study objective was to investigate whether women who frequently attend religious services are more likely to have breast cancerscreening—mammography and clinical breast examinations—than other women. Multivariate logistic regression models show that white women who attended religious services frequently had more than twice the odds of breast cancerscreening than white women who attended less frequently (Odds Ratio (OR)
Peter H. Van Ness; Stanislav V. Kasl; Beth A. Jones
Purpose of Review: To discuss how to recognise and manage high-risk individuals. Recent Findings: Publication of initial results of screening for pancreatic cancer from US centres. Several masses and premalignant lesions have been detected, but the detection of the first pancreatic cancer through an organised study of screening has yet to be published. There has been progress in risk stratification;
W. Greenhalf; C. Grocock; M. Harcus; J. Neoptolemos
This cross-sectional survey explored the association between functional health literacy and knowledge of, beliefs and attitudes about, and reported usage of colorectal cancerscreening tests. The results indicate that functional health literacy, as assessed by the Short Test of Functional Health Literacy in Adults (STOFHLA), is not an independent predictor of colorectal cancerscreening knowledge, beliefs, attitudes, or behavior. Latino
Carmen E. Guerra; Francisco Dominguez; Judy A. Shea
|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 cancerscreening among Panamanian women, as well as socio-cultural factors that deter or encourage screening…
Calvo, Arlene; Brown, Kelli McCormack; McDermott, Robert J.; Bryant, Carol A.; Coreil, Jeanine; Loseke, Donileen
PSA-based screening has always been one of the controversial topics among urological researchers. In spite of its benefit in detecting early prostate cancer, PSA-based screening may not only result in widespread overdiagnosis and overtreatment of an often indolent disease, which is life-threatening in only a minority of patients, but also subject participators to such complications as erectile dysfunction and incontinence. Besides, whether PSA-based screening can reduce prostate cancer specific mortality has received considerable attention. This review offers a comparative analysis of recent studies on PSA-based screening for prostate cancer. PMID:23862239
BACKGROUND: Cancerscreening programmes in England are publicly-funded. Professionals' beliefs in the public health benefits of screening can conflict with individuals' entitlements to exercise informed judgement over whether or not to participate. The recognition of the importance of individual autonomy in decision making requires greater understanding of the knowledge, attitudes and beliefs upon which people's screening choices are founded. Until
|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…
In the United States and Europe the high mortality of breast cancer has been significantly reduced by mammographic screening\\u000a of women aged over 50 years, the effectiveness of which has been documented in many reports. In contrast, the effectiveness\\u000a of such screening in women aged from 40 to 49 remains controversial. In Japan, breast cancerscreening has consisted of physical
This study characterizes demographic and past prostate screening behaviors of men who participated in a free screening for prostate cancer. Demographics, past prostate screening behavior, perceived risk, and cancer worry were assessed in 1,680 men. Mean age was 58.2 years, 56% were White, and 76% had health insurance. Men with insurance were more likely to have had a previous prostate-specific
Patricia A. Parker; Lorenzo Cohen; Vijaya A. Bhadkamkar; Richard J. Babaian; Murray A. Smith; Ellen R. Gritz; Karen M. Basen-Engquist
Objective To quantify the plausible contribution of prostate-specific antigen (PSA) screening to the nearly 30% decline in the US prostate\\u000a cancer mortality rate observed during the 1990s.\\u000a \\u000a \\u000a \\u000a Methods Two mathematical modeling teams of the US National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network\\u000a independently projected disease mortality in the absence and presence of PSA screening. Both teams relied on Surveillance,\\u000a Epidemiology,
Ruth Etzioni; Alex Tsodikov; Angela Mariotto; Aniko Szabo; Seth Falcon; Jake Wegelin; Dante diTommaso; Kent Karnofski; Roman Gulati; David F. Penson; Eric Feuer
One of the most difficult problems of large-screenprojection displays is overloading of a panel to be projected with illuminating light. The problem can be solved by using, on the way from a panel to be projected to a screen, an optical amplifier with high enough amplification. The prospects of using laser amplifiers in projection displays are discussed. Among all laser amplifiers the most suitable for application as optical amplifiers in projection systems are now pulsed metal vapor laser and metal halide laser amplifiers. They have rather high gain enabling amplification in the range from 102 to 104 and high average output power sufficient to illuminate a large screen. The main characteristics of these amplifiers are described. The results of experimental investigations of projection systems with copper, copper bromide, gold and some other metal vapor amplifiers are reported. In all cases good quality amplified images were obtained. Average power at the output of amplifiers was under typical conditions of operation comparable with the output power of a laser with the same amplifying element. Measurement of contrast of amplified images showed that under normal conditions of operation it is close to the contrast of the input picture even at strong saturation of the amplifying medium. The influence of the amplifier saturation is briefly discussed. The results of experiments with TV projection systems using two types of liquid crystal spatial light modulators are presented and prospects of large-screenprojection displays development are discussed.
Petrash, Gueorgii G.; Chvykov, Vladimir V.; Zemskov, Konstantin I.
Many economists argue that the primary economic function of banks is to provide cheap credit, and to facilitate this function, they advocate the strict protection of creditor rights. But banks can serve another important economic function: by screeningprojects they can reduce the number of project Pilures and thus mitigate their private and social costs. In this article we show
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.
Watson-Johnson, Lisa C.; Bhagatwala, Jigar; Reyes-Garcia, Claudia; Hinojosa, Andrea; Mason, Mondi; Meade, Cathy D.; Luque, John S.
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
Watson-Johnson, Lisa C; Bhagatwala, Jigar; Reyes-Garcia, Claudia; Hinojosa, Andrea; Mason, Mondi; Meade, Cathy D; Luque, John S
... (1) Prostate cancerscreening tests...detection of prostate cancer: (i) A screening digital rectal examination. ...detection of prostate cancer, taking into account...A screening digital rectal examination...
... (1) Prostate cancerscreening tests...detection of prostate cancer: (i) A screening digital rectal examination. ...detection of prostate cancer, taking into account...A screening digital rectal examination...
In 2007 alone, close to 1.5 million new cancer cases and over half of a million deaths from cancer are projected to occur in US. In general, cancer is much easier to be successfully treated before metastasis; the five-year survival rates for most of the cancers in the metastatic stage are lower than 10%. The origin of cancer is due to genomic instability; however, the genomics or proteomics studies focus on this phenomenon cannot thoroughly elucidate how cancer metastasis proceeds. During this process, cancer cells protrude and conquer their physical barriers, resist shear stress, establish anchorages and finally settle in a new environment. Each development in this process involves mechanical forces. Thus, whether force generation and cancer cells' mechanical properties can be integrated into the current mainstream of cancer research and offer new insight is worthy of being investigated. To measure the change of cell mechanics, specifically intracellular mechanics, a tool that least disrupts the probed cell's behavior and, simultaneously, can obtain real time quantitative measurement is necessary. To satisfy these criteria, we have developed a technique, ballistic intracellular nanorheology (BIN), in which we trace and analyze the trajectories of nanospheres that have been ballistically bombarded into the cytoplasm of individual cells. This technique allows us to probe the effects of chemical or mechanical stimuli on intracellular mechanics in various types of cells, on culture dishes or in a three-dimensional matrix. BIN is, currently, the first and only method available that can be applied to perform such tasks. Using this technique, we have gained detailed information about how the cytoskeletal remodeling pathways control the intracellular mechanics. We have also obtained information on the tempo-correlation between agonists and intracellular mechanics and how cells utilize their intracellular mechanics to react extracellular shear stress. These studies have set the framework for us to understand the mechanical mechanism of cancer cell metastasis on a molecular level. In this talk, I will describe the working principal using this technique to screencancer drugs that prevent cancer metastasis.
Its prevalence, long premalignant course, and favorable response to early intervention make colorectal cancer an ideal target\\u000a for screening regimens. The success of these regimens depends on accurate assessment of risk factors, patient compliance with\\u000a scheduled visits and tests, and physician knowledge of screening strategies. We review the current recommendations for colorectal\\u000a cancerscreening in general and at-risk populations, comment
Steve R. Martinez; Shawn E. Young; Rebecca E. Hoedema; Leland J. Foshag; Anton J. Bilchik
African American men participated in a screening initiative and completed the 22-item Barriers to Prostate CancerScreening 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.
Graham J. Mcdougall; Mary louise Adams; Wayne F. Voelmeck
The National Lung Screening Trial (NLST) recently reported that annual computed tomography (CT) screening is associated with decreased lung cancer mortality in high-risk smokers. Beliefs about lung cancer and screening, particularly across race and ethnicity, and their influence on CT screening utilization are largely unexamined. Our study recruited asymptomatic, high-risk smokers, 55-74 years of age from primary care clinics in an academic urban hospital. Guided by the self-regulation theory, we evaluated cognitive and affective beliefs about lung cancer. Intention to screen for lung cancer with a CT scan was assessed by self-report. We used univariate and logistic regression analyses to compare beliefs about screening and intention to screen among minority (Blacks and Hispanics) and non-minority participants. Overall, we enrolled 108 participants, of which 40% were Black and 34% were Hispanic; the mean age was 62.3 years, and median pack-years of smoking was 26. We found that intention to screen was similar among minorities and non-minorities (p=0.19); however, Hispanics were less likely to report intention to screen if they had to pay for the test (p=0.02). Fatalistic beliefs, fear of radiation exposure, and anxiety related to CT scans were significantly associated with decreased intention to screen (p<0.05). Several differences were observed in minority versus non-minority participants' beliefs toward lung cancer and screening. In conclusion, we found that concerns about cost, which were particularly prominent among Hispanics, as well as fatalism and radiation exposure fears may constitute barriers to lung cancerscreening. Lung cancerscreening programs should address these factors to ensure broad participation, particularly among minorities. PMID:22681870
Jonnalagadda, Sirisha; Bergamo, Cara; Lin, Jenny J; Lurslurchachai, Linda; Diefenbach, Michael; Smith, Cardinale; Nelson, Judith E; Wisnivesky, Juan P
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
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
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.
Ge, Yaorong; Vining, David J.; Ahn, David K.; Stelts, David R.
Objective To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death. Design Nationwide population based cohort study. Setting Sweden. Participants All 1230 women with cervical cancer diagnosed during 1999-2001 in Sweden prospectively followed up for an average of 8.5 years. Main outcome measures Cure proportions and five year relative survival ratios, stratified by screening history, mode of detection, age, histopathological type, and FIGO (International Federation of Gynecology and Obstetrics) stage. Results In the screening ages, the cure proportion for women with screen detected invasive cancer was 92% (95% confidence interval 75% to 98%) and for symptomatic women was 66% (62% to 70%), a statistically significant difference in cure of 26% (16% to 36%). Among symptomatic women, the cure proportion was significantly higher for those who had been screened according to recommendations (interval cancers) than among those overdue for screening: difference in cure 14% (95% confidence interval 6% to 23%). Cure proportions were similar for all histopathological types except small cell carcinomas and were closely related to FIGO stage. A significantly higher cure proportion for screen detected cancers remained after adjustment for stage at diagnosis (difference 15%, 7% to 22%). Conclusions Screening is associated with improved cure of cervical cancer. Confounding cannot be ruled out, but the effect was not attributable to lead time bias and was larger than what is reflected by down-staging. Evaluations of screening programmes should consider the assessment of cure proportions.
Study objective—To determine whether mortality from breast cancer could be reduced by repeated mammographic screening. Design—Birth year cohorts of city population separately randomised into study and control groups. Setting—Screening clinic outside main hospital. Patients—Women aged over 45; 21 088 invited for screening and 21 195 in control group. Interventions—Women in the study group were invited to attend for mammographic screening
Ingvar Andersson; Knut Aspegren; Lars Janzon; Torsten Landberg; Karin Lindholm; Folke Linell; Otto Ljungberg; Jonas Ranstam; Baldur Sigfússon
Objectives—To identify the characteris- tics of mode of travel to screening clinics; to estimate the time and travel costs incurred in attending; to investigate whether such costs are likely to bias screening compliance. Setting—Twelve centres in the trial of flexible sigmoidoscopy screening for colorectal cancer, drawn from across Great Britain. Method—Analysis of 3525 questionnaires completed by screening subjects while attending
Emma Frew; Jane L Wolstenholme; Wendy Atkin; David K Whynes
\\u000a There is a continuing lack of evidence that screening for prostate cancer results in a significant improvement in survival\\u000a and\\/or quality of life of men with the disease. Moreover, there is a growing concern that the introduction of a national prostate\\u000a cancerscreening programme might result in over-diagnosis of men with “clinically insignificant” or “indolent” prostate cancer\\u000a who could be
Tomosynthesis, or 3-dimensional (3-D) mammography, significantly reduced the number of patients being recalled for additional testing after receiving a mammogram, a Yale Cancer Center study found. The study appears in the journal Radiology. Digital mammography is considered the mainstay for breast cancerscreening. However, it is not a perfect test, and many women are asked to come back for additional testing that often turns out not to show cancer. These additional screening tests increase patient anxiety.
Since 1977, mass screening for breast cancer has been carried out in Miyagi prefecture, Japan. The main activities involve\\u000a itinerant screening in the communities and group screening at the workplaces. The first step in this screening is the physical\\u000a examination; the second step, for women with suspicious findings, is examination by mammography and ultrasonography, in a\\u000a specially equipped mobile unit.
Background Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer patients by assessing the (1) accuracy of depression screening tools; (2) effectiveness of depression treatment; and (3) effect of depression screening, either alone or in the context of comprehensive depression care, on depression outcomes. Methods Data sources were CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO and SCOPUS databases through January 24, 2011; manual journal searches; reference lists; citation tracking; trial registry reviews. Articles on cancer patients were included if they (1) compared a depression screening instrument to a valid criterion for major depressive disorder (MDD); (2) compared depression treatment with placebo or usual care in a randomized controlled trial (RCT); (3) assessed the effect of screening on depression outcomes in a RCT. Results There were 19 studies of screening accuracy, 1 MDD treatment RCT, but no RCTs that investigated effects of screening on depression outcomes. Screening accuracy studies generally had small sample sizes (median?=?17 depression cases) and used exploratory methods to set sample-specific cutoff scores that varied substantially across studies. A nurse-delivered intervention for MDD reduced depressive symptoms moderately (effect size?=?0.37). Conclusions The one treatment study reviewed reported modest improvement in depressive symptoms, but no evidence was found on whether or not depression screening in cancer patients, either alone or in the context of optimal depression care, improves depression outcomes compared to usual care. Depression screening in cancer should be evaluated in a RCT in which all patients identified as depressed, either through screening or via physician recognition and referral in a control group, have access to comprehensive depression care.
Meijer, Anna; Roseman, Michelle; Milette, Katherine; Coyne, James C.; Stefanek, Michael E.; Ziegelstein, Roy C.; Arthurs, Erin; Leavens, Allison; Palmer, Steven C.; Stewart, Donna E.; de Jonge, Peter; Thombs, Brett D.
Recent guidelines from the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology recommend cessation of cervical cancerscreening at age 65 years for women with an "adequate" history of negative Papanicolaou smears. In our view, those who formulated these guidelines did not consider a growing body of evidence from nonrandomized studies that provides insight into the efficacy of cervical cancerscreening among older women. First, older women are not at indefinitely low risk following negative screening results. Second, recent data from the United States, the United Kingdom, and Sweden suggest that screening of older women is associated with substantial reductions in cervical cancer incidence and mortality, even among previously screened women. It may be that after consideration of the reduced incidence of (and reduced mortality from) cervical cancer that may result from screening older women, the harms and economic costs of screening will be judged to outweigh its benefits. However, it is essential to consider the now-documented benefits of cervical screening when formulating screening guidelines for older women, and recommendations that do not do so will lack an evidence base. PMID:23966563
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.
In a six year period up to the end of December 1985 fine needle aspiration cytology specimens of the breast were obtained from 562 apparently healthy women invited to participate in a breast cancerscreening programme. Of these, 397 had a biopsy and 173 cancers were confirmed histologically. For the diagnosis of cancer, the procedure was less successful than in
Diagnosis of cancer at an early stage leads to improved survival. However, most current blood tests detect single biomarkers that are of limited suitability for screening, and existing screening programmes look only for cancers of one particular type. A new approach is needed. Recent developments suggest the possibility of blood-based screening for multiple tumour types. It may be feasible to develop a high-sensitivity general screen for cancer using multiple proteins and nucleic acids present in the blood of cancer patients, based on the biological characteristics of cancer. Positive samples in the general screen would be submitted automatically for secondary screening using tests to help define the likelihood of cancer and provide some indication of its type. Only those at high risk would be referred for further clinical assessment to permit early treatment and mitigate potential overdiagnosis. While the assays required for each step exist, they have not been used in this way. Recent experience of screening for breast, cervical and ovarian cancers suggest that there is likely to be widespread acceptance of such a strategy.
Background Lesbians have low rates of cervical cancerscreening, even though they are at risk of developing the disease. The aim of this study was to examine cervical cancerscreening behaviors in a national sample of lesbians. Methods A standardized internet survey was sent to 3,000 self-identified lesbians to assess cervical cancerscreening behaviors and barriers to screening. The sample consisted of 1,006 respondents. Results Sixty-two percent of the weighted sample of respondents were routine screeners. Lack of a physician referral (17.5%) and lack of a physician (17.3%) were the most commonly-cited top reasons for lack of screening. Adjusting for age, education, relationship status, employments status, and insurance status, women who had disclosed their sexual orientation to their primary care physician (adjusted odds ratio [OR] 2.84 [95% confidence interval 1.82-4.45]) or gynecologist (OR 2.30 [1.33-3.96]) had greater odds of routine screening than those who did not. Those who knew that lack of Pap testing is a risk factor for cervical cancer were also more likely to be routine screeners (OR 1.95 [1.30-2.91]), although no association with screening was apparent for women who had more knowledge of general cervical cancer risk factors. Physician recommendation appeared to be a potent determinant of regular screening behavior. Routine screeners perceived more benefits and fewer barriers to screening, as well as higher susceptibility to cervical cancer. Conclusions Some women who identify as lesbian are at a potentially elevated risk of cervical cancer because they are not routinely screened. Evidence-based interventions should be developed to address critical health beliefs that undermine participation in screening. Given the value placed on physician recommendation, patient-provider communication may serve as the optimal focus of effective intervention.
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 cancerscreening program, is urgently required. PMID:23679334
Rashid, Rima Ma; Dahlui, Maznah; Mohamed, Majdah; Gertig, Dorota
The purpose of this study was to examine the factors determining fecal occult blood test (FOBT) uptake in Chinese American immigrants. This study used a prospective, cross-sectional design with convenience sampling. An educational session on colorectal cancerscreening (CRS) was provided to the participants during a health fair, and each participant was offered a no-cost FOBT kit. Data was collected over two consecutive years during three different health fairs. A questionnaire was used to collect demographic data. A total of 113 participants were recruited and 72% of them returned the FOBT kit. There was a significant association between having a primary-care physician (PCP) and having CRS in the past, even after controlling for age, gender and the length of time in the US (P = .009). Participants who visited a doctor for health maintenance were less likely to participate in the FOBT, compared to participants who never visited a doctor or who only visited a doctor when they were sick (P = .001). The length of time in the US had a significant effect on having a PCP (P = .002). However, having a PCP or having CRS in the past was not associated with participating in the screening and so was feeling at risk for CRC. In fact, 49% of Chinese women and 45% of Chinese men felt no risk of CRC. Future research and interventions that address knowledge deficits and focus on recent immigrants and their access to health care may have the potential to increase CRS among Chinese American immigrants. PMID:22187109
Its prevalence, long premalignant course, and favorable response to early intervention make colorectal cancer an ideal target for screening regimens. The success of these regimens depends on accurate assessment of risk factors, patient compliance with scheduled visits and tests, and physician knowledge of screening strategies. We review the current recommendations for colorectal cancerscreening in general and at-risk populations, comment on surveillance methods in high-risk patients, and examine current trends that will likely influence screening regimens in the future. PMID:16604473
Martinez, Steve R; Young, Shawn E; Hoedema, Rebecca E; Foshag, Leland J; Bilchik, Anton J
Background Despite the documented benefits of colorectal cancerscreening, patient participation rates remain low. Physician recommendation\\u000a has been identified as a significant predictor of screening completion.\\u000a \\u000a \\u000a \\u000a Objective The aim of this study is to investigate how primary care physicians perceive colorectal cancerscreening communication tasks,\\u000a as well as to explore the form and content of actual screening discussions.\\u000a \\u000a \\u000a \\u000a Design The research design includes
Summary This article develops a probability distribution for the lead time in periodic cancerscreening examinations. The general aim is to allow statistical inference for a screening program's lead time, the length of time the diagnosis is advanced by screening. The program's lead time is distributed as a mixture of a point mass and a piecewise continuous distribution. Simulation studies using the HIP (Health Insurance Plan for Greater New York) study's data provide estimates of different characteristics of a screening program under different screening frequencies. The components of this mixture represent two aspects of screening's benefit, namely, a reduction in the number of interval cases and the extent by which screening advanced the age of diagnosis. We present estimates of these two measures for participants in a breast cancerscreening program. We also provide the mean, mode, variance, and density curve of the program's lead time. The model can provide policy makers with important information regarding the screening period, frequency, and the endpoints that may serve as surrogates for the benefit to women who take part in a periodic screening program. Though the study focuses on breast cancerscreening, it is also applicable to other kinds of chronic disease.
Wu, Dongfeng; Rosner, Gary L.; Broemeling, Lyle D.
We describe a way to display three-dimensional images by integral imaging using an ordinary projector. We first explain a method that uses a large-aperture converging lens, then we explain the proposed method that uses two sets of lens array. Based on the principle of this new approach, front projection as well as rear projection is possible. Only a proper viewing area can be formed on the optical screen by this method, which improves the brightness of images on the screen. The projector itself does not need an additional optical system. We report on the results of an experiment carried out to confirm the validity of the proposed method.
Using bi-convex cylinder lens with matrix structure, the transmissive projection display screen with high contrast and wider viewing angle has been widely used in large rear projection TV and video projectors, it obtained a inhere color shift and puzzled the designer of display screen for RGB projection tube in-line adjustment. Based on the method of light beam racing, the general software of designing projection display screen has been developed and the computer model of vanishing color shift for rear projection HDTV has bee completed. This paper discussed the practical designing method to vanish the defect of color shift and mentioned the relations between the primary optical parameters of display screen and relative geometry sizes of lens' surface. The distributions of optical gain to viewing angle and the influences on engineering design are briefly analyzed.
The objectives of the project were (a) to explore the prevailing attitudes toward screening for prostate cancer among Black men in the Cape Fear region of North Carolina (b) to determine the comparative effectiveness of a one- time presentation of informa...
The objectives of the project are: (a) to explore the prevailing attitudes toward prostate cancerscreening among Black men in the Cape Fear region of North Carolina; (b) to determine the comparative effectiveness of a one-time presentation of information...
The objectives of the project are: (a) to explore the prevailing attitudes toward screening for prostate cancer among Black men in the Cape Fear region of North Carolina; (b) to determine the comparative effectiveness of a one-time presentation of informa...
The objectives of the project are: (a) to explore the prevailing attitudes toward screening for prostate cancer among Black men in the Cape Fear region of North Carolina (b) to determine the comparative effectiveness of a one- time presentation of informa...
The objectives of the project are (a) to explore the prevailing attitudes toward screening for prostate cancer among Black men in the Cape Fear region of North Carolina (b) to determine the comparative effectiveness of a one- time presentation of informat...
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…
|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…
Endometrial cancer is the most common cancer in women with Lynch syndrome. The identification of individuals with Lynch syndrome is desirable because they can benefit from increased cancer surveillance. The purpose of this study was to determine the feasibility and desirability of mole- cular screening for Lynch syndrome in all endometrial cancer patients. Unselected endometrial cancer patients (N = 543)
Heather Hampel; Wendy Frankel; Jenny Panescu; Janet Lockman; Kaisa Sotamaa; Daniel Fix; Ilene Comeras; Jennifer La Jeunesse; Hidewaki Nakagawa; Judith A. Westman; Thomas W. Prior; Mark Clendenning; Pamela Penzone; Janet Lombardi; Patti Dunn; David E. Cohn; Larry Copeland; Lynne Eaton; Jeffrey Fowler; George Lewandowski; Luis Vaccarello; Jeffrey Bell; Gary Reid
Background: The Research Center for Cancer Prevention and Screening program is a one-arm prospective study designed to evaluate the effect of multiple modalities for cancerscreening. Basic programs consist of screening tests for cancer of the lung, esophagus, stomach, colon, rectum, liver, gall bladder, pancreas and kidneys, in addition to prostate cancerscreening for males and breast, cervical, endometrial and
Studies in women with a family history of cancer demonstrate a wide variability in the uptake of cancerscreening measures. Little data exist regarding the breast and ovarian cancerscreening practices of women who are members of hereditary breast cancer families. In order to address this issue, we examined the screening behaviors and the determinants of screening in a clinic
Claudine Isaacs; Beth N. Peshkin; Marc Schwartz; Tiffani A. DeMarco; David Main; Caryn Lerman
Background The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancerscreening among Chinese American women. Methods A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancerscreening. Results Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancerscreening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor. Conclusion This model highlights the significance of sociocultural factors in relation to cervical cancerscreening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical cancerscreening. Community organizations may play a role in assisting Chinese American women, which could enhance cervical cancerscreening rates.
Ma, Grace X; Wang, Min Qi; Ma, Xiang S; Shive, Steven E; Tan, Yin; Toubbeh, Jamil I
Background:Bowel cancerscreening using faecal occult blood testing and colonoscopy is currently being rolled out across England. Guidelines recommend that people identified by colonoscopy as having intermediate- or high-risk bowel polyps be offered periodic surveillance colonoscopy because of their elevated risk of bowel cancer. We make projections of the likely year-on-year increase in volumes and spending on colonoscopy due to
Incidence-based evaluations of cervical cancerscreening programs have suggested age-specific impacts and there is uncertainty regarding the effectiveness of screening outside the ages of 30-60 years. We audited the screening histories of cervical cancer deaths and conducted a case-control evaluation of the effectiveness of organized screening in different ages with mortality as outcome. We included all 506 cervical cancer deaths in Finland in 2000-2009 due to cancers diagnosed in 1990 or later, and 3,036 controls matched by age at diagnosis to the cases. Squamous cell carcinoma constituted 59% of the cases, adenocarcinomas 29%, and the remaining 12% were other specified and unspecified cervical malignancies. Most deaths (54%) were due to cancers diagnosed more than 5 years after last screening invitation, 24% were diagnosed among nonattenders and only 14% of deaths occurred among women who had attended invitational screening. The risk reduction associated with attending a single program screen at an age below 40 was nonsignificant (OR 0.70; 95% CI 0.33-1.48), while clear risk reductions were observed after screening at the age of 40-54 (OR 0.33; CI 0.20-0.56) and 55-69 (OR 0.29; CI 0.16-0.54). This study also provides some indication of a long-lasting additional effect of screening at the age of 65. Possible avenues for improving the effectiveness of the Finnish screening program include efforts to increase attendance and an extension of the target ages to include 65-to 69-year-old women. The potential benefit of increasing the sensitivity of the screening test or shortening the screening interval is smaller. PMID:22987437
Breast cancerscreening remains a subject of intense and, at times, passionate debate. Mammography has long been the mainstay of breast cancer detection and is the only screening test proven to reduce mortality. Although it remains the gold standard of breast cancerscreening, there is increasing awareness of subpopulations of women for whom mammography has reduced sensitivity. Mammography also has undergone increased scrutiny for false positives and excessive biopsies, which increase radiation dose, cost, and patient anxiety. In response to these challenges, new technologies for breast cancerscreening have been developed, including low-dose mammography, contrast-enhanced mammography, tomosynthesis, automated whole breast ultrasound, molecular imaging, and magnetic resonance imaging. Here we examine some of the current controversies and promising new technologies that may improve detection of breast cancer both in the general population and in high-risk groups, such as women with dense breasts. We propose that optimal breast cancerscreening will ultimately require a personalized approach based on metrics of cancer risk with selective application of specific screening technologies best suited to the individual's age, risk, and breast density. PMID:23561631
Drukteinis, Jennifer S; Mooney, Blaise P; Flowers, Chris I; Gatenby, Robert A
Prostate cancer is the most common solid malignancy in men. Screening with PSA and DRE has led to an increased incidence of the disease, but has also contributed to decreasing mortality. Improved technology has led to treatments focused on maintaining cancer cure rates while minimizing the effect of prostate cancer treatment on quality of life. Recently, docetaxel has been added to standard androgen ablation as an effective treatment for advanced prostate cancer. PMID:18018527
BACKGROUND: U.S. cancerscreening guidelines communicate important information regarding the ages for which screening tests are appropriate. Little attention has been given to whether breast, colorectal and prostate cancerscreening test use is responsive to guideline age information regarding the age of screening initiation. METHODS: The 2006 Behavioral Risk Factor Social Survey and the 2003 National Health Interview Surveys were
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.
Nielsen, Hans J; Jakobsen, Karen V; Christensen, IB J; Brunner, Nils
Background The evaluation of randomized trials for cancerscreening involves special statistical considerations not found in therapeutic trials. Although some of these issues have been discussed previously, we present important recent and new methodologies. Methods Our emphasis is on simple approaches. Results We make the following recommendations: (1) Use death from cancer as the primary endpoint, but review death records carefully and report all causes of death (2) Use a simple "causal" estimate to adjust for nonattendance and contamination occurring immediately after randomization (3) Use a simple adaptive estimate to adjust for dilution in follow-up after the last screen Conclusion The proposed guidelines combine recent methodological work on screening endpoints and noncompliance/contamination with a new adaptive method to adjust for dilution in a study where follow-up continues after the last screen. These guidelines ensure good practice in the design and analysis of randomized trials of cancerscreening.
Baker, Stuart G; Kramer, Barnett S; Prorok, Philip C
The U.S. health care system is indeed challenged to provide effective, equitable, and efficient care for its citizens (Aday, Begley, Lairson, & Balkrishnan, 2004). The past decades have witnessed profound concern about the quality of care Americans receive, the equality of care across racial ethnic communities, and the escalating costs of private and public coverage. These concerns apply to the cancer care continuum, including screening. This commentary reflects on the methods, findings, and implications of the articles from the Behavioral Constructs and Culture in CancerScreening (3Cs) in this Health Education & Behavior supplement. This commentary considers several important themes for consideration in applied screening research, including the (a) focus on population diversity in a cultural context, (b) domains of social context and their importance, and (c) contributions of an interdisciplinary team and mixed methods to research productivity. Although the articles focus on breast cancerscreening, the methods, observations, and recommendations are relevant to other screening tests.
Cervical screening presents several ethical dilemmas to family physicians. The author reviews the risks associated with screening, costs versus benefits of running a screening program, and the issues surrounding patient autonomy and patient coercion. Is saving one life worthwhile, and at what cost? Cervical screening programs are imperative in family practice, but only if harm to the patient is minimized and ethical objections are addressed.
The use of digital mammography for breast cancerscreening poses several novel problems such as development of digital sensors, computer assisted diagnosis (CAD) methods for image noise suppression, enhancement, and pattern recognition, compression algori...
L. P. Clarke G. J. Blaine K. Doi M. J. Yaffe F. Shtern
The use of computed tomography (CT) in lung cancerscreening may not reduce deaths from the disease and may expose some individuals to invasive and unnecessary treatments, according to the March 6, 2007, Journal of the American Medical Association.
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 cancerscreening, 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 cancerscreening 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
The overall objective of this study was to determine factors associated with sustaining regular participation in free prostate cancerscreening clinics, particularly among African American men. Intervention strategies were designed and used at the communi...
In the Screening Older Minority Women project, the authors applied a community capacity-enhancement approach to promoting breast and cervical cancerscreening 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…
|In the Screening Older Minority Women project, the authors applied a community capacity-enhancement approach to promoting breast and cervical cancerscreening 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…
Background. Colorectal cancer can be prevented through endoscopic removal of adenomatous polyps. Because screening endoscopy rates are low, it is critical to identify correlates of screening behavior that are amenable to interventions to improve screening rates. Our purpose was to identify the correlates of endoscopic screening among persons at risk for colorectal cancer.Methods. We surveyed 1,160 healthy, adult, first-degree relatives
Ann-Marie Codori; Gloria M. Petersen; Diana L. Mighoretti; Patricia Boyd
Project Safety Net identifies low-income urban frail elderly and provides comprehensive geriatric assessment and referral. During 8-month period, 814 older persons were screened including high proportions who were widowed (51%) and who lived alone (66%). Effectiveness of program remains to be determined in randomized clinical trials. (Author/NB)
Agency for Toxic Substances and Disease Registry (ATSDR) conducted a blood lead screeningproject in Coffeyville, Kansas. The goal was to determine if children from 6 through 71 months of age and pregnant women living in the vicinity of the Sherwin-Willia...
|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)|
Abstract Objective To determine family physician perspectives regarding the acceptability and effectiveness of 2 interventions—a targeted, mailed invitation for screening to patients, and family physician audit-feedback reports—and on the colorectal cancer (CRC) screening program generally. This information will be used to guide program strategies for increasing screening uptake. Design Qualitative study. Setting Ontario. Participants Family physicians (n = 65). Methods Seven 1-hour focus groups were conducted with family physicians using teleconferencing and Web-based technologies. Responses were elicited regarding family physicians’ perspectives on the mailing of invitations to patients, the content and design of the audit-feedback reports, the effect of participation in the pilot project on daily practice, and overall CRC screening program function. Main findings Key themes included strong support for both interventions and for the CRC screening program generally. Moderate support was found for direct mailing of fecal occult blood testing (FOBT) kits. Participants identified potential pitfalls if interventions were implemented outside of patient enrolment model practices. Participants expressed relatively strong support for colonoscopy as a CRC screening test but relatively weak support for FOBT. Conclusion Although the proposed interventions to increase the uptake of CRC screening were highly endorsed, concerns about their applicability to non–patient enrolment model practices and the current lack of physician support for FOBT will need to be addressed to optimize intervention and program effectiveness. Our study is highly relevant to other public health programs planning organized CRC screening programs.
Tinmouth, Jill; Ritvo, Paul; McGregor, S. Elizabeth; Guglietti, Criss; Green, Josh; Claus, Danielle; Levitt, Cheryl; Paszat, Lawrence F.; Rabeneck, Linda
:Background and Purpose. Women who have not had a Papanicolaou test in five years or more have increased risk of developing invasive cervical cancer. This study compares Appalachian women whose last screening was more than one year ago but less than five years ago with those not screened for the previous five years or more.Methods. Using PRECEDE\\/PROCEED as a guide,
Mark B. Dignan; Nancy E. Schoenberg; Christina R. Studts; Jennifer Hatcher; Lisa M. Turner
Background and Purpose. Women who have not had a Papanicolaou test in five years or more have increased risk of developing invasive cervical cancer. This study compares Appalachian women whose last screening was more than one year ago but less than five years ago with those not screened for the previous five years or more. Methods. Using PRECEDE\\/PROCEED as a
Mark B. Dignan; Nancy E. Schoenberg; Christina R. Studts; Jennifer Hatcher; Lisa M. Turner
Various interventions have been implemented to increase the rate of colon cancerscreening. The purpose of this study was\\u000a to determine if persons who are regular patients of a clinic, ages 50–64 years, and not up-to-date with colon cancerscreening\\u000a will complete the at-home fecal-immunochemical test (FIT) if it is mailed to them. This intervention was designed to have\\u000a the subject
Jeanette M. DalyBarcey; Barcey T. Levy; Mary L. Merchant; Jason Wilbur
Background. Although colorectal cancer is the third most common cancer in women, little is known about predictors of adherence to screening.Methods. A randomly selected sample of 202 predominantly low-income and African-American women were interviewed. Knowledge of, attitudes and beliefs about, and practices related to flexible sigmoidoscopy (FS) screening were assessed.Results. The majority of participants were in the precontemplation stage of
Introduction: Effective preventive services are needed most in underserved, inner-city settings that suffer disproportionately from morbidity and mortality. Primary care physicians can play an important role in the provision of efficacious cancer prevention and screening services to patients in these communities.Method: We surveyed 122 primary care physicians about their cancer prevention and screening knowledge, attitudes, and practices.Results: Relative to the
Alfred Ashford; Donald Gemson; Sherri N Sheinfeld Gorin; Susan Bloch; Rafael Lantigua; Habibul Ahsan; Alfred I Neugut
ABSTRACT A recommendationfrom,a physician is the most,influential factor in determining whether,a patient is screened for colorectal cancer. While the vast majority of primary care physicians report that they screen for colorectal cancer, many patients do not receive the rec- ommendation,they need. Evidence-based,strategies can help the physician ensure that every appropriate patient leaves the office with the needed,recommendation.,Choosing an office sys-
Introduction: The military health system (MHS) a unique setting to analyze implementation programs as well as outcomes for colorectal cancer (CRC). Here we look at the efficacy of different CRC screening methods, attributes and results within the MHS, and current barriers to increase compliance. Materials and Methods: A literature search was conducted utilizing PubMed and the Cochrane library. Key-word combinations included colorectal cancerscreening, racial disparity, risk factors, colorectal cancer, screening modalities, and randomized control trials. Directed searches were also performed of embedded references. Results: Despite screening guidelines from several national organizations, extensive barriers to widespread screening remain, especially for minority populations. These barriers are diverse, ranging from education and access problems to personal beliefs. Screening rates in MHS have been reported to be generally higher at 71% compared to national averages of 50-65%. Conclusion: CRC screening can be highly effective at improving detection of both pre-malignant and early cancers. Improved patient education and directed efforts are needed to improve CRC screening both nationally and within the MHS.
Background Several European countries have set up population screening programmes for cancer detection. By definition, screening tests are performed in a population that is not at increased risk. The benefits and harms both before and after programme implementation are to be balanced versus programme costs. Methods The Belgian Health Care Knowledge Centre (KCE) has performed four systematic reviews on respectively
Neyt M; Van de Sande S; Hulstaert F; Paulus D; Van den Bruel; Mambourg F; Vinck I
The purpose of this qualitative study (N = 98, 11 focus groups) is to investigate how low-income, African American and Hispanic older women make decisions about cervical cancerscreening. Using the health belief model to guide content analysis of transcripts, we found that primary barriers to screening were; embarrassment with, fear of, and pain from the test, difficulty in accessing
PURPOSE: Screening with sigmoidoscopy reduces the risk of death from colorectal cancer. Only 30% of eligible patients have undergone sigmoidoscopy, in part because of a limited supply of endoscopists. We evaluated the performance and safety of screening sigmoidoscopic examinations by trained nonphysician endoscopists in comparison with board-certified gastroenterologists.SUBJECTS AND METHODS: Asymptomatic patients 50 years or older without evidence of fecal
Michael B Wallace; James Alan Kemp; Frank Meyer; Kimberly Horton; Angela Reffel; Cindy L Christiansen; Francis A Farraye
|A study of cancerscreening 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)|
Objective To study interventions that provide people with information about cancer risk and about screening that is tailored to their personal characteristics. We assess the tailoring characteristics, theory base and effects on risk perception, knowledge and screening behavior of these interventions. Methods A systematic literature review in this field was performed. PubMed, EMBASE, PsychINFO, CINAHL and Cochrane databases were searched.
From September 15, 1977 to April 15, 1978 450,477 persons over the age of 7 were screened for schistosomiasis and 198,950 over the age of 30 were screened for colorectal cancer. 75 cases of colorectal malignant tumor were discovered, a positive rate of 37...
The EDIFICE survey was performed to ascertain how both the targeted general population and GPs in France deal with cancerscreening and especially with screening programmes. The assessment of compliance to national official statements and professional guidelines, rates and trends of compliance, specific profiles of individuals who do and those who do not attend were investigated and are presented in this supplement. PMID:21245675
BACKGROUND: To identify correlates of adherence to colorectal cancer (CRC) screening guidelines in average-risk Canadians. METHODS: 2003 Canadian Community Health Survey Cycle 2.1 respondents who were at least 50 years old, without past or present CRC and living in Ontario, Newfoundland, Saskatchewan, and British Columbia were included. Outcomes, defined according to current CRC screening guidelines, included adherence to: i) fecal
Maida J Sewitch; Caroline Fournier; Antonio Ciampi; Alina Dyachenko
Because informed consent for prostate cancerscreening with prostate specific antigen (PSA) is recommended, we determined how African Americans, Hispanics, and Caucasians want information about screening with PSA and the digital rectal exam (DRE) presented in culturally sensitive brochures specific for each group. We analyzed focus group discussions using content analysis and compared themes across groups in a university outpatient
Evelyn C. Y. Chan; Michelle C. Haynes; Frederick T. O'Donnell; Carolyn Bachino; Sally W. Vernon
To determine the optimal strategy for prostate cancerscreening, the cost-effectiveness of screening was analyzed using a\\u000a medical decision model. One hundred thousand asymptomatic males between the ages of 40 and 69 were modeled with and without\\u000a screening. The subjects were divided into three 10-year age groups. We used a 5-year survival rate as an effectiveness point\\u000a and assumed after
\\u000a Reduced incidence and mortality from colorectal cancer (CRC) associated with early detection of CRC and precursor lesions\\u000a by screening  is well documented in the literature. Screening for CRC is widely recommended for average-risk adults starting\\u000a at age 50 , and numerous efforts directed at increasing awareness of CRC, CRC screening and its efficacy have been deployed.\\u000a Yet currently, adherence
To date, nearly all studies examining gender disparities in colorectal cancerscreening report a lower endoscopic screening\\u000a rate in women. Using a statewide claims database, gender differences in screening rates were analyzed in an attempt to validate\\u000a gender disparities reported in prior survey-based studies. Procedural-level dataset containing all patient encounters for\\u000a 2003 in which a colonoscopy or flexible sigmoidoscopy were
Rachel A. Callcut; Stephanie Kaufman; Robert Stone-Newsom; Patrick Remington; David Mahvi
OBJECTIVE:Our aim was to identify predictors of colorectal cancerscreening in the United States and subgroups with particularly low rates of screening.METHODS:The responses to a telephone-administered questionnaire of a nationally representative sample of 61,068 persons aged ?50 yr were analyzed. Current screening was defined as either sigmoidoscopy\\/colonoscopy in the preceding 5 years or fecal occult blood testing (FOBT) in the
George N. Ioannou; Michael K. Chapko; Jason A. Dominitz
Pancreatic cancer is the fourth most common cause of cancer mortality in the United States, with 5-year survival rates for patients with resectable tumors ranging from 15% to 20%. However, most patients presenting with distant metastases, are not resectable, and have a 5-year survival rate of close to 0%. This demonstrates a need for improved screening to identify pancreatic cancer while the tumor is still localized and amenable to surgical resection. Studies of patients with pancreatic tumors incidentally diagnosed demonstrate longer median survival than tumors discovered only when the patient is symptomatic, suggesting that early detection may improve outcome. Recent evidence from genomic sequencing indicates a 15-year interval for genetic progression of pancreatic cancer from initiation to the metastatic stage, suggesting a sufficient window for early detection. Still, many challenges remain in implementing effective screening. Early diagnosis of pancreatic cancer relies on developing screening methodologies with highly sensitive and specific biomarkers and imaging modalities. It also depends on a better understanding of the risk factors and natural history of the disease to accurately identify high-risk groups that would be best served by screening. This review summarizes our current understanding of the biology of pancreatic cancer relevant to methods available for screening. At this time, given the lack of proven benefit in this disease, screening efforts should probably be undertaken in the context of prospective trials. PMID:22895395
Poruk, Katherine E; Firpo, Matthew A; Adler, Douglas G; Mulvihill, Sean J
MRI is used widely both for screening women who are at increased risk of breast cancer and for treatment selection. Prospective studies confirm that MRI screening of women with known or suspected genetic mutation results in a higher sensitivity for cancer detection than does mammography. However, survival data are not available. In women with breast cancer, MRI detects cancer not identified with other types of screening. In two randomised trials, this increased sensitivity did not translate into improved selection of surgical treatment or a reduction in the number of operations. Data for longer-term outcomes such as ipsilateral breast tumour recurrence rates and contralateral breast cancer incidence are scarce, but to date do not show clear benefit for MRI. MRI is better than other methods of assessing the response to neoadjuvant chemotherapy, and is helpful in identifying the primary tumour in patients who present with axillary adenopathy. PMID:22098853
European Guidelines for Quality Assurance in Cervical CancerScreening have been initiated in the Europe Against Cancer Programme. The first edition established the principles of organised population-based screening and stimulated numerous pilot projects. The second multidisciplinary edition was published in 2008 and comprises ?250 pages divided into seven chapters prepared by 48 authors and contributors. Considerable attention has been devoted to organised, population-based programme policies which minimise adverse effects and maximise benefits of screening. It is hoped that this expanded guidelines edition will have a greater impact on countries in which screening programmes are still lacking and in which opportunistic screening has been preferred in the past. Other methodological aspects such as future prospects of human papillomavirus testing and vaccination in cervical cancer control have also been examined in the second edition; recommendations for integration of the latter technologies into European guidelines are currently under development in a related project supported by the European Union Health Programme. An overview of the fundamental points and principles that should support any quality-assured screening programme and key performance indicators are presented here in a summary document of the second guidelines edition in order to make these principles and standards known to a wider scientific community.
Anttila, A.; Jordan, J.; Ronco, G.; Schenck, U.; Segnan, N.; Wiener, H.; Herbert, A.; von Karsa, L.
Comparisons were made between African-American women with and without a family history of breast cancer with respect to mammography screening, attitudes towards mammography screening, and perceptions of risk and concerns about breast cancer. Screening beh...
Background Although 64% of cancer survivors are expected to live at least five years beyond diagnosis, the receipt of cancerscreening by this population is unclear. The study objective is to assess the relation between a cancer diagnosis and future cancerscreening, exploring provider, patient, and cancer-specific factors that explain observed relationships. Methods The Wisconsin Longitudinal Study (WLS) and Wisconsin Tumor Registry were used to identify two participant groups: 415 diagnosed with non-metastatic cancer between 1992-1993 (pre-cancer) and 2003-2004 (post-cancer) and 4,680 no-cancer controls. Adjusted average predicted probabilities of cancerscreening were estimated with models that first did not include and then included, provider (provider relationship length), participant (depressive symptoms (CES-D)) and cancer-specific (time since diagnosis) factors. Participants with a history of the cancer associated with a given screening test were then excluded to assess whether relationships are explained by screening for recurrence versus second cancers. Results Female cancer survivors were more likely than no-cancer controls to undergo pelvic/pap (70%, 95% confidence interval (CI)=63-76% and 61%,CI=59-63%) and mammography screening (86%,CI=78-90% and 76%,CI=74-77%), though male cancer survivors were not more likely to receive prostate exams (76%,CI=70-82% and 69%,CI=67-71%). After excluding people with a history of the cancer being screened for, there were few significant differences in cancerscreening between short or long-term survivors (>5 years) and no-cancer controls. Relationships were not sensitive to adjustment for provider or participant factors. Conclusions The significant positive differences in cancerscreening between people with and without cancer can be explained by screening for recurrence. Long-term cancer survivors are not more likely to receive follow-up screening for second cancers. This information should be used by providers to ensure patients receive recommended follow-up preventive care.
Schumacher, Jessica R.; Witt, Whitney P.; Palta, Mari; LoConte, Noelle K.; Heidrich, Susan M.; Trentham-Dietz, Amy; Pandhi, Nancy; Smith, Maureen A.
Programs and Projects National Lung Screening Trial (NLST/LSS) Lung Screening Feasibility Study (LSS) Prostate, Lung, Colorectal and Ovarian CancerScreening Trial (PLCO) International Prostate Screening Trials Evaluation Group (IPSTEG) Early Detection
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 cancerscreening 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 cancerscreening 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 cancerscreening tests and remove barriers that hinder women from receiving clinical screening exams.
Harris, Dawne M.; Miller, Jane E.; Davis, Diane M.
Initial results from a large randomized trial conducted in the United States suggest that prostate cancerscreening with the digital rectal examination (DRE) and prostate specific antigen (PSA) tests may not reduce the number of deaths from prostate cancer.
Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. Objective To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide whether to participate in cervical cancerscreening. Study design The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels of analysis: naive reading, structural analysis and critical interpretation. Results These revealed that women were unprepared for screening results showing cervical cell changes, since they had no symptoms. When diagnosed, participants believed that they had early-stage cancer, leading to feelings of vulnerability and an increased need to care for themselves. Later on, an understanding of HPV as the basis for diagnosis and the realization that disease might not be accompanied by symptoms developed. The outcome for participants was a life experience, which they used to encourage others to participate in screening and to suggest ways that information about screening and HPV might reach a wider Greenlandic population. Conclusion Women living through the process of cervical disease, treatment and follow-up develop knowledge about HPV, cervical cell changes, cervical disease and their connection, which, if used to inform cervical screening programmes, will improve the quality of information about HPV, cervical cancer and screening participation. This includes that verbal and written information given at the point of screening and diagnosis needs to be complemented by visual imagery.
Despite the lack of absolute confirmation from a properly controlled clinical trial, there is now sufficient evidence to permit the working assumption that screening mammography beginning at age 40 will play a substantial role in controlling breast cancer. An anlaysis of available data indicates that the benefits of mammographic screening far exceed potential risk, and that earlier detection of cancer will actually add years to life rather than simply permit an earlier diagnosis. American radiologists are now challenged to provide screening mammography in an easily accessible and inexpensive form, so that it is effectively available to all women over age 40.
This paper investigates a method to remove hot spot speckle, which is produced by laser-long coherence, on a projectionscreen. The objective of the work has been to first create an image from a digital light processing (DLP) display system using an RGB laser source. We then successfully obtained a high-quality image with speckle contrast, which is less than 2%
Sung Chul Shin; Sin Sung Yoo; Sang Yeon Lee; Chan-Young Park; So-Yeon Park; Jae Wook Kwon; Seung-Gyu Lee
Serum tumor markers have a major role in the screening, diagnosis, and monitoring of most of the gynecologic cancers. Ovarian cancer is one of the deadliest of the group because it is so frequently asymptomatic until it has advanced to an untreatable stage. Even serum cancer antigen-125 (CA-125), clinically one of the most reliable serum markers for ovarian cancer, is elevated in only half of early-stage still-treatable tumors. Because of the very low prevalence of ovarian cancer in the general population, at present, there is no cost-effective imaging or simple microscopic screening test for ovarian cancer as there is for breast and cervical cancers. However, recent proteomics and nucleic acid-based analyses have shown great promise for the discovery of new and more useful serum biomarkers, which cumulatively might provide such a screening tool. In this review, we will discuss both the currently used serum tumor markers for screening, diagnosis, monitoring of ovarian cancer, and the novel biomarkers that are now under investigation and validation. PMID:22962405
Background: In 2004 the Institute of Medicine of the U.S. National Academies published a report, Saving Women's Lives - Strategies for Improving Breast Cancer Detection and Diagnosis. A major recommendation was to develop tools to identify women who would benefit most from breast cancerscreening, based on individually tailored risk prediction techniques. This talk examines what is known about risk
et's be clear. We need to acknowledge at least one point: the introduction of systematic screening for prostate cancer substantially reduces the mortality rate from this disease in the population. And a correction needs to be made: the incidence of cancer detectable by systematic biopsy, regardless of the detection rate of the prostate-specific antigen (PSA) test, is 15% and not
We evaluated screening sigmoidoscopy and risk of colon cancer incidence and mortality in a prospective study of men. In addition, we developed Markov model of colon cancer and evaluated screening strategies for colorectal cancer, in the prospective Health...
Background Despite the existence of different screening methods, the response to cancerscreening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancerscreening 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 cancerscreening, perceived benefits of cancerscreening, perceived barriers to cancerscreening, and cues to action. The majority of respondents had never heard of cancerscreening 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 cancerscreening. 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.
The purpose of this review is to identify clinical risk factors for prostate cancer and to assess the utility and limitations of our current tools for prostate cancerscreening. Prostate-specific antigen is the single most important factor for identifying men at increased risk of prostate cancer but is best assessed in the context of other clinical factors; increasing age, race, and family history are well-established risk factors for the diagnosis of prostate cancer. In addition to clinical risk calculators, novel tools such as multiparametric imaging, serum or urinary biomarkers, and genetic profiling show promise in improving prostate cancer diagnosis and characterization. Optimal use of existing and future tools will help alleviate the problems of overdiagnosis and overtreatment of low-risk prostate cancer without reversing the substantial mortality declines that have been achieved in the screening era. PMID:23532499
Glass, Allison S; Cary, K Clint; Cooperberg, Matthew R
Abstract Physicians must make decisions in day-to-day practice even when the balance of benefit and harm is not yet known. Adopting a clinical policy about screening is a case in point. Three controversies in screening healthy adults illustrate different aspects of resolving a dispute when the evidence is incomplete. The major controversy in cholesterol screening is whether to screen young
Background\\u000a There is no available evidence from randomized trials that early detection of prostate cancer improves health outcomes, but\\u000a the prostate-specific antigen (PSA) test is commonly used to screen men for prostate cancer.\\u000a \\u000a \\u000a \\u000a \\u000a Objective\\u000a The objective of the study is to see if screening with PSA decreases mortality from prostate cancer.\\u000a \\u000a \\u000a \\u000a \\u000a Design, setting, and participants\\u000a This is a case-control study
Stephen W. Marcella; George G. Rhoads; Jeffrey L. Carson; Frances Merlino; Homer Wilcox
Many different techniques for colon cancerscreening are available. The fecal immunochemical test is best for fecal-based screening, although the DNA investigation may be more specific when further developed. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but has limitations. The flexible sigmoidoscopic examination markedly decreases the incidence of cancer in the visualized segments, but colonoscopy is currently the best procedure for evaluating the large bowel. Techniques for retroflexion or backward view of the colon have been investigated, with all showing increased polyp detection. PMID:23735108
OBJECTIVES: To 1) compare the number of articles published about prostate, colon, and breast cancer in popular magazines during the past\\u000a 2 decades, and 2) evaluate the content of indepth prostate and colon cancerscreening articles identified from 1996 to 2001.\\u000a \\u000a \\u000a DESIGN: We used a searchable database to identify the number of prostate, colon, and breast cancer articles published in
Mira L. Katz; Stacey Sheridan; Michael Pignone; Carmen Lewis; Jamila Battle; Claudia Gollop; Michael O’Malley
Colorectal cancer is the third most common cancer in the United States and will cause 56,700 deaths in 2001, despite the availability\\u000a of screening tests capable of detecting the disease at earlier stages and reducing mortality. This article reviews the natural\\u000a history of colorectal cancer, common risk factors and prevention strategies, and the strengths, limitations, and cost effectiveness\\u000a of available
Objective—To derive a rational method of selecting the age range over which screen- ing tests for cancer should be oVered (that is, over which they would be most effective in saving life). Main outcome measure—The number of person-years of life that are lost through deaths occurring at each year of age from each of six cancers. Results—For each cancer the
The prevalence of mammography screening is unacceptably low. A history of trauma has been associated with poor health status, decreased health prevention behaviors, and increased mortality. We predicted that women who had a history of trauma were less likely to obtain mammography screening than women who did not report such a history. The relation between history of trauma and breast
The HIP trial was done in an era when the size of breast cancers was much larger than became usual in the subsequent two decades in North America. I recall no instance in which the masking of the allocation was compromised. The major difficulty for the reviewers was not whether the patient died of cancer, nor whether breast cancer had
INTRODUCTION: Compliance with colorectal cancer (CRC) screening in Canada is low. The aim of the present survey was to determine whether Canadian physicians older than 50 years were pursuing colon cancerscreening. Specifically, physicians were asked to identify their modality of choice and identify their barriers to screening. METHODS: Surveys were mailed to members, older than 50 years, of the Canadian Association of Gastroenterology, the Society of Obstetricians and Gynaecologists of Canada, the Canadian Society of Internal Medicine, the Canadian Psychiatric Association and the Canadian Association of Radiologists. RESULTS: Of 2807 surveys, 46% were returned. Screening for CRC was reported by 53% of respondents. The Canadian Association of Radiologists members (61%) and the Canadian Association of Gastroenterology members (61%) were more likely to be screened than other specialties (P<0.01 and P<0.05, respectively). Members of the Society of Obstetricians and Gynaecologists of Canada (44%) were least likely to be screened (P<0.001). Men (P<0.001) and Ontario physicians (P<0.01) were more likely to be screened than women and Canadian physicians from other provinces, respectively. Colonoscopy (56%) was the most common screening modality used, followed by fecal occult blood testing (27%). Respondents who had not been screened cited a lack of personal time (47%) and insufficient data to warrant screening (14%). DISCUSSION: More than one-half of all respondents were screened for CRC. Colonoscopy is the most common screening modality used. Lack of time is the most common reason cited for not participating in CRC screening.
Raza, Mamoon; Bernstein, Charles N; Ilnyckyj, Alexandra
Metastasisâ€”the spread of cancer from the place where it first started to another place in the bodyâ€”is the most common reason that cancer treatments fail. To metastasize, some types of cancer cells rely on invadopodia, cellular membrane projections that act like feet, helping them â€śwalkâ€ť away from the primary tumor and invade surrounding tissues. To determine how cells control invadopodia formation, scientists at Sanford-Burnham Medical Research Institute (Sanford-Burnham) screened a collection of pharmacologically active compounds to identify those that either promote or inhibit the process.
Background: Women with a family history of breast cancer (i.e., in a mother, sister or daughter) are at increased risk for this disease. Previous data also suggest that lesbians are at increased risk for breast cancer. While the screening behaviors of women with a family history have been described, little is known about factors that influence screening behaviors of lesbians
Caroline B. Burnett; Caryn S. Steakley; Rebecca Slack; Joan Roth; Caryn Lerman
Background & Aims: Identification of the hereditary nonpolyposis colorectal cancer (HNPCC) syndrome enables prevention of colorectal cancer (CRC) by means of colonoscopy and polypectomies. We evaluated the efficacy of screening in a controlled trial over 15 years. Methods: Incidence of CRC and survival were compared in 2 cohorts of at-risk members of 22 families with HNPCC. Colonic screening at 3-year
Heikki J. Järvinen; Markku Aarnio; Harri Mustonen; Lauri A. Aaltonen; Päivi Peltomäki; Albert De La Chapelle
We describe a way to display three-dimensional images by integral imaging using an ordinary projector. We first explain a method that uses a large-aperture converging lens, then we explain the proposed method that uses two sets of lens array. Based on the principle of this new approach, front projection as well as rear projection is possible. Only a proper viewing area can be formed on the optical screen by this method, which improves the brightness of images on the screen. The projector itself does not need an additional optical system. We report on the results of an experiment carried out to confirm the validity of the proposed method. PMID:17151752
A decline in breast cancer mortality has been observed in western European Countries since the middle of the 1990s. Different methodological approaches, including case-control studies, incidence-based mortality studies, and trend studies, have been used to assess the effectiveness of mammography screening programmes in reducing breast cancer mortality. However, not all methods succeed in distinguishing the relative contributions of service screening and taking correctly into consideration the potential source of bias that might affect the estimate. Recently, a review of six case-control studies confirmed a breast cancer mortality reduction ranging from 38% to 70% among screened women. This figure is in accordance with the estimate obtained from incidence-based mortality studies if screening compliance is taken into account. We will describe the methodological constraints of mortality trend studies in predicting the impact of screening on mortality and the necessary caution that must be applied when interpreting the results of such studies. In conclusion, when appropriate methodological approaches are used, it is evident that mammographic screening programmes have contributed substantially to the observed decline in breast cancer mortality.
In this paper, Sun Innovations demonstrates an innovative emissive projection display (EPD) system. It is comprised of a fully transparent fluorescent screen with a UV image projector. The screen can be applied to glass windows or windshield, without affecting visible light transmission. The UV projector can be based on either a DLP (digital light processor) or a laser scanner display engine. For a DLP based projector, a discharge lamp coupled to a set of UV filters can be applied to generate a full color video image on the transparent screen. UV or blue-ray laser diodes of different wavelengths can be combined with scanning mirrors to generate a vector display for full windshield display applications. This display combines the best of both worlds of conventional projection and emissive display technologies. Like a projection display, the screen has no pixel structure and can be manufactured roll to roll; the display is scalable. Like an emissive display (e.g. plasma or CRT), the quality of the image is superior, with very large viewing angles. It also offers some unique features. For example, in addition to a fully transparent display on windows or windshields, it can be applied to a black substrate to create the first front projection display on true "black" screen that has superior image contrast at low projection power. This fundamentally new display platform can enable multiple major commercial applications that can not be addressed by any of the existing display technologies.
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 cancerscreening 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 cancerscreening 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 cancerscreening 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 cancerscreening 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
Taylor, V M; Schwartz, S M; Jackson, J C; Kuniyuki, A; Fischer, M; Yasui, Y; Tu, S P; Thompson, B
Background Published decision analyses show that screening for colorectal cancer is cost-effective. However, because of the number of tests available, the optimal screening strategy in Canada is unknown. We estimated the incremental cost-effectiveness of 10 strategies for colorectal cancerscreening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and benefits of chemotherapy. Methods We used a probabilistic Markov model to estimate the costs and quality-adjusted life expectancy of 50-year-old average-risk Canadians without screening and with screening by each test. We populated the model with data from the published literature. We calculated costs from the perspective of a third-party payer, with inflation to 2007 Canadian dollars. Results Of the 10 strategies considered, we focused on three tests currently being used for population screening in some Canadian provinces: low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 44%, 65% and 81%, and mortality by 55%, 74% and 83%, respectively, compared with no screening. These strategies generated incremental cost-effectiveness ratios of $9159, $611 and $6133 per quality-adjusted life year, respectively. The findings were robust to probabilistic sensitivity analysis. Colonoscopy every 10 years yielded the greatest net health benefit. Interpretation Screening for colorectal cancer is cost-effective over conventional levels of willingness to pay. Annual high-sensitivity fecal occult blood testing, such as a fecal immunochemical test, or colonoscopy every 10 years offer the best value for the money in Canada.
Telford, Jennifer J.; Levy, Adrian R.; Sambrook, Jennifer C.; Zou, Denise; Enns, Robert A.
Breast cancer is the most common cancer in women in the United States; this year, approximately 215,900 new cases will be diagnosed. Mammography remains the cornerstone of screening, with technologies such as ultrasonography and magnetic resonance imaging having an increasingly defined role. Improved risk assessment and prevention strategies have been implemented, and current research in these areas includes better identification of patients at risk, the use of aromatase inhibitors and other agents to reduce risk, and the use of surrogate markers. Breast cancer staging has been optimized recently; also, local management of breast cancer, adjuvant systemic therapies, and treatment of patients with advanced disease have been evolving. Advances in screening, diagnosis, and treatment of breast cancer continue to influence our approach to patients with this disease. Many improvements have been made as well in supportive care, including increased tolerability of therapy and notable amelioration of disease symptoms. PMID:15182098
Two long awaited randomised trials of PSA screening have reported this year. However, as Jennifer Stark and colleagues explain, the results are unlikely to end the controversy over the benefits and harms of testing
Jennifer R Stark; Lorelei Mucci; Kenneth J Rothman; Hans-Olov Adami
The location, tissue background and imaging characteristics of true positive and false negative screens of breast cancers have been studied. This data can aid decisions in optimizing the display of mammographic information with the objective of minimizing false negative screens. Screening mammograms for four groups of women were digitized; those with screen detected cancers, those with false negative interval cancers,
S Meeson; K C YOUNG; M G WALLIS; J COOKE; M L RAMSDALE; Coventry Breast; Coventry CV
BACKGROUND: Colorectal cancerscreening rates are low among disadvantaged patients; few studies have explored barriers to screening in community health centers. The purpose of this study was to describe barriers to\\/facilitators of colorectal cancerscreening among diverse patients served by community health centers. METHODS: We identified twenty-three outpatients who were eligible for colorectal cancerscreening and their 10 primary care
Karen E Lasser; John Z Ayanian; Robert H Fletcher; Mary-Jo Good
Objectives One of the aims of the Chicago Cancer Navigation Project (CCNP) is to reduce the interval of time between abnormal breast cancerscreening and definitive diagnosis in patients who are navigated as compared to usual care. In this article, we investigate the extent to which total costs of breast cancer navigation can be off-set by survival benefits and savings in lifetime breast cancer-attributable costs. Methods Data sources for the cost-effectiveness analysis include data from published literature, secondary data from the NCI’s Surveillance Epidemiology and End Results program, and primary data from the CCNP. Results If women enrolled in CCNP receive breast cancer diagnosis earlier by 6-months as compared to usual care, then navigation is borderline cost-effective for $95,625 per life-year saved. Results from sensitivity analyses suggest that the cost-effectiveness of navigation is sensitive to: the interval of time between screening and diagnosis, percent increase in number of women who receive cancer diagnosis and treatment, women’s age, and the positive predictive value of a mammogram. Conclusions In planning cost-effective navigation programs, special considerations should be made regarding the characteristics of the disease, program participants, and the initial screening test that determines program eligibility.
Rectal cancer is one of the primary malignant neoplasms occurring in Mexican patients of reproductive age. Unfortunately, randomized studies in rectal cancer do not exist as they do with well-recognized colon cancer. We must individualize the epidemiology, risk factors, diagnostic approach, staging and treatment because management is different in rectal cancers affecting the mid- and lower third of the rectum than in the upper third and in colon cancers. Histological staging is the primary prognostic factor. TNM staging (tumor, node, and metastasis) is used internationally by the American Joint Committee on Cancer (AJCC). Staging is done with the assistance of endorectal ultrasound, which is best used in early-stage cancer; however, there are certain disadvantages in detecting node involvement. Magnetic resonance, on the other hand, allows for the evaluation of stenotic tumors and node involvement. Once the correct diagnosis and staging have been made, the next step is correct treatment. Neoadjuvant treatment has demonstrated to be better than adjuvant treatment. Abdominoperineal resection is rarely practiced currently, with sphincter preservation being the preferred procedure. Laparoscopic approach has conferred the advantages of the approach itself when performed by experts in the procedure but there is insufficient evidence to make it the "gold standard." Rectal cancer is a complex pathology that must be considered totally different from colon cancer for diagnosis and treatment. The patient must be staged completely and appropriately for individualizing correct treatment. More long-term studies are needed for optimizing treatment modalities. PMID:22385771
Background and study aim Inadequate colorectal cancerscreening wastes limited endoscopic resources. We examined patients factors associated with inadequate flexible sigmoidoscopy (FSG) screening at baseline screening and repeat screening 3–5 years later in 10 geographically-dispersed screening centers participating in the ongoing Prostate, Lung, Colorectal, and Ovarian CancerScreening Trial Methods A total of 64,554 participants (aged 55 – 74) completed baseline questionnaires and underwent FSG at baseline. Of these, 39,385 participants returned for repeat screening. We used logistic regression models to assess factors that are associated with inadequate FSG (defined as a study in which the depth of insertion of FSG was <50 cm or visual inspection was limited to <90% of the mucosal surface but without detection of a polyp or mass). Results Of 7,084 (11%) participants with inadequate FSG at baseline, 6,496 (91.7%) had <50 cm depth of insertion (75.3% due to patient discomfort) and 500 (7.1%) participants had adequate depth of insertion but suboptimal bowel preparation. Compared to 55–59 year age group, advancing age in 5-year increments (odds ratios (OR) from 1.08 to 1.51) and female sex (OR = 2.40; 95% confidence interval (CI): 2.27 – 2.54) were associated with inadequate FSG. Obesity (BMI >30 kg/m2) was associated with reduced odds (OR = 0.67; 95%CI: 0.62 – 0.72). Inadequate FSG screening at baseline was associated with inadequate FSG at repeat screening (OR = 6.24; 95%CI: 5.78 – 6.75). Conclusions Sedation should be considered for patients with inadequate FSG or an alternative colorectal cancerscreening method should be recommended.
Laiyemo, Adeyinka O.; Doubeni, Chyke; Pinsky, Paul F.; Doria-Rose, V. Paul; Sanderson, Andrew K.; Bresalier, Robert; Weissfeld, Joel; Schoen, Robert E.; Marcus, Pamela M.; Prorok, Philip C.; Berg, Christine D.
Changes in screening guidelines that imply suppression of procedures once recommended are always controversial because of the perception that benefits are being curtailed. Prior to 2012, cervical cancerscreening guidelines issued by US-based expert bodies differed in several decision areas, making clinicians essentially cherry-pick among recommendations. To some extent, this approach to screening practices also served to shield clinicians from litigation. It implied starting screening earlier, doing it more frequently, and stopping later in life than necessary. This state of affairs changed in 2012, when the most influential professional groups updated their cervical screening guidelines, and recommendations became essentially unified. All groups recommended that women older than 65 years of age discontinue cervical cancerscreening on the basis of evidence that screening benefits in this age group were minor and far outweighed by harms. The guidelines are very specific about the exceptions, which ensure acceptable safety. It is expected that the new guidelines will permit less wasteful cervical screening, while fostering the opportunity to direct resources towards ensuring adequate coverage of high-risk women. PMID:23966564
Purpose Colorectal cancer (CRC) screening has been shown to decrease CRC mortality. Organised mass screening programs are being implemented in France. Its perception in the general population and by general practitioners is not well known. Methods Two nationwide observational telephone surveys were conducted in early 2005. First among a representative sample of subjects living in France and aged between 50 and 74 years that covered both geographical departments with and without implemented screening services. Second among General Practionners (Gps). Descriptive and multiple logistic regression was carried out. Results Twenty-five percent of the persons(N = 1509) reported having undergone at least one CRC screening, 18% of the 600 interviewed GPs reported recommending a screening test for CRC systematically to their patients aged 50–74 years. The odds ratio (OR) of having undergone a screening test using FOBT was 3.91 (95% CI: 2.49–6.16) for those living in organised departments (referent group living in departments without organised screening), almost twice as high as impact educational level (OR = 2.03; 95% CI: 1.19–3.47). Conclusion CRC screening is improved in geographical departments where it is organised by health authorities. In France, an organised screening programs decrease inequalities for CRC screening.
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 woman’s 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 cancerscreening 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.
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.
Introduction Colorectal cancer survivors remain at risk for breast cancer. Thus, it is important to determine if screening mammography\\u000a rates are reduced by the diagnosis and treatment of incident colorectal cancer.\\u000a \\u000a \\u000a \\u000a Methods Mammography rates among 7,666 67–79 year-old stage 0-III colorectal cancer survivors were compared with rates among 36,433\\u000a age-, race\\/ethnicity-, SEER area-matched women controlling for pre-diagnosis mammography, stage, chemotherapy, income, co-morbidities,\\u000a treatment
New Zealand is currently exploring how population-based colorectal cancer (CRC) screening will be implemented. The United Kingdom (UK), Australia, France, Italy, Spain, Finland, Denmark, the Netherlands, and Switzerland have conducted or are currently conducting pilot\\/feasibility studies. The UK, Australia, Finland, Canada, France and Italy are all in the early stages of implementing population-based CRC screening programmes. Most of these countries
New recommendations on screening for breast cancer in the USA recently presented by the US Preventive Services Task Force (USPSTF) and the Society of Breast Imaging and American Council of Radiologists (ACR) provoke some concerns about the optimal screening strategy for breast cancer. USPSTF recommendations published in November 2009 do not recommend screening mammography in women younger than 50 years old because of high false-positive rates and low effects on mortality and vote against self examination of the breast because of lacking evidence for survival benefit from randomized trials. Nevertheless, the ACR guidelines published two months later strongly support the beginning of screening mammography by the age of 40.We asked Dr. Kettritz whether the new recommendation from the USA might have impact on the clinical routine in Europe?Oleg Gluz and Cornelia Liedtke. PMID:21048828
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
Health maintenance includes secondary prevention through cancerscreening. There are no established guidelines for cancerscreening patients with end-stage renal disease (ESRD). Using an established method of estimating life expectancy, published literature on cancerscreening, and information from databases on mortality and malignancy (US Renal Data System 1997 Annual Data Report and the SEER Cancer and Statistical Review, 1973-1994), a
Christopher J. LeBrun; Louis F. Diehl; Kevin C. Abbott; Paul G. Welch; Christina M. Yuan
Background: Although colorectal cancerscreening by using a fecal occult blood test (FOBT), flexible sigmoidoscopy, colonoscopy, or barium enema x-ray reduces the incidence of and death from colorectal cancer, the rate of colorectal cancerscreening in the general population is low. We con- ducted a randomized trial consisting of direct mailing of FOBT kits to increase colorectal cancerscreening among
Timothy R. Church; Mark W. Yeazel; Resa M. Jones; Laura K. Kochevar; Gavin D. Watt; Steven J. Mongin; Jill E. Cordes; Deborah Engelhard
Cervical cancer is recognized as tobacco-related malignancy. HPV vaccination and introducing screening protocols were found as the best way to decrease cervical cancer related mortality. Besides the cytological screening programs of the uterine cervix smear, nowadays co-factors of carcinogenesis are taken into consideration, also. The aim of our study was to analyse data included in questionnaire of 310 women who underwent cytological examination wi thin cervical cancerscreening program in our Department in 2011. There were no differences found between studied groups on rate of oral contraceptive or hormonal therapy use, as well as age and tobacco smoking. However, taking into account education and smoking, there was a significant correlation observed. Patients with higher education level smoked less often. The special attention should be paid to promote smoking cessation in the group of women who finished education on elementary level. PMID:23421059
Walentowicz-Sad?ecka, Ma?gorzata; Sad?ecki, Pawe?; Marsza?ek, Andrzej; Grabiec, Marek
Background Screening has become one of our best tools for early detection and prevention of cancer. The group-randomized trial is the most rigorous experimental design for evaluating multilevel interventions. However, identifying the proper sample size for a group-randomized trial requires reliable estimates of intraclass correlation (ICC) for screening outcomes, which are not available to researchers. We present crude and adjusted ICC estimates for cancerscreening outcomes for various levels of aggregation (physician, clinic, and county) and provide an example of how these ICC estimates may be used in the design of a future trial. Methods Investigators working in the area of cancerscreening were contacted and asked to provide crude and adjusted ICC estimates using the analysis of variance method estimator. Results Of the 29 investigators identified, estimates were obtained from 10 investigators who had relevant data. ICC estimates were calculated from 13 different studies, with more than half of the studies collecting information on colorectal screening. In the majority of cases, ICC estimates could be adjusted for age, education, and other demographic characteristics, leading to a reduction in the ICC. ICC estimates varied considerably by cancer site and level of aggregation of the groups. Conclusions Previously, only two articles had published ICCs for cancerscreening outcomes. We have complied more than 130 crude and adjusted ICC estimates covering breast, cervical, colon, and prostate screening and have detailed them by level of aggregation, screening measure, and study characteristics. We have also demonstrated their use in planning a future trial and the need for the evaluation of the proposed interval estimator for binary outcomes under conditions typically seen in GRTs.
Murray, David M.; Pennell, Michael L.; Rhoda, Dale; Paskett, Electra D.; Champion, Victoria L.; Crabtree, Benjamin F.; Dietrich, Allen; Dignan, Mark B.; Farmer, Melissa; Fenton, Joshua J.; Flocke, Susan; Hiatt, Robert A.; Hudson, Shawna V.; Mitchell, Michael; Monahan, Patrick; Shariff-Marco, Salma; Slone, Stacey L.; Stange, Kurt; Stewart, Susan L.; Ohman Strickland, Pamela A.
Objective To compare the skin and breast/cervical cancer prevention/screening practices of adult siblings of childhood cancer survivors with controls and to identify modifying factors for these practices. Methods Cross-sectional, self-report data from 2,588 adult siblings of 5+ year survivors of childhood cancer were analyzed to assess cancer prevention/screening practices. Two age, sex and race/ethnicity-matched samples (n=5,915 and n=37,789) of the Behavioral Risk Factor Surveillance System participants served as the comparison populations. Sociodemographic and cancer-related data were explored as modifying factors for sibling cancer prevention/screening practices through multivariable logistic regression. Results Compared to controls, siblings were more likely to practice skin cancer prevention behaviors: use of protective clothing (OR 2.85, 95% 2.39-3.39), use of shade (OR 2. 11, 95% 1.88-2.36), use of sunscreen (OR 1.27, 95% 1.14-1.40), and wearing a hat (OR 1.77, 95% 1.58-1.98). No differences were noted for breast/cervical cancerscreening including mammography and Pap testing. Having less than a high school education and lack of health insurance were associated with diminished cancer prevention/screening behaviors. Survivor diagnosis, treatment intensity, adverse health, chronic health conditions, and second cancers were not associated with sibling cancer prevention/screening behaviors. Conclusions Siblings of cancer survivors report greater skin cancer prevention practices when compared with controls; however, no differences were noted for breast/cervical cancerscreening practices. Access to care and lack of education may be associated with decreased cancer prevention/screening behaviors. Interventions are needed to address these barriers. Impact Research should be directed at understanding the impact of the cancer experience on sibling health behaviors.
Objective. To investigate factors associated with receipt of colorectal cancer (CRC) screening among urban senior Chinese-Americans.Methods. Two hundred three men and women from three senior centers completed a questionnaire that included sections on demographics, fecal occult blood testing (FOBT) and sigmoidoscopy use, and potential barriers to screening.Results. Receipt of a FOBT within the prior 12 months (37.9% of sample) was
Wei Yue Sun; Charles E Basch; Randi L Wolf; Xiao Jing Li
There is no direct evidence that colonoscopy screening reduces mortality from colorectal cancer. However, results from studies\\u000a using fecal occult blood testing and sigmoidoscopy, along with the fact that colonoscopy is performed after positive primary\\u000a screening tests, support this assumption. Colonoscopy every 10 years is the preferred strategy in terms of clinical outcomes\\u000a and cost effectiveness. The purpose of this
CT colonography (CTC) is a validated colorectal cancer test that provides an additional minimally-invasive screening option which is likely to be preferred by some patients. Important examination prerequisites include adequate colonic cleansing and distention. Tagging of residual material aids in the differentiation of true polyps from stool. Low radiation dose technique should be employed routinely for screening studies. Readers must be skilled in the use of both 2D and 3D interpretation methods.
BACKGROUND:: Although the incidence rates of breast cancer have been increasing remarkably in Hong Kong over the last 2 decades, little is known on breast cancerscreening practices among this group of women. OBJECTIVES:: This study aimed to report breast cancerscreening practices among Hong Kong Chinese women and to examine the relationship between (1) demographic factors and (2) the modified Chinese Breast CancerScreening Beliefs Questionnaire (CBCSB) score and women's breast screening behaviors. METHODS:: A descriptive and cross-sectional method was used. Both English and Chinese versions of the modified CBCSB were administered. Of 946 Hong Kong Chinese women older than 18 years and invited to participate in the study, 753 (79.6%) completed and returned the questionnaire. RESULTS:: The majority of participants (70%-90%) had heard of breast self-examination (BSE), clinical breast examination (CBE), and mammograms. Only 33.3% performed a BSE monthly; 37.8% and 32.7% of women within the targeted age group had a CBE annually and had a mammogram every 2 years, respectively. Being married and part-time employment were positively associated with women who performed BSE as recommended. In terms of modified CBCSB score, women who had BSE, CBE, and mammogram as recommended had significantly higher scores on the subscale attitudes to health check-up. CONCLUSION:: Attitudes toward health check-up was influential in compliance with breast cancerscreening practices among Chinese-Australian women. IMPLICATIONS FOR PRACTICE:: Effort should be focused on specific subgroups of Hong Kong Chinese women, to fully understand the barriers involved in participating in breast cancerscreening practices. PMID:23357890
Objective: Our purpose was to report the cancers arising during a familial ovarian cancerscreening program and investigate the tumor’s clonality and association with BRCA1 and BRCA2 mutations. Study Design: Program participants with a diagnosis of ovarian cancer or peritoneal serous papillary carcinoma were identified and their demographic characteristics, ultrasonographic findings, CA 125 results, operative reports, and pathology slides reviewed.
Beth Y. Karlan; Rae Lynn Baldwin; Eloise Lopez-Luevanos; Leslie J. Raffel; Denise Barbuto; Steven Narod; Lawrence D. Platt
Rapid development of knowledge about genetic mutations as well as evolving technologies to screen for mutations in colon cancer has brought us to a new frontier in the prevention and control of familial colorectal cancer. This frontier embodies the hopes and fears of a generation of cancer researchers, health care professionals, and health care providers. The useful poten- tial of
Objective To test the Sociocultural Health Behavior Model in relation to the health behavior of prostate cancer (PCa) screening among Chinese American men. Methods Confirmatory factor analysis and structural equation model analyses were conducted among Chinese American men. Results The path analysis supported the components of the sociocultural model and indicated a positive and significant relationship between PCa screening and the enabling factors; between cultural factors and predisposing, enabling, and access/satisfaction with health care factors; and between enabling factors and access/satisfaction with health care. Conclusions The model highlights the significance that sociocultural factors play in relation to PCa screening.
Ma, Grace X.; Shive, Steven E.; Gao, Wanzhen; Tan, Yin; Wang, Min Qi
Background Postgraduate training involves intensive clinical education characterized by long work hours with minimal flexibility. Time demands may be a barrier to obtaining preventive care for housestaff during postgraduate training. Objective Assess adherence to United States Preventive Services Task Force (USPSTF) cervical cancerscreening recommendations. Design Cross-sectional survey. Participants Convenience sample of female housestaff at 1 university hospital. Measurements Primary outcomes included (1) adherence to USPSTF recommendations, (2) perception of adherence to recommendations, and (3) barriers to obtaining preventive care. Results Surveys were completed by 204 housestaff. Overall, 81% of housestaff were adherent to USPSTF screening recommendations. Housestaff requiring screening in the past year were less likely to be adherent when compared with housestaff requiring screening in the past 3 years. Overall, 84% accurately perceived their screening behavior as adherent or nonadherent (?=0.58). Of the 43% who identified a barrier to obtaining preventive care, not having time to schedule or keep appointments was reported most frequently (n=72). Conclusions Housestaff accurately perceived their need for cervical cancerscreening and were generally adherent to USPSTF recommendations, even though lack of time during postgraduate training was frequently reported as a barrier to obtaining preventive care. However, we found lower adherence among a small subgroup of housestaff at a slightly greater risk for cervical disease and most likely to benefit from screening.
Ross, Joseph S; Forsyth, Beverly A; Rosenbaum, Julie R
A system for screening cervical cytological preparations is described which employs the Leitz Texture Analyzer System (E. Leitz, Rockleigh, N. J.) quantitative staining with acridine orange, and a fluorescence standard. The instrumentation scans cells on microscope slides and detects objects which it interprets to be nuclei with excess total nuclear green fluorescence intensity (Previous results employing manual measurements have indicated
JAMES F. GOLDEN; SEYMOUR S. WEST; HUGH M. SHINGLETON; ACE K. ECHOLS
The following non-invasive stool tests for colorectal cancer (CRC) screening exist: guaiac or immunochemical fecal occult blood testing (FOBT), genetic stool tests and the M2-PK. Currently the most widely used tests are guaiac-based (gFOBT). Several randomized controlled trials have shown that gFOBT are able to achieve a reduction in CRC-related mortality. This reduction is achieved by detecting asymptomatic cancers at
BACKGROUND: We are reporting on the development of a psychosocial screening tool for cancer patients. The tool was to be brief, at a relatively low reading level, capture psychological variables relevant to distress and health-related quality-of-life in cancer patients, possess good reliability and validity, and be free of copyright protection. METHOD: Item derivation is described, data on reliability and validity
Wolfgang Linden; Dahyun Yi; Maria Cristina Barroetavena; Regina MacKenzie; Richard Doll
Although the third largest Asian subgroup in the U.S., South Asians have rarely been included in cancer research. The purpose\\u000a of this study was to assess rates and correlates of cancerscreening in a community sample of South Asians. This study was\\u000a a collaboration between the UCLA School of Public Health and South Asian Network (SAN), a social service organization
Beth A. Glenn; Neetu Chawla; Zul Surani; Roshan Bastani
The aim of this article is to highlight some concerns regarding lung cancerscreening with CT through a thorough analysis of scientific literature. The publication of the National Lung Screening Trial in 2011 has revealed that CT screening of smokers and ex-smokers in three annual rounds reduces lung cancer mortality a 20% when compared with thorax x-ray screening. The first limitation of this screening modality is its lack of downstaging in successive screening rounds compared with the initial round. Also, lung cancerscreening with CT has a low positive predictive value, similar to the percentage of unnecessary surgeries performed in false positives. Another problem is that, at present, the burden of lung cancer overdiagnosis is not known. It is to be expected that if overdiagnosis occurs when thorax x-ray screening is used it will be greater when using CT. CT, even at low doses, exposes patients to high levels of radiation. Dealing with positive nodules entails an even higher radiation dose and the number of cancer cases induced by radiation in patients screened with CT is not known. Lastly, published studies on lung cancer CT screening are vastly heterogeneous. They include different age groups, different types of smokers and ex-smokers and different tomogram thickness, making the results hardly comparable. In this context we do not recommend lung cancerscreening with CT for smokers or ex-smokers outside of the context of individual counseling. PMID:23317766
Ruano-Ravina, Alberto; Pérez Ríos, Mónica; Fernández-Villar, Alberto
IMPORTANCE Screening colonoscopy seemingly decreases colorectal cancer rates in the United States. In addition to removing benign lesions and preventing progression to malignancy, screening colonoscopy theoretically identifies asymptomatic patients with early-stage disease, potentially leading to higher survival rates. OBJECTIVES To assess the effect of screening colonoscopy on outcomes of colon cancer surgery by reviewing differences in staging, disease-free interval, risk of recurrence, and survival and to identify whether diagnosis through screening improves long-term outcomes independent of staging. DESIGN Retrospective review of prospectively maintained, institutional review board-approved database. SETTING Tertiary care center with high patient volume. PATIENTS All patients who underwent colon cancer surgery at Massachusetts General Hospital from January 1, 2004, through December 31, 2011. INTERVENTION Colon cancer surgery. MAIN OUTCOMES AND MEASURES Postoperative staging, death, and recurrence, measured as incidence and time to event. RESULTS A total of 1071 patients were included, with 217 diagnosed through screening. Patients not diagnosed through screening were at risk for a more invasive tumor (?T3: relative risk [RR]?=?1.96; P?.001), nodal disease (RR?=?1.92; P?.001), and metastatic disease on presentation (RR?=?3.37; P?.001). In follow-up, these patients had higher death rates (RR?=?3.02; P?.001) and recurrence rates (RR?=?2.19; P?=?.004) as well as shorter survival (P?.001) and disease-free intervals (P?.001). Cox and logistic regression controlling for staging and baseline characteristics revealed that death rate (P?=?.02) and survival duration (P?=?.01) were better stage for stage with diagnosis through screening. Death and metastasis rates also remained significantly lower in tumors without nodal or metastatic spread (all P?.001). CONCLUSIONS AND RELEVANCE Patients with colon cancer identified on screening colonoscopy not only have lower-stage disease on presentation but also have better outcomes independent of their staging. Compliance to screening colonoscopy guidelines can play an important role in prolonging longevity, improving quality of life, and reducing health care costs through early detection of colon cancer. PMID:23784448
Amri, Ramzi; Bordeianou, Liliana G; Sylla, Patricia; Berger, David L
The accumulation of national epidemiological data since the late 1990s has led to the adoption of evidence-based guidelines for breast cancerscreening in Lebanon (2006). Almost 50% of breast cancer patients in Lebanon are below the age of 50 years and the age-adjusted incidence rate is estimated at 69 new cases per 100,000 per year (2004). This official notification calls for breast self-examination (BSE) every month starting age 20, and a clinical breast examination (CBE) performed by a physician every three years between the ages of 20 and 40 years. Starting age 40, and for as long as a woman is in good health, an annual CBE and mammography are recommended. Women with known genetic family history of breast cancer should start screening 10 years earlier than the first young patient in the family, or earlier depending on medical advice. The Breast Cancer National Task Force (BCNTF) recommends certification of mammography centers and continued training of personnel to assure high quality mammograms, and to minimize unnecessary investigations and surgeries.It recommends that a national program should record call-backs of women for annual screening and follow-up data on abnormal mammograms. BCNTF encourages the adoption of these guidelines and monitoring of their results, as well as follow-up of breast cancer epidemiology and registry in Lebanon, and scientific progress in early breast cancer detection to determine needs for modifications in the future. PMID:19623881
Economic decision models are being increasingly used to assess medical interventions. Advances in this field are mainly due to enhanced processing capacity of computers, availability of specific software to perform the necessary tasks, and refined mathematical techniques. We here estimated the incremental cost-effectiveness of ten strategies for colon cancerscreening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and profit of chemotherapy in Iran. We used a Markov model to measure the costs and quality-adjusted life expectancy of a 50-year-old average-risk Iranian without screening and with screening by each test. In this paper, we tested the model with data from the Ministry of Health and published literature. We considered costs from the perspective of a health insurance organization, with inflation to 2011, the Iranian Rial being converted into US dollars. We focused on three tests for the 10 strategies considered currently being used for population screening in some Iranians provinces (Kerman, Golestan Mazandaran, Ardabil, and Tehran): low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 39%, 60% and 76%, and mortality by 50%, 69% and 78%, respectively, compared with no screening. These approaches generated ICER (incremental cost-effectiveness ratios) of $9067, $654 and $8700 per QALY (quality-adjusted life year), respectively. Sensitivity analyses were conducted to assess the influence of various scales on the economic evaluation of screening. The results were sensitive to probabilistic sensitivity analysis. Colonoscopy every ten years yielded the greatest net health value. Screening for colon cancer is economical and cost-effective over conventional levels of WTP8. PMID:23244122
Barouni, Mohsen; Larizadeh, Mohammad Hassan; Sabermahani, Asma; Ghaderi, Hossien
Lifestyle factors including smoking, obesity, and diabetes can increase colorectal cancer (CRC) risk. Controversy exists regarding screening rates in individuals at increased CRC risk. To examine the effect of risk on CRC screening in primary care, cross-sectional data collected during January 2006-July 2007 from 720 participants in 24 New Jersey primary care practices were analyzed. Participants were stratified by risk: high (personal/family history of CRC, history of polyps, inflammatory bowel disease), increased (obesity, Type II diabetes, current/former smokers), and average. Outcomes were up-to-date with CRC screening, receiving a physician recommendation for screening, and recommendation adherence. Chi-square and generalized linear modeling were used to determine the effect of independent variables on risk group and risk group on outcomes. Thirty-seven percent of participants were high-risk, 46% increased-risk, and 17% average-risk. Age, race, insurance, education, and health status were related to risk. High-risk participants had increased odds of being up-to-date with screening (OR 3.14 95% CI 1.85-5.32) and adhering to physician recommendation (OR 7.18 95% CI 3.58-14.4) compared to average-risk. Increased-risk participants had 32% decreased odds of screening (OR 0.68, 95% CI 0.42-1.08). Low screening rates among increased-risk individuals highlight the need for screening interventions targeting these patients. PMID:21203806
Felsen, Christina B; Piasecki, Alicja; Ferrante, Jeanne M; Ohman-Strickland, Pamela A; Crabtree, Benjamin F
The effect of the implementation of the Dutch breast cancerscreening programme during 1990–1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Netherlands Cancer Registry provided detailed data on breast cancer incidence in 1989–1997 by tumour stage, age and
J. Fracheboud; S. J. Otto; M. J. M. Broeders; A. L. M. Verbeek; H. J. de Koning
Background. A few studies have reported gender differences along the colorectal cancer (CRC) continuum but none has done so longitudinally to compare a cancer and a non-cancer populations.^ Objectives and Methods. To examine gender differences in colorectal cancerscreening (CRCS); to examine trends in gender differences in CRC screening among two groups of patients (Medicare beneficiaries with and without cancer);
Background Colorectal cancerscreening (CRCS) is the only type of cancerscreening 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 cancerscreening 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 Ontario’s 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 ‘arm’s 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).
In recent years, medical ethics has become an undisputed part of medical studies. Many people believe that modern advances in medical technology--such as the development of dialysis machines, respirators, magnetic resonance imaging, and genetic testing and types of cancerscreenings--have created the bioethical dilemmas that confront physicians in the 21st century. Debates over research and screening ethics have until recently revolved around two related questions: the voluntary, informed consent of subjects, and the appropriate relationship between risk and benefit to subjects in the experiment. Every patient has a right to full and accurate information about his or her medical condition. This legal principle arose primarily through court decisions concerning informed consent, but over time, physicians recognized that most patients prefer to learn the truth about their condition and use the information well. To screen is to search for disease in the absence of symptoms or, in other words, to attempt to find disease in someone not thought to have a disease. Examples of screening include routine mammography to detect breast cancer, routine Pap smears to detect cervical cancer and routine prostate specific antigen (PSA) testing to detect prostate cancer. Ethical principles to be followed in cancerscreening programs are intended mainly to minimize unnecessary harm to the participating individuals. Numerous ethical questions can be raised about the practice of screening for disease. This paper reviews recommendation for cancerscreening from five countries, examine them from an ethical perspective, and make conclusion from this analysis. PMID:15226029
The first evidence that screening for colorectal cancer (CRC) could effectively reduce mortality dates back 20 years. However, actual population screening has, in many countries, halted at the level of individual testing and discussions on differences between screening tests. With a wealth of new evidence from various community-based studies looking at test uptake, screening-programme organization and the importance of quality assurance, population screening for CRC is now moving into a new realm, promising better results in terms of reducing CRC-specific morbidity and mortality. Such a shift in the paradigm requires a change from opportunistic, individual testing towards organized population screening with comprehensive monitoring and full-programme quality assurance. To achieve this, a combination of factors--including test characteristics, uptake, screenee autonomy, costs and capacity--must be considered. Thus, evidence from randomized trials comparing different tests must be supplemented by studies of acceptance and uptake to obtain the full picture of the effectiveness (in terms of morbidity, mortality and cost) the different strategies have. In this Review, we discuss a range of screening modalities and describe the factors to be considered to achieve a truly effective population CRC screening programme. PMID:23381005
Kuipers, Ernst J; Rösch, Thomas; Bretthauer, Michael
Objective To assess the impact of health care access and socioeconomic determinants on Pap smear screening in Latin America. Methods Individual-level data was collected from the Demographic and Health Surveys in Bolivia, Brazil, Dominican Republic, Ecuador, Guatemala, Nicaragua, Peru, and Trinidad and Tobago between 1987 and 2008. Multivariate logistic regression analyses were used to identify socioeconomic and health care determinants of two outcomes: knowledge of Pap smears and recent Pap smear screening. Results In all countries, the proportion of women with a recent Pap smear screening remained below 55%. Key determinants of knowledge of Pap smears were age, education, and recent doctor’s visit. For recent Pap smear screening, key determinants were wealth and recent doctor’s visit. Women were between 1.47 and 3.44 times more likely to have received a recent Pap smear if they had a recent doctor’s visit. Even the poorest women with a recent doctor’s visit were more likely to screen than the richest women without a recent visit. Conclusions These data suggest that visiting a doctor is an important determinant of cervical cancerscreening in Latin America. Because screening may coincide with other medical visits, physicians could effectively encourage screening.
Background.This study analyzed the relationship between past screening behavior, determinants, intention, and future screening participation in the Dutch national breast cancerscreening program.Methods.Participation at the first and second screening rounds was monitored. Furthermore, between the first and the second screening rounds, women received a questionnaire (response 58%,n= 395). The questionnaire was based on the ASE model, including attitude (consequences, anticipated
The paper presents some mathematical models which optimize, from medico-economics point of view, the natural evolution of the cervical lesions and their evolution when the woman attends a cervical cancerscreening program. A new index, MEI, constructed by using vectorial optimization, is given.
This article addresses the role of culture in breast cancerscreening 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…
Compared individuals at high versus average risk for colorectal cancer (CRC) with respect to factors they cited as affecting their risk of developing CRC. We also examined the relationship of these risk-factor perceptions to perceived susceptibility and participation in a CRC screening test. All individuals in the high-risk group were informed that, as a sibling of someone with CRC, they
Susan J. Blalock; Brenda McEvoy DeVellis; Rema A. Afifi; Robert S. Sandier
BACKGROUND AND AIMS: Periodic colonoscopy is an effective means of reducing the incidence and mortality of colorectal cancer in individuals with a family history of the disease. The aims of this study were to determine the degree of compliance and to identify the factors related significantly to noncompliance with periodic screening in this high-risk population. METHODS: A total of 178
Eveline M. A. Bleiker; Fred H. Menko; Babs G. Taal; Irma Kluijt; Lidwina D. V. Wever; Miranda A. Gerritsma; Hans F. A. Vasen; Neil K. Aaronson
|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…
James, Aimee S.; Daley, Christine M.; Greiner, K. Allen
While the guaiac-based fecal occult blood test (FOBT) has been found to be effective for population screening for colorectal cancer, immunochemical FOBT (IFOBT) deserves attention as offering superior sensitivity, usually with no major loss of specificity. A great deal of interest has been concentrated on sigmoidoscopy or colonoscopy as alternatives but medical capacity is a major problem with these approaches,
Background: Studies have shown that screening reduces colorectal cancer mortality. We analyzed national survey data to determine rates of use of fecal occult blood testing (FOBT) and sigmoidoscopy, and to determine if these rates differ by demographic factors and other health behaviors.Methods: A total of 52,754 respondents aged ?50 years were questioned in the 1997 Behavioral Risk Factor Surveillance System
BackgroundAmerican men have lower overall rates of cancerscreening than women. This study was designed to elicit men's health care experiences and knowledge of testicular, prostate, and colorectal cancer (CRC) screening.
Catherine E. Dubé; Barbara K. Fuller; Rochelle K. Rosen; Mark Fagan; Joseph O'Donnell
Objectives The objective of this systematic review was to determine whether screening for prostate cancer reduces prostate cancer mortality.\\u000a \\u000a \\u000a \\u000a Methods A systematic search for randomised controlled trials was conducted through electronic scientific databases and a specialist\\u000a register of the Cochrane Prostatic Diseases and Urologic Cancers Group. Manual searching of specific journals was also conducted.\\u000a Two authors independently reviewed studies that met the
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%.
The recognition that infection with certain human papillomavirus (HPV) types is a necessary cause of cervical cancer has opened new fronts for the prevention of this disease. Primary prevention is now possible via immunization with highly efficacious HPV vaccines and secondary prevention has gained impetus with the advent of sensitive HPV DNA testing to improve traditional Pap cytology screening programs. Although universal vaccination of teenagers and young women is a desirable policy cost remains a key obstacle. To achieve cost-effective reductions in the burden of cervical cancer prevention initiatives must consider screening and immunization as integrated and organized approaches that take advantage of HPV testing as primary screening test followed by triage with Pap cytology. This strategy has the added benefit of providing epidemiological surveillance of vaccinated populations. PMID:18642468
Colorectal cancer (CRC) can be effectively prevented via screening colonoscopy, yet adherence rates remain low among Latinos. Interventions targeting individual and cultural barriers to screening are needed. We developed an educational brochure to target these barriers faced by a diverse Latino population. The objective was to evaluate the responses of the target population to the culturally and theoretically informed brochure through community member focus groups. Facilitators conducted six focus groups, stratified by gender, language, and prior colonoscopy experience. Topics included: brochure content and layout, cancer knowledge, and CRC screening determinants. Focus groups documented community members' responses to the brochure's overall message and its informational and visual components. Changes to wording, visual aids, and content were suggested to make the brochure culturally more acceptable. Results indicated relevance of the theoretically and culturally guided approach to the development of the brochure leading to refinement of its content and design. PMID:23821134
Colorectal cancer control has long been a focus area for Comprehensive Cancer Control programs and their coalitions, given\\u000a the high burden of disease and the availability of effective screening interventions. Colorectal cancer control has been a\\u000a growing priority at the national, state, territorial, tribal, and local level. This paper summarizes several national initiatives\\u000a and features several Comprehensive Cancer Control Program
Laura C. Seeff; Anne Major; Julie S. Townsend; Ellen Provost; Diana Redwood; David Espey; Diane Dwyer; Robert Villanueva; Leslie Larsen; Kathryn Rowley; Banning Leonard
Although regular screening can decrease morbidity and mortality from colorectal cancer, screening rates nationwide are suboptimal\\u000a due to a lack of organized screening programs. Since workplace colorectal cancer–awareness programs can potentially mitigate\\u000a both patient and physician barriers to screening, we assessed the workplace as a venue for implementing a colorectal cancer\\u000a screening–awareness program. In this cross-sectional study, 3756 members of
Akshay Bagai; Karen Parsons; Brenda Malone; Julian Fantino; Lawrence Paszat; Linda Rabeneck
Background Native Americans are disproportionately affected by cancer morbidity and mortality. This study examined intention to receive cancerscreening in a large sample of Native Americans from the Northern Plains, a region with high cancer mortality rates. Methods A survey was administered orally to 975 individuals in 2004–2006 from three reservations and among the urban Native American community in the service region of the Rapid City Regional Hospital. Data analysis was conducted in 2009. Results About 63% of the sample planned to receive cancerscreening. In multivariate analyses, individuals who planned to receive cancerscreening were women, responsible for four or more people, received physical examinations at least yearly and had received prior cancerscreening. They also were more likely to hold the belief that most people would go through cancer treatment even though these treatments can be emotionally or physically uncomfortable. About 90% of those who did not plan to receive cancerscreening would be more likely to intend to receive cancerscreening if additional resources were available. Conclusions In an area of high cancer morbidity and mortality, over one-third of screening eligible individuals did not plan to receive cancerscreening. Future research should evaluate the potential for improving cancerscreening rates through interventions that seek to facilitate increased knowledge about cancerscreening and access to cancerscreening services in the community.
Guadagnolo, B. Ashleigh; Kanekar, Shalini; Petereit, Daniel G.; Karki, Chitra; Smith, Maureen A.
In response to a union request, a cancerscreening program was conducted for the Pattern Makers' League of North America. Ten colon cancer cases were detected among the 1,465 white men screened with a flexible sigmoidoscope. The difficulties in obtaining appropriate "expected" numbers were that prevalent detectable preclinical colon cancer is not equivalent to incident disease, and the flexible sigmoidoscope yields results not directly comparable to those of the rigid sigmoidoscope used previously. The "expected" number of cancers was obtained by using an independent estimate of 5 years for the mean duration of the detectable preclinical phase. This implied that the expected number of colon cancer cases should be based on the age-specific incident rates among white men in the next-older 5-year age group and that the annual expected number should be multiplied by five. Therefore, the ten observed cases of colon malignancies represented an approximately threefold increase. For invasive cancer only, there was a slightly less than twofold cancer increase. Fifteen percent of the men had one or more colorectal polyps. PMID:3746494
Hoar, S K; Bang, K M; Tillett, S; Rodriguez, M; Cantor, K P; Blair, A
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BACKGROUND: Public sector health care providers in rural Guatemala have infrequently offered family planning information and services in routine visits. This operations research project tested a strategy to modify certain practices that prevent health workers from proactively screening clients' needs and meeting them. METHODS: The research design was quasi-experimental with a pretest-posttest-follow-up comparison group design. Health districts, which comprise health centers and posts, were purposively assigned to intervention or comparison groups to assure comparability of the two groups. The strategy was based on a job-aid designed to guide health workers in screening clients' reproductive intentions and family planning needs, help them to offer contraceptive methods if the woman expressed interest, and facilitate the provision of the method chosen at the time of the visit. The strategy was implemented at intervention sites during a period of six months. Upon completion of post-intervention measurements, the strategy was scaled up to the comparison sites, and a follow-up assessment was conducted nine months later. Results were evaluated by conducting three rounds of exit interviews with women exposed to the risk of unwanted pregnancy. RESULTS: Study results showed a two to five-fold increase in providers' screening of clients' reproductive intentions. The proportion of clients who received information about contraceptives increased from 8% at the baseline to 42% immediately post-intervention, and 36% at the follow-up survey. The intervention also proved successful in improving the role service providers play in offering women a chance to ask questions and assisting women in making a selection. The proportion of women who received a method, referral or appointment increased and remained high in the intervention group, although no change was seen in the comparison group after their participation in the strategy. CONCLUSION: The easy-to-use job aid developed for this project proved useful for screening clients' needs and reducing providers' reluctance to discuss family planning with clients and offer contraceptive services. Such family planning screening devices can be useful in traditional settings where both providers and clients shy away from discussing family planning issues. PMID:15132752
BlackScreen rear-projection display screens, developed by Jenmar Visual Systems of Fremont California are well suited for cockpit avionics applications primarily because they exhibit both high image resolution and high ambient light rejection. These characteristics combine to produce a high- contrast image on these screens, even in very brightly lit viewing environments. On-screen optical noise commonly referred to as graininess or
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.
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.
African American men have the highest prostate cancer incidence and mortality rates worldwide, but have lower screening rates compared with Caucasian men. The purpose of the study was to identify social ecological factors that affect screening behaviors in African American men, knowledge that could be integral to the design of culturally appropriate interventions. The exploratory study included 60 African American males recruited from the greater Detroit metropolitan area. Social ecological variables examined included age, marital status, presence of health insurance, education, health values and behaviors, physician trust, and perceived stress coping (John Henryism). Analyses included descriptives, chi-square tests, one-way ANOVAs, and logistic regression. Findings concluded that a parsimonious model consisting of two variables (age and health values) was predictive. African American males, > or =50 years, with higher positive health values were more likely to obtain screening. Findings imply the importance of health values and targeted educational and screening interventions for younger African American men. PMID:20696846
Racial and ethnic disparities exist in both incidence and stage detection of colorectal cancer (CRC). We hypothesized that cultural practices (i.e., communication norms and expectations) influence patients’ and their physicians’ understanding and talk about CRC screening. We examined 44 videotaped observations of clinic visits that included a CRC screening recommendation and transcripts from semistructured interviews that doctors and patients separately completed following the visit. We found that interpersonal relationship themes such as power distance, trust, directness/indirectness, and an ability to listen, as well as personal health beliefs, emerged as affecting patients’ definitions of provider–patient effective communication. In addition, we found that in discordant physician–patient interactions (when each is from a different ethnic group), physicians did not solicit or address cultural barriers to CRC screening and patients did not volunteer culture-related concerns regarding CRC screening.
Gao, Ge; Burke, Nancy; Somkin, Carol P.; Pasick, Rena
BACKGROUND: Colorectal cancer (CRC) screening rates are low in most Asian countries and remain largely unknown. This study examined trends in CRC screening rates after the introduction of the Korean National CancerScreening Programme (NCSP) and determined the factors associated with uptake of CRC screening by test modality over time. METHODS: An annual population-based survey conducted through nationally representative random
Kui Son Choi; Jae Kwan Jun; Hoo-Yeon Lee; Myung-Il Hahm; Jae Hwan Oh; Eun-Cheol Park
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 20–79 years age-group
Victoria M. Taylor; J. Carey Jackson; Shin-Ping Tu; Yutaka Yasui; Stephen M. Schwartz; Alan Kuniyuki; Elizabeth Acorda; Kathy Lin; Gregory Hislop
\\u000a Colonoscopy is an imperfect and operator-dependent technology with regard to detection of colorectal neoplasia. The evidence\\u000a for operator dependency is overwhelming, and the extent of variation is alarming [1–10]. These detection problems with colonoscopy\\u000a are particularly problematic, given that the technology is used for almost all colorectal cancer detection and prevention\\u000a . In the United States and some European countries,
As part of the formative research for developing interventions to increase colorectal cancerscreening in men and women aged 50 and older, 14 focus groups were conducted to identify (1) knowledge, attitudes, and beliefs about colorectal cancer and colorectal cancerscreening, (2) barriers to screening, and (3) strategies for motivating and supporting behavior change. Participants had either private insurance or
Carolyn Beeker; Joan Marie Kraft; Brian G. Southwell; Cynthia M. Jorgensen
This review summarizes and synthesizes research findings on risk perception and risk communication related to cancerscreening behaviors. The focus is on cancers for which there is evidence that screening reduces mortality, i.e., cervical, breast, and colorectal cancers. The following questions are addressed: 1) Is perceived risk associated with relevant can- cer screening behaviors? 2) What factors are associated with
|Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancerscreening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancerscreening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the…
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.
This workshop will convene scientists, clinicians, and government officials to discuss cancer prevention and screening research, including clinical trials of cancerscreening, community based cancerscreening programs, and biomarker studies. The workshop will review the status of research in these areas in the U.S. and China, and explore possible opportunities for future collaboration.
The optimal schedules for breast cancerscreening in terms of examination frequency and ages at examination are of practical\\u000a interest. A decision-theoretic approach is explored to search for optimal cancerscreening programs which should achieve maximum\\u000a survival benefit while balancing the associated cost to the health care system. We propose a class of utility functions that\\u000a account for costs associated
We have investigated factors affecting the probability that a woman with breast cancer participating in a mammographic screening programme will be diagnosed by the screen. Data from a large American case-control study, with subjects drawn from women participating in an annual screening programme, were used. During the screening programme, 409 cases were identified, the mode of diagnosis being screen detection
There is an excess burden of colorectal cancer (CRC) in the Appalachian region of the United States, which could be reduced by increased uptake of CRC screening tests. Thus, we examined correlates of screening among Appalachian residents at average-risk for CRC. Using a population-based sample, we conducted interviews with and obtained medical records of Appalachian Ohio residents 51-75 years between September 2009 and April 2010. Using multivariable logistic regression, we identified correlates of being within CRC screening guidelines by medical records. About half of participants were within CRC screening guidelines. Participants who were older (OR = 1.04, 95 % CI 1.01, 1.07), had higher income ($30,000-$60,000, OR = 1.92, 95 % CI 1.29, 2.86; ?$60,000, OR = 1.80, 95 % CI 1.19, 2.72), a primary care provider (OR = 4.22, 95 % CI 1.33, 13.39), a recent check-up (OR = 2.37, 95 % CI 1.12, 4.99), had been encouraged to be screened (OR = 1.57, 95 % CI 1.11, 2.22), had been recommended by their doctor to be screened (OR = 6.68, 95 % CI 3.87, 11.52), or asked their doctor to order a screening test (OR = 2.24, 95 % CI 1.36, 3.69) had higher odds of being screened within guidelines in multivariable analysis. Findings suggest that access to and utilization of healthcare services, social influence, and patient-provider communication were the major factors associated with CRC screening. Researchers and healthcare providers should develop and implement strategies targeting these barriers/facilitators to improve CRC screening rates and reduce the CRC burden among residents of Appalachia. PMID:23529450
Paskett, Electra D; Llanos, Adana A; Young, Gregory S; Pennell, Michael L; Lee, Chul-joo; Katz, Mira L
Purpose:The purpose of this study was to compare health behaviors and cancerscreening among Californians with and without a family history of cancer.Methods:We analyzed data from the 2005 California Health Interview Survey to ascertain cancerscreening test use and to estimate the prevalence of health behaviors that may reduce the risk of cancer. We used logistic regression to control for demographic factors and health-care access.Results:Women with a family history of breast or ovarian cancer were more likely to be up to date with mammography as compared with women with no family history of cancer (odds ratio = 1.69, 95% confidence interval (1.39, 2.04)); their health behaviors were similar to other women. Men and women with a family history of colorectal cancer were more likely to be up to date with colorectal cancerscreening as compared with individuals with no family history of cancer (odds ratio = 2.77, 95% confidence interval (2.20, 3.49)) but were less likely to have a body mass index <25?kg/m(2) (odds ratio = 0.80, 95% confidence interval (0.67, 0.94)).Conclusion:Innovative methods are needed to encourage those with a moderate-to-strong familial risk for breast cancer and colorectal cancer to increase their physical activity levels, strive to maintain a healthy weight, quit smoking, and reduce alcohol use.Genet Med 2013:15(3):212-221. PMID:23018750
Townsend, Julie S; Steele, C Brooke; Richardson, Lisa C; Stewart, Sherri L
Purpose The Korean National CancerScreening Survey (KNCSS), a nationwide, annual cross-sectional survey, has been conducted since 2004. The current study was conducted in order to report on trends in cancerscreening rates for five types of cancer (stomach, liver, colorectal, breast, and cervix uteri). Materials and Methods KNCSS data were collected between 2004 and 2012. The eligible study population included cancer-free men who were 40 years of age and older and women who were 30 years of age and older. The lifetime screening rate, screening rate with recommendation, and changes in annual rates were calculated. Results Lifetime screening rates and screening rates with recommendation for the five types of cancer rose steadily until 2010, showed a slight drop or were stable in 2011, and increased again in 2012. On average, screening rates with recommendation have shown annual increases of 4.3% (95% confidence interval [CI], 3.6 to 5.0%) for stomach cancer, 0.8% (95% CI, -0.5 to 2.1%) for liver cancer, 2.4% (95% CI, 1.3 to 3.5%) for colorectal cancer, 4.5% (95% CI, 3.9 to 5.1%) for breast cancer, and 1.3% (95% CI, 0.6 to 2.0%) for cervical cancer. Disparities in age groups and household incomes have been decreasing since 2004. Conclusion Cancerscreening rates in Korea showed a significant increase from 2004 to 2012, and screening rates for gastric and breast cancer are now approaching 70%. The 10-Year Plan for Cancer Control target for screening rates was met or nearly met for all cancer types examined, with the exception of liver and colorectal cancer.
PURPOSE Although current practice guidelines do not recommend screening asymptomatic patients for lung cancer, physicians may still order lung cancerscreening tests. No recent national survey of health care professionals has focused on lung cancerscreening. In this study, we examined the lung cancerscreening practices of US primary care physicians and characteristics of those who order lung cancerscreening tests. METHODS We conducted a nationally representative survey of practicing primary care physicians in 2006–2007. Mailed questionnaires assessed the physicians’ knowledge of lung cancerscreening guidelines, beliefs about the effectiveness of screening tests, and ordering of screening chest radiograph, low-dose spiral computed tomography, or sputum cytology in the past 12 months. Clinical vignettes were used to assess the physicians’ intentions to screen asymptomatic 50-year-old patients with varying smoking histories for lung cancer. RESULTS A total of 962 family physicians, general practitioners, and general internists completed questionnaires (cooperation rate = 76.8%). Overall, 38% had ordered no lung cancerscreening tests; 55% had ordered chest radiograph, 22% low-dose spiral computed tomography, and less than 5% sputum cytology. In multivariate modeling, physicians were more likely to have ordered lung cancerscreening tests if they believed that expert groups recommend lung cancerscreening or that screening tests are effective; if they would recommend screening for asymptomatic patients, including patients without substantial smoking exposure; and if their patients had asked them about screening. CONCLUSIONS Primary care physicians in the United States frequently order lung cancerscreening tests for asymptomatic patients, even though expert groups do not recommend it. Primary care physicians and patients need more information about lung cancerscreening’s evidence base, guidelines, potential harms, and costs to avert inappropriate ordering.
Klabunde, Carrie N.; Marcus, Pamela M.; Han, Paul K. J.; Richards, Thomas B.; Vernon, Sally W.; Yuan, Gigi; Silvestri, Gerard A.
BlackScreen rear-projection display screens, developed by Jenmar Visual Systems of Fremont California are well suited for cockpit avionics applications primarily because they exhibit both high image resolution and high ambient light rejection. These characteristics combine to produce a high- contrast image on these screens, even in very brightly lit viewing environments. On-screen optical noise commonly referred to as graininess or speckle, can often be a problem in rear-projection systems. These image artifacts appear as grainy patches in the image that move with the field-of-view of the observer and are most visible in the near field (i.e., approximately 12 to 24 inches from the screen). This paper will describe the methods we are using to characterize these artifacts in BlackScreen. Our testing uses a range of projection systems and characterization methods. We will also describe our approach to reduce these artifacts, and will illustrate that approach with engineering data.
European Commission recommends the implementation of organized screening programs for cervical cancer based on active invitation of the target population and with a systematic monitoring system and quality assurance. Nevertheless, in many Member States opportunistic screening is still the only or the main way to access Pap test. In Italy, Pap test coverage in women aged 25-64 is close to 80%, about half of them are screened in organized programs and half by opportunistic screening. Organized programs are diffused in the vast majority of the country (78% in 2009) even if in some cases they are not able to actively invite all the target population every three years (actual extension 67%); furthermore, participation rate after invitation is quite low (39%). Organized screening programs showed performance indicators in line with most of the international standards: low referral rates (2.4%), low inadequate cytological results (4.7%), and high positive predictive value for high grade cervical intraepithelial neoplasia (16.2%). Opportunistic screening has no systematic monitoring system. The coexistence of the two screening models, organized programs and opportunistic, can be a source of inappropriate use of secondary prevention duplicating the tests and favoring deviations from recommended protocols. The Italian Ministry of Health recommends re-organizing cervical cancer prevention favoring organized programs or integrating spontaneous Pap testing in an organized system. To implement such integration it is necessary to have monitoring system and quality assurance for all providers and to integrate archives in order to avoid over-testing and deviation from protocols. PMID:24047033
Little is known about strategies that physicians use to encourage receipt of colorectal cancerscreening (CRCS). This study conducted focus groups with physicians. Twenty-seven physicians participated in four focus groups. Physicians described four categories of approaches: (1) why screening is important, (2) providing test information, (3) motivational strategies, and (4) tailoring strategies. Participants reported tailoring based on their relationship with a patient, as well as to patient gender, education, and language. Tailoring to cultural background or ethnicity was not prominent. Most physicians reported a typical approach to CRCS and reported some tailoring based on gender, education, and language, but not on ethnicity.
Karliner, Leah; Burke, Nancy; Somkin, Carol P.; Pham, Linda A.; Pasick, Rena
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.