Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer (Archived Tables): Home Organization
Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer: Mortality Rates | Organization
It has been confirmed recently that the volunteer effect in lung cancer screening is characterized by higher lung cancer mortality risk in self-selected screening participants. The Mayo Lung Project, the most influential trial of screening for lung cancer ever completed, was conducted in nonvolunteer Mayo Clinic outpatients, with a peculiar study design that rendered the randomization vulnerable to the volunteer effect. Of all nonvolunteers randomized in the Mayo Lung Project, only those allocated in the screened group were asked consent to participate in the trial. The final Mayo Lung Project report stated that 655 randomized nonvolunteers refused screening and were excluded from the study, thus documenting violation of the rule that no selection should occur after randomization. The long-term follow-up of the Mayo Lung Project showed an enigmatic result which has never been explained: the lung cancer mortality was 13% higher in the screening intervention group than in the control group [4.4 (95% CI 3.9-4.9) vs. 3.9 (95% CI 3.5-4.4) per 1,000 person-years; P = 0.09]. Such overrepresented mortality is consistent with the volunteer effect and supports the concept that the Mayo Lung Project randomization was compromised by the post-randomization self-selection of participant nonvolunteers. PMID:20972608
Dominioni, Lorenzo; Poli, Albino; Mantovani, William; Rotolo, Nicola; Imperatori, Andrea
... cancer screening: Cancer Screening Overview General Information About Breast Cancer Breast cancer is a disease in which malignant (cancer) cells ... Cancer Treatment Genetics of Breast and Ovarian Cancer Breast cancer is the second leading cause of death from ...
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.
The DOM project is a non-randomized population-based breast cancer screening programme in Utrecht which started in 1974-75. The 17-year effect has been evaluated by a case-control study of breast cancer deaths during the period 1975-92 in women living in the city of Utrecht, born between 1911 and 1925, whose breast cancers were diagnosed after the initiation of the DOM project. Controls (three for each case) were defined as women having the same year of birth as the case, living in the city of Utrecht at the time the case died, and having had the opportunity of screening in the DOM project. Screening in the period 1975-92 indicated a breast cancer mortality reduction of 46% (odds ratio of 0.54, 95% confidence interval 0.37-0.79). The strongest protective effect was found at a screening interval of 2 years or less (mortality reduction of 62%, odds ratio of 0.38), and for the highest number of screens (mortality reduction of 68%, odds ratio of 0.32 for more than four screens). Exclusion of breast cancer deaths that occurred within 1 year of diagnosis, to allow for 'lead-time' bias, gave an odds ratio of 0.61. Early diagnosis of breast cancer by screening reduces breast cancer mortality in the long term. Bias due to the study design may slightly overestimate the protective effect. A screening programme with a 2-yearly, or smaller, interval between successive screens will improve the protection of screening. PMID:9764591
Miltenburg, G. A.; Peeters, P. H.; Fracheboud, J.; Collette, H. J.
Mortality from colorectal cancer can be reduced by early diagnosis and by cancer prevention through polypectomy. These NCCN Guidelines for Colorectal Cancer Screening describe various colorectal screening modalities and recommended screening schedules for patients at average or increased risk of developing colorectal cancer. In addition, the guidelines provide recommendations for the management of patients with high-risk colorectal cancer syndromes, including Lynch syndrome. Screening approaches for Lynch syndrome are also described. PMID:24335688
Burt, Randall W; Cannon, Jamie A; David, Donald S; Early, Dayna S; Ford, James M; Giardiello, Francis M; Halverson, Amy L; Hamilton, Stanley R; Hampel, Heather; Ismail, Mohammad K; Jasperson, Kory; Klapman, Jason B; Lazenby, Audrey J; Lynch, Patrick M; Mayer, Robert J; Ness, Reid M; Provenzale, Dawn; Rao, M Sambasiva; Shike, Moshe; Steinbach, Gideon; Terdiman, Jonathan P; Weinberg, David; Dwyer, Mary; Freedman-Cass, Deborah
BACKGROUND: Concern over the cost of screening for asymptomatic prostate cancer by means of prostate-specific antigen (PSA) testing has played an important role in PSA screening policy. However, little is known about the true costs of current PSA screening in Canada and how costs may change in the future. METHODS: The authors performed a cost identification study from the perspective of provincial ministries of health. They used data from published reports, hospital discharge data, claims data from several provinces, a laboratory survey, a national survey of knowledge, attitudes and beliefs about screening, a provincial cancer registry and expert opinion to estimate current first-year screening costs. Using demographic data from Statistics Canada and various scenarios regarding changes in screening patterns, the authors derived estimates of the future costs of PSA screening. RESULTS: In 1995 PSA screening cost an estimated $45 million (range $40 million to $84 million). Treatment accounted for over 61% of total costs, whereas screening, diagnosis and staging accounted for 35%. Screening all eligible men in Canada in 1995 would have cost $317 million (range $356 million to $691 million), more than the costs of all prostate cancer care in that year. Annual recurrent screening for all eligible men in 2005 would cost $219 million (range $208 million to $412 million). Projections from existing trends suggest that annual costs of PSA screening in 2000 are likely to increase from the estimated $45 million to approximately $66 million (range $59 million to $126 million). INTERPRETATION: PSA screening is costly, but even universal screening would consume a smaller share of national health expenditures than previous studies have suggested. Costs attributable to PSA screening may increase in the future owing to changes in utilization patterns and demographic shifts. PMID:9934343
Krahn, M D; Coombs, A; Levy, I G
Lung cancer is the leading cause of cancer-related mortality globally and the American cancer society estimates approximately 226,160 new cases and 160,340 deaths from lung cancer in the USA in the year 2012. The majority of lung cancers are diagnosed in the later stages which impacts the overall survival. The 5-year survival rate for pathological st age IA lung cancer is 73% but drops to only 13% for stage IV. Thus, early detection through screening and prevention are the keys to reduce the global burden of lung cancer. This article discusses the current state of lung cancer screening, including the results of the National Lung Cancer Screening Trial, the consideration of implementing computed tomography screening, and a brief overview of the role of bronchoscopy in early detection and potential biomarkers that may aid in the early diagnosis of lung cancer. PMID:23599684
Dhillon, Samjot Singh; Loewen, Gregory; Jayaprakash, Vijayvel; Reid, Mary E.
Background: Lung cancer is by far the major cause of cancer deaths largely because in the majority of patients it is at an advanced stage at the time it is discovered, when curative treatment is no longer feasible. This article examines the data regarding the ability of screening to decrease the number of lung cancer deaths. Methods: A systematic review was conducted of controlled studies that address the effectiveness of methods of screening for lung cancer. Results: Several large randomized controlled trials (RCTs), including a recent one, have demonstrated that screening for lung cancer using a chest radiograph does not reduce the number of deaths from lung cancer. One large RCT involving low-dose CT (LDCT) screening demonstrated a significant reduction in lung cancer deaths, with few harms to individuals at elevated risk when done in the context of a structured program of selection, screening, evaluation, and management of the relatively high number of benign abnormalities. Whether other RCTs involving LDCT screening are consistent is unclear because data are limited or not yet mature. Conclusions: Screening is a complex interplay of selection (a population with sufficient risk and few serious comorbidities), the value of the screening test, the interval between screening tests, the availability of effective treatment, the risk of complications or harms as a result of screening, and the degree with which the screened individuals comply with screening and treatment recommendations. Screening with LDCT of appropriate individuals in the context of a structured process is associated with a significant reduction in the number of lung cancer deaths in the screened population. Given the complex interplay of factors inherent in screening, many questions remain on how to effectively implement screening on a broader scale. PMID:23649455
Mazzone, Peter J.; Naidich, David P.; Bach, Peter B.
Six annual screenings for prostate cancer led to more diagnoses of the disease, but no fewer prostate cancer deaths, according to a major new report from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a 17-year project of the NCI. The PLCO was designed to provide answers about the effectiveness of prostate cancer screening.
Radiographic imaging of the breast began in the early years of the twentieth century. Continuous advances in film quality, energy sources, targets, grids, and filters have all contributed to superior image resolution. Federal quality standards now regulate screening mammography, and mass screening for breast cancer has become widely accepted in the United States. Wider application of screening has resulted in
Kathleen M. Harris; Victor G. Vogel
For decades, black radio has reached African American communities with relevant, culturally appropriate information, and it continues to be an ideal communication channel to use for contemporary health promotion. In an effort to combat excess breast cancer mortality rates and help eliminate cancer disparities among low-income African American women, the Centers for Disease Control and Prevention's (CDC) Division of Cancer Prevention and Control designed, implemented, and evaluated the African American Women and Mass Media (AAMM) pilot campaign. The AAMM campaign uses black radio, radio stations with broad African American listenership, as a platform for targeted, culturally competent health promotion and outreach to low-income, African American women. The AAMM campaign uses radio advertisements and print materials disseminated in predominantly African American neighborhoods to promote awareness of breast cancer, early detection, and the CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Evaluation of the AAMM campaign found that the campaign successfully reached its target audience of low-income, African American women and increased women's awareness of breast cancer screening services through the Breast and Cervical Cancer Program in Savannah and Macon, Georgia. PMID:23072329
Hall, Ingrid J; Rim, Sun Hee; Johnson-Turbes, C Ashani; Vanderpool, Robin; Kamalu, Ngozi N
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 cancer screening 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
Mammography remains the primary technique for breast cancer screening. Women with dense breast tissue may benefit from digital mammography and tomosynthesis, and women at high risk may benefit from magnetic resonance imaging. However, false-positive results are problematic. The North Carolina breast density law necessitates education about screening options for women with dense breasts. PMID:24663133
Freimanis, Rita I; Yacobozzi, Margaret
... date with mammography screening. Cancer Screening Colorectal Cancer Breast Cancer 22M 22 million adults aged 50–75 need ... of people who get screened for colon or breast cancer is very different from state to state. The ...
Cost-effectiveness analyses have shown that the cost per year of life saved by screening with any of the tests recommended is reasonable by US standards. Although the specific results vary among analyses, in general the marginal cost-effectiveness of this screening is less than $25,000 per year of life saved. Screening for CRC was among the highest ranked services in an analysis of the value of preventive services based on the burden of disease prevented and cost-effectiveness. Although the up-front costs vary by screening modality, the long-term cost-effectiveness is similar across screening tests, so that decisions about which options to include--in the long run and from the perspective of society--do not need to be affected heavily by costs. Costs increase out of proportion to benefits with shorter intervals between screening examinations. Screening has provided great opportunities. Screening can prevent CRC by polypectomy and find early-stage cancers for treatment with less morbidity. Screening can reduce the burden of treating advanced cancers and can identify families at increased risk. Screening also has provided a better understanding of the biology of CRC. Screening for CRC should be part of a complete prevention program that includes a healthy lifestyle and familial risk assessment. Individuals with increased familial risk require special screening approaches, whereas individuals with average risk can have more standard screening. The average-risk individuals can be stratified further into persons who require intensive follow-up and persons who require less intensive or no follow-up at all. We are beginning to learn how to apply screening and surveillance approaches based on risk stratification for a more cost-effective approach to conserve resources and reduce complications and costs. Chemoprevention can be added to the program when substantial benefit of agents has been demonstrated. We have a better understanding of the biology of CRC and the technology to intervene in that biology to make a difference in the lives of many people. We have the concepts and technology to reduce substantially the mortality for CRC and even prevent it entirely. Newer screening tests or others yet to be developed may, with time, replace the modern options. Screening should take place with the tests currently available and not wait until something better comes along. In this way, needless suffering and loss of life can be avoided for this leading cause of cancer death. Screening may become even more successful if the promise of new technologies is confirmed and they enter clinical practice. In the last analysis, the best test is the one that gets done and gets done immediately. PMID:16226687
Winawer, Sidney J
\\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
Prior attempts to screen for lung cancer using chest radiography and sputum cytology have proved unsuccessful. Recent reports have investigated the role of spiral CT in early lung cancer detection and have suggested that screening would be of value. Prior to the introduction of a national lung cancer screening programme, it would be essential to demonstrate that this would reduce
J R C ELLIS; F V GLEESON
Colorectal cancer is the paradigm of tumoral growth that is susceptible to preventive measures, especially screening. Various screening strategies with demonstrated efficacy and efficiency are currently available, notable examples being the fecal occult blood test and endoscopic tests. In addition, new modalities have appeared in the last few years that could become viable alternatives in the near future. The present article reviews the most important presentations on colorectal screening at the annual congress of the American Gastroenterological Association held in Orlando in May 2013, with special emphasis on the medium- and long-term results of strategies using the fecal occult blood test and flexible sigmoidoscopy, as well as initial experiences with the use of new biomarkers. PMID:24160954
... These are called diagnostic tests . General Information About Prostate Cancer Prostate cancer is a disease in which malignant (cancer) cells ... prostate cancer: Prostate Cancer Prevention Prostate Cancer Treatment Prostate cancer is the most common nonskin cancer among men ...
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 cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation. PMID:23315954
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.
Overview of cancer screening, and screening and detection methods for many types of cancer, including bladder, endometrial, esophageal, stomach (gastric), liver, neuroblastoma, oral, ovarian, skin, and testicular cancer.
Celebrities often promote cancer screening by relating personal anec- dotes about their own diagnosis or that of a loved one. We used data obtained from a random-digit dialing survey conducted in the United States from December 2001 through July 2002 to examine the extent to which adults of screening age without a his- tory of cancer had seen or heard
Robin J. Larson; Steven Woloshin; Lisa M. Schwartz; H. Gilbert
The authors report on a method to calculate radiological risks, applicable to breast screening programs and other controlled medical exposures to ionizing radiation. In particular, it has been applied to make a risk assessment in the Valencian Breast Cancer Early Detection Program (VBCEDP) in Spain. This method is based on a parametric approach, through Markov processes, of hazard functions for radio-induced breast cancer incidence and mortality, with mean glandular breast dose, attained age and age-at-exposure as covariates. Excess relative risk functions of breast cancer mortality have been obtained from two different case-control studies exposed to ionizing radiation, with different follow-up time: the Canadian Fluoroscopy Cohort Study (1950-1987) and the Life Span Study (1950-1985 and 1950-1990), whereas relative risk functions for incidence have been obtained from the Life Span Study (1958-1993), the Massachusetts tuberculosis cohorts (1926-1985 and 1970-1985), the New York post-partum mastitis patients (1930-1981) and the Swedish benign breast disease cohort (1958-1987). Relative risks from these cohorts have been transported to the target population undergoing screening in the Valencian Community, a region in Spain with about four and a half million inhabitants. The SCREENRISK software has been developed to estimate radiological detriments in breast screening. Some hypotheses corresponding to different screening conditions have been considered in order to estimate the total risk associated with a woman who takes part in all screening rounds. In the case of the VBCEDP, the total radio-induced risk probability for fatal breast cancer is in a range between [5 × 10-6, 6 × 10-4] versus the natural rate of dying from breast cancer in the Valencian Community which is 9.2 × 10-3. The results show that these indicators could be included in quality control tests and could be adequate for making comparisons between several screening programs.
Ramos, M.; Ferrer, S.; Villaescusa, J. I.; Verdú, G.; Salas, M. D.; Cuevas, M. D.
In 2011, BreastScreen Australia celebrated 20 years of mammographic screening for breast cancer in Australia. There has been a reduction in mortality from breast cancer over the last two decades, coincident with mammographic screening. However, there are concerns that mammographic screening may result in overdiagnosis of breast cancer and that the reduction in mortality from breast cancer is the result of better treatment rather than screening. This article reviews the evidence on which mammographic screening for breast cancer is based, considers the issue of overdiagnosis of breast cancer by screening mammography, and assesses the role of screening mammography in the reduction in breast cancer mortality seen over the last two decades.
Lee, Warwick; Peters, Gudrun
...Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) (NCI) SUMMARY...data collection projects, the National Cancer Institute (NCI), the National Institutes...Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) (NCI)....
...Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) (NCI) SUMMARY...data collection projects, the National Cancer Institute (NCI), the National Institutes...Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (NCI)....
The International Cancer Screening Network (ICSN) is a voluntary consortium of countries that have active population-based cancer screening programs and active efforts to evaluate and improve the processes and outcomes from cancer screening in practice. The ICSN includes efforts to evaluate cancer screening 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.
Objectives: The present retrospective study was designed to investigate the value of transition zone (TZ) biopsies for prostate cancer (PC) detection rate in a combined contrast enhanced color Doppler targeted (CECD) and gray-scale systematic biopsy (SB) approach. Methods: PSA screening participants totalling 1475 with tPSA of >1.25 ng\\/ml (fPSA 18%) were assessed. Ten SB and additionally 5 or fewer CECD
Alexandre E. Pelzer; Jasmin Bektic; Andreas P. Berger; Ethan J. Halpern; Florian Koppelstatter; Andrea Klauser; Peter Rehder; Wolfgang Horninger; Georg Bartsch; Ferdinand Frauscher
Despite recent advances in both the survival and cure rates for many forms of cancer, unfortunately the same has not been true for prostate cancer. In fact, the age-adjusted death rate from prostate cancer has not significantly improved since 1949, and prostate cancer remains the most common cancer in American men, causing the second highest cancer mortality rate. Topics discussed include the following: serum testosterone levels; diagnosis; mortality statistics; prostate-sppecific antigen (PSA) tests; and the Occupational Medicine Services policy at LeRC.
Weirich, Stephen A.
... the type of cells that become malignant (cancerous): Squamous cell carcinoma : Cancer that begins in squamous cells , the thin, ... adenocarcinoma each year and fewer new cases of squamous cell carcinoma. Squamous cell carcinoma of the esophagus is found ...
Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Collaborative Projects: Participation Rates
Colorectal Cancer Screening Implementation of a public health programme An Expert Group on Colorectal Cancer Screening Cancer Society of Finland, Finnish Cancer Registry, Mass Screening Registry Aims of colorectal cancer screening • The main aim is
Context: Malignant melanoma is often lethal, and its incidence in the United States has increased rapidly over the past 2 decades. Nonmelanoma skin cancer is seldom lethal, but, if advanced, can cause severe disfigurement and morbidity. Early detection and treatment of melanoma might reduce mortality, while early detection and treatment of nonmelanoma skin cancer might prevent major disfigurement and to
Mark Helfand; Susan M Mahon; Karen B Eden; Paul S Frame; C. Tracy Orleans
... even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as biopsy ), which also have risks. Side effects may be caused by the test itself. Side ...
Dr. Barry Kramer summaries the results of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Dr. Christine Berg discuss the results of the colorectal cancer arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening 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.
Churches have been suggested as avenues to reach African-American populations with messages about health because of their strong participation in church activities. Membership in several religious denominations has been associated with healthy lifestyle practices that are associated with lower cancer-incidence rates and better coping strategies among cancer patients. Among African-American women, however, belief in God as their doctor might preempt
Electra D. Paskett; L. Douglas Case; Cathy Tatum; Ramon Velez; Alma Wilson
... cancers are treated Cervical cancer prevention and screening: Financial issues Additional resources References Previous Topic How women with abnormal Pap test results or pre-cancers are treated Next Topic Additional ...
Lung cancer screening with low dose computed tomography (CT) is the only method ever proven to reduce lung cancer-specific mortality in high-risk current and former cigarette smokers. Radiation exposure from annual screening CT examinations and subsequent CT and nuclear medicine testing to further evaluate positive screening CTs is sometimes raised as a reason to avoid screening and is often misunderstood. With all testing, there are potential benefits and risks. As we sit on the brink of widespread adoption of lung cancer screening CT, we aim to explain why the risks associated with radiation exposure from lung cancer screening are very low and should not be used to avoid screening or dissuade individuals who qualify for screening CT to participate in a lung cancer screening program. PMID:24258564
Frank, Luba; Christodoulou, Emmanuel; Kazerooni, Ella A
Non–AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening 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
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Although the effectiveness of prostate cancer screening is controversial, screening rates have risen dramatically among primary care providers in the United States. The authors' findings suggest more collaboration among primary care and specialty organizations, especially with respect to decision aid endorsement, is needed to achieve more discriminatory and patient-centered prostate cancer screening. PMID:21572298
Skolarus, Ted A; Holmes-Rovner, Margaret; Northouse, Laurel L; Fagerlin, Angela; Garlinghouse, Carol; Demers, Raymond Y; Rovner, David R; Darwish-Yassine, May; Wei, John T
Major professional organizations have called for psychosocial risk screening to identify specific psychosocial needs of children with cancer and their families and facilitate the delivery of appropriate evidence-based care to address these concerns. However, systematic screening of risk factors at diagnosis is rare in pediatric oncology practice. Subsequent to a brief summary of psychosocial risks in pediatric cancer and the rationale for screening, this review identified three screening models and two screening approaches (Distress Thermometer [DT], Psychosocial Assessment Tool [PAT]), among many more papers calling for screening. Implications of broadly implemented screening for all patients across treatment settings are discussed. PMID:22492662
Kazak, Anne E.; Brier, Moriah; Alderfer, Melissa A.; Reilly, Anne; Parker, Stephanie Fooks; Rogerwick, Stephanie; Ditaranto, Susan; Barakat, Lamia P.
Celebrities often promote cancer screening by relating personal anecdotes about their own diagnosis or that of a loved one. We used data obtained from a random-digit dialing survey conducted in the United States from December 2001 through July 2002 to examine the extent to which adults of screening age without a history of cancer had seen or heard or been influenced by celebrity endorsements of screening mammography, prostate-specific antigen (PSA) testing, or sigmoidoscopy or colonoscopy. The survey response rate was 72% among those known to be eligible and 51% among potentially eligible people accounting for those who could not be contacted. A total of 360 women aged 40 years or older and 140 men aged 50 years or older participated in the survey. Most respondents reported they "had seen or heard a celebrity talk about" mammography (73% of women aged 40 years or older), PSA testing (63% of men aged 50 years or older), or sigmoidoscopy or colonoscopy (52% of adults aged 50 years or older). At least one-fourth of respondents who had seen or heard a celebrity endorsement said that the endorsement made them more likely to undergo mammography (25%), PSA testing (31%), or sigmoidoscopy or colonoscopy (37%). PMID:15870440
Larson, Robin J; Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert
Cancer screening is a process of care consisting of several steps and interfaces. This article reviews what is known about the association between organizational factors and cancer screening rates and examines how organizational strategies can address the steps and interfaces of cancer screening in the context of both intraorganizational and interorganizational processes. We reviewed 79 studies assessing the relationship between organizational factors and cancer screening. Screening rates are largely driven by strategies to 1) limit the number of interfaces across organizational boundaries; 2) recruit patients, promote referrals, and facilitate appointment scheduling; and 3) promote continuous patient care. Optimal screening rates can be achieved when health-care organizations tailor strategies to the steps and interfaces in the cancer screening process that are most critical for their organizations, the providers who work within them, and the patients they serve. PMID:20386053
Zapka, Jane; Edwards, Heather; Taplin, Stephen H.
overall rates of cancer incidence and rates of cancer mortality for most racial and ethnic populations in the United States. The overall decrease was driven largely by declines in incidence of and mortality from the three most common cancers in men (lung, prostate, and colorectal cancer) and two of the three leading cancers in women (breast and colorectal cancer). National Cancer Institute (NCI) Director Dr. John Niederhuber frames the nation’s
Sangeetha Shivaji; M. S. Lindsay Jones; M. S. Arthur; G. Cosby, Ph.D.; Sanya Springfield; Oropharyngeal Cancer; Colorectal Cancer
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
... Policy Makers CDC Employees and Reasonable Accommodations (RA) Women with Disabilities and Breast Cancer Screening Share Compartir ... for breast cancer live long and healthy lives. Women with Disabilities Are Less Likely to Have Received ...
The US National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality and a 6.7% decrease in all-cause mortality. The NLST is the only trial showing positive results in a high-risk population, such as in patients with old age and heavy ever smokers. Lung cancer screening using a low-dose chest computed tomography might be beneficial for the high-risk group. However, there may also be potential adverse outcomes in terms of over diagnosis, bias and cost-effectiveness. Until now, lung cancer screening remains controversial. In this review, we wish to discuss the evolution of lung cancer screening and summarize existing evidences and recommendations. PMID:25237375
NCI funded the National Lung Screening Trial, an eight-year study that used new technology to detect small, aggressive tumors early enough to surgically remove them. This approach reduced lung cancer deaths among participants by 20 percent.
On May 18, 1985, the Philadelphia Division of the American Cancer Society and WCAU-TV entered into a jointly-sponsored colorectal health day to do mass screening throughout the greater Philadelphia area. This was preceded by a week-long series of television awareness programs, and an organization based on having individual hospital coordinators for those hospitals participating. A total of 46 hospitals in Pennsylvania alone participated in this project, and over 16,000 people were screened in a single day. 410 patients had positive stools for occult blood on site, and 359 were positive on take-home 3-packs. Rectal pathology was diagnosed initially in 502 patients. 13 colorectal cancers and 38 polyps have been diagnosed directly as a result of this screen. Total cost to the Cancer Society was $13,300, meaning each diagnosed cancer cost $1,023 and each cancer or polyp cost $266 in actual funds expended for the screen. This overwhelming response by the public to such a mass screening effort indicates the potential for such programs for colorectal cancer, and the techniques employed in planning, implementing, and following up on data retrieval are discussed. This mass screening effort should serve as a model for future projects, and emphasize the importance not only of interrelationships with the media, but also liaison efforts with a network of area hospitals and individual hospital coordinators. PMID:3274967
Frazier, T G; Bassett, J G; Weiss, S M; Zimmelman, S
The National Cancer Institute (NCI) is recruiting 3,000 current and former smokers for the Lung Screening Study, a year-long, $3 million study of spiral computed tomography (CT) scans, promising but unproven technology for lung cancer screening. Fact Sheet
Abstract Background: African American women have increased mortality rates for cervical, breast, and colorectal cancers, yet not all receive the recommended screening tests for these cancers. We characterized the cancer screening behaviors of African American women enrolled in a community-based cancer prevention trial. Methods: We examined cross-sectional data from 1123 African American customers aged ?18 years from 37 beauty salons in North Carolina who completed the North Carolina BEAUTY and Health Project baseline survey. Mixed logistic regression models were used to identify correlates of receiving cervical, breast, and colorectal cancer screening tests within recommended screening guidelines. Results: Overall, 94% (1026 of 1089) of women aged ?18 years reported receiving a Pap smear test within the last 3 years, 70% (298 of 425) of women aged ?40 years reported receiving a mammography within the last year, and 64% (116 of 180) of women aged ?50 years were considered to be within recommended screening guidelines for colorectal cancer. Age was correlated with recent Pap smear testing and mammography. Women who reported receiving a recent Pap smear test were more likely to report a mammogram in the last year, and women with a recent mammogram were more likely to be within recommended screening guidelines for colorectal cancer. Many women reported multiple barriers to getting recommended cancer screening tests. Conclusions: Almost all women reported receiving a Pap smear test within the last 3 years. Future interventions should focus on increasing breast and colorectal cancer screening among African American women. PMID:21332413
Reiter, Paul L; Linnan, Laura A
Background: The incidence of prostate cancer has increased substantially since it became common practice to screen asymptomatic men for the disease. The European Randomized Study of Screening for Prostate Cancer (ERSPC) was initiated in 1993 to determine how prostate-specific antigen (PSA) screening affects prostate cancer mortality. Variations in the screening algorithm, such as the interval between screening rounds, likely influence
M. J. Roobol; A. Grenabo; F. H. Schröder; J. Hugosson
Colorectal cancer has been identified as an appropriate candidate for early detection and treatment of both asymptomatic individuals and those at risk of the disease. The lifetime incidence of colorectal cancer among persons at average risk is sufficiently high to justify screening the general population. This review presents the latest strategies employed in early detection of the colorectal cancer. An ideal screening test should satisfy some basic criteria: must be simple, secure, accepted by the population with valid and reproductive results. Despite the demonstrated benefits of colorectal cancer screening, incidence and mortality rates of this common cancer remain high. More optimally tailored screening tools are needed that combine the features of a potentially ideal screening test. PMID:16607794
Dajbog, Elena; Lefter, L P; Scripcariu, V; D?nil?, R; Dragomir, C
... These are called diagnostic tests . General Information About Ovarian Cancer Ovarian cancer is a disease in which malignant (cancer) cells ... Malignant Potential Tumors Treatment In the United States, ovarian cancer is the fifth leading cause of cancer death ...
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
Over 2,500 preschool children were screened for emotional and behavioral problems using the three-state, multiple-gating procedures of the Early Screening Project (ESP). Significant differences were found between children who did and did not exceed the ESP's normative referral criteria. Results suggest the ESP procedures can minimize both the time…
Feil, Edward G.; Severson, Herbert H.; Walker, Hill M.
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
Rengaswamy Sankaranarayanan; Somanathan Thara; Pulikottil Okkuru Esmy; Partha Basu
Colorectal cancer remains one of the most common causes of cancer death in this country. This malignancy is ideally suited for screening because the detection and removal of the precursor adenomatous polyp can prevent most colorectal cancers from ever forming. The choice of a test for screening involves consideration of various individual parameters, including patient age and the presence of risk factors for the development of colorectal cancer. Computed tomographic colonography (CTC) has emerged as the leading imaging technique for colorectal cancer screening in average-risk individuals on the basis of the evidence presented in this paper. The double-contrast barium enema is an alternative imaging test that is appropriate particularly when CTC is not available. In 2008, the American Cancer Society guideline for colorectal cancer screening was revised jointly with the US Multi-Society Task Force on Colorectal Cancer and the ACR to include CTC every 5 years as an option for average-risk individuals. Computed tomographic colonography is also the preferred test for colon evaluation after an incomplete colonoscopy. Imaging tests including CTC and the double-contrast barium enema are usually not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the new colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging. PMID:20816627
Yee, Judy; Rosen, Max Paul; Blake, Michael A; Baker, Mark E; Cash, Brooks D; Fidler, Jeff L; Grant, Thomas H; Greene, Frederick L; Jones, Bronwyn; Katz, Douglas S; Lalani, Tasneem; Miller, Frank H; Small, William C; Sudakoff, Gary S; Warshauer, David M
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
Howayda S Abd El All; Amany Refaat; Khadiga Dandash
Abstract The poor outcome in symptomatic lung cancer patients and the much better prognosis when lung cancer is diagnosed and treated at early asymptomatic stages call for screening. As lung cancer predominantly affects smokers and individuals exposed to other carcinogens, screening programs need not include the whole population but only these risk groups. Every screening program will tend to better identify the more indolent tumours that grow slowly enough to be detected by screening before symptoms develop, whereas aggressive fast-growing tumours may present as interval cancers despite screening (length-time bias). Some malignant tumours detected with screening may never cause the person’s death due to competing causes for death, particularly in heavy smokers, such as cardiovascular disease or other cancers (overdiagnosis bias). If a cancer is still lethal despite detection through screening, the affected individual may live longer with the diagnosis of cancer but not longer altogether (lead-time bias). It is likely that this will have a negative effect on that individual’s quality of life. Participation in screening programs may have beneficial as well as adverse effects on smoking habits; in the worst case it may encourage people to continue smoking. Trials assessing chest radiography or sputum microscopy have not demonstrated a reduction in lung cancer mortality through screening, probably because the tests were not sensitive enough. computed tomography promises better sensitivity. Other modern tests such as fibre optic bronchoscopy, analysis of molecular markers or genetic testing in serum, sputum or exhaled air are not yet ready for clinical practice. PMID:22185788
Screening methods to find colon or rectal changes that may lead to cancer include laboratory tests such as fecal occult blood tests (FOBT), and imaging tests such as sigmoidoscopy and colonoscopy. Screening by the latter two tests can find precancerous polyps which can be removed during the test and may find cancer early when it is most treatable.
In the United States, new screening tests can become widely used often without valid scientific evidence of benefit or proper assessment of harm. Consequently, it is important for new tests to undergo rigorous trials as quickly as possible before widespread community use precludes establishment of a proper control arm. As exemplified by the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, it is possible to evaluate several screening tests and cancers in the same trial to preserve resources.
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.
Foundation, Wgbh E.
The purpose of this study was through a survey of awareness of cancer and cancer screening of Korean community residents to identify the stereotypes of cancer and bases for development of improved screening programs for early detection. Subjects were residing in South Korea Gangwon-Province and were over 30 years and under 69 years old. The total was 2,700 persons which underwent structured telephone survey questionnaires considered with specific rates of gender, region, and age. For statistical analysis, PASW Statistics 17.0 WIN was utilized. Frequency analysis, the Chi-square (??) test for univariate analysis, and logistic regression analysis were performed. The awareness of cancer and cancer screening in subjects differed by gender, region and age. For the idea of cancer, women thought about death less than men (OR: 0.73, p<0.001). On the other hand, women had negative thoughts - fear/terror/suffering/pain/pain - more than their male counterparts (OR: 2.04, p<0.001). Next, for the idea of cancer screening, women recognized fear/terror more than men (OR: 1.38, p<0.01). The higher age, the more tension/anxiety/worry/burden/irritated/pressure (OR: 1.43, p<0.01, OR: 2.15, p<0.001, OR: 2.49, p<0.001)). People may be reminded of fear and death for cancer and of fear, terror, tension and anxiety for cancer screening. To change vague fear and negative attitudes of cancer could increase the rate of cancer screening as well as help to improve the quality of life for community cancer survivors and facilitate return to normal social life. Therefore, it is necessary to provide promotion and education to improve the awareness of cancer and cancer screening. PMID:24998568
Jo, Heui-Sug; Kwon, Myung Soon; Jung, Su-Mi; Lee, Bo-Young
Cancer screening studies have shown that more screening does not necessarily translate into fewer cancer deaths. This article explains how to interpret the statistics used to describe the results of screening studies.
Background: Identifying opportunities to offer cervical cancer screening to underscreened women is important for increasing early detection. Maryland law mandates offering Pap tests during hospital admissions. We examined organizational and physician attitudes and practices regarding inpatient screening, to identify mechanisms for increasing the law's effectiveness.Methods: We analyzed state admission data, a hospital administrators telephone survey, and a mailed survey of
Ann Klassen; Allyson Hall; Janice Bowie; Carol S. Weisman
Early detection of cancer is a core task in family medicine, and patients have come to expect screening tests, sometimes out of proportion to what evidence can justify. To understand the controversies surrounding screening and to provide sound advice to patients, family physicians should be familiar with the fundamental concepts of screening. Failure to account for the effects of lead-time, length-time, and overdiagnosis biases can lead to overestimation of screening benefits. For this reason, the best method for evaluating the benefit of screening tests is a randomized controlled trial showing decreased disease-specific or all-cause mortality. The number needed to screen can be used to measure the magnitude of benefit of screening tests. Accepted screening tests often require screening several hundred to more than 1,000 asymptomatic patients to prevent one death from the disease. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend screening for colorectal cancer in adults 50 to 75 years of age, and recommend against prostate-specific antigen testing to screen for prostate cancer. Annual low-dose computed tomography screening for lung cancer reduces mortality in persons 55 to 80 years of age with at least a 30-pack-year history who are otherwise healthy smokers or who have quit smoking within the past 15 years; however, it is associated with a high false-positive rate, uncertain harms from radiation exposure, and overdiagnosis. Therefore, it should be performed only in conjunction with smoking cessation interventions. PMID:25368922
Gates, Thomas J
The National Cancer Institute has launched the Cancer Genome Anatomy Project to "achieve a comprehensive molecular characterization of normal, precancerous, and malignant cells." Sequenced genes are held as library entries in a database and are available for downloading (fasta format). Each cDNA library entry may include biological source, number of sequences, and library construction detail information. Thousands of gene sequences are available for over 15 cancers, including breast, colon, and prostrate. Contact information for donating or obtaining tissue samples for research purposes is provided.
... even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests and procedures which also have risks. Side effects may be caused by the screening test itself. ...
Screening has a central role in colorectal cancer (CRC) control. Different screening tests are effective in reducing CRC-specific mortality. Influence on cancer incidence depends on test sensitivity for pre-malignant lesions, ranging from almost no influence for guaiac-based fecal occult blood testing (gFOBT) to an estimated reduction of 66–90% for colonoscopy. Screening tests detect lesions indirectly in the stool [gFOBT, fecal immunochemical testing (FIT), and fecal DNA] or directly by colonic inspection [flexible sigmoidoscopy, colonoscopy, CT colonography (CTC), and capsule endoscopy]. CRC screening is cost-effective compared to no screening but no screening strategy is clearly better than the others. Stool tests are the most widely used in worldwide screening interventions. FIT will soon replace gFOBT. The use of colonoscopy as a screening test is increasing and this strategy has superseded all alternatives in the US and Germany. Despite its undisputed importance, CRC screening is under-used and participation rarely reaches 70% of target population. Strategies to increase participation include ensuring recommendation by physicians, introducing organized screening and developing new, more acceptable tests. Available evidence for DNA fecal testing, CTC, and capsule endoscopy is reviewed. PMID:25386553
Stracci, Fabrizio; Zorzi, Manuel; Grazzini, Grazia
Colorectal cancer is an important public health problem. Several screening methods have been shown to be effective in reducing colorectal cancer mortality. The objective of this review was to assess the cost-effectiveness of the different colorectal cancer screening methods and to determine the preferred method from a cost-effectiveness point of view. Five databases (MEDLINE, EMBASE, the Cost-Effectiveness Analysis Registry, the British National Health Service Economic Evaluation Database, and the lists of technology assessments of the Centers for Medicare and Medicaid Services) were searched for cost-effectiveness analyses published in English between January 1993 and December 2009. Fifty-five publications relating to 32 unique cost-effectiveness models were identified. All studies found that colorectal cancer screening was cost-effective or even cost-saving compared with no screening. However, the studies disagreed as to which screening method was most effective or had the best incremental cost-effectiveness ratio for a given willingness to pay per life-year gained. There was agreement among studies that the newly developed screening tests of stool DNA testing, computed tomographic colonography, and capsule endoscopy were not yet cost-effective compared with the established screening options. PMID:21633092
Lansdorp-Vogelaar, Iris; Knudsen, Amy B.; Brenner, Hermann
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.
Takeda, Yuya; Tamaru, Masatsugu; Kawata, Yoshiki; Kubo, Mitsuru; Niki, Noboru; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Kaneko, Masahiro; Kusumoto, Masahiro; Eguchi, Kenji; Moriyama, Noriyuki; Mori, Kiyoshi; Nishiyama, Hiroyuki
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.
Takeda, Yuya; Tamaru, Masaaki; Kawata, Yoshiki; Kubo, Mitsuru; Niki, Noboru; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Kaneko, Masahiro; Kusumoto, Masahiko; Eguchi, Kenji; Moriyama, Noriyuki; Mori, Kiyoshi; Nishiyama, Hiroyuki
Background Data from Egyptian studies provide widely varying estimates on the prevalence of pre-malignant and malignant cervical abnormalities and human papilloma virus (HPVs) infection. To define the prevalence and risk factors of pre-invasive and invasive cervical cancer (cacx), a community based full-scale cross sectional, household survey including 5453 women aged between 35 and 60 years was conducted. Methods The study period was between February 2000 and December 2002. Initially, conventional Papanicolaou (Pap) smears were evaluated using the Bethesda system (TBS), followed by colposcopic guided biopsy (CGB) for all epithelial abnormalities (EA). In a third step, HPV was tested on all EA by in-situ hybridization (ISH) using first the broad spectrum HPV probe recognizing HPVs 6, 11, 16, 18, 30, 31, 35, 45, 51 and 52 followed by subtyping with probes 6/11, 16/18 and 31/33. Lastly, unequivocal cases were immunostained for herpes simplex type-2 (HSV-2), cytomegalovirus (CMV), and human immunodeficiency virus (HIV). Results EA representing 7.8% (424/5453), were categorized into atypical squamous cell of undetermined significance (ASCUS) (34.4%), atypical glandular cell of undetermined significance (AGCUS) (15.3%), combined ASCUS and AGCUS (3.1%), low grade squamous intraepithelial lesions (SIL) (41.0%), high grade SIL (5.2%) and invasive lesions (1%). CGB of EA (n = 281) showed non neoplastic lesions (12.8%), atypical squamous metaplasia (ASM) (19.2%), cervical intraepithelial neoplasia I (CIN) (44.4%), CIN II (4.4%), CINIII (2.8%), endocervical lesions (5.2%), combined squamous and endocervical lesions (10.0%), invasive squamous cell carcinoma (SCC) (0.02%) and extranodal marginal zone B cell lymphoma (MZBCL) (0.02%). The overall predictive value of cytology was 87% while the predictive value for high grade lesions was 80%. On histological basis, HPVs were present in 94.3% of squamous lesions while it was difficult to be identified in endocervical ones. ISH revealed positivity for pan HPV in 65.9% of the studied biopsies (n = 217), with incorporation of the viral genome HPV 6/11, 16/18 and 31/33 in 11.1%, 33.3% and 17.1% respectively. Multiple HPVs infections were identified in 0.02%. Conclusion Pre-invasive high grade lesions and invasive cervical carcinoma represent 0.5% and 0.04% respectively in Egyptian women. HPV mostly 16/18 as a risk factor (p < 0.001), was frequently associated with mixed infections (p < 0.001) and bilharzial infestation (p < 0.001). PMID:17610742
Abd El All, Howayda S; Refaat, Amany; Dandash, Khadiga
Colon cancer screening 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 cancer screening increases uptake of colon cancer screening 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
In a tribal village in Kerala, India, local volunteers were trained to work in a programme for the primary prevention of tobacco-related cancers and the secondary prevention of common cancers. They gathered data on the use of tobacco and alcohol in a population of some 19,000 people, and identified one or more warning signals of cancer in 430 persons, who were subsequently examined by physicians. Confirmation was obtained of 10 new cancers, 7 recurrent cancers, 46 oral precancerous conditions, and 58 precancers at other sites. The community's awareness of cancer problems increased and the people learnt about the importance of self-examination in the detection of breast cancer and oral cancer. PMID:9060235
Mathew, B; Wesley, R; Dutt, S C; Amma, S; Sreekumar, C
Abstract Objective To evaluate current colorectal cancer (CRC) screening practices in Saskatchewan and identify barriers to screening with the goal of improving current practice. Design Survey of family physicians. Setting Saskatchewan. Participants A total of 773 family physicians were surveyed. Main outcome measures Demographic characteristics, individual screening practices, and perceived barriers to screening. Results The response rate to the survey was 44.5%. When asked what method they used for fecal occult blood testing, almost 40% of respondents were either unsure or did not answer the question. Of those who did respond, 35.8% employed hemoccult testing following digital rectal examination, a practice not recommended for CRC screening. Screening guidelines for average-risk patients were generally well adhered to, with 79.9% of respondents recommending screening beginning at age 50. For screening patients at increased risk of CRC owing to family history, only 64.2% of respondents began screening 10 years before the age of the index patient at diagnosis. Physicians who were more likely to follow guidelines were female, in practice fewer than 10 years, trained in Canada, and practising in urban areas. More than 90% of family physicians agreed that a standard provincewide screening program would be beneficial. Conclusion We have identified considerable knowledge gaps with regard to CRC screening. There is confusion about which fecal occult blood tests are recommended for screening. Also, screening guidelines for patients with a family history of CRC are poorly understood. These findings suggest that better physician education about CRC screening is required. Introduction of a provincewide screening program should improve overall screening success. PMID:24336561
Deobald, Ray; Graham, Peter; Chad, Jennifer; Di Gregorio, Carlo; Johnstone, Jennifer; Balbuena, Lloyd; Kenyon, Chris; Lees, Mark
This paper examines cultural models for breast and cervical cancer among low-income African-American women over 40, in order to better understand how those models might affect cancer screening behavior. The study is part of The Community-Based Cancer Screening Project, which is sponsored by Emory University, Grady Memorial Hospital, and the American Cancer Society. The Screening Project attempts to increase the
Jessica Gregg; Robert H. Curry
Few medical issues have been as controversial—or as political, at least in the United States—as the role of mammographic screening for breast cancer. The advantages of finding a cancer early seem obvious. Indeed, randomized trials evaluating screening mammography demonstrate a reduction in breast cancer mortality, but the benefits are less than one would hope. Moreover, the randomized trials are themselves subject to criticism, including that they are irrelevant in the modern era because most were conducted before chemotherapy and hormonal therapy became widely used. In this article I chronicle the evidence and controversies regarding mammographic screening, including attempts to assess the relative contributions of screening and therapy in the substantial decreases in breast cancer mortality that have been observed in many countries over the last 20 to 25 years. I emphasize the trade-off between harms and benefits depending on the woman’s age and other risk factors. I also discuss ways for communicating the associated risks to women who have to decide whether screening (and what screening strategy) is right for them. PMID:24074796
This article assessed the relationship between breast and cervical cancer screening 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 cancer screening 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
BACKGROUND The National Lung Screening Trial (NLST) used risk factors for lung cancer (e.g., ?30 pack-years of smoking and <15 years since quitting) as selection criteria for lung-cancer screening. Use of an accurate model that incorporates additional risk factors to select persons for screening may identify more persons who have lung cancer or in whom lung cancer will develop. METHODS We modified the 2011 lung-cancer risk-prediction model from our Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial to ensure applicability to NLST data; risk was the probability of a diagnosis of lung cancer during the 6-year study period. We developed and validated the model (PLCOM2012) with data from the 80,375 persons in the PLCO control and intervention groups who had ever smoked. Discrimination (area under the receiver-operating-characteristic curve [AUC]) and calibration were assessed. In the validation data set, 14,144 of 37,332 persons (37.9%) met NLST criteria. For comparison, 14,144 highest-risk persons were considered positive (eligible for screening) according to PLCOM2012 criteria. We compared the accuracy of PLCOM2012 criteria with NLST criteria to detect lung cancer. Cox models were used to evaluate whether the reduction in mortality among 53,202 persons undergoing low-dose computed tomographic screening in the NLST differed according to risk. RESULTS The AUC was 0.803 in the development data set and 0.797 in the validation data set. As compared with NLST criteria, PLCOM2012 criteria had improved sensitivity (83.0% vs. 71.1%, P<0.001) and positive predictive value (4.0% vs. 3.4%, P = 0.01), without loss of specificity (62.9% and. 62.7%, respectively; P = 0.54); 41.3% fewer lung cancers were missed. The NLST screening effect did not vary according to PLCOM2012 risk (P = 0.61 for interaction). CONCLUSIONS The use of the PLCOM2012 model was more sensitive than the NLST criteria for lung-cancer detection. PMID:23425165
Tammemagi, Martin C.; Katki, Hormuzd A.; Hocking, William G.; Church, Timothy R.; Caporaso, Neil; Kvale, Paul A.; Chaturvedi, Anil K.; Silvestri, Gerard A.; Riley, Tom L.; Commins, John; Berg, Christine D.
NCI appreciates the U.S. Preventive Services Task Force's careful review and analysis of the evidence regarding breast cancer screening for women at average risk. The take-away message is that each woman needs to consider her individual benefits and risks and discuss them with her health care provider before making a decision on when to start screening mammography and how often to get one.
Smoking is a major health care problem and is projected to cause over 8 million deaths per year worldwide in the coming decades. To reduce lung cancer mortality in heavy smokers, several randomized screening trials were initiated in the past years using screening with low-dose Computed Tomography (CT). Recently, the National Lung Screening Trial (NLST), which was performed in the
O. M. Mets
Abstract Objective To see if refugee women at a community health centre (CHC) in Toronto, Ont, are appropriately screened for cervical cancer and if there are any demographic characteristics that affect whether they are screened. Design Chart review. Setting A CHC in downtown Toronto. Participants A total of 357 eligible refugee women attending the CHC. Main outcome measures Papanicolaou test received or documented reason for no Pap test. Results Ninety-two percent of women in the study sample were either appropriately screened for cervical cancer or had been approached for screening. Eighty percent of women were appropriately screened. Demographic variables including pregnancy, being uninsured, not speaking English, recent migration to Canada, and being a visible minority did not affect receipt of a Pap test after migration in multivariate analyses. Not speaking English was associated with a delay to receiving a first Pap test after migration. Conclusion The clients at our centre are demographically similar to women who are typically overlooked for Pap tests in the greater Toronto area. Despite belonging to a high-risk population, refugee women in this multidisciplinary CHC were screened for cervical cancer at a higher rate than the local population. PMID:22972744
Wiedmeyer, Mei-ling; Lofters, Aisha; Rashid, Meb
Pancreatic cancer remains today the cancer with the worst prognosis with 330300 deaths per year worldwide with a cancer prevalence of 211500 cases in 2012. Despite progress made in the understanding of the pathophysiology of this neoplasia, morbidity and mortality have not been modified. Tobacco remains the only modifiable risk factor with an impact on the incidence of pancreatic cancer. Screening programs involving medical imaging and serum markers have so far failed to alter the incidence and prognosis of the disease, even in selected populations with high risk. However, screening programs allowed some high-risk patients to be diagnosed early and therefore have been received care at an asymptomatic stage. The impact on the prognosis has nevertheless not been demonstrated yet. PMID:25276995
Bochatay, Laurent; Girardin, Marc; Bichard, Philippe; Frossard, Jean-Louis
The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett’s esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of superficial capillaries; then characterization of the morphology of the lesion according to the Paris classification and prediction of the risk of malignancy and depth of invasion, with the help of chromoscopy, magnification and image processing with neutrophil bactericidal index or FICE. Then treatment decision offers 3 options according to histologic prediction: abstention, endoscopic resection, surgery. The rigorous quality control of endoscopy will reduce the miss rate of lesions and the occurrence of interval cancer. PMID:23293721
In this audio clip, Drs. Lisa Schwartz and Steven Woloshin of the Dartmouth Institute for Health Policy discuss the benefits and harms of cancer screening and highlight popular misconceptions about cancer screening statistics.
Colorectal cancer is the third leading cause of cancer deaths in the United States. Most colorectal cancers can be prevented by detecting and removing the precursor adenomatous polyp. Individual risk factors for the development of colorectal cancer will influence the particular choice of screening tool. CT colonography (CTC) is the primary imaging test for colorectal cancer screening in average-risk individuals, whereas the double-contrast barium enema (DCBE) is now considered to be a test that may be appropriate, particularly in settings where CTC is unavailable. Single-contrast barium enema has a lower performance profile and is indicated for screening only when CTC and DCBE are not available. CTC is also the preferred test for colon evaluation following an incomplete colonoscopy. Imaging tests including CTC and DCBE are not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the updated colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:24793959
Yee, Judy; Kim, David H; Rosen, Max P; Lalani, Tasneem; Carucci, Laura R; Cash, Brooks D; Feig, Barry W; Fowler, Kathryn J; Katz, Douglas S; Smith, Martin P; Yaghmai, Vahid
Prostate cancer fulfils some of the conditions required of a disease that might be managed by population screening. In a cohort of 50- to 60-year-old men, carrying out a rectal examination and prostate specific antigen (PSA) test will detect clinically suspicious areas within the prostate in approximately 5%, and approximately 10% will have a raised PSA. We are however unsure
D. E Neal; H. Y Leung; P. H Powell; F. C Hamdy; J. L Donovan
Purpose: To identify women's sources of information about cervical cancer screening, information which women report receiving during Pap consultations, information they would like to receive, and the relationships between perceived information needs, personal characteristics and information sources. Design/methodology/approach: Logistic regression…
Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark
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…
This tutorial explains how the Cancer Genome Anatomy Project (CGAP) studies the molecular changes that occur in cancer genomes and shares this information with all scientists. The information in NCI's CGAP databases is being used to improve the diagnosis and treatment of cancer.
This article assessed the relationship between breast and cervical cancer screening 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 cancer screening 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 cancer screening, 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 cancer screening in underserved populations. PMID:21451008
Ochoa-Frongia, Lisa; Thompson, Hayley S; Lewis-Kelly, Yulinda; Deans-McFarlane, Terri; Jandorf, Lina
PLCO trial data showed that six rounds of annual screening for prostate cancer led to finding 22 percent more prostate cancers by seven years after the start of screening and 17 percent more prostate cancers by 10 years after the start of screening.
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 cancer screening 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 cancer screening. Particularly low levels were found in breast, cervical, prostate, and colon cancer screening. In multivariate analyses, the strongest determinant of receiving cancer screening overall or cancer screening for a specific cancer site was recommendation for screening by a doctor or nurse. Other determinants associated with increased likelihood of ever having cancer screening included older age, female gender, and receiving physical exams more than once a year. Increased age was a determinant of breast cancer screening and receiving physical exams was associated with cervical cancer screening. Conclusions Cancer screening was markedly underutilized in this sample of Native Americans from the Northern Plains. Future research should evaluate the potential for improving cancer screening. PMID:20307807
Pandhi, Nancy; Guadagnolo, B. Ashleigh; Kanekar, Shalini; Petereit, Daniel G.; Smith, Maureen A.
Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori (H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing. No organized screening programs can be found outside Asia (Japan and South Korea). Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern. Searches for new screening biomarkers, including microRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach.
Pasechnikov, Victor; Chukov, Sergej; Fedorov, Evgeny; Kikuste, Ilze; Leja, Marcis
Clinical Cancer Care Â· Full screening services and diagnostics Â· Advanced treatments for all forms of cancer Â· Most frequent cancers at the Cancer Center: Breast 15% Gastrointestinal 13% Skin 17% Lung 13 treatment protocols that link the latest Cancer Center research to clinical care Â· Familial Cancer Program
Myers, Lawrence C.
Targeted Prevention Programs Branch Canberra, ACT, Australia Following the successful pilot program that ran from 2002-2004, a National Bowel Cancer Screening Program which uses immunochemical FOBT, followed by colonoscopy if indicated, will be introduced. The first phase of the program (2006-2008) will target people turning 55 or 65 years of age between 1 May 2006 and 30 June 2008 and those who participated in the pilot program.
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…
Redmond, Jennifer; Vanderpool, Robin; McClung, Rebecca
Although the prevalence of gastric cancer (GC) progressively decreased during the last decades, due to improved dietary habit, introduction of food refrigeration and recovered socio-economic level, it still accounts for 10% of the total cancer-related deaths. The best strategy to reduce the mortality for GC is to schedule appropriate screening and surveillance programs, that rises many relevant concerns taking into account its worldwide variability, natural history, diagnostic tools, therapeutic strategies, and cost-effectiveness. Intestinal-type, the most frequent GC histotype, develops through a multistep process triggered by Helicobacter pylori (H. pylori) and progressing from gastritis to atrophy, intestinal metaplasia (IM), and dysplasia. However, the majority of patients infected with H. pylori and carrying premalignant lesions do not develop GC. Therefore, it remains unclear who should be screened, when the screening should be started and how the screening should be performed. It seems reasonable that screening programs should target the general population in eastern countries, at high prevalence of GC and the high-risk subjects in western countries, at low prevalence of GC. As far as concern surveillance, currently, we are lacking of standardized international recommendations and many features have to be defined regarding the optimal diagnostic approach, the patients at higher risk, the best timing and the cost-effectiveness. Anyway, patients with corpus atrophic gastritis, extensive incomplete IM and dysplasia should enter a surveillance program. At present, screening and surveillance programs need further studies to draw worldwide reliable recommendations and evaluate the impact on mortality for GC. PMID:25320506
Compare, Debora; Rocco, Alba; Nardone, Gerardo
The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial is a large-scale clinical trial to determine whether certain cancer screening tests reduce deaths from prostate, lung, colorectal, and ovarian cancer. The underlying rationale for the trial is that screening for cancer may enable doctors to discover and treat the disease earlier. Numerous epidemiologic and ancillary studies are included to answer related crucial questions.
Each state is autonomous in its comprehensive cancer control (CCC) program, and considerable heterogeneity exists in the program plans. However, researchers often focus on the concept of nationally representative data and pool observations across states using regression analysis to come up with average effects when interpreting results. Due to considerable state autonomy and heterogeneity in various dimensions—including culture, politics, historical precedent, regulatory environment, and CCC efforts—it is important to examine states separately and to use geographic analysis to translate findings in place and time. We used 100 percent population data for Medicare-insured persons aged 65 or older and examined predictors of breast cancer (BC) and colorectal cancer (CRC) screening from 2001–2005. Examining BC and CRC screening behavior separately in each state, we performed 100 multilevel regressions. We summarize the state-specific findings of racial disparities in screening for either cancer in a single bivariate map of the 50 states, producing a separate map for African American and for Hispanic disparities in each state relative to whites. The maps serve to spatially translate the voluminous regression findings regarding statistically significant disparities between whites and minorities in cancer screening within states. Qualitative comparisons can be made of the states’ disparity environments or for a state against a national benchmark using the bivariate maps. We find that African Americans in Michigan and Hispanics in New Jersey are significantly more likely than whites to utilize CRC screening and that Hispanics in 6 states are significantly and persistently more likely to utilize mammography than whites. We stress the importance of spatial translation research for informing and evaluating CCC activities within states and over time. PMID:24944346
Mobley, Lee R.; Kuo, Tzy-Mey; Urato, Matthew; Subramanian, Sujha; Watson, Lisa; Anselin, Luc
Purpose:The benefit of prostate specific antigen (PSA) and digital rectal examination (DRE) screening for prostate cancer is under evaluation in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Followup of positive screens in PLCO is done by subject personal physicians and it is outside of trial control. We describe the pattern of prostate biopsy in men with positive
PAUL F. PINSKY; GERALD L. ANDRIOLE; BARNETT S. KRAMER; RICHARD B. HAYES; PHILIP C. PROROK; JOHN K. GOHAGAN
From December 1987 to December 1993, 6470 women underwent screening with transvaginal sonography (TVS) as part of the University of Kentucky Ovarian Cancer Screening Project. 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
... is the second leading cause of cancer deaths in the United States. Sixty percent of colorectal cancer deaths could be prevented with regular testing of adults age 50 years and older, but current screening rates are ... on colorectal cancer screening are included in the survey periodically. For the purposes of this ...
Fluorescence-guided OCT for Colon Cancer Screening A Critical Review of "Fluorescence-guided Optical Coherence Tomography Imaging for Colon Cancer Screening: A Preliminary Mouse Study" - Iftimia et (aka Team Beard) #12;Background Â· What is the problem? Â· How do we currently find colon cancer
George, Steven C.
In the US, colorectal cancer is the fourth most common cancer and the second most deadly. Screening is recommended, not only to reduce mortality, but to prevent cancer by detecting precancerous polyps. Many screening methods are available now, and newer methods based on molecular markers show promise for the future. PMID:25031625
Purpose We analyzed patterns and factors associated with receipt of breast and cervical cancer screening in a cohort of colorectal cancer survivors. Methods Individuals diagnosed with colorectal cancer in Nova Scotia between January 2001 and December 2005 were eligible for inclusion. Receipt of breast and cervical cancer screening was determined using administrative data. General-population age restrictions were used in the analysis (breast: 40–69 years; cervical: 21–75 years). Kaplan–Meier and Cox proportional hazards models were used to assess time to first screen. Results Of 318 and 443 colorectal cancer survivors eligible for the breast and cervical cancer screening analysis respectively, 30.1% [95% confidence interval (ci): 21.2% to 39.0%] never received screening mammography, and 47.9% (95% ci: 37.8% to 58.0%) never received cervical cancer screening during the study period. Receipt of screening before the colorectal cancer diagnosis was strongly associated with receipt of screening after diagnosis (hazard ratio for breast cancer screening: 4.71; 95% ci: 3.42 to 6.51; hazard ratio for cervical cancer screening: 6.83; 95% ci: 4.58 to 10.16). Conclusions Many colorectal cancer survivors within general-population screening age recommendations did not receive breast and cervical cancer screening. Future research should focus on survivors who meet age recommendations for population-based cancer screening. PMID:25302037
Corkum, M.; Urquhart, R.; Kephart, G.; Hayden, J.A.; Porter, G.
Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and “screen and treat” method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening. PMID:25320514
Full field digital mammography (FFDM) was introduced into the Irish National Breast Screening Program (INBSP) in 2005. The\\u000a aim of this study is to review the use of FFDM in a National Breast Screening Program and to compare the results to standard\\u000a screen-film mammography with respect to recall rate and cancer detection rate. All women who underwent breast cancer screening
N. Hambly; Niall Phelan; G. Hargaden; A. O’Doherty; F. Flanagan
Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancer screening has proven its benefit in terms of incidence and mortality reduction in randomized controlled trials. In fact, it has been recommended by medical organizations either in average-risk or family-risk populations. Success of a screening campaign highly depends on how compliant the target population is. Several factors influence colorectal cancer screening uptake including sociodemographics, provider and healthcare system factors, and psychosocial factors. Awareness of the target population of colorectal cancer and screening is crucial in order to increase screening participation rates. Knowledge about this disease and its prevention has been used across studies as a measurement of public awareness. Some studies found a positive relationship between knowledge about colorectal cancer, risk perception, and attitudes (perceived benefits and barriers against screening) and willingness to participate in a colorectal cancer screening campaign. The mentioned factors are modifiable and therefore susceptible of intervention. In fact, interventional studies focused on average-risk population have tried to increase colorectal cancer screening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancer screening and interventions targeting participants for increasing screening uptake. PMID:24729896
Gimeno Garcia, Antonio Z.; Hernandez Alvarez Buylla, Noemi; Nicolas-Perez, David; Quintero, Enrique
STUDY OBJECTIVE: To assess the performance of breast cancer screening in different age categories over two decades. DESIGN: Important determinants of reduced breast cancer mortality such as attendance, mammography performance, cancer detection, and disease stage were recorded. SETTING: Nijmegen, The Netherlands, 1975-92. SUBJECTS: Since 1975 more than 40,000 women aged 35 years and older have been invited biennially for breast screening in a population based project in Nijmegen. MAIN RESULTS: Rates of attendance, referral, detection, and disease stage were calculated, as well as the specificity of screening mammography and the predictive value of referral and biopsy. From round 3 onwards, the attendance rate of women younger than 50 years stabilised at 70%, in women of 50-69 years it was 62%, and in women aged 70 and over it was 22%. In these three age categories, the referral rates of a positive screening mammography per 1000 screened women were 4.9, 6.2, and 11.8, respectively. Specificity rates were between 99% and 100%. Current predictive values of referral were high: in the specific age categories 39%, 59%, and 68% of the referred women had cancer. Detection rates remained fairly stable over the rounds 4-9, at 1.9, 3.6, and 8.0 cancers per 1000 screened women. In the two year period between screening the numbers of interval cancers per 1000 screened women were 2.2, 2.2, and 2.9, for the three age categories respectively. With regard to invasive cancers detected during screening, the percentage of small tumours (< or = 20 mm on the mammogram) was 84% in each age category. For women younger than 50 years, the proportion of intraductal carcinoma in all the cancers detected at screening was 40%, while it was 15% in the other age categories. CONCLUSION: Throughout the nine rounds, the screening outcomes were found to be adequate, particularly considering the high specificity rate and the predictive value of referral without the interference of a low detection rate. Although the occurrence of interval cancers seemed high, it was similar to other screening programmes. Despite a relatively low referral rate, the ratios of screen detected versus interval cancer cases were favourable. Well organised screening programmes can achieve good mammography results without too many false positives. It is important that women continue to participate in a screening programme because cancer can still be detected even after several successive negative screening examinations. PMID:8935470
Otten, J D; van Dijck, J A; Peer, P G; Straatman, H; Verbeek, A L; Mravunac, M; Hendriks, J H; Holland, R
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. PMID:22641210
Downing, James R; Wilson, Richard K; Zhang, Jinghui; Mardis, Elaine R; Pui, Ching-Hon; Ding, Li; Ley, Timothy J; Evans, William E
The selection of a rear projection screen for a learning carrel should take into account the viewing angle involved. In some carrels, the viewer can be seated in front of the screen (i.e., on the normal axis) since the screen is used primarily to present information. In these cases, where the screen will be viewed only from a restricted range, a…
Smith, Edgar A.
Colorectal cancer is a leading cause of cancer death throughout the world. There is evidence that screening of average-risk individuals can result in mortality reduction with early cancer detection and cancer prevention by detection and removal of cancer precursor lesions. The optimal form of screening is not clear. Fecal screening tests can be performed at home at low initial cost, but current versions lack high sensitivity for cancer precursor lesions, and tests need to be repeated at regular intervals. Adherence to repeat testing for negative tests and referral for colonoscopy for positive tests are important elements of program effectiveness. Structural examinations of the colon are more invasive and may result in detection of both early cancer and cancer precursor lesions. Every screening program has advantages and limitations, but each program ultimately depends on quality and patient adherence. PMID:20167216
The National Lung Screening Trial (NLST) has sparked new interest in the adoption of lung cancer screening using low-dose computed tomography (LDCT). If adopted at a national level, LDCT screening may prevent approximately 18,000 lung cancer deaths per year, potentially constituting a high-value public health intervention. Before incorporating LDCT screening into practice, health care institutions need to consider the risks associated with LDCT screening and the impact of LDCT screening on health care costs, as well as other remaining areas of uncertainty, including the unknown cost-effectiveness of LDCT screening. This article will review the benefits and risks of LDCT screening in light of the results of the NLST and other randomized trials, it will discuss the additional health care costs associated with LDCT screening from the perspective of health care payers, and it will examine the published cost-effectiveness analyses of LDCT screening. A subsequent discussion highlights guideline recommendations for implementation strategies, the goals of which are to ensure that those eligible for LDCT screening derive the benefits while minimizing the risks of screening and avoiding an unnecessary escalation in screening-related costs. The article concludes by endorsing the use of LDCT screening in institutions capable of responsible implementation of screening in both medical and economic terms. The key elements of responsible implementation include the development of standardized screening practices, careful selection of screening candidates, and the creation of prospective registries that will mitigate current areas of uncertainty regarding LDCT screening. PMID:23873718
Ramsey, Scott D.
The characteristics of the rear-projection screen are examined in detail. Numerical constants are provided that define these characteristics for practical screens and convert foot-candles to footlamberts. A procedure is given by which an optimum screen may be specified for a specific application. Contents include--(1) introduction, (2) projection…
The Bureau of Reclamation proposes to construct and operate a fish screen at the inlet of the A Canal, a feature of the Klamath Project, from Upper Klamath Lake. The fish screen project would include construction of trash rack structure, a fish screen, a ...
Evidence of a mortality benefit continues to elude ovarian cancer (OC) screening. Data from the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial which used a screening strategy incorporating CA125 cut-off and transvaginal ultrasound has not shown mortality benefit. The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is using the Risk of Ovarian Cancer (ROC) time series algorithm to interpret CA125, which has shown an encouraging sensitivity and specificity however the mortality data will only be available in 2015. The article explores the impact of growing insights into disease aetiology and evolution and biomarker discovery on future screening strategies. A better understanding of the target lesion, improved design of biomarker discovery studies, a focus on detecting low volume disease using cancer specific markers, novel biospecimens such as cervical cytology and targeted imaging and use of time series algorithms for interpreting markers profile suggests that a new era in screening is underway. PMID:24316306
Menon, Usha; Griffin, Michelle; Gentry-Maharaj, Aleksandra
Lung cancer is the leading cause of cancer related death throughout the world. Lung cancer is an example of a disease for which a large percentage of the high-risk population can be easily identified via a smoking history. This has led to the investigation of lung cancer screening with low-dose helical/multi-detector CT. Evidences suggest that early detection of lung cancer allow more timely therapeutic intervention and thus a more favorable prognosis for the patient. The positive relationship of lesion size to likelihood of malignancy has been demonstrated previously, at least 99% of all nodules 4 mm or smaller are benign, while noncalcified nodules larger than 8 mm diameter bear a substantial risk of malignancy. In the recent years, the availability of high-performance gradient systems, in conjunction with phased-array receiver coils and optimized imaging sequences, has made MR imaging of the lung feasible. It can now be assumed a threshold size of 3-4 mm for detection of lung nodules with MRI under the optimal conditions of successful breath-holds with reliable gating or triggering. In these conditions, 90% of all 3-mm nodules can be correctly diagnosed and that nodules 5 mm and larger are detected with 100% sensitivity. Parallel imaging can significantly shorten the imaging acquisition time by utilizing the diversity of sensitivity profile of individual coil elements in multi-channel radiofrequency receive coil arrays or transmit/receive coil arrays to reduce the number of phase encoding steps required in imaging procedure. Compressed sensing technique accelerates imaging acquisition from dramatically undersampled data set by exploiting the sparsity of the images in an appropriate transform domain. With the combined imaging algorithm of parallel imaging and compressed sensing and advanced 32-channel or 64-channel RF hardware, overall imaging acceleration of 20 folds or higher can then be expected, ultimately achieve free-breathing and no ECG gating acquisitions in lung cancer MRI screening. Further development of protocols, more clinical trials and the use of advanced analysis tools will further evaluate the real significance of lung MRI.
Lo, Gladys G.; Yuan, Jing; Larson, Peder E. Z.
Lung cancer is the leading cause of cancer related death throughout the world. Lung cancer is an example of a disease for which a large percentage of the high-risk population can be easily identified via a smoking history. This has led to the investigation of lung cancer screening with low-dose helical/multi-detector CT. Evidences suggest that early detection of lung cancer allow more timely therapeutic intervention and thus a more favorable prognosis for the patient. The positive relationship of lesion size to likelihood of malignancy has been demonstrated previously, at least 99% of all nodules 4 mm or smaller are benign, while noncalcified nodules larger than 8 mm diameter bear a substantial risk of malignancy. In the recent years, the availability of high-performance gradient systems, in conjunction with phased-array receiver coils and optimized imaging sequences, has made MR imaging of the lung feasible. It can now be assumed a threshold size of 3-4 mm for detection of lung nodules with MRI under the optimal conditions of successful breath-holds with reliable gating or triggering. In these conditions, 90% of all 3-mm nodules can be correctly diagnosed and that nodules 5 mm and larger are detected with 100% sensitivity. Parallel imaging can significantly shorten the imaging acquisition time by utilizing the diversity of sensitivity profile of individual coil elements in multi-channel radiofrequency receive coil arrays or transmit/receive coil arrays to reduce the number of phase encoding steps required in imaging procedure. Compressed sensing technique accelerates imaging acquisition from dramatically undersampled data set by exploiting the sparsity of the images in an appropriate transform domain. With the combined imaging algorithm of parallel imaging and compressed sensing and advanced 32-channel or 64-channel RF hardware, overall imaging acceleration of 20 folds or higher can then be expected, ultimately achieve free-breathing and no ECG gating acquisitions in lung cancer MRI screening. Further development of protocols, more clinical trials and the use of advanced analysis tools will further evaluate the real significance of lung MRI. PMID:25276380
Wang, Yi-Xiang J; Lo, Gladys G; Yuan, Jing; Larson, Peder E Z; Zhang, Xiaoliang
December 2010 Overview: ICCB-L/NSRB Screening Facility User Agreement for Small Molecule Screening Projects There are two different ICCB-L/NSRB User Agreements, one for small molecule screeners and one for RNAi screeners. Small molecule user agreements apply only to small molecule screening projects and data
Some of the biggest barriers to increase colorectal cancer screening are negative attitudes to screening tests. These negative attitudes might be evoked through reading cancer prevention information and impede the decision to get screened. Forty-two adults aged ?50 years completed a 12-item attitude questionnaire after reading colorectal cancer prevention information. African-Americans perceived that others had higher cancer risk than themselves whereas Caucasians did not show the difference. Regardless of ethnicity and adherence to screening guidelines, no participants had strong feelings of fear and embarrassment. However, non-adherent Caucasians had higher anxiety than adherent Caucasians. The degree of negativity was not associated with intention to get screened in non-adherent participants. Adequate health literacy of participants may account for flat responses in negative attitudes. Further research in individuals with limited health literacy is recommended. Moreover, additional education about self-relevance of cancer risk is considered necessary to increase cancer awareness in African-Americans. PMID:21360028
Liu, Chiung-Ju; Fleck, Tara; Goldfarb, Joan; Green, Casey; Porter, Elizabeth
Colorectal and breast cancer represent serious and common public-health problems in the United States. While effective screening tests exist for both types of cancer, Connecticut lacks a consistent source of data about screening rates to guide improvement efforts. Beginning in 2011, the Connecticut Department of Public Health commissioned Qualidigm, the state's Medicare Quality Improvement Organization, to conduct an analysis of the most recent fee-for-service Medicare claims data to determine screening rates for colorectal cancer (2000-2009) and breast cancer (2008-2009). This article highlights key findings of this analysis in order to increase awareness of opportunities for improvement in colorectal and breast cancer screening. The article also offers recommendations about next steps that primary care clinicians can consider to improve cancer screening among their patient populations. PMID:23427366
Van Hoof, Thomas J; Ho, Shih-Yieh; Kelvey-Albert, Michele; Wright, Ches Donette; Meehan, Thomas P
Our previous study found cancer detection rates were equivalent for direct radiography compared to screen-film mammography, while rates for computed radiography were significantly lower. This study compares prognostic features of invasive breast cancers by type of mammography. Approved by the University of Toronto Research Ethics Board, this study identified invasive breast cancers diagnosed among concurrent cohorts of women aged 50-74 screened by direct radiography, computed radiography, or screen-film mammography from January 1, 2008 to December 31, 2009. During the study period, 816,232 mammograms were performed on 668,418 women, and 3,323 invasive breast cancers were diagnosed. Of 2,642 eligible women contacted, 2,041 participated (77.3 %). The final sample size for analysis included 1,405 screen-detected and 418 interval cancers (diagnosed within 24 months of a negative screening mammogram). Polytomous logistic regression was performed to evaluate the association between tumour characteristics and type of mammography, and between tumour characteristics and detection method. Odds ratios (OR) and 95 % confidence intervals (CI) were recorded. Cancers detected by computed radiography compared to screen-film mammography were significantly more likely to be lymph node positive (OR 1.94, 95 %CI 1.01-3.73) and have higher stage (II:I, OR 2.14, 95 %CI 1.11-4.13 and III/IV:I, OR 2.97, 95 %CI 1.02-8.59). Compared to screen-film mammography, significantly more cancers detected by direct radiography (OR 1.64, 95 %CI 1.12-2.38) were lymph node positive. Interval cancers had worse prognostic features compared to screen-detected cancers, irrespective of mammography type. Screening with computed radiography may lead to the detection of cancers with a less favourable stage distribution compared to screen-film mammography that may reflect a delayed diagnosis. Screening programs should re-evaluate their use of computed radiography for breast screening. PMID:25108740
Prummel, Maegan V; Done, Susan J; Muradali, Derek; Majpruz, Vicky; Brown, Patrick; Jiang, Hedy; Shumak, Rene S; Yaffe, Martin J; Holloway, Claire M B; Chiarelli, Anna M
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.
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
EDITORIAL Colon Cancer Screening The Good, the Bad, and the Ugly T HIS YEAR, IT IS ESTIMATED THAT THERE WILL be 55 170 colorectal cancer (CRC)Â related deaths, making it the second lead- ing cause of cancer nature of CRC, only about one third of patients are diagnosed as having the cancer at the localized stage
Ottino, Julio M.
Background: The optimum management of esophageal cancers with synchronous second pri- mary cancer (SPC) has not been determined. The aim of this study was to evaluate the efficacy of intense screening and treatment for esophageal cancers with synchronous SPC. Methods: Between 1981 and 1997, 1479 patients with esophageal cancers were screened for synchronous SPC during the process of initial staging.
Kenji Kagei; Masao Hosokawa; Hiroki Shirato; Takaya Kusumi; Yuichi Shimizu; Akihito Watanabe; Michihiro Ueda
Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical cancer development and its precursors is the human papillomavirus (HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methods for cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals. PMID:25302174
McGraw, Shaniqua L; Ferrante, Jeanne M
The scope of this article is to describe persons with disabilities (PwD) being subjected to cancer screening and the relationship between some social variables and inequalities in performing these tests. A cross-sectional study of cancer screening among PwD was conducted in 2007 with 333 participants interviewed in residence in 4 cities of São Paulo. Variables in the practice of cancer screening, disabilities, gender, age, income of main family breadwinner, ethnicity, use of health services, assistance required, private health insurance, and coverage by the family health program were studied. Frequencies, ?²-test, trend ?² percentages and the Odds Ratios (OR) were used for data analysis. 44% of PwD attended at least one cancer screening at the appropriate time. Persons with visual disabilities and with hearing disabilities were subjected to more screening examinations than those with mobility disabilities and women were attended in screening exams more than men. Persons between the ages of 21 and 60 reported cancer screening more frequently than those between 80 and 97 years of age. The outcomes indicate that PwD have different attitudes toward cancer screening according to the type of disability, gender, and age, which were the variables that directly influenced cancer screening exams. PMID:24263886
de Castro, Shamyr Sulyvan; Cieza, Alarcos; Cesar, Chester Luiz Galvão
Cervical cancer is the third most common cause of cancer in women in the world. During the past few decades tremendous strides have been made toward decreasing the incidence and mortality of cervical cancer with the implementation of various prevention and screening strategies. The causative agent linked to cervical cancer development and its precursors is the human papillomavirus (HPV). Prevention and screening measures for cervical cancer are paramount because the ability to identify and treat the illness at its premature stage often disrupts the process of neoplasia. Cervical carcinogenesis can be the result of infections from multiple high-risk HPV types that act synergistically. This imposes a level of complexity to identifying and vaccinating against the actual causative agent. Additionally, most HPV infections spontaneously clear. Therefore, screening strategies should optimally weigh the benefits and risks of screening to avoid the discovery and needless treatment of transient HPV infections. This article provides an update of the preventative and screening methods for cervical cancer, mainly HPV vaccination, screening with Pap smear cytology, and HPV testing. It also provides a discussion of the newest United States 2012 guidelines for cervical cancer screening, which changed the age to begin and end screening and lengthened the screening intervals. PMID:25302174
McGraw, Shaniqua L; Ferrante, Jeanne M
Cervical Cancer Detection Using SVM Based Feature Screening Jiayong Zhang and Yanxi Liu the proposed method to a bottom-up approach for automatic cervical cancer detection in multispectral cervical screening extract morphometric/photometric features at the cellular level in accordance
Background: Understanding how "health issues" are socially constructed may be useful for creating culturally relevant programs for Hispanic/Latino populations. Purpose: We explored the constructed meanings of cervical cancer and cervical cancer screening among Panamanian women, as well as socio-cultural factors that deter or encourage screening…
Calvo, Arlene; Brown, Kelli McCormack; McDermott, Robert J.; Bryant, Carol A.; Coreil, Jeanine; Loseke, Donileen
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.
Dr. Dorothy Lane, of Stony Brook University, investigated whether a telephone counseling intervention aimed at women who are known to underuse breast cancer screening can with, or without, an accompanying educational intervention for their physicians, increase use of breast cancer screening.
Used social marketing to identify factors influencing women's breast cancer screening behaviors. Data from focus groups and interviews with diverse women highlighted women's attitudes, knowledge, and barriers regarding screening. Results were used to develop a comprehensive social marketing plan to motivate irregular users of breast cancer…
Bryant, Carol A.; Forthofer, Melinda S.; McCormack Brown, Kelli; Alfonso, Moya Lynn; Quinn, Gwen
Colorectal cancer is a major public health challenge worldwide. In Europe it is the first malignancy in terms of incidence and the second in terms of mortality in both genders. Despite evidence indicating that removal of premalignant and early-stage cancer lesion scan greatly reduce mortality, remarkable differences are still found among countries both in terms of organized screening programs and of the tests used. In 2003 the European Council recommended that priority be given to activation of organized cancer screening programs, and various states have been making significant efforts to adopt effective prevention programs with international quality standards and centralizing screening organization and result evaluation. After a 2008 European Union report on the state of screening program, activation highlighted that little more than 50% (12/22) of Member States had colorectal cancer screening programs, Screening programs have been adopted or earlier pilot projects have been extended nationwide. This paper examines the state of activation and the screening strategies of colorectal cancer screening programs in EU States as of July 2013. PMID:24530610
Altobelli, E; Lattanzi, A; Paduano, R; Varassi, G; di Orio, F
BACKGROUND/AIMS—The characteristics of pepsinogen screening for gastric cancer were investigated to establish a suitable cut off point for identifying gastric cancer, using endoscopic diagnosis as the yardstick. ?SUBJECTS/METHODS—Serum pepsinogen concentrations were measured in 5113 subjects who were also screened for gastric cancer by endoscopy. The cut off point for pepsinogen was determined using receiver operator characteristics curves. ?RESULTS—The most suitable cut off point was a pepsinogen I concentration of less than 70 ng/ml and a ratio of pepsinogen I to pepsinogen II of less than 3.0. Using this cut off point, the sensitivity and specificity of pepsinogen screening for gastric cancer were 84.6% and 73.5% respectively. All cases of gastric cancer in patients with severe atrophic gastritis were detected. However, two of four cases of gastric cancer in patients with mild atrophic gastritis were overlooked. In subjects with mild atrophic gastritis, when gastric cancer arises within the fundic gland region, the size of the lesion determines whether it is possible to detect cancer by serum pepsinogen screening. ?CONCLUSION—Pepsinogen screening has many advantages, including its suitability for combination with other screening methods because it is simple and inexpensive. ?? Keywords: pepsinogen; gastric cancer; screening; cut off point; receiver operator characteristics curves; atrophic gastritis PMID:10205207
Kitahara, F; Kobayashi, K; Sato, T; Kojima, Y; Araki, T; Fujino, M
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…
Audet, Carolyn M.; Matos, Carla Silva; Blevins, Meridith; Cardoso, Aventina; Moon, Troy D.; Sidat, Mohsin
BACKGROUND: Cancer screening 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
Tracey H Sach; David K Whynes
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 screen cancer drugs that prevent cancer metastasis.
Cervical cancer may be prevented by human papillomavirus (HPV) vaccination and the treatment of intraepithelial lesions diagnosed using cervical pap smears. HPV vaccines are effective for the prevention of CIN2/3 related to HPV 16, 18 and some other oncogenic HPV subtypes in HPV-naïve women. They are very well tolerated and to date, no increase in the incidence of auto-immune diseases has been reported. HPV vaccines primarily target girls aged 11-14 years old and catch-up programs include girls aged 15-19 years old. Vaccination coverage is below 40% in France, which is insufficient to induce herd immunity. Screening via pap smears is performed every three years in women between 25 and 65 years old, after two normal annual smears. However, screening is an individualised decision and is only performed in 57% of women. Abnormal smears require subsequent diagnostic investigations. Apart from high grade intra-epithelial lesions which generally require treatment, these abnormalities may be observed as they often undergo spontaneous regression due to viral clearance. PMID:25090760
Rakotomahenina, Hajanirina; Garrigue, Isabelle; Marty, Marion; Brun, Jean-Luc
In Europe, colorectal cancer is the most common newly diagnosed cancer and the second most common cause of cancer deaths, accounting for approximately 436,000 incident cases and 212,000 deaths in 2008. The potential of high-quality screening to improve control of the disease has been recognized by the Council of the European Union who issued a recommendation on cancer screening in 2003. Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancer screening and diagnosis have recently been developed by experts in a pan-European project coordinated by the International Agency for Research on Cancer. The full guideline document consists of ten chapters and an extensive evidence base. The content of the chapter dealing with pathology in colorectal cancer screening and diagnosis is presented here in order to promote international discussion and collaboration leading to improvements in colorectal cancer screening and diagnosis by making the principles and standards recommended in the new EU Guidelines known to a wider scientific community. PMID:21061133
Quirke, Phil; Risio, Mauro; Lambert, Rene; von Karsa, Lawrence
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 cancer screening. 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.
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
A survey was conducted with 409 Hispanic and 138 Anglo women in Tucson, Arizona, to assess their knowledge of breast cancer and cancer screening tests, their attitudes toward breast cancer and cancer screening, and their use of screening tests. There were few differences between these two groups in use of breast cancer screening tests, with both groups falling well below
Michelle A. Saint-Germain; Alice J. Longman
SVM Based Feature Screening Applied To Hierarchical Cervical Cancer Detection Â£ Jiayong Zhang to cervical cancer detection in multispectral PAP smear images that has been recently proposed by the authors Detection Region Merging Region Detection Cancerous Regions (c) Figure 1: A bottom-up approach to cervical
There have been no consistent breast cancer screening guidelines for women 65 years of age and older. Given that 15% of the population will soon be 65 years of age or older and given that breast cancer incidence rises dramatically with age, clear recommendations are needed. The most important issues are the following: is mammography effective in finding breast cancer
Mary E. Costanza
Researchers at the NCI have developed a new method to identify genes that keep cancer cells active and that could be potential targets of anticancer therapies. The method uses RNA interference, a technology for silencing genes, to screen cancer cells for genes that, when silenced, cause cancer cells to die or stop dividing.
Our primary objective was to assess the screening preferences of patients at familial risk of colorectal cancer. Asymptomatic subjects aged 18-75 with a single first-degree relative diagnosed with colorectal cancer (n = 48) or polyps (n = 52) were asked to identify a preferred screening strategy, test features influencing their choice, and level of interest in decision-making after reviewing a decision aid describing the pros and cons of currently recommended screening tests. Although both groups preferred colonoscopy, 40% of subjects with a family history of colorectal cancer and 48% of those with a family history of polyps preferred alternative strategies. Accuracy was the most commonly identified test feature influencing test preference. Most subjects (66%) felt that selection of screening test should be a patient dominant or shared process. We conclude that patients at familial risk of colorectal cancer have distinct screening preferences that often vary from current recommendations. PMID:17404844
Schroy Iii, Paul C; Glick, Julie T; Robinson, Patricia A; Heeren, Timothy
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
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 cancer screening 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 cancer screening 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
Rustagi, Alison S.; Kamineni, Aruna; Weiss, Noel S.
Objective We aim to examine whether distrust of health care system (hereafter distrust) is associated with prostate cancer screening and whether different dimensions of distrust demonstrate similar relationships with prostate cancer screening. Method With data on 1,784 men aged 45–75 from the Philadelphia metropolitan area, we first applied factor analysis to generate factor scores capturing two distrust sub-scales: competence and values. We then implemented logistic regressions to estimate the relationships between distrust and prostate cancer screening, controlling for covariates related to demographics (e.g., race and age), socioeconomic status (e.g., poverty status and education), health care resources (e.g., insurance status), and health status (i.e., self-rated health). Results Without considering any other covariates, both competence and values distrust were negatively associated to the receipt of prostate cancer screening. After accounting for other covariates shown above, values distrust remained negatively associated with the odds of receiving prostate cancer screening (OR=0.89, 95% CI=[0.81, 0.98]) but competence distrust was not a significant predictor. Conclusions Values distrust was independently associated with prostate cancer screening. Macro-level change in the health care system may influence men’s health behaviors. Our findings suggested that efforts to make the health care system more transparent and enhanced communications between men and health providers may facilitate prostate cancer screening. PMID:23775208
Yang, Tse-Chuan; Matthews, Stephen A.; Anderson, Roger T.
Breast cancer is the most common cancer in Pacific Islander women, yet relatively little is known about their cancer risks and screening behaviors. Chamorros are indigenous people from Guam, and California is home to the largest numbers of Chamorros on the mainland United States. This study examined the breast cancer risk, knowledge, and screening behaviors in a nonprobability sample of Chamorro women age 40 years and older in Los Angeles and Orange Counties (n = 227). The proportional incidence ratio for breast cancer among Chamorro women was found to be 0.7 compared with white women in California, indicating a lower current breast cancer risk for Chamorro women compared with white women. Thirty-seven percent of respondents ever performed a breast self-examination (BSE), 93% ever had a clinical breast examination (CBE), and 77% ever had a mammogram. In terms of screening maintenance, only 27% did BSE monthly, 66% received a CBE in the past year, and 25% received yearly mammograms. Significant correlates of CBE were higher educational attainment, married status, higher income, and health insurance coverage. Women who knew of breast cancer symptoms, would undergo treatment, and would like to know if they had breast cancer were also more likely to have ever had a CBE. With regard to mammography, older age, moderate income, married status, and use of traditional healers and healing practices were associated with higher screening incidence. Implications of these findings for developing culturally tailored and appropriate cancer screening programs are discussed. PMID:11445047
Tanjasiri, S P; Sablan-Santos, L
Since prostate cancer reaches the advanced and non curable stage in the absence of any specific symptom or sign, it seems reasonable to diagnose this cancer at an early and curable stage. Screening by prostate-specific antigen (PSA) has been the common technology used. The last follow-up of the first two prospective and randomized screening studies for prostate cancer, namely the Quebec and ERSPC (European Randomized Study of Screening for Prostate Cancer) clinical trials started in 1988 and 1991, respectively, have shown reductions of prostate cancer death of 62% (P<0.002) and 21% (P<0.001) (38% in the tenth and eleventh years of follow-up, P<0.003), respectively, while the PLCO (Prostate Lung Colorectal and Ovarian Cancer) screening trial reported no benefit. It has been estimated, however, that 85% of men in the planned ‘non-screened' group of the US study have been screened. With such a serious flaw, the PLCO study does not have the statistical power to reach any valid conclusion. In the Quebec study, only 7.3% of men were screened in the control arm. The important benefit observed in the ERSPC study was achieved using a less than optimal 4-year PSA screening interval which misses a significant number of cancers while the Quebec study used the optimal 1-year interval. With proper information obtained from their physicians or otherwise using data collected only from the clinical trials having the required statistical power, men should be in a good position to decide about being or not being screened for prostate cancer. PMID:23770941
Background The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancer screening 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 cancer screening. 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 cancer screening. 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 cancer screening. 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 cancer screening. Community organizations may play a role in assisting Chinese American women, which could enhance cervical cancer screening rates. PMID:23843708
Ma, Grace X; Wang, Min Qi; Ma, Xiang S; Shive, Steven E; Tan, Yin; Toubbeh, Jamil I
Breast cancer screening 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 cancer screening, there is increasing awareness of subpopulations of women for whom mammography has reduced sensitivity. Mammography has also 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 cancer screening have been developed, including; low dose mammography; contrast enhanced mammography, tomosynthesis, automated whole breast ultrasound, molecular imaging and MRI. 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 cancer screening 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
Cancer screening programs aim at reducing the tumor-related morbidity and mortality by early detection of malignant tumors or precancerous lesions. The basic ethical dilemma in cancer screening is, however, that many people have to be exposed to the burdens and risks of the intervention for a few people to benefit from early cancer diagnosis. This article discusses under which conditions it is ethically acceptable to offer or even recommend cancer screening. First, the benefit of the program in terms of a reduced cancer-related mortality should be proven by randomized controlled trials. The risks and burdens of the program related to the side effects of the investigation itself, false-positive findings, as well as overdiagnoses and overtherapy should be in an acceptable relationship to the expected benefit of the program. In addition to a solid empirical scientific basis, the benefit-harm evaluation necessarily involves value judgments. The potential participants in the screening program therefore should receive transparent, objective, unbiased, and understandable information to enable them to make a truly informed choice about participation. Given the complex benefit-risk assessment, it is discussed whether-and if so under which circumstances-it is ethically acceptable to make a recommendation for or against participation in a cancer screening program. Socioempirical research, such as focus group studies and public deliberations, can be used to elicit the preferences and value judgments of members of the target population that should be taken into consideration in recommendations about a cancer screening program. PMID:24562708
Marckmann, G; In der Schmitten, J
Breast cancer screening 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 cancer screening, 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 cancer screening 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 cancer screening 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
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.
Deborah M. Winn
Less-developed-region countries (LDCs) are seeing a rapid rise in cancer incidence owing to changing lifestyles, infections, environmental carcinogens and increasing longevity. LDCs have poor resources to deal with cancers, leading to high mortality rates. Investment in nationally implementable and sustainable cancer prevention and screening strategies would be more appropriate for LDCs. This Science and Society article outlines the burden of preventable cancers in selected LDCs and discusses evidence on cost-effective and widely implementable prevention and screening strategies. PMID:25355377
Shastri, Aditi; Shastri, Surendra Srinivas
With respect to steady increasing incidence of malignant tumors in Czechoslovakia the oncological program was established with the aim to achieve a gradual dispensarization of all population. The main part of the program is the secondary prevention through oncological examinations to find out early stages of tumors or precancerous lesions. The experimental examinations started in four districts and during two years 111,783 inhabitants from selected groups passed the screening. The examinations were also aimed on hypertension and diabetes. The first results revealed 0.2% new malignancies and 24% preneoplastic lesions. As far as hypertension and diabetes concerns there were 6,204 new cases of hypertension and 2,616 of diabetes. The examinations were supported by centers of clinical oncology created 3 years ago in all district and county hospitals. The task of the centers is not only the early diagnosis of all malignancies but also the application of a suitable therapy. For early diagnosis of some tumors there were established special committees which closely cooperate with the center. These are specially the committees for breast cancer and in some hospitals committees for malignant melanoma. The examinations will be gradually extended to other countries in CSR and in spite of many problems which remain to be solved we hope that all these arrangements will help in the fight against malignant tumors. PMID:7224805
The burden of cervical cancer remains greater among minority women. The purpose of this study was to evaluate racial/ethnic disparities in cervical cancer screening among minority women in Michigan. Data from 8,023 women (? 40 years) surveyed in the 2004-2008 Michigan Special Cancer Behavioral Risk Factor Survey were used to assess racial/ethnic differences in cervical cancer screening, knowledge and beliefs. Unexpectedly, African-American and Hispanic women reported being screened for cervical cancer at rates similar to, or higher than, Whites. Women demonstrated limited knowledge of cervical cancer risk factors and its signs/symptoms. Most minority women were more likely than Whites to believe in the importance of cervical screening, with Hispanic women more likely to support HPV vaccination. Differential utilisation of screening does not explain the disproportionately high rates of cervical cancer among minorities. Future research should examine disparities in the follow-up of abnormal cervical results and receipt of treatment. PMID:23919863
Pierce Campbell, C M; Darwish-Yassine, M; Harlow, S D; Johnston, C M; Curado, M P; Cho, K R; Soliman, A S
ICSN Biennial Meeting 2008 Helsingør, Denmark Attendance Rate (2003-2005) of the Hungarian Organized, Nation-Wide Cervical Cancer Screening Program Authors: I Boncz, A Sebestyén Affiliation: Department of Health Economics, Policy & Management, University
ICSN Biennial Meeting 2008 Helsingør, Denmark Quality Indicators of Colorectal Cancer Screening Programme in Catalonia (Spain) Authors: M Peris, G Binefa, M Navarro, M Garcia, JA Espinàs, JM Borràs Affiliation: Catalan Institute of Oncology
Cancer screening is widely practiced and participation is promoted by various social, technical, and commercial drivers, but there are growing concerns about the emerging harms, risks, and costs of cancer screening. Deliberative democracy methods engage citizens in dialogue on substantial and complex problems: especially when evidence and values are important and people need time to understand and consider the relevant issues. Information derived from such deliberations can provide important guidance to cancer screening policies: citizens' values are made explicit, revealing what really matters to people and why. Policy makers can see what informed, rather than uninformed, citizens would decide on the provision of services and information on cancer screening. Caveats can be elicited to guide changes to existing policies and practices. Policies that take account of citizens' opinions through a deliberative democracy process can be considered more legitimate, justifiable, and feasible than those that don't. PMID:23378639
Rychetnik, Lucie; Carter, Stacy M; Abelson, Julia; Thornton, Hazel; Barratt, Alexandra; Entwistle, Vikki A; Mackenzie, Geraldine; Salkeld, Glenn; Glasziou, Paul
The use of computed tomography (CT) in lung cancer screening 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.
Background Although 64% of cancer survivors are expected to live at least five years beyond diagnosis, the receipt of cancer screening by this population is unclear. The study objective is to assess the relation between a cancer diagnosis and future cancer screening, 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 cancer screening 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 cancer screening 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 cancer screening 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. PMID:22773714
Schumacher, Jessica R.; Witt, Whitney P.; Palta, Mari; LoConte, Noelle K.; Heidrich, Susan M.; Trentham-Dietz, Amy; Pandhi, Nancy; Smith, Maureen A.
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…
Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah
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 cancer screening, 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. PMID:23459768
DeBarros, Mia; Steele, Scott R.
Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant screening and the appropriate management of lung nodules found at screening. An accurate risk prediction model is more efficient than age and pack years of smoking alone at identifying those who will develop lung cancer and die from the disease. Algorithms are available for assessing people who screen positive to determine who needs additional imaging or invasive investigations. Concerns about low dose computed tomography screening include false positive results, overdiagnosis, radiation exposure, and costs. Further work is needed to define the frequency and duration of screening and to refine risk prediction models so that they can be used to assess the risk of lung cancer in special populations. Another important area is the use of computer vision software tools to facilitate high throughput interpretation of low dose computed tomography images so that costs can be reduced and the consistency of scan interpretation can be improved. Sufficient data are available to support the implementation of screening programs at the population level in stages that can be expanded when found to perform well to improve the outcome of patients with lung cancer. PMID:24865600
Tammemagi, Martin C; Lam, Stephen
# The Author(s) 2011. This article is published with open access at Springerlink.com Abstract Cancer of the cervix is the commonest genital tract malignancy in the female, and it has been ranked second to breast cancer. It has positive association with infection of human papillomavirus. Cervical cancer incidence and mortality have declined substantially in western countries following the introduction of screening programmes. This present study investigated the knowledge, attitude and practice of nurses in Lagos University Teaching Hospital (LUTH) towards cervical cancer screening as they are important health personnel that are suppose to educate women on the need for cervical cancer screening. The study is a descriptive cross-sectional survey
V. Kwashi; O. Awodele; A. A. A. Adeyomoye; D. F. Awodele; V. Kwashi; I. O. Awodele; D. C. Dolapo
Objective. Thisstudy examined reports of perceived risk of ovarian cancer, worry, and screening use in a large sample of women. While screening for asymptomatic women is not generally recommended, in 1994 a consensus conference concluded that women with multiple affected relatives are at high risk for ovarian cancer and should be encouraged to participate in screening. The consensus report also
M. R. Andersen; S. Peacock; J. Nelson; S. Wilson; M. McIntosh; C. Drescher; N. Urban
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 cancer screening. 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. PMID:23984277
Hounsgaard, Lise; Augustussen, Mikaela; M?ller, Helle; Bradley, Stephen K.; M?ller, Suzanne
The incidence of breast cancer in sub-Saharan nations is increasing. There is a worsening scarcity of Human Resource for Health in Uganda in particular and Sub Saharan Africa in general. Resources available for health care are predominantly spent on infectious disease care such as (HIV/AIDS, Tuberculosis and Malaria). These factors and more make the future of breast cancer care including screening in Sub Saharan African grim.Although mass breast cancer screening by mammography has been proved to be efficacious in the developed nations of the world, this has not been replicated in the developing nations because mass screening is not yet possible for the reasons stated. This paper proposes an alternative to mammography mass screening.Breast health programs for the most part are adhoc or non-existent in Uganda. The challenge of mass screening is not only limited to less readily available mammogram machines and trained human resources but also to the fact that the targeted population is of relatively young women in their 30s, implying that screening should commence earlier than it is practiced in nations where breast cancer peaks among women in their 50s. Mammography is not efficacious in young women with dense breast tissue. Ultra sound scans are not only up to 10 fold more available than mammography machines but are half the cost per examination.Although using ultra sound Scan for screening for non-palpable lumps is not up to par with standard breast cancer care mammography. It may be better than nothing, may be beneficial in aiding early cancer diagnosis. This concept is akin to the 'task shifting' advocated by WHO. It is worth investigating use of ultra sound scan for mass screening for breast cancer in resource-limited environments. This is not in any way lowering standards of oncologic diagnosis but filling the otherwise unattended to gap, the unmet need. PMID:20811531
Galukande, M; Kiguli-Malwadde, E
We present a method to determine the speckle properties of front projection screens. Seven different screens are investigated in a backscattering geometry for 808 nm light. The speckle contrast reduction that results from polarization scrambling and reduced temporal coherence is modeled for the case of volume scattering in the screens. For this purpose, the screen's volume scattering path length distributions and depolarization characteristics are determined. This is done via a streak camera setup to measure the temporal broadening of ultrashort 50 fs light pulses scattered in the screens. We show that it is essential to properly select a projection screen with large volume roughness in order to achieve low speckle contrast values for moderate illumination bandwidths. PMID:19252632
Riechert, Falko; Glöckler, Felix; Lemmer, Uli
In the Screening Older Minority Women project, the authors applied a community capacity-enhancement approach to promoting breast and cervical cancer screening among older women of color. Members of informal support networks were recruited for this health promotion intervention to empower Latina and African American women to engage in positive…
Bullock, Karen; McGraw, Sarah A.
Colorectal cancer (CRC) is the third leading cause of cancer death among African Americans. Less than 50% of African Americans have had CRC screening. This study examined the relationships between family support and influence, cultural identity, CRC beliefs, and a screening informed decision among 129 urban African Americans. Family support (p < .01) significantly predicted CRC beliefs and CRC beliefs significantly predicted informed decision (p < .01). Based on study results, practitioners should routinely assess family support and CRC beliefs with African Americans patients. This may improve patient-provider shared decision-making satisfaction and CRC screening adherence among African American patients. PMID:23086216
Brittain, Kelly; Taylor, Jacquelyn Y.; Loveland-Cherry, Carol; Northouse, Laurel; Caldwell, Cleopatra H.
Colorectal cancer (CRC) is the third leading cause of cancer death among African Americans. Less than 50% of African Americans have had CRC screening. This study examined the relationships between family support and influence, cultural identity, CRC beliefs, and a screening informed decision among 129 urban African Americans. Family support (p < .01) significantly predicted CRC beliefs and CRC beliefs significantly predicted informed decision (p < .01). Based on study results, practitioners should routinely assess family support and CRC beliefs with African Americans patients. This may improve patient-provider shared decision-making satisfaction and CRC screening adherence among African American patients. PMID:23086216
Brittain, Kelly; Taylor, Jacquelyn Y; Loveland-Cherry, Carol; Northouse, Laurel; Caldwell, Cleopatra H
and Ovarian (PLCO) cancer screening trial: Findings from theovarian cancer, and some with familial risk history United States Type of TrialOvarian Cancer Screening Test vs. Diagnostic Reference Citation Type of Trial
California Health Benefits Review Program (CHBRP)
Background Despite the existence of different screening methods, the response to cancer screening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancer screening and early diagnosis. Methods A qualitative methodology was used to collect in-depth information from cancer patients. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian) were approached. Twenty semi-structured interviews were conducted. All interviews were audiotaped, transcribed verbatim, and translated into English for thematic content analysis. Results Thematic content analysis yielded four major themes: awareness of cancer screening, perceived benefits of cancer screening, perceived barriers to cancer screening, and cues to action. The majority of respondents had never heard of cancer screening before their diagnosis. Some participants reported hearing about mammogram and Pap smear tests but did not undergo screening due to a lack of belief in personal susceptibility. Those who had negative results from screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constraints were reported as barriers to cancer screening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including the role of mass media in disseminating the message ‘prevention is better than cure’. Conclusions Patients’ narratives revealed some significant issues that were in line with the Health Belief Model which could explain negative health behaviour. The description of the personal experiences of people with cancer could provide many cues to action for those who have never encountered this potentially deadly disease, if incorporated into health promotion activities. PMID:23331785
ObjectiveEarly detection and early treatment are of vital importance to the successful treatment of various cancers. The development of a novel screening method that is as economical and non-invasive as the faecal occult blood test (FOBT) for early detection of colorectal cancer (CRC) is needed. A study was undertaken using canine scent detection to determine whether odour material can become
Hideto Sonoda; Shunji Kohnoe; Tetsuro Yamazato; Yuji Satoh; Gouki Morizono; Kentaro Shikata; Makoto Morita; Akihiro Watanabe; Masaru Morita; Yoshihiro Kakeji; Fumio Inoue; Yoshihiko Maehara
This research aims to support chest computed tomography (CT) medical checkups to decrease the death rate by lung cancer. We have developed a remote cooperative reading system for lung cancer screening over the Internet, a secure transmission function, and a cooperative reading environment. It is called the Network-based Reading System. A telemedicine system involves many issues, such as network costs
Yuichi Fujino; Kaori Fujimura; Shin-ichiro Nomura; Harumi Kawashima; Megumu Tsuchikawa; Toru Matsumoto; Kei-ichi Nagao; Takahiro Uruma; Shinji Yamamoto; Hotaka Takizawa; Chikazumi Kuroda; Tomio Nakayama
The World Health Organization has clearly indentified prevention and early detection as major objectives in the control of the oral cancer burden worldwide. At the present time, screening of oral cancer and its pre-invasive intra-epithelial stages, as well as its early detection, is still largely based on visual examination of the mouth. There is strong available evidence to suggest that
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
P. M. McMahon; G. S. Gazelle
At any given moment, engineering and chemical companies have a host of projects that they are either trying to screen to advance to the next stage of research or select from for implementation. These choices could range ...
Adeyemo, Adekunle M
Distress is a psychological state that is often observed in patients with chronic disease. Many cancers are considered chronic in nature, with patients experiencing long, disease-free states and intervals of metastatic disease. Distress can negatively affect the biopsychosocial balance in cancer survivors and impede their progress along the cancer trajectory. Distress can also affect medical and psychological outcomes and hinder advancement into long-term survivorship. Distress may contribute to disease progression, although despite research findings, health-care providers seldom screen for indications of persistent or unresolved distress. This article discusses research findings related to the prevalence of distress in multiple chronic diseases. Validated instruments used to screen for distress in cancer survivors, such as the Distress Thermometer and symptom checklist from the National Comprehensive Cancer Network, are reviewed. With the availability of brief and concise instruments to screen for distress, providers have the ability to provide holistic and comprehensive care for cancer survivors. The overall financial impact of cancer-related distress is understudied, although similar psychological studies indicate that prevention or elimination of distress is beneficial. Cancer is a lifelong, chronic disease; patients have ongoing needs and varied sources of distress. As the number of cancer survivors exponentially increases, their psychosocial needs will likewise expand. PMID:25032045
Petty, Lorie; Lester, Joanne
International Breast Cancer & Nutrition (IBCN) Project NEED Breast cancer is emerging as a uniquely on molecularly- driven research and to design models that adequately serve the study of breast cancer risk scientists and public health experts is dedicated to research on the primary prevention of breast cancer
Background: Guidelines underline the role of individual preferences in the selection of a screening test, as insufficient evidence is available to recommend one screening test over another. We conducted a study to determine the preferences of individuals and to predict uptake for colorectal cancer (CRC) screening programmes using various screening tests. Methods: A discrete choice experiment (DCE) questionnaire was distributed among naive subjects, yet to be screened, and previously screened subjects, aged 50–75 years. Subjects were asked to choose between scenarios on the basis of faecal occult blood test (FOBT), flexible sigmoidoscopy (FS), total colonoscopy (TC) with various test-specific screening intervals and mortality reductions, and no screening (opt-out). Results: In total, 489 out of 1498 (33%) screening-naïve subjects (52% male; mean age±s.d. 61±7?years) and 545 out of 769 (71%) previously screened subjects (52% male; mean age±s.d. 61±6?years) returned the questionnaire. The type of screening test, screening interval, and risk reduction of CRC-related mortality influenced subjects' preferences (all P<0.05). Screening-naive and previously screened subjects equally preferred 5-yearly FS and 10-yearly TC (P=0.24; P=0.11), but favoured both strategies to annual FOBT screening (all P-values <0.001) if, based on the literature, realistic risk reduction of CRC-related mortality was applied. Screening-naive and previously screened subjects were willing to undergo a 10-yearly TC instead of a 5-yearly FS to obtain an additional risk reduction of CRC-related mortality of 45% (P<0.001). Conclusion: These data provide insight into the extent by which interval and risk reduction of CRC-related mortality affect preferences for CRC screening tests. Assuming realistic test characteristics, subjects in the target population preferred endoscopic screening over FOBT screening, partly, due to the more favourable risk reduction of CRC-related mortality by endoscopy screening. Increasing the knowledge of potential screenees regarding risk reduction by different screening strategies is, therefore, warranted to prevent unrealistic expectations and to optimise informed choice. PMID:20197766
Hol, L; de Bekker-Grob, E W; van Dam, L; Donkers, B; Kuipers, E J; Habbema, J D F; Steyerberg, E W; van Leerdam, M E; Essink-Bot, M L
Background Multiple clinical practice guidelines exist for breast and cervical cancer screening, and differ in aggressiveness with respect to the recommended frequency and target populations for screening. Objectives To determine (1) US primary care physicians’ (PCPs) perceptions of the influence of different clinical practice guidelines; (2) the relationship between the number, aggressiveness, and agreement of influential guidelines and the aggressiveness of physicians’ screening recommendations; and (3) factors associated with guideline perceptions. Research Design and Methods A nationally representative sample of 1212 PCPs was surveyed in 2006–2007. Cross-sectional analyses examined physicians’ perceptions of the influence of different breast and cervical cancer screening guidelines, the relationship of guideline perceptions to screening recommendations in response to hypothetical vignettes, and the predictors of guideline perceptions. Results American Cancer Society and American College of Obstetricians and Gynecologists guidelines were perceived as more influential than other guidelines. Most physicians (62%) valued multiple guidelines, and conflicting and aggressive rather than conservative guideline combinations. The number, aggressiveness, and agreement of influential guidelines were associated with the aggressiveness of screening recommendations (P < 0.01)—which was highest for physicians valuing multiple-aggressive, lowest for physicians valuing multiple-conservative, and intermediate for physicians valuing multiple-conflicting, single, and no guidelines. Obstetrician/gynecologists specialty predicted valuation of aggressive guidelines (P < 0.001). Conclusions PCPs’ perceptions of cancer screening guidelines vary, relate to screening recommendations in logically-consistent ways, and are predicted by specialty and other factors. The number, aggressiveness, and agreement of valued guidelines are associated with screening recommendations, suggesting that guideline multiplicity is an important problem in clinical decision-making. PMID:21206294
Han, Paul K. J.; Klabunde, Carrie N.; Breen, Nancy; Yuan, Gigi; Grauman, Alyssa; Davis, William W.; Taplin, Stephen H.
Metastasis—the spread of cancer from the place where it first started to another place in the body—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 “walk” 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 The benefits of endoscopic testing for colorectal-cancer screening are uncertain. We evaluated the effect of screening with flexible sigmoidoscopy on colorectal-cancer incidence and mortality. Methods From 1993 through 2001, we randomly assigned 154,900 men and women 55 to 74 years of age either to screening with flexible sigmoidoscopy, with a repeat screening at 3 or 5 years, or to usual care. Cases of colorectal cancer and deaths from the disease were ascertained. Results Of the 77,445 participants randomly assigned to screening (intervention group), 83.5% underwent baseline flexible sigmoidoscopy and 54.0% were screened at 3 or 5 years. The incidence of colorectal cancer after a median follow-up of 11.9 years was 11.9 cases per 10,000 person-years in the intervention group (1012 cases), as compared with 15.2 cases per 10,000 person-years in the usual-care group (1287 cases), which represents a 21% reduction (relative risk, 0.79; 95% confidence interval [CI], 0.72 to 0.85; P<0.001). Significant reductions were observed in the incidence of both distal colorectal cancer (479 cases in the intervention group vs. 669 cases in the usual-care group; relative risk, 0.71; 95% CI, 0.64 to 0.80; P<0.001) and proximal colorectal cancer (512 cases vs. 595 cases; relative risk, 0.86; 95% CI, 0.76 to 0.97; P = 0.01). There were 2.9 deaths from colorectal cancer per 10,000 person-years in the intervention group (252 deaths), as compared with 3.9 per 10,000 person-years in the usual-care group (341 deaths), which represents a 26% reduction (relative risk, 0.74; 95% CI, 0.63 to 0.87; P<0.001). Mortality from distal colorectal cancer was reduced by 50% (87 deaths in the intervention group vs. 175 in the usual-care group; relative risk, 0.50; 95% CI, 0.38 to 0.64; P<0.001); mortality from proximal colorectal cancer was unaffected (143 and 147 deaths, respectively; relative risk, 0.97; 95% CI, 0.77 to 1.22; P = 0.81). Conclusions Screening with flexible sigmoidoscopy was associated with a significant decrease in colorectal-cancer incidence (in both the distal and proximal colon) and mortality (distal colon only). (Funded by the National Cancer Institute; PLCO ClinicalTrials.gov number, NCT00002540.) PMID:22612596
Schoen, Robert E.; Pinsky, Paul F.; Weissfeld, Joel L.; Yokochi, Lance A.; Church, Timothy; Laiyemo, Adeyinka O.; Bresalier, Robert; Andriole, Gerald L.; Buys, Saundra S.; Crawford, E. David; Fouad, Mona N.; Isaacs, Claudine; Johnson, Christine C.; Reding, Douglas J.; O'Brien, Barbara; Carrick, Danielle M.; Wright, Patrick; Riley, Thomas L.; Purdue, Mark P.; Izmirlian, Grant; Kramer, Barnett S.; Miller, Anthony B.; Gohagan, John K.; Prorok, Philip C.; Berg, Christine D.
bearing a leukemia- associated mutation. Sarco/endoplasmic reticulum calcium ATPase (SERCA) channels emerged at the intersection of these complementary screens. SERCA inhibition preferentially impairs). Notch receptors regulate many aspects of normal develop- ment and tissue homeostasis (reviewed in Kopan
The incidence of esophageal cancer remains on the rise worldwide and despite aggressive research in the field of gastrointestinal oncology, the survival remains poor. Much remains to be defined in esophageal cancer, including the development of an effective screening tool, identifying a good tumor marker for surveillance purposes, ways to target esophageal cancer stem cells as well as circulating tumor cells, and developing minimally invasive protocols to treat early-stage disease. The goal of this chapter is to highlight some of the recent advances and ongoing research in the field of esophageal cancer.
Gaur, Puja; Kim, Min P.; Dunkin, Brian J.
Background Physician recommendation is one of the strongest, most consistent predictors of colorectal cancer (CRC) screening. Little is known regarding characteristics associated with patient adherence to physician recommendations in community and academic based primary care settings. Methods Data were analyzed from 975 patients, aged 50 and over, recruited from 25 primary care practices in New Jersey. Chi-square and generalized estimate equation (GEE) analyses determined independent correlates of receipt of and adherence to physician recommendation for CRC. Results Patients reported high screening rates for CRC (59%). More than three-quarters of patients reported either screening or having received a screening recommendation (82%). Men (P=.0425), non-smokers (P=.0029), and patients who were highly educated (P=.0311) were more likely to receive a CRC screening recommendation. Patients more likely to adhere to CRC screening recommendations were older adults (P<.0001), non-smokers (P=.0005), those who were more highly educated (P=.0365), Hispanics (P=.0325), and those who were married (P<.0001). Conclusions Community and academic primary care clinicians appropriately recommended screening to high risk patients with familial risk factors. However, they less frequently recommended screening to others (i.e., women and smokers) also likely to benefit. To further increase CRC screening, clinicians must systematically recommend screening to all patients who may benefit. PMID:23136316
Hudson, Shawna V.; Ferrante, Jeanne M.; Ohman-Strickland, Pamela; Hahn, Karissa A.; Shaw, Eric K.; Hemler, Jennifer; Crabtree, Benjamin F.
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. PMID:18412950
Eisinger, Francois; Cals, Laurent; Calazel-Benque, Anne; Blay, Jean-Yves; Coscas, Yvan; Dolbeault, Sylvie; Namer, Moise; Pivot, Xavier; Rixe, Olivier; Serin, Daniel; Roussel, Claire; Morere, Jean-Francois
Using a state cancer registry to recruit young breast cancer survivors and high-risk relatives: protocol of a randomized trial testing the efficacy of a targeted versus a tailored intervention to increase breast cancer screening
Background The Michigan Prevention Research Center, the University of Michigan Schools of Nursing, Public Health, and Medicine, and the Michigan Department of Community Health propose a multidisciplinary academic-clinical practice three-year project to increase breast cancer screening among young breast cancer survivors and their cancer-free female relatives at greatest risk for breast cancer. Methods/design The study has three specific aims: 1) Identify and survey 3,000 young breast cancer survivors (diagnosed at 20–45 years old) regarding their breast cancer screening utilization. 2) Identify and survey survivors’ high-risk relatives regarding their breast cancer screening utilization. 3) Test two versions (Targeted vs. Enhanced Tailored) of an intervention to increase breast cancer screening among survivors and relatives. Following approval by human subjects review boards, 3,000 young breast cancer survivors will be identified through the Michigan Cancer Registry and mailed an invitation letter and a baseline survey. The baseline survey will obtain information on the survivors’: a) current breast cancer screening status and use of genetic counseling; b) perceived barriers and facilitators to screening; c) family health history. Based on the family history information provided by survivors, we will identify up to two high-risk relatives per survivor. Young breast cancer survivors will be mailed consent forms and baseline surveys to distribute to their selected high-risk relatives. Relatives’ baseline survey will obtain information on their: a) current breast cancer screening status and use of genetic counseling; and b) perceived barriers and facilitators to screening. Young breast cancer survivors and high-risk relatives will be randomized as a family unit to receive two versions of an intervention aiming to increase breast cancer screening and use of cancer genetic services. A follow-up survey will be mailed 9 months after the intervention to survivors and high-risk relatives to evaluate the efficacy of each intervention version on: a) use of breast cancer screening and genetic counseling; b) perceived barriers and facilitators to screening; c) self-efficacy in utilizing cancer genetic and screening services; d) family support related to screening; e) knowledge of breast cancer genetics; and f) satisfaction with the intervention. Discussion The study will enhance efforts of the state of Michigan surrounding cancer prevention, control, and public health genomics. Trial registration NCT01612338 PMID:23448100
This article focuses on cancer fatalism as a barrier to reg- ular cancer screening among African American and Hispanic women. The purpose of the study was to identify variables associated with cancer fatalism and to investigate the relationship of cancer fatalism and its cor- relates with adherence to screening for gynecological cancer. Study par- ticipants (83 African American women and
Lucia Dettenborn; Gary Butts; Hayley Thompson
Cost-effectiveness analyses (CEAs) can help to quantify the contribution of the promotion of a screening program to increased participation in screening. The cost-effectiveness (C/E) of screening promotion depends in large part on the endpoints of interest. At the most fundamental level, the C/E of a strategy for promoting screening would focus on the attendance rate, or cost per person screened, and the C/E would be influenced by the costs of promotion, as well as by the size and responsiveness of the target population. In addition, the costs of screening promotion (measured as the cost per additional participant in screening) can be included in a CEA estimate of the screening technology. In this case, depending on the efficacy of the screening test and the costs and influence of the promotion, the C/E of screening may improve or become poorer. In the current study, the authors reviewed the literature on the C/E of cancer screening promotion. The following lessons were learned regarding the C/E of screening and its promotion: 1) high-quality information on the C/E of screening is increasingly available; 2) cost-effective promotion of screening is dependent on cost-effective screening strategies; 3) quality-of-life effects may be important in assessing the overall C/E of screening programs; 4) research efforts aimed at identifying cost-effective approaches to screening promotion are useful but sparse; 5) C/E studies should be better incorporated into well designed effectiveness research efforts; 6) variations in C/E according to intervention characteristics, population characteristics, and context should be evaluated in greater depth; 7) the long-term effects of screening promotion are critical to assessing C/E; 8) the effects of promotion on costs of screening must be better understood; and 9) CEA must be interpreted in light of other information. The authors showed that CEA can be a valuable tool for understanding the merits of health promotion interventions and that CEA is particularly valuable in identifying screening strategies that might be promoted most cost-effectively. PMID:15316909
Andersen, M Robyn; Urban, Nicole; Ramsey, Scott; Briss, Peter A
The purpose of this study was to explore an older Mexican American woman's decision-making process to engage in cervical cancer screening. A qualitative single case study design was used along with a purposive, typical case sampling strategy. The participant, a 52-year-old Mexican American woman, was interviewed using a semi-structured format. Qualitative content analysis was used to analyze the data. The analytic process revealed three concepts and motivators that influenced the participant's behavior regarding cervical cancer screening practices: knowledge, family history, and sexual history. As such, these findings are useful for crafting subsequent investigations. Although the study participant's experience is instructive regarding facilitators or motivators for engaging in screening practices, further exploration of barriers faced by older Mexican American women who decline to be screened is warranted. PMID:21210574
Flores, Bertha Penny; Volker, Deborah L
Background Alaska Native people have nearly twice the rate of colorectal cancer (CRC) incidence and mortality as the US White population. Objective Building upon storytelling as a culturally respectful way to share information among Alaska Native people, a 25-minute telenovela-style movie, What's the Big Deal?, was developed to increase CRC screening awareness and knowledge, role-model CRC conversations, and support wellness choices. Design Alaska Native cultural values of family, community, storytelling, and humor were woven into seven, 3–4 minute movie vignettes. Written post-movie viewing evaluations completed by 71.3% of viewers (305/428) were collected at several venues, including the premiere of the movie in the urban city of Anchorage at a local movie theater, seven rural Alaska community movie nights, and five cancer education trainings with Community Health Workers. Paper and pencil evaluations included check box and open-ended questions to learn participants' response to a telenovela-style movie. Results On written-post movie viewing evaluations, viewers reported an increase in CRC knowledge and comfort with talking about recommended CRC screening exams. Notably, 81.6% of respondents (249/305) wrote positive intent to change behavior. Multiple responses included: 65% talking with family and friends about colon screening (162), 24% talking with their provider about colon screening (59), 31% having a colon screening (76), and 44% increasing physical activity (110). Conclusions Written evaluations revealed the telenovela genre to be an innovative way to communicate colorectal cancer health messages with Alaska Native, American Indian, and Caucasian people both in an urban and rural setting to empower conversations and action related to colorectal cancer screening. Telenovela is a promising health communication tool to shift community norms by generating enthusiasm and conversations about the importance of having recommended colorectal cancer screening exams. PMID:23930245
Cueva, Melany; Kuhnley, Regina; Slatton, Jozieta; Dignan, Mark; Underwood, Emily; Landis, Kate
Socioeconomic status is the most significant factor influencing the decreased survival associated with breast cancer in minority groups in the United States. Barriers to the use of early detection programs by low-income women often result in the detection of breast cancer at stages too advanced to assure optimum outcomes. In an effort to increase accessibility of breast cancer screening among such individuals, the Early Detection Program (EDP) was initiated in 1987. The program provided breast cancer screening to women 40 years of age and older who attended eight primary healthcare centers located in low-income neighborhoods throughout Dade County, Florida. From its inception in October 1987 through December 1993, 23,866 medically underserved women had mammography examinations, with more than 17,000 of these women undergoing baseline mammograms. Since the program's inception, 126 cancers were diagnosed in 123 women. A dramatic shift from later to earlier stage breast cancers was observed. These results warrant a greater inclusion of medically underserved and lower socioeconomic status women in screening programs for the early detection of breast cancer. PMID:7858653
McCoy, C B; Smith, S A; Metsch, L R; Anwyl, R S; Correa, R; Bankston, L; Zavertnik, J J
System of two optical assemblies for projecting image onto tilted toroidal screen. One projection lens optimized for red and green spectral region; other for blue. Dual-channel approach offers several advantages which include: simplified color filtering, simplified chromatic aberration corrections, less complex polarizing prism arrangement, and increased throughput of blue light energy. Used in conjunction with any source of imagery, designed especially to project images formed by reflection of light from liquid-crystal light valve (LCLV).
Gold, Ronald S.; Hudyma, Russell M.
Introduction Early identification of psychological distress and depression is important to optimise the quality of life in patients with\\u000a advanced non-small cell lung cancer (NSCLC). The prevalence of depression may vary, depending on the time since diagnosis\\u000a of cancer, results of the treatment and the prognosis. The purpose of this study was to compare the efficacy of a self-administered\\u000a screening tool
S. Néron; J. A. Correa; E. Dajczman; G. Kasymjanova; H. Kreisman; D. Small
We are using whole-body positron emission tomography (PET) for cancer screening. A total of 1,105 healthy subjects have undergone PET studies 1,138 times in fifteen months. Emission scans were performed from the pelvis to the maxilla 45 to 60 minutes after intravenous administration of 260 to 370 MBq 2-deoxy-2-[18F]fluoro-D-glucose (FDG). Malignant tumors were detected with PET in nine patients (0.81%): 2 lung cancers, 2 colonic cancers, 1 breast cancer, 1 thyroid cancer, 1 gastric cancer, 1 renal cancer, and 1 lymphoma. Eight of these patients underwent surgery (excepting the lymphoma patient). Lymph node metastasis was not observed in any of the eight cases and surgery was curative. PET scan results were negative in the cases of three prostatic cancers, one bladder cancer, and two colonic mucosal cancers. High FDG accumulations were noticed in benign lesions such as sarcoidosis, chronic thyroiditis, pulmonary tuberculoma, Warthin's tumor of the parotid gland, and chronic sinusitis. In some cases, image artifacts caused by intense myocardial FDG accumulations resulted in incomplete examinations of the lung. Occasionally, high FDG accumulations were observed in the bowel. Our study results suggest the possibility of using whole-body PET for detecting wide varieties of cancers in resectable stages. PMID:8952258
Yasuda, S; Ide, M; Takagi, S; Shohtsu, A
ObjectiveIn the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), ovarian cancer screening with transvaginal ultrasound (TVU) and CA-125 produced a large number of false-positive tests. We examined relationships between histopathologic diagnoses, false-positive test group, and participant and screening test characteristics.
Sarah J. Nyante; Amanda Black; Aimée R. Kreimer; Máire A. Duggan; J. Daniel Carreon; Bruce Kessel; Saundra S. Buys; Lawrence R. Ragard; Karen A. Johnson; Barbara K. Dunn; Lois Lamerato; John M. Commins; Christine D. Berg; Mark E. Sherman
The purpose of this study was to determine if providing men with information about screening for prostate cancer would enable them to assume a more active role in decision making with their family physician, and lower levels of anxiety and decisional conflict. Men were recruited from one family medical clinic in Winnipeg, Manitoba. One hundred men scheduled for a periodic
B. Joyce Davison; Peter Kirk; Lesley F Degner; Thomas H Hassard
This article addresses the role of culture in breast cancer screening behavior among African American, American Indian/Alaskan Native, Asian American/Pacific Islander, and Hispanic/Latina women. It reviews cultural beliefs, attitudes, and knowledge and their relative influence on women's decisions regarding health tests. The article explores how…
Simon, Cassandra E.
Purpose The Korean National Cancer Screening Survey (KNCSS) is a continuous nationwide survey implemented by the National Cancer Center in Korea since 2004. The purpose of the present study was to report trends in cancer screening rates for the five major cancers (stomach, liver, colorectal, breast, and cervix uteri) in Korean men and women. Materials and Methods The study used KNCSS data collected between 2004 and 2010. The survey was conducted on Korean men aged 40-74 years and Korean women aged 30-74 years with no history of cancer diagnosis. The annual percentage change and corresponding 95% confidence intervals were used to examine changes in annual screening rates. Results Screening rates with recommendation increased by 4.4% annually for stomach cancer, 1.5% for liver cancer, 2.8% per year for colorectal cancer, 4.5% for breast cancer, and 1.2% for cervix uteri cancer. The increasing trend in cancer screening rates, with the exception of liver cancer, was significant. Conclusion Cancer screening rates have increased consistently from 2004 to 2010 among Korean men and women. Stomach and breast cancer screening rates in particular have increased markedly. PMID:22022290
Lee, Eun-Ha; Lee, Hoo-Yeon; Choi, Kui Son; Park, Eun-Cheol; Lee, Jin Soo
Background Native Americans are disproportionately affected by cancer morbidity and mortality. This study examined intention to receive cancer screening 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 cancer screening. In multivariate analyses, individuals who planned to receive cancer screening were women, responsible for four or more people, received physical examinations at least yearly and had received prior cancer screening. 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 cancer screening would be more likely to intend to receive cancer screening 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 cancer screening. Future research should evaluate the potential for improving cancer screening rates through interventions that seek to facilitate increased knowledge about cancer screening and access to cancer screening services in the community. PMID:21132524
Guadagnolo, B. Ashleigh; Kanekar, Shalini; Petereit, Daniel G.; Karki, Chitra; Smith, Maureen A.
Colorectal cancer is a paradigm of neoplasms that are amenable to preventative measures, especially screening. Currently, to carry this out, there are various strategies that have proven effective and efficient. In countries that have organized population- level screening programs, the most common strategy is fecal occult blood testing. In recent years, new methods have appeared that could constitute viable alternatives in the near future, among which the detection of changes in fecal DNA is emphasized. In this article, we review the most relevant papers on colorectal cancer screening presented at the annual meeting of the American Gastroenterological Association held in Chicago in May 2014, with special emphasis on the medium and long-term performance of strategies to detect occult blood in feces and the first results obtained with fecal DNA testing. PMID:25294268
Recent guidelines on cancer screening have given not only more screening options but also conflicting recommendations. Thus, patients, with their clinicians’ support, must decide whether to get screened or not, which modality to use, and how often to get screened. Decision aids could potentially lead to better shared decision making regarding screening between the patient and the clinician. We reviewed 73 decision aids on screening for breast, cervical, colorectal, and prostate cancers. The goal of this review was to assess the effectiveness of such decision aids, examine areas in need for more research, and determine how the decision aids can be currently applied in the real world setting. Most studies used sound study design. Significant variation existed in setting, theoretical framework, and measured outcomes. Just over a third of the decision aids included an explicit values clarification. Other than knowledge, little consistency was noted in which patient attributes were measured as outcomes. Few studies actually measured shared decision making. Little information was available on the feasibility and outcomes of integrating decision aids into practice. We discuss the implications for future research, as well as what the clinicians can do now to incorporate decision aids into their practice. PMID:23504675
Jimbo, Masahito; Rana, Gurpreet K.; Hawley, Sarah; Holmes-Rovner, Margaret; Kelly-Blake, Karen; Nease, Donald E.; Ruffin, Mack T.
Aim: Our aim was to assess the prevalence of breast cancer among women who showed up and participated in the breast cancer screening program during October 2007-October 2008 in Tirana, the Albanian capital city. Methods: A breast cancer prevention and treatment campaign was undertaken in Tirana, Albania, in 2007 which included also mammography examination for the early detection of breast cancer. All women residing in Tirana municipality were invited to undergo a mammography examination free of charge. Results: A total number of 5224 women underwent mammography examination during October 2007 – October 2008 time period in Tirana. The highest number of mammography tests were performed in October 2008 (1284 tests), followed by June 2008 with 746 mammography examinations realized. In general, the prevalence of breast cancer positive mammography readings where higher among women older than 60 years, followed by the 51-60 and 41-50 years age-groups. Conclusion: Our findings indicate that, among 5224 examined women during a one-year period, 1.9% had a positive reading in mammography. This is one of the few reports large-scale breast cancer screening in Albania. The increasing of breast cancer rates necessitates implementation of multi-directional programs to prevent, early diagnose and control this condition in Albanian women. PMID:24511273
Kopeci, Aurel; Canaku, Dorina; Muja, Herion; Petrela, Kreshnik; Mone, Iris; Qirjako, Gentiana; Hyska, Jolanda; Preza, Krenar
Background This analysis was conducted to determine whether there is a difference among blacks, Hispanics, and whites in their perception of risks associated with participating in either a biomedical study or a cancer screening. Methods The Tuskegee Legacy Project Questionnaire, which focused on research subject participation, was administered in two different surveys (1999-2000 and 2003) in seven cities. The Cancer Screening Questionnaire was administered in 2003 in three cities. Results The study sample across the three surveys consisted of 1,064 blacks, 781 Hispanics, and 1,598 non-Hispanic whites. Response rates ranged from 44% to 70% by city. Logistic regression analyses, adjusted for age, sex, education, income, and city, revealed that blacks and Hispanics each self-reported that minorities, compared with whites, are more likely to be “taken advantage of” in biomedical studies and much less likely to get a “thorough and careful examination” in a cancer screening (odds ratios ranged from 3.6 to 14.2). Conclusions Blacks and Hispanics perceive equally high levels of risk for participating in cancer screening examinations and for volunteering to become research subjects in biomedical studies. This perception provides a strong message about the need to overtly address this critical health disparities issue. PMID:18813202
Katz, Ralph V.; Wang, Min Qi; Green, B. Lee; Kressin, Nancy R.; Claudio, Cristina; Russell, Stefanie Luise; Sommervil, Christelle
Background Colorectal cancer is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related death in Wisconsin. Incidence and mortality rates for colorectal cancer vary by age, race/ethnicity, geography, and socioeconomic status. From 2010 through 2012, the Wisconsin Comprehensive Cancer Control Program awarded grants to 5 regional health systems for the purpose of planning and implementing events to increase colorectal cancer screening rates in underserved communities. Community Context Grantees were chosen for their ability to engage community partners in reaching underserved groups including African American, Hispanic/Latino, Hmong, rural, and uninsured populations in their service areas. Methods Grantees identified target populations for proposed screening events, designated institutional planning teams, engaged appropriate local partner organizations, and created plans for follow-up. All grantees implemented 1 or more colorectal cancer screening events within 6 months of receiving their awards. Events were conducted in 2 phases. Outcomes Participating health systems organized 36 screening events and distributed 633 individual test kits; 506 kits were returned, of which 57 (9%) tested positive for colorectal abnormalities. Of attendees who received screening, 63% were uninsured or underinsured, 55% had no previous screening, 46% were of a racial/ethnic minority group, 22% had a family history of cancer, and 13% were rural residents. This project strengthened partnerships between health systems and local organizations. Interpretation An effective strategy for improving colorectal cancer screening rates, particularly among underserved populations, is to award health systems grants for implementing community-based screening events in conjunction with community partners. PMID:24262024
Weeth-Feinstein, Lauren; Conlon, Amy; Scott, Sheryl
Objectives The purpose of this study was to evaluate the prevalence of cancer-related behavioral risk factors among female cancer survivors, relative to women without a previous diagnosis of cancer. Methods In a large cohort of 19,948 women presenting for screening mammography, questionnaires on health behaviors were administered. Results 18,510 had detailed history on health behaviors and previous cancer history. Overall 2,713 (14.7%) reported a previous cancer history. We found statistically significant results indicating cancer survivors were less likely than those with no cancer history to: report their overall health as “excellent” (13.6% vs. 21.5%), to engage in moderate or strenuous exercise (56.5% vs. 63.3%), and to use complementary and alternative medicine (CAM) (57.4% vs. 60.2%). Conversely, cancer survivors were more likely to be current smokers (6.3% vs. 5.5%) rate their overall health as “poor” (15.8% vs. 9.1%), and to report more weight gain over time. Among cancer survivors, differences also emerged by type of primary cancer. For example, cervical cancer survivors (n=370) were most likely to report being current smokers (15.7%) and regular alcohol users (71.7%) compared to other survivors. Ovarian (n=185) and uterine (n=262) cancer survivors most frequently reported being obese (41% and 34.4% respectively). Cervical cancer survivors reported the largest weight gain (4.9 lbs at 5 yrs and 13.4 lbs at 10 yrs). Conclusions These results suggest opportunities for tailored behavioral health risk factor interventions for specific populations of cancer survivors. PMID:21293247
Rausch, Sarah M.; Millay, Shannon; Scott, Chris; Pruthi, Sandhya; Clark, Matthew M.; Patten, Christi; Stan, Daniela; Sellers, Thomas; Vachon, Celine
In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s at family planning clinics, various central and district government hospitals, and in private practice. The initial results of a cervical cancer screening program introduced in a district hospital (Salvation Army Howard Hospital) in the Chiweshe rural community in 1994 were investigated. The aim is for every mother to receive a Pap smear at her 6-week postpartum visit. By May 1996, a total of 419 Pap smears--representing less than 20% of the hospital's postnatal population--had been performed at this facility. If all postnatal visits included a Pap smear, there would have been 2500 screenings. 58.7% of smears were classified as inadequate, primarily because of the coexistence of sexually transmitted infections. A total of 173 slides (41.3%) were normal. Of the abnormal smears, 158 (37.7%) had inflammation. Abnormal cytology was reported in 65 cases (15.5%); 15 of these cases (3.6%) were high-grade squamous intraepithelial lesions. Factors contributing to the low number of Pap smears actually performed included a high default rate for the postpartum visit, shortages of test-related supplies, and the rapid turnover of trained staff. Cervical cancer screening efforts in Zimbabwe require physical resources to perform smears, well-trained personnel, transport and laboratory services, and adequate patient follow up and treatment. Finally, since cervical cancer primarily affects older women, young women of reproductive age may not be the most appropriate target population for screening efforts. PMID:9509642
Thistle, P J; Chirenje, Z M
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.
Mammographic screening is associated with a reduced risk of breast cancer recurrence. The objective of the study was to evaluate treatment costs due to breast cancer recurrence in relation to patients’ use of mammographic screening, consecutively collected in a defined population. The study included 418 women exposed to screening and 109 women unexposed to screening diagnosed with stage I–III breast
Lea Kauhava; Pirjo Immonen-Räihä; Ilmo Parvinen; Kaija Holli; Liisa Pylkkänen; Anne Kaljonen; Hans Helenius; Pauliina Kronqvist; Pekka J. Klemi
The development of low-dose spiral computed tomography (CT) has rekindled hope that effective lung cancer screening might yet be found. Screening is justified when there is evidence that it will extend lives at reasonable cost and acceptable levels of risk. A screening test should detect all extant cancers while avoiding unnecessary workups. Thus optimal screening modalities have both high sensitivity
Noah Lee; Andrew F. Laine; Guillermo Márquez; Jeffrey M. Levsky; John K. Gohagan
Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as the evidentiary foundation for an implementation guideline. Poor reporting, lack of precision and consistency in defining operational elements, and insufficient consideration of context and differences among populations are areas for additional research. PMID:21958556
Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancer screening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancer screening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the…
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.
...2010-10-01 2010-10-01 false Prostate cancer screening tests: Conditions for and...Health Services § 410.39 Prostate cancer screening tests: Conditions for and limitations...following definitions apply: (1) Prostate cancer screening tests means any of the...
...2012-10-01 2012-10-01 false Prostate cancer screening tests: Conditions for and...Health Services § 410.39 Prostate cancer screening tests: Conditions for and limitations...following definitions apply: (1) Prostate cancer screening tests means any of the...
OBJECTIVES: The specific aim of this study was to determine the self-reported likelihood of New York Puerto Ricans (NYPR) and San Juan Puerto Ricans (SJPR) to participate in: 10 site-specific cancer screenings, cancer-screenings conducted by different specific persons/agencies and cancer-screening under specific conditions of what one was asked to do as a part of cancer screening. METHODS: The Cancer Screening Questionnaire (CSQ) was administered via random-digit-dial telephone interviews to 154 adults living in San Juan, PR and 155 in New York, NY. RESULTS: Although the self-reported willingness to participate across the 10 site-specific cancer screening exams was consistently high in both cities, SJPR had higher rates, as compared to NYPR for all 10 site-specific cancer screening exams in the unadjusted analyses. A similar pattern was observed regarding the influence of both "who conducts the cancer-screening exam" and "what one is asked to do in a cancer-screening exam" as factors in the willingness to participate in such exams. Adjusted multivariate analysis showed that the odds of SJPR participating in skin cancer screening as compared to NYPR, were three-fold higher to participate in skin cancer screening and were two-fold higher to participate in a cancer screening where they have to be interviewed about their alcohol habits. These two observed differences might reflect the effect of acculturation in the NYPR. PMID:17534012
Claudio, Cristina; Katz, Ralph V.; Green, B. Lee; Kressin, Nancy R.; Wang, Min Qi; Russell, Stefanie L.
Although Pap screening has decreased morbidity and mortality from cervical cancer, reported statistics indicate that among ethnic groups, Hispanic women are one of the least likely to follow screening guidelines. Human papillomavirus (HPV), a major risk factor for cervical cancer, as well as pre-cancerous lesions, may be detected by early Pap screening. With a reported 43% prevalence of HPV infection
Marilyn E Tompkins
cervical cancer screening among underserved Hispanic and African-American women.cervical cancer screening among low-income HIV- positive African American women.cervical cancer screening [26, 237, 258-260]. Datta and colleagues used 1995 survey of African American women
Gatchell, Melissa Sue
Behavior change interventions to promote colorectal cancer (CRC) screening have targeted people in community and primary care settings, health care providers, and health systems. Randomized controlled trials provide the strongest evidence of intervention efficacy. The purpose of this integrative review was to evaluate trials of CRC screening interventions published between 1997 and 2007 and to identify knowledge gaps and future directions for research. Thirty-three randomized trials that met inclusion criteria were evaluated using a modified version of the TREND criteria. Significant intervention effects were reported in 6 of 10 trials focused on increasing fecal occult blood testing, 4 of 7 trials focused on sigmoidoscopy or colonoscopy completion, and 9 of 16 trials focused on completion of any screening test. Several effective interventions to promote CRC screening were identified. Future trials need to use theory to guide interventions, examine moderators and mediators, consistently report results, and use comparable outcome measures. PMID:22261002
Rawl, Susan M; Menon, Usha; Burness, Allison; Breslau, Erica S
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. PMID:19363141
Gao, Ge; Burke, Nancy; Somkin, Carol P.; Pasick, Rena
Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US. PMID:12643332
Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas
Background: Lung cancer (LC) is the leading cause of cancer-related death for veterans cared for by the US Veterans Health Administration. The LC burden among veterans is almost double that of the general population. Before implementation of an LC screening program, we set out to assess the role of beliefs and attitudes toward LC screening among veterans. Methods: Veterans presenting to the Ralph H. Johnson VA Medical Center were invited to complete a self-administered survey. The survey comprised questions about demographics, smoking status, health status, and knowledge about LC and willingness to be screened. Responses from veteran ever and never smokers were compared. Results: A total of 209 veterans completed the survey. Smokers were significantly (P < .05) more likely than never smokers to be less educated, have a lower income, and report poorer health. Smokers were more likely than never smokers to have two or more comorbidities, which trended toward significance (P = .062). Smokers were more likely to have been told by a physician that they were at high risk for LC and to believe that they were at risk. Nearly all veterans surveyed (92.8%) would have a CT scan for LC screening, and 92.4% would have surgery for a screen-detected LC. Conclusions: Veterans are overwhelmingly willing to undergo screening for LC, and it seems that participation will not be a barrier to implementation of an LC screening program. The mortality benefit of LC screening, however, may not be generalizable to the veteran population because of a higher number of comorbid conditions. PMID:23764896
Egede, Leonard E.; Shamblin, Clayton; Gebregziabher, Mulugeta; Silvestri, Gerard A.
There is an excess burden of colorectal cancer (CRC) in the Appalachian region of the U.S., 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 50–75 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.
AIM: To investigate barriers to colorectal cancer (CRC) screening in a community population. METHODS: We conducted a community-based case-control study in an urban Chinese population by questionnaire. Cases were selected from those completing both a fecal occult blood test (FOBT) case and colonoscopy in a CRC screening program in 2004. Control groups were matched by gender, age group and community. Control 1 included those having a positive FOBT but refusing a colonoscopy. Control 2 included those who refused both an FOBT and colonoscopy. RESULTS: The impact of occupation on willingness to attend a colorectal screening program differed by gender. P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2. Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate. Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test. Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid. Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy. CONCLUSION: Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate. PMID:19469005
Cai, Shan-Rong; Zhang, Su-Zhan; Zhu, Hong-Hong; Zheng, Shu
Objectives One of the aims of the Chicago Cancer Navigation Project (CCNP) is to reduce the interval of time between abnormal breast cancer screening 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. PMID:20685001
Markossian, Talar W.; Calhoun, Elizabeth A.
by utilizing the waste heat generated during the cooling cycle. For buildings with high water heating loads (eTech-Specific Assistance Preliminary Screening for Project Feasibility and Applications.g., residences, hotels, laundry facilities), GHPs can provide hot water at essentially no cost during the cooling
Oak Ridge National Laboratory
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)
Lum, Gifford; And Others
BackgroundLung cancer screening may provide a new opportunity for attempts to quit among smokers or might delay smoking cessation, but studies to date failed to provide evidence for this. This study investigated the effect of lung cancer screening on smoking abstinence in male smokers participating in the Dutch–Belgian randomised controlled lung cancer screening trial (NELSON trial).MethodsIn the NELSON trial, 50-
Carlijn Michelle van der Aalst; Karien Anna Margaretha van den Bergh; Marc Christiaan Willemsen; Henricus Johannes de Koning; Robertus Johannes van Klaveren
Colorectal carcinoma is common, but screening for this cancer has found less acceptance with the public than screening for breast, prostate, and cervical cancer. Available methods include fecal occult blood tests (FOBTs), flexible sigmoidoscopy (FOS), double-contrast barium enema, colonoscopy, computed tomographic colography, and fecal DNA. Evaluation of these options demonstrates that colonoscopy at ages 55 and 65 offers the best combination of reduction in colorectal cancer at the lowest cost. However, when compliance with screening recommendations is very high, costs are high, and the proportion of cancers arising from adenomas is low, the combination of FOS and FOBT is most cost effective. Malignant polyps look friable and irregular and feel hard. Sessile malignant polyps need to be treated by formal resection. Patients with pedunculated polyps with favorable histology (clear margin, well or moderately differentiated, no lymphovascular invasion) can be observed, and those whose polyps show unfavorable histology should have the polyp-bearing segment of colon resected along with its draining lymph nodes. PMID:20011297
Church, James M
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The aim of this study was to review published studies that examined factors influencing breast and cervical cancer screening behavior in Hispanic women, using the Health Belief Model (HBM). MEDLINE and PsycINFO databases and manual search were used to identify articles. Cancer screening barriers common among Hispanic women include fear of cancer, fatalistic views on cancer, linguistic barriers, and culturally
LaToya T Austin; Farah Ahmad; Mary-Jane McNally; Donna E Stewart
Background\\/Aims: Early gastric cancer (EGC) can be treated by endoscopic resection, which results in an excellent prognosis. Optimal screening intervals considering risk factors for gastric cancer have not been established. The aim of this study was to determine the maximum gastric cancer screening interval in terms of long-term survival. Methods: Curative resection was performed in 561 patients with gastric cancer
Hyuk Lee; Byung-Hoon Min; Jun Haeng Lee; Hee Jung Son; Jae J. Kim; Jong Chul Rhee; Seonwoo Kim; Poong-Lyul Rhee
Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization\\u000a of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer\\u000a screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to\\u000a cancer screening for
Hee Yun Lee; Suzanne Vang
Modeled Estimates of the Effects of Screening: Results from the CISNET Breast Cancer Consortium International Breast Cancer Scr eening Network Biennial Meeting Kathleen Cronin Statistical Research and Applications Branch National Cancer Institute May
The authors analyzed data from almost 150,000 subjects aged 55-74 years enrolled in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial who completed a self-administered baseline questionnaire (1993-2001) that included items about family history of cancer. Male respondents reported significantly less family history of cancer than females. The relative underreporting by male respondents relative to females was greater for
Paul F. Pinsky; Barnett S. Kramer; Douglas Reding; Saundra Buys
Background Colorectal cancer (CRC) is one of the leading causes of cancer related deaths among residents of rural Appalachia. Rates of guideline-consistent CRC screening in Appalachian Kentucky are suboptimal. Objective This study sought to determine the relationship between colorectal cancer screening knowledge, specifically regarding recommended screening intervals, and receipt of screening among residents of rural Appalachian Kentucky. Methods Residents of Appalachian Kentucky (n=1096) between the ages of 50 and 76 completed a telephone survey including questions on demographics, health history, and knowledge about colorectal cancer screening between November 20, 2009 and April 22, 2010. Results While 67% of respondents indicated receiving screenings according to guidelines, respondents also demonstrated significant knowledge deficiencies about screening recommendations. Nearly half of respondents were unable to identify the recommended screening frequency for any of the colorectal cancer screening modalities. Accuracy about the recommended frequency of screening was positively associated with screening adherence. Conclusions Enhanced educational approaches have the potential to increase colorectal cancer screening adherence in this population and reduce cancer mortality in this underserved region. Implications for practice Nurses play a critical role in patient education, which ultimately may increase screening rates. To fulfill this role, nurses should incorporate current recommendation about CRC screening into educational sessions. Advanced practices nurses in rural settings should also be aware of the increased vulnerability of their patient population and develop strategies to enhance awareness about CRC and the accompanying screening tests. PMID:21946905
Bardach, Shoshana H.; Schoenberg, Nancy E.; Fleming, Steven T.; Hatcher, Jennifer
Health care disparities have been documented in cancer screenings of adults with intellectual and other developmental disabilities. Developmental disabilities nurses were surveyed to better understand and improve this deficiency. Two thirds of respondents believed that adults with intellectual and developmental disabilities received fewer cancer screenings compared with the general population. The most frequently cited barriers to cancer screenings were as follows: patient need for sedation, unsuccessful attempts at screening, and failure of the primary care clinician to order cancer screening tests. Nurses observed that health care providers frequently did not tailor cancer screening recommendations to individuals' family histories, life expectancies, or their disability-specific cancer risks. The authors suggest interventions to improve cancer screening centered around education and training, accessibility, financing-insurance, modification of procedures, and patient tracking. PMID:20722477
Tyler, Carl V; Zyzanski, Stephen J; Panaite, Vanessa; Council, Linda
Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were “bad food,” digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening. PMID:19776255
Goldman, Roberta E.; Diaz, Joseph A.; Kim, Ivone
Distress has been declared the 6th vital sign in Canadian cancer care. Accordingly, health care professionals in Canada are expected to screen for distress in patients with cancer, for which a toolkit has been developed. Identifying patients who may be in need of further resources has the potential to improve quality of care because those patients are more likely to have their existing distress identified and to be referred for appropriate follow-up services. The present article briefly reviews the background literature and the validation of the measures in the toolkit, and highlights future directions for methodologic validation of the toolkit for use according to the protocol. PMID:24764715
Feldstain, A.; Tomei, C.; Bélanger, M.; Lebel, S.
The National Lung Screening Trial (NLST) has provided compelling evidence of the efficacy of lung cancer screening using low-dose helical computed tomography (LDCT) to reduce lung cancer mortality. The NLST randomized 53,454 older current or former heavy smokers to receive LDCT or chest radiography (CXR) for three annual screens. Participants were observed for a median of 6.5 years for outcomes. Vital status was available in more than 95% of participants. LDCT was positive in 24.2% of screens, compared with 6.9% of CXRs; more than 95% of all positive LDCT screens were not associated with lung cancer. LDCT detected more than twice the number of early-stage lung cancers and resulted in a stage shift from advanced to early-stage disease. Complications of LDCT screening were minimal. Lung cancer–specific mortality was reduced by 20% relative to CXR; all-cause mortality was reduced by 6.7%. The major harms of LDCT are radiation exposure, high false-positive rates, and the potential for overdiagnosis. This review discusses the risks and benefits of LDCT screening as well as an approach to LDCT implementation that incorporates systematic screening practice with smoking cessation programs and offers opportunities for better determination of appropriate risk cohorts for screening and for better diagnostic prediction of lung cancer in the setting of screen-detected nodules. The challenges of implementation are considered for screening programs, for primary care clinicians, and across socioeconomic strata. Considerations for future research to complement imaging-based screening to reduce the burden of lung cancer are discussed. PMID:23401434
Aberle, Denise R.; Abtin, Fereidoun; Brown, Kathleen
Following the successful pilot program that ran from 2002-2004, the Australian government has allocated funding to phase in a National Bowel Cancer Screening Program, using an immunochemical FOBT, followed by colonoscopy if indicated. The first phase of the program (2006-2008) will target people turning 55 or 65 years of age between 1 May 2006 and 30 June 2008 and those who participated in the Pilot Program.
SummaryBackground Guidelines for screening women post-breast cancer treatment are generally lacking. This study was conducted to review the literature on guidelines for this population and to evaluate whether there is a common practice in the community for following these women.Methods The literature was reviewed for presence of published or inferred guidelines. Data were then used from the Carolina Mammography Registry (CMR) to
Arun Krishnaraj; Bonnie C. Yankaskas; Sally C. Stearns
Annually 133.000 people world-wide get sick on malign melanoma, tendency increasing. The purpose of this study is the early diagnosis of malignant skin cancer. At the moment the dermatologists are screening for anomalies at the relevant lesion by examining the skin area with a microscope. To determine changes, another scan has to be taken in a follow-up session after a
Thorsten M. Buzug; Steffen Schumann; Lucas Pfaffmann; Uwe Reinhold; Jürgen Ruhlmann
Cosmetic breast enlargement surgery has become common in Japan. There are some reports suggesting that implants can interfere\\u000a with mammography (MMG) and may lead to delayed breast cancer diagnosis, even when implant-displaced MMG (Eklund technique)\\u000a is performed. Screening MMG was recommended in a notification issued by the Japanese Ministry of Health, Labor and Welfare\\u000a in 1999, and MMG is just
The aim of this study was to compare responses to two interventions (personalized- form (PF) letter messages versus personalized-tailored (PT) letter messages) using medical record data for promoting appointment scheduling and screening for breast and cervical cancer among urban low-income women from three ethnic groups: African-American, Mexican-American, and non-Hispanic white women. The 1,574 women participating in the randomized controlled trial
Maria L. Jibaja-Weiss; Robert J. Volk; Quentin W. Smith; J. David Holcomb
The shift from illness to disease has had a profound impact on modern medicine - particularly in the realm of cancer screening. In screening, it is not patients with illness who seek help from the healthcare system; it is asymptomatic healthy individuals who are invited into the healthcare system to be examined for pathology. The underlying assumption of screening is that abnormalities and pathology always progress. If this were true, it would always make sense to look for disease even when people feel well. The million (or more accurately multi-billion) dollar question is whether the fundamental assumption that disease invariably leads to illness is valid. This is the question that the present paper will try to explore and answer. PMID:24862511
Brodersen, John; Schwartz, Lisa M; Woloshin, Steven
8/30/2013 7:53 AM Combined DES/SD Model of Breast Cancer Screening for Older Women, II: Screening-and-Treatment Combined DES/SD Model of Breast Cancer Screening for Older Women, II: Screening-and-Treatment Simulation for screening and treatment of breast cancer in the growing popu- lation of US women who are at least 65 years
INTRODUCTION: Minority women, particularly immigrants, have lower cancer screening rates than Caucasian women, but little else is known about cancer screening among immigrant women. Our objective was to assess breast, cervical, and colorectal cancer screening rates among immigrant women from Cambodia, Somalia, and Vietnam and explore screening barriers. METHODS: We measured screening rates by systematic chart review (N = 100)
Ponnila S Samuel; Jane P Pringle; Nathaniel W James IV; Susan J Fielding; Kathleen M Fairfield
Depression is a frequent problem in advanced cancer patients. However, there is no systematic screening for depression in the majority of cancer center resulting in underdiagnosed depression among cancer patients. The main objective of this study was to assess the level of agreement between self-reported depression by the patient and the physician and nurse assessment using the same tools. One of the secondary objectives was to estimate the possibility of a systematic and repeated (at one month) assessment. We used two scales for depression screening: the Brief Edinburg Depression Scale (BEDS) and the depression item of the Edmonton Symptom Assessment System (ESAS). Twenty-nine patients were included and eight of them (28%) had a BEDS score >6 and benefited from the initiation or modification of their antidepressant treatment. At visit 2, 15 patients were seen again and BEDS score was found ?6 for all of them. A moderate concordance was found between assessment using the BEDS by patient and physician's (?=0.519) and low agreement was found between physician and nurse regardless of the tool used (? from 0.071 to 0.313). Researches with larger cohorts are now needed to confirm the benefits of depression's screening in this frail population and also to assess available strategies. PMID:24556283
Rhondali, Wadih; Chirac, Anne; Celles, Laurent; Filbet, Marilène
STUDY OBJECTIVE--The aim of the study was to evaluate the effectiveness of a centralised population based cervical cytology screening programme. DESIGN--The study was a case-control investigation. SETTING--Cases and controls were confined to the province of Florence. PARTICIPANTS--191 out of 208 cases of cervical cancer in women less than 75 years old at diagnosis in the period 1982-85 were interviewed. For each case three living controls were selected, strictly matched by year of birth and district of residence; in all 573 controls were eventually identified. Of these, 15 had had a hysterectomy (2.6%) and were excluded, and a further 18 (3.2%) did not take part for other reasons, leaving a total of 540 controls. MEASUREMENT AND RESULTS--Screening history was taken from a computerised archive for both cases and controls. A mail questionnaire was used to collect information on several potential confounding variables. For women screened only once in comparison with those never screened, the reduction in risk was about 70% (odds ratio 0.29. 95% confidence limits 0.15-0.55), while the reduction was even greater for those screened twice or more. No trend of increasing risk with increasing interval since last test was shown: considering separately women who had only had one test and those who had had two or more tests, the risk estimates were stable across different time intervals since the last test. CONCLUSIONS--There is a strong protective effect against developing invasive cervical cancer through participation in the screening programme. PMID:2348148
Palli, D; Carli, S; Cecchini, S; Venturini, A; Piazzesi, G; Buiatti, E
Cancer health disparities are a reality for Hmong women who are often diagnosed at a later stage and have low literacy and experienced care that are not culturally appropriate. Lack of attention to cultural appropriateness and literacy levels of cancer screening materials may contribute to disproportionately low levels of cancer screening among Hmong women. The purposes of this study were to evaluate the Hmong Health Awareness Project (HHAP), a program designed to create awareness and acceptance of breast and cervical cancer screening, and to examine participants' perceptions of the utility of the content of the workshops. Hmong researchers partnered with three Midwestern Hmong community centers to implement six workshops. Three teaching techniques: pictographs, videos, and hands-on activities were utilized to teach Hmong participants about cancer screening. Participants included 150 Hmong (male participants?=?30 and female participants?=?120). Teach-back method was used to assess the participants' understanding of cancer screening throughout the workshops. Qualitative data were collected in focus groups to assess the feasibility of teaching methods and participants' perceptions of the utility of the content of the workshops. Directed content analysis was used to analyze participants' responses. The three teaching techniques were helpful in increasing the Hmong people's understanding about breast and cervical cancer screening. Nearly, all participants perceived an increased in their understanding, greater acceptance of cancer screening, and increased willingness to be screened. Men expressed support for screening after the workshops. Findings can guide future interventions to improve health communications and screening and reduce diagnostic disparities among Hmong and immigrant populations. PMID:24488558
Lor, Maichou; Bowers, Barbara
Cancer is a critical disease with a high mortality rate in the US. Although useful information exists on the Internet, many people experience difficulty finding information about cancer prevention because they have limited eHealth literacy. This study aimed to identify relationships between the level of eHealth literacy and cancer information seeking experience or prior experience with cancer screeningtests. A total of 108 adults participated in this study through questionnaires. Data covering demographics, eHealth literacy, cancer information seeking experience, educational needs for cancer information searching, and previous cancer screening tests were obtained. Study findings show that the level of eHealth literacy influences cancer information seeking. Individuals with low eHealth literacy are likely to be less confident about finding cancer information. In addition, people who have a low level of eHealth literacy need more education about seeking information than do those with a higher level of eHealth literacy. However, there is no significant relationship between eHealth literacy and cancer screening tests. More people today are using the Internet for access to information to maintain good health. It is therefore critical to educate those with low eHealth literacy so they can better self-manage their health. PMID:25105588
Park, Hyejin; Moon, Mikyung; Baeg, Jung Hoon
Cancer of stomach is currently regarded as the final result of a staged multifactor process during which the microenvironment affects cells and causes their changes. One of the main triggering factors is Hp infection. Adenocarcinoma of stomach develops via stages of gastritis, precancerous changes, and cancer. The possibility to prevent cancer ensues from the potential irreversibility of premalignant processes in gastric mucosa, in the first place its atrophy; hence, the importance of its early diagnosis. The state of the endoscopic service in this country is inadequate for mass screening of patients with symptoms of dyspepsia. "GastroPanel", a new serological test for the diagnosis of gastric pathology provides information about histological and functional characteristics of gastric mucosa in the antral and fundal regions of the stomach. The method determines serum gastrin-17, pepsinogen-1, and IgG expressed in response to Hp infection. Our results demonstrate high diagnostic efficiency of "GastroPanel" as a screening technique for atrophic gastritis and assessment of stomach cancer risk. PMID:19177794
Maev, I V; Mel'nikova, E V; Kashin, S V; Nadezhin, A S; Kriukova, T V
Breast cancer is the most common type of cancer worldwide. In response, breast cancer screening programs are becoming common around the world and public programs now serve millions of women worldwide. These programs are expensive, requiring many specialized radiologists to examine all images. Nevertheless, there is a lack of trained radiologists in many countries as in Mexico, which is a barrier towards decreasing breast cancer mortality, pointing at the need of a triaging system that prioritizes high risk cases for prompt interpretation. Therefore we explored in an image database of Mexican patients whether high risk cases can be distinguished using image features. We collected a set of 200 digital screening mammography cases from a hospital in Mexico, and assigned low or high risk labels according to its BIRADS score. Breast tissue segmentation was performed using an automatic procedure. Image features were obtained considering only the segmented region on each view and comparing the bilateral di erences of the obtained features. Predictive combinations of features were chosen using a genetic algorithms based feature selection procedure. The best model found was able to classify low-risk and high-risk cases with an area under the ROC curve of 0.88 on a 150-fold cross-validation test. The features selected were associated to the differences of signal distribution and tissue shape on bilateral views. The model found can be used to automatically identify high risk cases and trigger the necessary measures to provide prompt treatment.
Rodriguez-Rojas, Juan; Garza-Montemayor, Margarita; Trevino-Alvarado, Victor; Tamez-Pena, José Gerardo
In addition to discussing effectiveness of breast cancer screening initiated within the National Public Health Programme, the problem of how to treat non-palpable, early invasive and in situ breast cancer (DCIS) is considered. The theoretical issue of the sentinel lymph node and its impact on biopsy practice have also been dealt with. In the authors' region, screening was introduced in 1999 and after a short break has been continued since 2002. Patient data of three periods, each of two years, each with ten years' interval (1982-1983, 1992-1993, 2002-2003) have been analysed. Changes in the number of surgical operations and tumour size, incidence of in situ cancer, lymph node involvement and distribution of types of surgery have been studied. Biopsy of the sentinel lymph node has been applied since May, 2003 (with 45 biopsies performed until 31 December, 2004). The number of persons participating in the screening programme has gradually increased, the number of surgical operations because of breast cancer increased from period to period. Size of the detected tumours has decreased, the percentage of non-palpable cases has been significant (445 surgical interventions during the years 2002-2004: surgery: 19%). The proportion of DCIS has increased to nearly four times as compared to data of years immediately preceding the era of screening (1993-1998: 11 cases, 2%; 1999-2004: 62 cases, 7.5%). Specificity of sentinel lymph node biopsy was 90%, with a sensitivity of 65%. The proportion of breast saving surgery has increased above 50%. The authors regard screening as successful, in their opinion, its benefits cannot be questioned, in spite of some controversial issues. As to the treatment of non-palpable, early invasive cancer, they underline the importance of preoperative evaluation--cytology, core biopsy--and establishing dignity. The issues of localisation--wire hook marking--and histological processing--large blocks--have also been dealt with. In spite of the fact that the risk for potential malignancy of DCIS lesions has not yet been fully clarified, adequate treatment is indicated; the authors take stand on the issues of indication for surgery, postoperative radiotherapy and use of Tamoxifen. Indications and contraindications of sentinel lymph node biopsy have been summed up. PMID:17201346
Márkus, Béla; Bajner, Agnes; Csejtei, András; Firisz, Borbála; Hegedus, Agnes; Kocsis, Eszter; Kovács, Beáta; Pintér, Gábor; Tóth, Csaba
Objective To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. Data Sources/Study Setting Primary care director survey (1999–2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). Study Design Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. Data Collection/Extraction Methods Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. Principal Findings After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (p<.04), more clinical support arrangements (p < .03), and smaller size (p < .001). Conclusions Deficits in primary care clinical support arrangements and local autonomy over operational management and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices. PMID:17489907
Yano, Elizabeth M; Soban, Lynn M; Parkerton, Patricia H; Etzioni, David A
Using the results of screening trials, the NCI Cancer Intervention and Surveillance Modeling Network is trying to estimate the true benefit of cancer screening in the general population and identify the optimal way to implement screening within the health care system.
Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…
Underhill, Meghan L.; Kiviniemi, Marc T.
Annual screening for lung cancer using a standard chest x-ray does not reduce the risk of dying from lung cancer when compared with no annual screening, according to findings from the NCI-led Prostate, Lung, Colorectal, and Ovarian (PLCO) screening trial.
It has been more than 30 years since the first consensus development meeting was held to deal with guidelines of mammography screening. Although the National Cancer Institute has wisely focused on the science of screening and of screening benefits vs harm, many professional organizations, advocacy groups, and the media have maintained a focus on establishing who should be screened and promoting recommendations for which age groups should be screened. Guidelines have been developed not only for mammography but also for screening at virtually all major cancer sites, especially for prostate cancer, and most recently, with the preliminary results of the National Lung Screening Trial, for lung cancer. It seems clear that we have done an inadequate job of educating screening candidates about the harms and benefits of cancer screening, including the extent to which screening can reduce cancer mortality. We must also question whether our practice of summoning women to have mammograms, while providing men informed choice for prostate cancer screening, is consistent with a scientific analysis of the relative harms and benefits. We have spent a staggering amount of time and energy over the past several decades developing, discussing, and debating guidelines. Professional and advocacy groups have spent much time aggressively advocating the adoption of guidelines supported by their respective groups. It seems that it would be much more productive to devote such energy to educating screening candidates about the harms and benefits of screening and to engaging in shared decision making. PMID:22106094
Stefanek, Michael Edward
...screened according to guidelines. Rates of screening for colorectal cancer are consistently lower than those for other common cancers, particularly breast and cervical cancer. Reasons for this disparity are complex. Unlike most other...
Background: A gastric cancer (GC) screening program using gastrofiberscopy (GFS) or double contrast upper gastrointestinal series (UGIS),\\u000a as a public policy, has been used in Korea since 1996. The aim of this study was to assess whether there have been major changes\\u000a in clinicopathologic features of GC by introducing GC screening.\\u000a \\u000a \\u000a Method: We reviewed the medical records of 1478 consecutive
Ji-Youn Han; Hyehyun Son; Won Chul Lee; Byung Gil Choi
Canine bone cancer is a common type of cancer that grows fast and may be fatal. It usually appears in the limbs which is called "appendicular bone cancer." Diagnostic imaging methods such as X-rays, computed tomography (CT scan), and magnetic resonance imaging (MRI) are more common methods in bone cancer detection than invasive physical examination such as biopsy. These imaging methods have some disadvantages; including high expense, high dose of radiation, and keeping the patient (canine) motionless during the imaging procedures. This project study identifies the possibility of using thermographic images as a pre-screening tool for diagnosis of bone cancer in dogs. Experiments were performed with thermographic images from 40 dogs exhibiting the disease bone cancer. Experiments were performed with color normalization using temperature data provided by the Long Island Veterinary Specialists. The images were first divided into four groups according to body parts (Elbow/Knee, Full Limb, Shoulder/Hip and Wrist). Each of the groups was then further divided into three sub-groups according to views (Anterior, Lateral and Posterior). Thermographic pattern of normal and abnormal dogs were analyzed using feature extraction and pattern classification tools. Texture features, spectral feature and histogram features were extracted from the thermograms and were used for pattern classification. The best classification success rate in canine bone cancer detection is 90% with sensitivity of 100% and specificity of 80% produced by anterior view of full-limb region with nearest neighbor classification method and normRGB-lum color normalization method. Our results show that it is possible to use thermographic imaging as a pre-screening tool for detection of canine bone cancer.
Subedi, Samrat; Umbaugh, Scott E.; Fu, Jiyuan; Marino, Dominic J.; Loughin, Catherine A.; Sackman, Joseph
Several barriers impede cancer prevention in the Mexican American population. This study identified sociocultural factors that could be used to increase screening rates for cervical cancer in women of reproductive age. A survey was conducted in 1991 of 366 Mexican American women ages 18 to 40 in Tucson, Arizona, to assess current compliance with cervical cancer screening guidelines and several
Prostate Cancer Screening: Facts, Statistics, and Interpretation in Response to the US Preventive-cause mortality."1(p764) It is a basic misunderstanding to believe that the screening trials such as ERSPCortheProstate,Lung,ColorectalandOvarianCancer Services Task Force Review Sigrid Carlsson, Memorial Sloan-Kettering Cancer Center, New York, NY
El Zarki, Magda
March 2012 Women Be Healthy: Increasing Cervical and Breast Cancer Screening for Women with Intellectual Disabilities Issue Cervical and breast cancer are both treatable if detected early. However, women with intellectual disabilities receive screening for cervical and breast cancer at lower rates than their peers
This study was conducted to identify the factors perceived by African-American men as influencing their behavior relative to prostate cancer screening. A total of 49 African-American men, age 40 and above, participated in 10 focus group discussions in Florida. Data collection was between October 12, 2001 and March 9, 2002 in Tallahassee, Tampa, and Miami. Data analysis was conducted using a comprehensive ethnographical analysis, including the use of an ethnographical retrieval program, Nonnumerical Unstructured Data Indexing Searching and Theorizing (QSR NUD*IST 4.0) software. Factors identified as influencing prostate cancer screening participation by African-American men were impediments to prostate cancer screening; positive outcome beliefs associated with prostate cancer screening; social influence; negative outcome beliefs associated with prostate cancer screening; resources or opportunities that facilitate prostate cancer screening; prostate cancer knowledge; perceived susceptibility to prostate cancer; perceived threat of prostate cancer; perceived severity of prostate cancer; positive health activities; illness experience; and prostate cancer screening intervention message concept, message source, and message channel. The results of this study may offer an excellent guide to designing effective, culturally sensitive, and relevant interventions, which would increase African-American men's participation in prostate cancer screening. PMID:15233488
Odedina, Folakemi T.; Scrivens, John; Emanuel, Angela; LaRose-Pierre, Margareth; Brown, James; Nash, Rowena
Breast cancer remains one of the leading causes of cancer death among African American women, and rates of mammography screening for African American women remain lower than rates for their Caucasian counterparts. The purpose of the current study was to explore the reasons for nonadherence to American Cancer Society breast screening guidelines among African American women who had not received
Cindy Davis; Janice S. Emerson; Baqar A. Husaini
:Several barriers impede cancer prevention in the Mexican American population. This study identified sociocultural factors that could be used to increase screening rates for cervical cancer in women of reproductive age. A survey was conducted in 1991 of 366 Mexican American women ages 18 to 40 in Tucson, Arizona, to assess current compliance with cervical cancer screening guidelines and several
David Buller; Manuel R. Modiano; Jill Guernsey de Zapien; Joel Meister; Sallie Saltzman; Frank Hunsaker
Cervical cancer screening with Pap smear test is a cost-effective method. The Ministry of Health in Turkey recommends that it be performed once every five years after age 35. The purpose of this study was to determine the cervical cancer risk levels of women between 35 and 69, and the intervals they have the Pap smear test, and to investigate the relation between the two. This study was performed on 227 women aged between 35 and 69 living in Balçova District of ?zmir province. Using the cervical cancer risk index program of Harvard School of Public Health, the cervical cancer risk level of 70% of the women was found below average, 22.1% average, and 7.9% above average. Only 52% of the women have had Pap smear test at least once in their lives. The percentage screening regularly in conformity with the national screening standard was 39.2%. Women in the 40-49 age group, were married, conformed significantly more (p<0.05) to the national screening standard. Compliance also increased with the level of education and decreased with the cervical cancer risk level (p<0.05). A logistic regression model was constructed including age, education level, menstruation state of the women and the economic level of the family. Not having the Pap smear test in conformity with the national cervical cancer screening standard in 35-39 age group was 2.52 times more than 40-49 age group, while it was 3.26 times more in 60-69 age group (p< 0.05). Not having Pap smear test in 35-39 age group more than other groups might result from lack of information on the cervical cancer national screening standard and the necessity of having Pap smear test. As for 60-69 age group, the low education level might cause not having Pap smear test. Under these circumstances, the cervical cancer risk levels should be determined and the individuals should be informed. Providing Pap smear test screening service to individuals in the target group of national screening standard, as a public service may resolve the inequalities due to age and educational differences. PMID:21790227
Açikgöz, Ayla; Ergör, Gül
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.
Sun, Ted X.; Cheng, Botao
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897
Miller, Jacqueline W; Hanson, Vivien; Johnson, Gale D; Royalty, Janet E; Richardson, Lisa C
Prostate cancer (PCa) has become the most prevalent cancer among males in Nigeria, and similar to other black populations, Nigerian men present with more advanced disease at an earlier age than in several other ethnic groups. In this unscreened, high-risk group, the reference range for early detection and diagnosis as well as risk factors need to be determined through large-scale screening. Over 4 years, 1124 previously unscreened men between 40 and 85 years of age were screened at free community health programmes for PCa, using the common parameters of prostate-specific antigen (PSA) plus digital rectal examination (DRE). We thereby assessed the practicality and importance of screening. Consent was obtained, demographic data obtained, PSA measured using qualitative laboratory kits, and DRE performed by surgeons. We found that the number of men attending and consenting to screening increases from year to year. Of 40-85-year-old men, 85.4% consented, of whom 33.3% (a third) and 60% were 51-60 years old and 51-65 years, respectively. While 11.5% of men had PSA >4 ng/ml, 31.45% showed abnormal DRE. Of the men who took the PSA test, 79.2% also consented to the DRE, of whom 5.8% had combined abnormal DRE and PSA >4 ng/ml. Our findings suggest that Nigerian men are a willing group for screening by both the PSA and DRE with the positive response to calls for health screening and interest in prostate health. The finding of PSA >4 ng/ml in 11.15% of this population reveals the need for greater awareness and measures to increase early detection. However, the value and validity of established PSA reference ranges and cutoff of 'normal' still need to be established. Screening is very important to better define the PCa prevalence and characteristics in our population; otherwise political and economic circumstances will ensure that men still present late with aggressive PCa. PMID:25228913
Akinremi, To; Adeniyi, A; Olutunde, A; Oduniyi, A; Ogo, Cn
Prostate cancer (PCa) has become the most prevalent cancer among males in Nigeria, and similar to other black populations, Nigerian men present with more advanced disease at an earlier age than in several other ethnic groups. In this unscreened, high-risk group, the reference range for early detection and diagnosis as well as risk factors need to be determined through large-scale screening. Over 4 years, 1124 previously unscreened men between 40 and 85 years of age were screened at free community health programmes for PCa, using the common parameters of prostate-specific antigen (PSA) plus digital rectal examination (DRE). We thereby assessed the practicality and importance of screening. Consent was obtained, demographic data obtained, PSA measured using qualitative laboratory kits, and DRE performed by surgeons. We found that the number of men attending and consenting to screening increases from year to year. Of 40–85-year-old men, 85.4% consented, of whom 33.3% (a third) and 60% were 51–60 years old and 51–65 years, respectively. While 11.5% of men had PSA >4 ng/ml, 31.45% showed abnormal DRE. Of the men who took the PSA test, 79.2% also consented to the DRE, of whom 5.8% had combined abnormal DRE and PSA >4 ng/ml. Our findings suggest that Nigerian men are a willing group for screening by both the PSA and DRE with the positive response to calls for health screening and interest in prostate health. The finding of PSA >4 ng/ml in 11.15% of this population reveals the need for greater awareness and measures to increase early detection. However, the value and validity of established PSA reference ranges and cutoff of ‘normal’ still need to be established. Screening is very important to better define the PCa prevalence and characteristics in our population; otherwise political and economic circumstances will ensure that men still present late with aggressive PCa. PMID:25228913
Akinremi, TO; Adeniyi, A; Olutunde, A; Oduniyi, A; Ogo, CN
Breast and cervical cancer account for nearly one-third of new cancer cases and one-sixth of cancer deaths. Cancer, the second leading cause of all deaths in the US, will claim the lives of nearly 800,000 women this year, which is particularly unfortunate because effective modes of early detection could significantly reduce mortality from breast and cervical cancer. We examined patterns of non-screening among Appalachian women. In-person interviews were conducted with 222 Appalachian women who fell outside of screening recommendations for timing of Pap tests and mammograms. These women, from six Appalachian counties, were participating in a group-randomized, multi-component trial aimed at increasing adherence to cancer screening recommendations. Results indicated that participants who were rarely or never screened for breast cancer were also likely to be rarely or never screened for cervical cancer. In addition, four key barriers were identified as independently and significantly associated with being rarely or never screened for both cervical and breast cancer. An improved understanding of cancer screening patterns plus the barriers underlying lack of screening may move us closer to developing effective interventions that facilitate women’s use of screening. PMID:23937729
Schoenberg, Nancy E.; Studts, Christina R.; Hatcher-Keller, Jenna; Buelt, Eliza; Adams, Elwanda
Not for reproduction without permission Monitoring Diagnosis and Treatment of Screen-Detected Breast Cancer in the NHSBSP Julietta Patnick ICSN 2008 Not for reproduction without permission Monitoring Screening: Principles • Maintenance of minimum
What happens when organisation of cervical cancer screening is delayed or stopped? Elsebeth Lynge email@example.com DENMARK Opportunistic screening, 1969: • All smears paid by the national health insurance National guidelines for organisation,
Dartmouth researchers say lung cancer screening in the National Lung Screening Trial meets a commonly accepted standard for cost effectiveness as reported in the Nov. 6 issue of the New England Journal of Medicine.
The bill aims to amend title XVIII of the Social Security Act to waive coinsurance under Medicare for colorectal cancer screening tests, regardless of whether therapeutic intervention is required during the screening. This would provide for full coverage
Although cervical cancer screening rates have increased in the United States, there are still geographic areas that experience a high cervical cancer burden, including the Mississippi Delta. Human papillomavirus (HPV) self-collection may be a feasible alternative to traditional clinician-collection for cervical cancer screening for under-screened women. This study examined women's preferences for cervical cancer screening methods. Interviewer-administered questionnaires regarding cervical cancer screening preferences were completed by 524 African American women in the Mississippi Delta. Statistically significant differences were observed for age, employment status, and number of children across recruitment groups. Regardless of how women were recruited, the majority preferred self-sampling for HPV testing method to clinician-collection. Among women who preferred self-collected sampling for HPV testing, the most frequent reasons given were convenience, privacy, and comfort. Alternative strategies must be considered when targeting the under-screened to reduce the burden of cervical cancer. PMID:23377716
Litton, Allison G; Castle, Philip E; Partridge, Edward E; Scarinci, Isabel C
BACKGROUND: Most authorities advocate mammogram screening for breast cancer beginning at age 40 based on the age-specific distribution and incidence of breast cancer in the general population. This policy has been bolstered by studies that demonstrate that, for the general population, mammography in the 40-49 age bracket reduces mortality. However, it also has been reported that African-American breast cancer patients are diagnosed more often than white patients below the age of 40. Young African-American women are also more likely to have advanced disease at the time of diagnosis with predictably higher mortality. The purpose of this investigation is to explore the question, whether a subset of African-American women, age 30-39, by virtue of increased vulnerability, would benefit from early mammogram screening. STUDY DESIGN: The age-specific distribution (age 30-84) of African-American and white breast cancer patients in five State cancer registries were compared. Prognostic indicators (tumor size and nodal status) in two of the five registries in African-American and white breast cancer cases below the age of 40 were compared. Age-specific incidence in the 30-39 age group and the relative populations of black and white women in the United States were noted in the Surveillance Epidemiology and End Report (SEER) (1994-1998) and The U.S. Census 2000. RESULTS: The differences of age-specific distribution and age-specific incidence of African-American and white breast cancer patients were found to be significant. More than 10% of African-American women with breast cancer were diagnosed before age 40 compared to 5% of white patients. The incidence of breast cancer (SEER Report 1994-1998) in the 30-39-age bracket for African-American and white women was 48.9 and 40.2 at the 95% confidence level, while the proportion of African-American and white women reported by the Census Bureau was not too dissimilar, 15.8% and 14.6% respectively. Prognostic indicators (tumor size and nodal status) support the notion that young African-American women are more likely to have advanced disease at diagnosis. CONCLUSIONS: African-American women in the 30-39 age group have twice the age-specific distribution, have a higher incidence compared to their white counterparts, and exhibit more ominous prognostic signs. This study provides evidence that African-American women in the 30-39 age category represent a high-risk group that may benefit from efforts at earlier detection. Although mammography remains the preferred screening modality, investigators have pointed out difficulties encountered when using mammography in young women, including low sensitivity, high breast density, cost/benefit concerns, and low positive predictive value. Nevertheless, the increasing mortality and persistent racial incidence gap in young African-American women, age 30-39, argue for considering early screening mammography in spite of recognized concerns. PMID:11918384
Johnson, Edwin T.
The National Lung Screening Trial (NLST), a randomized national trial involving more than 53,000 current and former heavy smokers ages 55 to 74, compared the effects of two screening procedures for lung cancer -- low-dose helical computed tomography (CT) and standard chest X-ray -- on lung cancer mortality and found 20 percent fewer lung cancer deaths among trial participants screened with low-dose helical CT.
Obese white women have lower rates of cancer screening compared to non-obese women. This study will determine if a relationship\\u000a exists between weight and adherence to cancer screening guidelines among African Americans. We used multivariate logistic\\u000a regression to examine the relationship between being up-to-date with cancer screening (colorectal, breast, cervical, and prostate)\\u000a and weight group (normal, overweight, obese I, obese
Lucia A. Leone; Marlyn Allicock; Michael P. Pignone; La-Shell Johnson; Joan F. Walsh; Marci K. Campbell
The objectives of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial are to determine in screenees ages 55–74 at entry whether screening with flexible sigmoidoscopy (60-cm sigmoidoscope) can reduce mortality from colorectal cancer, whether screening with chest X-ray can reduce mortality from lung cancer, whether screenng men with digital rectal examination (DRE) plus serum prostate-specific antigen (PSA) can reduce
Philip C. Prorok; Gerald L. Andriole; Robert S. Bresalier; Saundra S. Buys; David Chia; E. David Crawford; Ronald Fogel; Edward P. Gelmann; Fred Gilbert; Marsha A. Hasson; Richard B. Hayes; Christine Cole Johnson; Jack S. Mandel; Albert Oberman; Barbara O'Brien; Martin M. Oken; Sameer Rafla; Douglas Reding; Wilmer Rutt; Joel L. Weissfeld; Lance Yokochi; John K. Gohagan
The National Lung Screening Trial is evaluating the effectiveness of low-dose spiral CT and conventional chest X-ray as screening tests for persons who are at high risk for developing lung cancer. This multicenter trial requires quality assurance (QA) for the image quality and technical parameters of the scans. The electronic system described here helps manage the QA process. The system
Stephen M. Moore; David S. Gierada; Kenneth W. Clark; James Blaine
Background Public health aims to provide universal safety and progressive opportunities to populations to realise their highest level of health through prevention of disease, its progression or transmission. Screening asymptomatic individuals to detect early unapparent conditions is an important public health intervention strategy. It may be designed to be compulsory or voluntary depending on the epidemiological characteristics of the disease. Integrated screening, including for both syphilis and cancer of the cervix, is a core component of the national reproductive health program in Kenya. Screening for syphilis is compulsory while it is voluntary for cervical cancer. Participants’ perspectives of either form of screening approach provide the necessary contextual information that clarifies mundane community concerns. Methods Focus group discussions with female clients screened for syphilis and cancer of the cervix were conducted to elicit their perspectives of compulsory and voluntary screening. The discussions were audiotaped, transcribed and thematic content analysis performed manually to explore emerging ethics issues. Results The results indicate that real ethical challenges exist in either of the approaches. Also, participants were more concerned about the benefits of the procedure and whether their dignity is respected than the compulsoriness of screening per se. The implication is for the policy makers to clarify in the guidelines how to manage ethical challenges, while at the operational level, providers need to be judicious to minimize potential harms participants and families when screening for disease in women. Conclusions The context for mounting screening as a public health intervention and attendant ethical issues may be more complex than hitherto perceived. Interpreting emerging ethics issues in screening requires more nuanced considerations of individuals’ contextual experiences since these may be contradictory to the policy position. In considering mounting screening for Syphilis and cervical cancer as a public heal intervention, the community interests and perspectives should be inculcated into the program. Population lack of information on procedures may influence adversely the demand for screening services by the individuals at risk or the community as a collective agent. PMID:24678613
African Americans have higher colorectal cancer (CRC) morbidity and mortality than whites, yet have low rates of CRC screening.\\u000a Few studies have explored African Americans’ own perceptions of barriers to CRC screening or elucidated gender differences\\u000a in screening status. Focus groups were conducted with 23 African American patients between 50 and 70 years of age who were\\u000a patients in a general
Sarah Bauerle Bass; Thomas F. Gordon; Sheryl Burt Ruzek; Caitlin Wolak; Stephanie Ward; Anuradha Paranjape; Karen Lin; Brian Meyer; Dominique G. Ruggieri
The scientific program for the next International Cancer Screening Network (ICSN) meeting is being developed. The meeting is being co-chaired by Drs. Carrie Klabunde (ARP Health Services and Economics Branch) and Harry de Koning (Erasmus Medical Center), and will be held on June 2-4, 2015, in the Netherlands. Staff involved in the planning effort include Dr. Klabunde and Dr. Paul Doria-Rose (ARP Health Services and Economics Branch), Dr. Stephen Taplin (Chief, Process of Care Research Branch, Behavioral Research Program), Ms.
Background Malnutrition is a frequent complication in patients with cancer and can negatively affect the outcome of treatments. On the\\u000a other hand, side effects of anticancer therapies can also lead to inadequate nutrient intake and subsequent malnutrition.\\u000a The nutritional screening aims to identify patients at risk of malnutrition for prompt treatment and\\/or careful follow-up.\\u000a \\u000a \\u000a \\u000a \\u000a Methods and results This manuscript highlights the need
Lidia Santarpia; Franco Contaldo; Fabrizio Pasanisi
The goals of the Advanced Cancer Detection Center include the discovery of molecular and genetic markers of cancer risk, the identification of individuals at high risk for cancer through screening and the testing of methods to prevent cancer. The projects...
J. P. Krischer
Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer (Archived Tables): Home Other
Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer (Archived Tables): Home Participation
Because of the complexity of cervical cancer prevention guidelines, clinicians often fail to follow best-practice recommendations. Moreover, existing clinical decision support (CDS) systems generally recommend a cervical cytology every three years for all female patients, which is inappropriate for patients with abnormal findings that require surveillance at shorter intervals. To address this problem, we developed a decision tree-based CDS system that integrates national guidelines to provide comprehensive guidance to clinicians. Validation was performed in several iterations by comparing recommendations generated by the system with those of clinicians for 333 patients. The CDS system extracted relevant patient information from the electronic health record and applied the guideline model with an overall accuracy of 87%. Providers without CDS assistance needed an average of 1 minute 39 seconds to decide on recommendations for management of abnormal findings. Overall, our work demonstrates the feasibility and potential utility of automated recommendation system for cervical cancer screening and surveillance. PMID:25368505
Wagholikar, Kavishwar B; MacLaughlin, Kathy L; Casey, Petra M; Kastner, Thomas M; Henry, Michael R; Hankey, Ronald A; Peters, Steve G; Greenes, Robert A; Chute, Christopher G; Liu, Hongfang; Chaudhry, Rajeev
African Americans have higher colorectal cancer (CRC) morbidity and mortality than whites, yet have low rates of CRC screening. Few studies have explored African Americans’ own perceptions of barriers to CRC screening or elucidated gender differences in screening status. Focus groups were conducted with 23 African American patients between 50 and 70 years of age who were patients in a general internal medicine clinic in a large urban teaching hospital. Focus groups were delimited by gender and CRC screening status. Focus group transcripts were analyzed using an iterative coding process with consensus and triangulation to develop thematic categories. Results indicated key thematic differences in perceptions of screening by gender and CRC screening status. While both men and women who had never been screened had a general lack of knowledge about CRC and screening modalities, women had an overall sense that health screenings were needed and indicated a stronger need to have a positive relationship with their doctor. Women also reported that African American men do not get colonoscopy because of the perceived sexual connotation. Men who had never been screened, compared to those who had been screened, had less trust of their doctors and the health care system and indicated an overall fear of going to the doctor. They also reiterated the sexual connotation of having a colonoscopy and were apprehensive about being sedated during the procedure. Overall, men expressed more fear and were more reluctant to undergo CRC screening than women, but among those who had undergone CRC screening, particularly colonoscopy, men expressed advantages of having the screening. All groups were also found to have a negative attitude about the use of fecal occult blood testing and felt colonoscopy was the superior screening modality. Results suggest that messages and education about CRC screening, particularly colonoscopy, might place more emphasis on accuracy and might be more effective in increasing screening rates among African Americans if tailored to gender and screening status. PMID:20443096
Gordon, Thomas F.; Ruzek, Sheryl Burt; Wolak, Caitlin; Ward, Stephanie; Paranjape, Anuradha; Lin, Karen; Meyer, Brian; Ruggieri, Dominique G.
... Prostate Cancer Screening Guidelines: What Has—and Hasn't—Changed Article date: March 3, 2010 By: Rebecca ... the American Cancer Society (ACS). While this isn't a radical change from the previous recommendations, the ...
Exploring Gender Differences in Colon Cancer Screening Knowledge and Health Beliefs among African University-Purdue University Indianapolis, IN 46204 Mentor: Susan M. Rawl African Americans are diagnosed. Culturally appropriate, effective interventions are urgently needed to reduce these cancer disparities
Increasing mammography screening rates and investing in research to improve breast cancer detection technologies should be top priorities, according to authors of a study published in the October 20, 2004, Journal of the National Cancer Institute
The Ages and Stages Questionnaires–3® (ASQ-3) for developmental screening in our young oncology patients was pilot tested in children 4 to 48 months of age with newly diagnosed cancer. Subjects were screened within 28 days of diagnosis (baseline), at 6 and 12 months. Twenty-six of 30 enrolled parents (87%) completed all 3 screens. Screens were completed by parents within 15 minutes. ASQ-3 screening identified unsuspected developmental delays as follows: 7 at baseline, 4 at 6 months, and 3 at 12 months. ASQ-3 developmental screening is feasible, identifies early developmental delays in young children with cancer, and helps initiate appropriate referrals. PMID:23867965
Quigg, Troy C.; Mahajerin, Arash; Sullivan, Paula D.; Pradhan, Kamnesh; Bauer, Nerissa S.
Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Breast Cancer: Mortality Rates | Screening
are at high risk for lung cancer should undergo low-dose CT screening. Source: The US Preventive Services Task cancer prevention method. "Screening for lung cancer, while beneficial, should not be an alternative://www.cancernetwork.com) USPSTF Recommends Low-Dose CT Screening for Heavy Smokers News  | January 07, 2014 | Lung Cancer [2
This study examined demographic and lifestyle factors that influenced decisions and obstacles to being screened for breast cancer in low-income African Americans in three urban Tennessee cities. As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, health care access and utilization, and screening practices for various cancers in low-income African Americans. For this study, only African American women 40 years and older (n = 334) were selected from the Meharry CNP community survey database. There were several predictors of breast cancer screening such as marital status and having health insurance (P < .05). Additionally, there were associations between obstacles to screening and geographic region such as transportation and not having enough information about screenings (P < .05). Educational interventions aimed at improving breast cancer knowledge and screening rates should incorporate information about obstacles and predictors to screening. PMID:24554393
Patel, Kushal; Kanu, Mohamed; Liu, Jianguo; Bond, Brea; Brown, Elizabeth; Williams, Elizabeth; Theriot, Rosemary; Bailey, Stephanie; Sanderson, Maureen; Hargreaves, Margaret
This study examined demographic and lifestyle factors that influenced decisions and obstacles to being screened for breast cancer in low-income African Americans in three urban Tennessee cities. As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, health care access and utilization, and screening practices for various cancers in low-income African Americans. For this study, only African American women 40 years and older (n=334) were selected from the Meharry CNP community survey database. There were several predictors of breast cancer screening such as marital status and having health insurance (P< .05). Additionally, there were associations between obstacles to screening and geographic region such as transportation and not having enough information about screenings (P< .05). Educational interventions aimed at improving breast cancer knowledge and screening rates should incorporate information about obstacles and predictors to screening. PMID:24554393
Patel, Kushal; Kanu, Mohamed; Liu, Jianguo; Bond, Brea; Brown, Elizabeth; Williams, Elizabeth; Theriot, Rosemary; Bailey, Stephanie; Sanderson, Maureen; Hargreaves, Margaret
cancer detection results of the baseline screening round. Methods: Of the 154 942 participants enrolled, who were aged 55 - 74 years with no history of PLCO cancers, 77 465 were randomly assigned to the intervention arm. Current or former smokers and never smokers in this arm received an initial single-view posterior-anterior chest radiograph. Results: In the initial screen, 5991
Martin M. Oken; Pamela M. Marcus; Ping Hu; Thomas M. Beck
As part of the formative research for developing interventions to increase colorectal cancer screening 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 cancer screening, (2) barriers to screening, and (3) strategies for motivating and supporting behavior change. Participants had either private insurance or Medicare and reported different levels of experience with colorectal cancer screening. Overall, they were poorly informed about colorectal cancer and the possible benefits of screening, reporting little or no information from physicians or mass media, negative attitudes toward screening procedures, and fear of cancer. Despite references to the subject matter as embarrassing or private, both men and women, African Americans and whites, appeared to talk candidly and comfortably in the permissive context of the focus group. This study's findings suggest that public education campaigns, decision aids, and targeted interventions are urgently needed to put colorectal cancer screening on the public's "radar screen," to increase awareness of the prevention and early detection benefits of screening, and to encourage people 50 and older-and the health care providers who serve them-to make screening a high priority. PMID:10868818
Beeker, C; Kraft, J M; Southwell, B G; Jorgensen, C M
Lung cancer remains the leading cause of cancer-related death in the United States. Cigarette smoking is a well-recognized risk factor for lung cancer, and a sustained elevation of lung cancer risk persists even after smoking cessation. Despite identifiable risk factors, there has been minimal improvement in mortality for patients with lung cancer primarily stemming from diagnosis at a late stage when there are few effective therapeutic options. Early detection of lung cancer and effective screening of high-risk individuals may help improve lung cancer mortality. While low dose computerized tomography (LDCT) screening of high risk smokers has been shown to reduce lung cancer mortality, the high rates of false positives and potential for over-diagnosis have raised questions on how to best implement lung cancer screening. The rapidly evolving field of lung cancer screening and early-detection biomarkers may ultimately improve the ability to diagnose lung cancer in its early stages, identify smokers at highest-risk for this disease, and target chemoprevention strategies. This review aims to provide an overview of the opportunities and challenges related to lung cancer screening, the field of biomarker development for early lung cancer detection, and the future of lung cancer chemoprevention. PMID:24840047
Kathuria, Hasmeena; Gesthalter, Yaron; Spira, Avrum; Brody, Jerome S.; Steiling, Katrina
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
Mendez, Francisco; Lopez, Felipe; Brambila, Carlos; Burkhart, Marianne
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 and illustrated in the Screening Adherence Follow-up (SAFe) protocol: (1) evidence for known risks and barriers for the target population; (2) standardized assessment elements; (3) evidence for the accuracy, efficiency, and validity of the protocol in use. Testing of the assessment tool in a pilot study of more than 600 women demonstrated practical utility in matching assessed needs with service intensity and confirmed that differential amounts of service and different provider effort achieved equally satisfactory adherence results. The evidence-based components described and the types and nature of evidence on which they draw can be generalized to new settings and client concerns. PMID:15974370
Vourlekis, Betsy; Ell, Kathleen; Padgett, Deborah
BACKGROUND: Screening for prostate cancer advances the time of diagnosis\\u000a (lead time) and detects cancers that would not have been diagnosed in the\\u000a absence of screening (overdetection). Both consequences have considerable\\u000a impact on the net benefits of screening. METHODS: We developed simulation\\u000a models based on results of the Rotterdam section of the European\\u000a Randomized Study of Screening for Prostate Cancer
Gerrit Draisma; Rob Boer; Suzie J. Otto; Cruijsen-Koeter van der I. W; Ronald A. M. Damhuis; F. H. Schröder; Koning de H. J
As people with learning disabilities now live longer, they will experience the same age-related illnesses as the general population and cancer is a prime example of this. In women, cancer screening is used to detect early on-set of cancer of the breast and abnormalities of the cervix which might, if left untreated, develop into cancer.…
Willis, Diane S.; Kennedy, Catriona M.; Kilbride, Lynn
Background Understanding factors relating to the perception of wait time by patients is key to improving the patient experience. Methods We surveyed 122 breast and 90 prostate cancer patients presenting at clinics or listed on the cancer registry in Newfoundland and Labrador and reviewed their charts. We compared the wait time (first visit to diagnosis) and the wait-related satisfaction for breast and prostate cancer patients who received regular screening tests and whose cancer was screening test–detected (“screen/screen”); who received regular screening tests and whose cancer was symptomatic (“screen/symptomatic”); who did not receive regular screening tests and whose cancer was screen test–detected (“no screen/screen”); and who did not receive regular screening tests and whose cancer was symptomatic (“no screen/symptomatic”). Results Although there were no group differences with respect to having a long wait (greater than the median of 47.5 days) for breast cancer patients (47.8% screen/screen, 54.7% screen/symptomatic, 50.0% no screen/ screen, 40.0% no screen/symptomatic; p = 0.814), a smaller proportion of the screen/symptomatic patients were satisfied with their wait (72.5% screen/ screen, 56.4% screen/symptomatic, 100% no screen/ screen, 90.9% no screen/symptomatic; p = 0.048). A larger proportion of screen/symptomatic prostate cancer patients had long waits (>104.5 days: 41.3% screen/screen, 92.0% screen/symptomatic, 46.0% no screen/screen, 40.0% no screen/symptomatic; p = 0.011) and a smaller proportion of screen/ symptomatic patients were satisfied with their wait (71.2% screen/screen, 30.8% screen/symptomatic, 76.9% no screen/screen, 90.9% no screen/symptomatic; p = 0.008). Conclusions Diagnosis-related wait times and satisfaction were poorest among patients who received regular screening tests but whose cancer was not detected by those tests. PMID:24940104
Mathews, M.; Ryan, D.; Gadag, V.; West, R.
The genetic complexity and heterogeneity of cancer has posed a problem in designing rationally targeted therapies effective in a large proportion of human cancer. Genomic characterization of many cancer types has provided a staggering amount of data that needs to be interpreted to further our understanding of this disease. Forward genetic screening in mice using Sleeping Beauty (SB) based insertional mutagenesis is an effective method for candidate cancer gene discovery that can aid in distinguishing driver from passenger mutations in human cancer. This system has been adapted for unbiased screens to identify drivers of multiple cancer types. These screens have already identified hundreds of candidate cancer-promoting mutations. These can be used to develop new mouse models for further study, which may prove useful for therapeutic testing. SB technology may also hold the key for rapid generation of reverse genetic mouse models of cancer, and has already been used to model glioblastoma and liver cancer. PMID:24468652
Tschida, Barbara R; Largaespada, David A; Keng, Vincent W
Lung cancer is the leading cause of cancer death in the United States, but no scientific organization currently recommends screening because of limited evidence for its effectiveness. Despite this, physicians often order screening tests such as chest X-rays and computerized tomography scans for their patients. Limited information is available about how physicians decide when to order these tests. To identify factors that affect whether physicians' screen patients for lung cancer, we conducted five 75-min telephone-based focus groups with 28 US primary care physicians and used inductive qualitative research methods to analyze their responses. We identified seven factors that influenced these physicians' decisions about screening patients for lung cancer: (1) their perception of a screening test's effectiveness, (2) their attitude toward recommended screening guidelines, (3) their practice experience, (4) their perception of a patient's risk for lung cancer, (5) reimbursement and payment for screening, (6) their concern about litigation, and (7) whether a patient requested screening. Because these factors may have conflicting effects on physicians' decisions to order screening tests, physicians may struggle in determining when screening for lung cancer is appropriate. We recommend (1) more clinician education, beginning in medical school, about the existing evidence related to lung cancer screening, with emphasis on the benefit of and training in tobacco use prevention and cessation, (2) more patient education about the benefits and limitations of screening, (3) further studies about the effect of patients' requests to be screened on physicians' decisions to order screening tests, and (4) larger, quantitative studies to follow up on our formative data. PMID:21442338
Henderson, Susan; DeGroff, Amy; Richards, Thomas B; Kish-Doto, Julia; Soloe, Cindy; Heminger, Christina; Rohan, Elizabeth
Purpose To establish the performance characteristics of annual transvaginal ultrasound and serum CA125 screening for women at high risk of ovarian/fallopian tube cancer (OC/FTC) and to investigate the impact of delayed screening interval and surgical intervention. Patients and Methods Between May 6, 2002, and January 5, 2008, 3,563 women at an estimated ? 10% lifetime risk of OC/FTC were recruited and screened by 37 centers in the United Kingdom. Participants were observed prospectively by centers, questionnaire, and national cancer registries. Results Sensitivity for detection of incident OC/FTC at 1 year after last annual screen was 81.3% (95% CI, 54.3% to 96.0%) if occult cancers were classified as false negatives and 87.5% (95% CI, 61.7% to 98.5%) if they were classified as true positives. Positive and negative predictive values of incident screening were 25.5% (95% CI, 14.3 to 40.0) and 99.9% (95% CI, 99.8 to 100) respectively. Four (30.8%) of 13 incident screen-detected OC/FTCs were stage I or II. Compared with women screened in the year before diagnosis, those not screened in the year before diagnosis were more likely to have ? stage IIIc disease (85.7% v 26.1%; P = .009). Screening interval was delayed by a median of 88 days before detection of incident OC/FTC. Median interval from detection screen to surgical intervention was 79 days in prevalent and incident OC/FTC. Conclusion These results in the high-risk population highlight the need for strict adherence to screening schedule. Screening more frequently than annually with prompt surgical intervention seems to offer a better chance of early-stage detection. PMID:23213100
Rosenthal, Adam N.; Fraser, Lindsay; Manchanda, Ranjit; Badman, Philip; Philpott, Susan; Mozersky, Jessica; Hadwin, Richard; Cafferty, Fay H.; Benjamin, Elizabeth; Singh, Naveena; Evans, D. Gareth; Eccles, Diana M.; Skates, Steven J.; Mackay, James; Menon, Usha; Jacobs, Ian J.
CRCHD PNP Project: Moffitt Cancer Center Patient Navigator Program Back to CRCHD Ongoing Research PNP Project Listing Patient Navigation Research Program (PNRP) Participating Research Sites Moffitt Cancer Center Patient Navigator Program
Background Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers. Methods We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000–2006 and followed-up until 2009. A total of 5,309 screen-detected and 1,653 interval cancers were diagnosed. Among the latter, 1,012 could be classified on the basis of findings in screening and diagnostic mammograms, consisting of 489 true interval cancers (48.2%), 235 false-negatives (23.2%), 172 minimal-signs (17.2%) and 114 occult tumors (11.3%). Information on the screening protocol and women's characteristics were obtained from the screening program registry. Cause-specific Cox regression models were used to estimate the hazard ratios (HR) of risks factors for interval cancer and incident screen-detected cancer. A multinomial regression model, using screen-detected tumors as a reference group, was used to assess the effect of breast density and other factors on the occurrence of interval cancer subtypes. Results A previous false-positive was the main risk factor for interval cancer (HR?=?2.71, 95%CI: 2.28–3.23); this risk was higher for false-negatives (HR?=?8.79, 95%CI: 6.24–12.40) than for true interval cancer (HR?=?2.26, 95%CI: 1.59–3.21). A family history of breast cancer was associated with true intervals (HR?=?2.11, 95%CI: 1.60–2.78), previous benign biopsy with a false-negatives (HR?=?1.83, 95%CI: 1.23–2.71). High breast density was mainly associated with occult tumors (RRR?=?4.92, 95%CI: 2.58–9.38), followed by true intervals (RRR?=?1.67, 95%CI: 1.18–2.36) and false-negatives (RRR?=?1.58, 95%CI: 1.00–2.49). Conclusion The role of women's characteristics differs among interval cancer subtypes. This information could be useful to improve effectiveness of breast cancer screening programmes and to better classify subgroups of women with different risks of developing cancer. PMID:25333936
Blanch, Jordi; Sala, Maria; Ibanez, Josefa; Domingo, Laia; Fernandez, Belen; Otegi, Arantza; Barata, Teresa; Zubizarreta, Raquel; Ferrer, Joana; Castells, Xavier; Rue, Montserrat; Salas, Dolores
Background Data suggest that colorectal cancer could be cut by approximately 60% if all people aged 50 years or older received regular screening. Studies have identified socio-cultural attitudes that might inform cancer education and screening promotion campaigns. This article applies item response theory (IRT) to a set of survey items selected to assess sociocultural attitudes in order to determine how current measures may affect what we know about how these attitudes affect colorectal cancer screening (CRCS). Design and Methods A survey of colorectal cancer screening, screening attitudes and cultural beliefs was administered to 1021 African Americans – 683 women and 338 men, ages 50 to 75. Eligibility criteria for participation included being born in the United States, self-identified African American male or female, age 50 to 75 years. The IRT analysis was performed on 655 individuals with complete data for the 43 observed variables. Results Twenty-nine items comprise the Multi-construct African American Cultural Survey (MAACS) that addresses seven cultural constructs: mistrust/distrust, privacy, ethnic identity, collectivism, empowerment, and male gender roles. The items provide adequate information about the attitudes of the population across most levels of the constructs assessed. Among the sociocultural variables considered, empowerment (OR=1.078; 95% CI: 1.008, 1.151) had the strongest association with CRCS adherence and privacy showed promise. Conclusions The MAACS provides a fixed length questionnaire to assess African American CRCS attitudes, two new constructs that might assist in CRCS promotion, and a suggested focus for identification of additional constructs of interest. Significance for public health The 29 items of the Multi-construct African American Cultural Survey, identified through IRT analyses, can be used by community health researchers interested in determining the relevance of cultural constructs in the design and implementation of colorectal cancer screening programs in the African American community. With appropriate identification of sociocultural concerns, CRC health education materials and promotion strategies may avoid unnecessary conflicts with community beliefs and values. Avoiding conflicts between beliefs and values increases the likelihood that evidence and the recommended behaviours are considered for adoption. In addition, the short survey, as well as the broader item set, may be useful as a starting point for surveys to be used with other cancer sites. The application of IRT analysis to measures of cultural constructs to facilitate the development of accurate and efficient measures may prove useful in other racial/ethnic communities where cultural concerns may be relevant for health education and promotion.
Thompson, Vetta L. Sanders; Bugbee, Alan; Meriac, John P.; Harris, Jenine K.
New evidence on breast Magnetic Resonance Imaging (MRI) screening has become available since the American Cancer Society (ACS) last issued guidelines for the early detection of breast cancer in 2003. A guideline panel has reviewed this evidence and developed new recommendations for women at different defined levels of risk. Screening MRI is recommended for women with an approximately 20-25% or
Debbie Saslow; Carla Boetes; Wylie Burke; Steven Harms; Martin O. Leach; Constance D. Lehman; Elizabeth Morris; Etta Pisano; Mitchell Schnall; Stephen Sener; Robert A. Smith; Ellen Warner; Martin Yaffe; Kimberly S. Andrews; Christy A. Russell
Serbia employs opportunistic approaches to cervical cancer screening, leading to inequitable health care access. To better understand the health care needs of women, we investigated their knowledge of and perceived barriers to cervical cancer screening. Data reported in the paper arise from nine focus group discussions with 62 women from diverse socio-economic backgrounds. They were recruited in two cities with
Milica Markovic; Vesna Kesic; Lidija Topic; Bojana Matejic
The purpose of the study was to assess the impact of an educational intervention on prostate cancer screening behavior and knowledge. Participants were 104 African American men, 45 years and older, who had not been screened for prostate cancer with a prostate-specific antigen and/or digital rectal exam within the past year. All participants…
Patel, Kushal; Ukoli, Flora; Liu, Jianguo; Beech, Derrick; Beard, Katina; Brown, Byron; Sanderson, Maureen; Kenerson, Donna; Cooper, Leslie; Canto, Marie; Blot, Bill; Hargreaves, Margaret
Background: Evidence suggests that rural minority populations experience disparities in cancer screening, treatment, and outcomes. It is unknown how race/ethnicity and rurality intersect in these disparities. The purpose of this analysis is to examine the cancer screening rates among minorities in rural areas. Methods: We utilized the 2008…
Bennett, Kevin J.; Probst, Janice C.; Bellinger, Jessica D.
Purpose: The purpose of this study was to enhance adherence among older (aged 55 years and older) African American men enrolled in a cancer screening trial for prostate, lung, and colorectal cancer. For this study, we defined "adherence" as completing the trial screenings. Design and Methods: We used a randomized trial design. Case managers…
Ford, Marvella E.; Havstad, Suzanne; Vernon, Sally W.; Davis, Shawna D.; Kroll, David; Lamerato, Lois; Swanson, G. Marie
Background: The incidence of non-AIDS-defining cancers has increased significantly among persons living with HIV (PLHIV). Screening education is recommended. Purpose: Social learning, minority stress, and cultural safety theories informed this pilot to assess the feasibility of a colorectal cancer screening intervention targeted to PLHIV, with…
Ka'opua, Lana Sue I.; Diaz, Tressa P.; Park, Soon H.; Bowen, Talita; Patrick, Kevin; Tamang, Suresh; Braun, Kathryn L.
The purpose of this study was to explore women's memories and feelings concerning their breasts and breast cancer screening experiences in relation to their current breast cancer screening behaviors. Twelve African American women shared stories that were generated in written narratives and individual interviews. Two core themes emerged from the…
Women with developmental disabilities are significantly less likely than women without disabilities to receive cervical and breast cancer screening according to clinical guidelines. The reasons for this gap are not understood. The present study examined the extent of women's knowledge about cervical and breast cancer screening, with the intention…
Parish, Susan L.; Swaine, Jamie G.; Luken, Karen; Rose, Roderick A.; Dababnah, Sarah
Purpose: We examined the rural-urban disparity of screening for breast cancer and colorectal cancer (CRC) among the elder Medicare beneficiaries and assessed rurality's independent impact on receipt of screening. Methods: Using 2005 Medicare Current Beneficiary Survey, we applied weighted logistic regression to estimate the overall rural-urban…
Fan, Lin; Mohile, Supriya; Zhang, Ning; Fiscella, Kevin; Noyes, Katia
African American women (AAW) have the highest breast cancer mortality rate than any other racial or ethnic group. Limited access to care reduces mammography screening for AAW. Despite barriers, some AAW engage in breast cancer screening (BCS) behaviors like mammography. The salutogenic theory of health focuses on positive health behaviors and offers a framework to understand personal factors which allow
Despite its history of success in cancer screening, Pap cytol- ogy has important limitations, particularly its high false- negative rate, which carries important public health impli- cations. Since the mid-1990s, there has been substantial interest in the use of human papillomavirus (HPV) DNA testing in cervical cancer screening under the premise that the testing of cervical cells for the causative
Eduardo L. Franco
New results from the NCI-sponsored Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial show that screening for ovarian cancer with transvaginal ultrasound (TVU) and the CA-125 blood test did not result in fewer deaths from the disease compared with usual care.
Background Patient education materials can assist patient decision making on prostate cancer screening.\\u000a \\u000a \\u000a \\u000a Objective To explore the effectiveness of presenting health information on prostate cancer screening using video, internet, and written\\u000a interventions on patient decision making, attitudes, knowledge, and screening interest.\\u000a \\u000a \\u000a \\u000a Design Randomized controlled trial.\\u000a \\u000a \\u000a \\u000a Participants A total of 161 men aged over 45, who had never been screened for prostate cancer, were randomized
Dragan Ilic; Kristine Egberts; Joanne E. McKenzie; Gail Risbridger; Sally Green
Since the 1960s, there have been revolutionary developments in imaging technology. Undoubtedly, these advances in imaging technology have made it possible to detect most cancers much earlier than they would have presented with clinical signs or symptoms. However, there are harms from screening, including false-positive results and overdiagnosis, and the costs of screening can be substantial. Therefore, screening for cancer must be rigorously evaluated to ensure that it provides more benefit than harm at an acceptable cost. Unfortunately, the evaluation of cancer screening is difficult and susceptible to several forms of bias. Randomized clinical trials are the most valid study design for cancer screening, but they cannot be expected to answer all the questions that arise with the implementation of screening. Decision modeling can be used to extrapolate the results of randomized clinical trials to help inform public policy and individual decision making. PMID:16829649
Black, William C
Preventative screening in the form of clinical breast examinations remains among the best protections against breast cancer. Despite the benefits that regular examinations confer, many women fail to obtain screening tests. Because ethnic minority women are particularly unlikely to undergo regular screening, and experience increased mortality and…
Regan, Pamela C.; Durvasula, Ramani S.
Background: Women with developmental disabilities are much less likely than nondisabled women to receive cervical and breast cancer screening according to clinical guidelines. One barrier to receipt of screenings is a lack of knowledge about preventive screenings. Method: To address this barrier, we used a randomized control trial (n = 175 women)…
Parish, Susan L.; Rose, Roderick A.; Luken, Karen; Swaine, Jamie G.; O'Hare, Lindsey
Screening using low-dose computed tomography (CT) represents an exciting new development in the struggle to improve outcomes for people with lung cancer. Randomised controlled evidence demonstrating a 20% relative lung cancer mortality benefit has led to endorsement of screening by several expert bodies in the US and funding by healthcare providers. Despite this pivotal result, many questions remain regarding technical and logistical aspects of screening, cost-effectiveness and generalizability to other settings. This review discusses the rationale behind screening, the results of on-going trials, potential harms of screening and current knowledge gaps. PMID:24163745
Bowman, Rayleen V.; Yang, Ian A.; Fong, Kwun M.; Berg, Christine D.
The aim of the present study was to screen candidate genes that are closely associated with bladder cancer and to select the most distinct candidate target genes in order to provide theoretical evidence and direction for improved treatment of bladder cancer. The gene microarray dataset GSE45184 was downloaded from the Gene Expression Omnibus database. There were a total of six expression prolife microarrays from three pairs of freshly frozen bladder cancer tissues and corresponding normal adjacent tissues. Differentially expressed genes (DEGs) were identified using the limma package in R software and then subjected to further biological information analysis, including hierarchical clustering analysis and gene ontology enrichment analysis. Co?expression networks and functional interaction networks were established using the up? and downregulated genes. Pathway enrichment analysis was then performed for the genes in the functional interaction networks. A total of 522 DEGs were identified, including 223 upregulated and 299 downregulated genes. Functional enrichment analysis of the target genes indicated that downregulated genes were associated with the regulation of biological processes, while the upregulated genes participated in the processes involved in the cell cycle. The functional network of the upregulated genes comprised 1,518 connections and 92 gene nodes that were associated with 10 closely?related functions, while the network of the downregulated genes consisted of 129 connections and 24 gene nodes involving 11 significantly related functions. Pathway enrichment analysis revealed that the downregulated genes were mainly involved in the mitogen?activated protein kinase signaling pathway, while the upregulated genes were closely associated with the cell cycle. These DEGs and the relevant cell cycle pathways have the potential to be used as targets for the treatment of bladder cancer. PMID:25323786
Xu, Axiang; Wang, Chunyang; Sun, Shengkun
Background. Substantial subgroups of American women, specifically those of ethnic minorities, have not been screened for cervical cancer or are not screened at regular intervals. The rates for receipt of female-related cancer screening tests remain far below the goals set forth in Healthy People 2010.Objective. This study applied a well-known, recently revised theoretical model of health care access and utilization,
Mohsen Bazargan; Shahrzad H Bazargan; Muhammad Farooq; Richard S Baker
Cervical cancer incidence and mortality have declined in the U.S. over the past 50 years because of broad screening efforts;\\u000a however, some states continue to bear a greater burden due to under-screened and -treated populations. The purpose of this\\u000a study was to utilize the socio-ecological model to examine barriers to cervical cancer screening and treatment in Florida.\\u000a A qualitative semi-structured interview
Ellen DaleyAmina; Amina Alio; Erica H. Anstey; Rasheeta Chandler; Karen Dyer; Hannah Helmy
Despite recommendations for cancer screening for breast and colorectal cancer among the Medicare population, preventive screenings rates are often lower among vulnerable populations such as the small but rapidly growing older American Indian...
Towne, Samuel D; Smith, Matthew Lee; Ory, Marcia G
ObjectiveQuantitative analysis of circulating cell free DNA is considered as a possible aid for lung cancer screening. We aimed to comprehensively review the evidence for use of circulating cell free DNA to screen for lung cancer.
Ruifeng Zhang; Fangchun Shao; Xiaohong Wu; Kejing Ying
Purpose Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women’s willingness to undergo cervical cancer screening in the Wufeng area. Participants and Methods A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Results Women who were willing to undergo screenings had higher knowledge levels. “Anxious feeling once the disease was diagnosed” (47.6%), “No symptoms/discomfort” (34.1%) and “Do not know the benefits of cervical cancer screening” (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Conclusion Efforts are needed to increase women’s knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates. PMID:23843976
Zhou, Hang; Xiang, Qunying; Hu, Ting; Zhang, Qinghua; Chen, Zhilan; Ma, Ding; Feng, Ling
The use of digital mammography for breast cancer screening poses several novel problems such as development of digital sensors, computer assisted diagnosis (CAD) methods for image noise suppression, enhancement, and pattern recognition, compression algorithms for image storage, transmission, and remote diagnosis. X-ray digital mammography using novel direct digital detection schemes or film digitizers results in large data sets and, therefore, image compression methods will play a significant role in the image processing and analysis by CAD techniques. In view of the extensive compression required, the relative merit of 'virtually lossless' versus lossy methods should be determined. A brief overview is presented here of the developments of digital sensors, CAD, and compression methods currently proposed and tested for mammography. The objective of the NCI/NASA Working Group on Digital Mammography is to stimulate the interest of the image processing and compression scientific community for this medical application and identify possible dual use technologies within the NASA centers.
Clarke, Laurence P.; Blaine, G. James; Doi, Kunio; Yaffe, Martin J.; Shtern, Faina; Brown, G. Stephen; Winfield, Daniel L.; Kallergi, Maria
The aim of this study was to examine the influence of demographic variables and the interplay between collectivism and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 111 Vietnamese women from the Richmond, VA, metropolitan area, who participated in a larger cancer screening intervention. All participants completed measures on demographic variables, collectivism, acculturation, and cancer-screening-related variables (i.e., attitudes, self-efficacy, and screening behavior). Findings indicated that collectivism predicted both positive attitudes and higher levels of self-efficacy with regard to breast and cervical cancer screening. Collectivism also moderated the relationship between acculturation and attitudes toward breast cancer screening such that for women with low levels of collectivistic orientation, increasing acculturation predicted less positive attitudes towards breast cancer screening. This relationship was not found for women with high levels of collectivistic orientation. The current findings highlight the important roles that sociodemographic and cultural variables play in affecting health attitudes, self-efficacy, and behavior among Vietnamese women. The findings potentially inform screening programs that rely on culturally relevant values in helping increase Vietnamese women's motivation to screen. PMID:24313445
Nguyen, Anh B; Clark, Trenette T
Objective Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identified as distressed; and (2) effects of screening for distress on distress outcomes. Methods CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT. Results There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement. Conclusion Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening. PMID:23751231
Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.
A new study by Johns Hopkins researchers shows that obese white women may be less likely than normal-weight counterparts and African-Americans of any weight or gender to seek potentially lifesaving colon cancer screening tests. Results of this study follow the same Johns Hopkins group’s previous research suggesting that obese white women also are less likely to arrange for mammograms, which screen for breast cancer, and Pap smears, which search for early signs of cervical cancer.
Objective To compare the effect of evidence based information on risk with that of standard information on informed choice in screening for colorectal cancer.Design Randomised controlled trial with 6 months’ follow-up.Setting German statutory health insurance scheme.Participants 1577 insured people who were members of the target group for colorectal cancer screening (age 50-75, no history of colorectal cancer).Interventions Brochure with evidence
Anke Steckelberg; Christian Hülfenhaus; Burkhard Haastert; Ingrid Mühlhauser
Abstract. CT has recently been used in mass,screening for lung cancer. Small cancers have been identified but the growth,characteristics of these lesions are not fully understood. We identified 82 primary cancers in our 3-year mass CT screening programme, of which 61 were examined in the present study. The volume,doubling,time (VDT) was calculated based on the exponential,model using successive annual,CT images,or
M Hasegawa; S Sone; S Takashima; Z G Yang; Y Maruyama; T Watanabe
Background The Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO) is a US National Cancer Institute (NCI)-funded randomized controlled trial designed to evaluate whether certain screening tests reduce mortality from prostate, lung, colorectal, and ovarian cancer. To obtain adequate statistical power, it was necessary to enroll over 150,000 healthy volunteers. Recruitment began in 1993 and ended in 2001.Purpose Our
Lisa Gren; Karen Broski; Jeffery Childs; Jill Cordes; Deborah Engelhard; Betsy Gahagan; Eduard Gamito; Vivien Gardner; Mindy Geisser; Darlene Higgins; Victoria Jenkins; Lois Lamerato; Karen Lappe; Heidi Lowery; Colleen McGuire; Mollie Miedzinski; Sheryl Ogden; Sally Tenorio; Gavin Watt; Bonita Wohlers; Pamela Marcus
The percentage of U.S. citizens screened for cancer remains below national targets, with significant disparities among racial and ethnic populations, according to the first federal study to identify cancer screening disparities among Asian and Hispanic groups. The report by the Centers for Disease Control and Prevention and the National Cancer Institute (NCI), part of the National Institutes of Health, was published today in the CDC Morbidity and Mortality Weekly Report.
Simpson NK, Johnson CC, Ogden SL, Gamito E, Trocky N, McGuire C, Martin J, Barrow S, Lamerato L, Flickinger LM, Broski KG, Engelhard D, Hilke C, Bonk J, Gahagan B, Gren LH, Childs J, Lappe K, Fouad M, Thompson J, Sullivan D, Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial Project Team. Control Clin Trials. 2000 Dec 01. 21. 6 Suppl. 356S-78S.
BACKGROUND: Inequalities in uptake of cancer screening by ethnic minority populations are well documented in a number of international studies. However, most studies to date have explored screening uptake for a single cancer only. This paper compares breast and bowel cancer screening uptake for a cohort of South Asian women invited to undertake both, and similarly investigates these women's breast
Charlotte L Price; Ala K Szczepura; Anil K Gumber; Julietta Patnick
Colorectal cancer (CRC) screening rates in the US are suboptimal, particularly among lower income and racial\\/ethnically diverse\\u000a groups. If specific populations have limited awareness of screening when they reach age 50, there may be delays in screening\\u000a adoption. This study investigated sociodemographic and social contextual factors associated with awareness of CRC and intentions\\u000a to be screened at age 50 among
Karen Emmons; Elaine Puleo; Lorna H. McNeill; Gary Bennett; Sophia Chan; Sapna Syngal
Objective The authors report the outcomes of a community-based, barber health adviser pilot intervention that aims to develop customized educational materials to promote knowledge and awareness of prostate cancer (CaP) and informed decision making about prostate cancer screening (PCS) among a predominantly African American clientele. Method First, the authors implemented a series of learner verification processes with barbershop clients (n = 15) to adapt existing CaP health promotion materials. Following intervention implementation in the barbershop, they conducted structured surveys with barbershop clients (n = 40) to evaluate the intervention. Results Findings from the posttest showed both a significant increase in barbershop clients' self-reported knowledge of CaP and in the likelihood of discussing PCS with a health care provider (p < .001). The client's cultural model of CaP risk factors revealed cultural consensus (eigenratio = 3.3) and mirrored the biomedical model. All clients surveyed reported positively on the contents of the educational materials, and more than half (53%) had discussed CaP at least twice with their barber in the last month. Conclusion Based on the pilot results, the barber-administered intervention was an appropriate and viable communication channel for promoting CaP knowledge and awareness in a priority population, African American men. PMID:20413392
Luque, John S.; Rivers, Brian M.; Gwede, Clement K.; Kambon, Maisha; Green, B. Lee; Meade, Cathy D.
Potential use of thermography for more effective detection of breast carcinoma was evaluated on 26 patients scheduled for breast carcinoma surgery. Ultrasonographic scan, mammography and thermography were performed at the University Hospital for Tumors. Thermographic imaging was performed using a new generation of digital thermal cameras with high sensitivity and resolution (ThermoTracer TH7102WL, NEC). Five images for each patient were recorded: front, right semi-oblique, right oblique, left- semi oblique and left oblique. While mammography detected 31 changes in 26 patients, thermography was more sensitive and detected 6 more changes in the same patients. All 37 changes were subjected to the cytological analysis and it was found that 16 of samples were malignant, 8 were suspected malignant and 11 were benign with atypia or proliferation while only 2 samples had benign findings. The pathohistological method (PHD) recorded 75.75% malignant changes within the total number of samples. Statistical analysis of the data has shown a probability of a correct mammographic finding in 85% of the cases (sensitivity of 85%, specificity of 84%) and a probability of a correct thermographic finding in 92% of the cases (sensitivity of 100%, specificity of 79%). As breast cancer remains the most prevalent cancer in women and thermography exhibited superior sensitivity, we believe that thermography should immediately find its place in the screening programs for early detection of breast carcinoma, in order to reduce the sufferings from this devastating disease. PMID:23941007
Kolari?, Darko; Herceg, Zeljko; Nola, Iskra Alexandra; Ramljak, Vesna; Kulis, Tomislav; Holjevac, Jadranka Katanci?; Deutsch, Judith A; Antonini, Svetlana
OBJECTIVE. The purpose of this study was to review the records of patients with diagnoses of lung cancer in annual repeat rounds of CT screening in the International Early Lung Cancer Action Program to determine whether the cancer could have been identified in the previous round of screening. MATERIALS AND METHODS. Three radiologists reviewed the scans of 104 lung cancer patients and assigned the findings to one of three categories: 1, cancer was not visible at previous CT screening; 2, cancer was visible at previous CT screening but not identified; 3, abnormality was identified at previous CT screening but not classified as malignant. Nodule size, nodule consistency, cell type, and stage at the previous screening and when identified for further workup for each of the three categories were tabulated. RESULTS. Twenty-four (23%) patients had category 1 findings; 56 (54%) category 2; and 24 (23%) category 3. When diagnosed, seven (29%) category 1, 10 (18%) category 2, and four (17%) category three cancers had progressed beyond stage I. All cancers seen in retrospect were in clinical stage I at the previous screening. Category 1 cancers, compared with categories 2 and 3, had faster growth rates, were less frequently adenocarcinomas (29% vs 54% and 67%, p = 0.01), and were more often small cell carcinomas (29% vs 14% and 12%, p = 0.12). CONCLUSION. Lung cancers found on annual repeat screenings were frequently identified in the previous round of screening, suggesting that review of the varied appearance and incorporation of advanced image display may be useful for earlier detection. PMID:25247825
Ming Xu, Dong; Yip, Rowena; Smith, James P; Yankelevitz, David F; Henschke, Claudia I
IMPORTANCE Screening for lung cancer has the potential to reduce mortality, but in addition to detecting aggressive tumors, screening will also detect indolent tumors that otherwise may not cause clinical symptoms. These overdiagnosis cases represent an important potential harm of screening because they incur additional cost, anxiety, and morbidity associated with cancer treatment. OBJECTIVE To estimate overdiagnosis in the National Lung Screening Trial (NLST). DESIGN, SETTING, AND PARTICIPANTS We used data from the NLST, a randomized trial comparing screening using low-dose computed tomography (LDCT) vs chest radiography (CXR) among 53 452 persons at high risk for lung cancer observed for 6.4 years, to estimate the excess number of lung cancers in the LDCT arm of the NLST compared with the CXR arm. MAIN OUTCOMES AND MEASURES We calculated 2 measures of overdiagnosis: the probability that a lung cancer detected by screening with LDCT is an overdiagnosis (PS), defined as the excess lung cancers detected by LDCT divided by all lung cancers detected by screening in the LDCT arm; and the number of cases that were considered overdiagnosis relative to the number of persons needed to screen to prevent 1 death from lung cancer. RESULTS During follow-up, 1089 lung cancers were reported in the LDCT arm and 969 in the CXR arm of the NLST. The probability is 18.5% (95% CI, 5.4%–30.6%) that any lung cancer detected by screening with LDCT was an overdiagnosis, 22.5% (95% CI, 9.7%–34.3%) that a non-small cell lung cancer detected by LDCT was an overdiagnosis, and 78.9% (95% CI, 62.2%–93.5%) that a bronchioalveolar lung cancer detected by LDCT was an overdiagnosis. The number of cases of overdiagnosis found among the 320 participants who would need to be screened in the NLST to prevent 1 death from lung cancer was 1.38. CONCLUSIONS AND RELEVANCE More than 18% of all lung cancers detected by LDCT in the NLST seem to be indolent, and overdiagnosis should be considered when describing the risks of LDCT screening for lung cancer. PMID:24322569
Patz, Edward F.; Pinsky, Paul; Gatsonis, Constantine; Sicks, JoRean D.; Kramer, Barnett S.; Tammemagi, Martin C.; Chiles, Caroline; Black, William C.; Aberle, Denise R.
increasingly complex with the introduction of human papillomavirus (HPV) vaccination and newer screening (CxCa) screening have grown increasingly complex with the introduction of human papillomavirus (HPV
Druzdzel, Marek J.
recurrences of earlier breast primaries or other malignancies not classified as primary breast cancer (e.g. cytosarcoma phyllodes) [19,20]. Results Numbers of cases, rates per 1000 screened, and odds of presenting with interval cancer or having a cancer...
McCann, Jenny; Stockton, Diane; Godward, Sara
The study reports a questionnaire survey of female university students intended (1) to delin- eate their knowledge of cervical cancer and screening, and (2) to impute their valuation of the introduction of human papillomavirus (HPV) testing. It was found that almost 80% of respondents thought cervical cancer was a leading cause of cancer death amongst women. Most subjects consistently over-estimated
Stacy Johnson; Mark Avis; David K. Whynes
Algorithmic guided screening of drug combinations of arbitrary size for activity against cancer Imaging, and 3 Systems Biology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas; 4 Institute, Santa Fe, New Mexico Abstract The standard treatment for most advanced cancers is multidrug
Low-coherence enhanced backscattering: review of principles and applications for colon cancer the risk of colon carcinogenesis and colonoscopy-free screening for colorectal cancer CRC . Â© 2006 Society; enhanced backscattering; low coherence; elas- tic light scattering; spectroscopy; colorectal cancer. Paper
Ottino, Julio M.
Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes — either organized or opportunistic — have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in
Rengaswamy Sankaranarayanan; Atul Madhukar Budukh; Rajamanickam Rajkumar
A case-control study was conducted to evaluate the efficacy of an on-going oral cancer screening programme in Cuba in preventing advanced oral cancer in Cuba. The cases for the study consisted of 200 oral cancer patients with stage III and IV disease. Three apparently healthy subjects per case, matched for sex, age (plus or minus 5 years) and residing within
R Sankaranarayanan; L Fernandez Garrote; J Lence Anta; P Pisani; A Rodriguez Salva
The high cervical cancer mortality rate among Latinas compared with other ethnic groups in the United States is of major concern. Latina women are almost twice as likely to die from cervical cancer as non-Hispanic white women. To improve Latina cervical cancer screening rates, interventions have been developed and tested. This systematic review…
Corcoran, Jacqueline; Dattalo, Patrick; Crowley, Meghan
African-American women are most likely to die from cervical cancer.cervical cancer screening. The outlook is favorable for most women of color: Nonelderly African- American womenAFRICAN AMERICAN AIAN NHOPI OTHER/MULTIRACIAL WOMEN AGE 18 AND OLDER Note: Women diagnosed with cervical cancer
Ponce, Ninez A.; Babey, Susan H.; Etzioni, David; Spencer, Benjamin A.; Brown, E. Richard R; Chawla, Neetu
Synchronous or metachronous occurrences of both prostate cancer and male breast cancer are rarely reported, but provide insight into their hormonal and genetic biology. We sought to determine the incidence of prostate cancer in male breast cancer patients at our institution, and to examine estrogen receptor (ER), progesterone receptor (PR) and HER-2\\/neu receptor (HR) status in these patients. A retrospective
U J Lee; J S Jones
The National Lung Screening Trial demonstrated a significant mortality benefit for patients at high risk for lung cancer undergoing serial low-dose CT. Currently, the National Comprehensive Cancer Network and several United States-based professional associations recommend CT Lung screening for high-risk patients. In the absence of established reimbursement, the authors modeled and implemented a free low-dose CT lung cancer screening program to provide equitable access to all eligible patients. Elements of the program reported in this article include a decentralized referral network, centralized program coordination, structured reporting, and a patient data management system. The experience and initial results observed in this clinical setting closely match the performance metrics of the National Lung Screening Trial with regard to cancer detection and incidental findings rates. To eliminate health care disparities a vigorous lobbying effort will be needed to expedite reimbursement and make CT lung screening equally available to all patients at high-risk. PMID:23623708
McKee, Brady J; McKee, Andrea B; Flacke, Sebastian; Lamb, Carla R; Hesketh, Paul J; Wald, Christoph
Despite ongoing awareness, educational campaigns, and advances in technology, breast cancer screening remains a complex topic for women and for the health care system. Lack of consensus among organizations developing screening guidelines has caused confusion for patients and providers. The psychosocial factors related to breast cancer screening are not well understood. The prevailing algorithm for screening results in significant rates of patient recall for further diagnostic imaging or procedures, the majority of which rule out breast cancer rather than confirming it. For women, the consequences of the status quo range from unnecessary stress to additional out-of-pocket expenses to indirect costs that are more difficult to quantify. A more thoughtful approach to breast cancer screening, coupled with a research agenda that recognizes the indirect and intangible costs that women bear, is needed to improve cost and quality outcomes in this area. PMID:25247383
Harvey, Susan C; Vegesna, Ashok; Mass, Sharon; Clarke, Janice; Skoufalos, Alexandria
Serbia employs opportunistic approaches to cervical cancer screening, leading to inequitable health care access. To better understand the health care needs of women, we investigated their knowledge of and perceived barriers to cervical cancer screening. Data reported in the paper arise from nine focus group discussions with 62 women from diverse socio-economic backgrounds. They were recruited in two cities with contrasting social settings, Belgrade, the Serbian capital, and a regional town, Smederevo. Thematic analysis identified that the interplay of social and personal barriers influenced women's poor presentation for screening. Inadequate public health education, lack of patient-friendly health services, socio-cultural health beliefs, gender roles, and personal difficulties were the most salient barriers to screening. We suggest how within the context of opportunistic screening patient education may be employed. The introduction of compulsory cervical cancer screening, suggested by some participants, is also discussed. PMID:15953668
Markovic, Milica; Kesic, Vesna; Topic, Lidija; Matejic, Bojana
Cervical cancer incidence rates have decreased dramatically since the implementation of the Papanicolaou (Pap) smear. Nevertheless, the American Cancer Society (ACS) estimates for 2013 predicted more than 12,000 new cases of cervical cancer in the United States. Given that some subpopulations in the United States are at a higher risk for cervical cancer than others, efforts to increase screening adherence are warranted. Many studies have explored the demographics of underscreened women, but no systematic reviews of screening demographics in adult US women were identified in the past 10 years, after release of the 2002 ACS cervical cancer screening guidelines. Knowledge of adherence to these guidelines becomes important as new guidelines were developed and released in 2012. The purpose of this systematic review of relevant studies was to identify factors that predict the use of cervical cancer screening in US women. Variables found to be significantly associated with adherence to screening included education, financial status, acculturation, psychosocial issues, and marital status. Using this information, nurse practitioners and other providers can target specific at-risk populations to increase screening by educating women about the need for cervical cancer screening and ensuring access to methods for prevention and early detection of the disease. PMID:25032031
Limmer, Karen; LoBiondo-Wood, Geri; Dains, Joyce
BACKGROUND Discrimination has been shown as a major causal factor in health disparities, yet little is known about the relationship between perceived medical discrimination (vs. general discrimination outside medical settings) and cancer screening behaviors. We examined whether perceived medical discrimination is associated with lower screening rates for colorectal and breast cancers among racial and ethnic minority adult Californians. METHODS Pooled cross-sectional data from 2003 and 2005 California Health Interview Surveys were examined for cancer screening trends among African-American, American-Indian/Alaskan-Native, Asian, and Latino adult respondents reporting perceived medical discrimination compared to those not reporting discrimination (n=11,245). Outcome measures were dichotomous screening variables for colorectal cancer among respondents, ages 50 -75; and breast cancer among women, ages 40 - 75. RESULTS Women perceiving medical discrimination were less likely to be screened for colorectal (OR = 0.66; CI = 0.64 - 0.69) or breast cancer (OR = 0.52; CI = 0.51 - 0.54) compared to women not perceiving discrimination. Although men who perceived medical discrimination were no less likely to be screened for colorectal cancer than those who did not (OR = 1.02; CI = 0.97 - 1.07), significantly lower screening rates were found among men who perceived discrimination and reported having a usual source of health care (OR = 0.30; CI = 0.28 - 0.32). CONCLUSIONS These findings of a significant association between perceived racial or ethnic-based medical discrimination and cancer screening behaviors have serious implications for cancer health disparities. Gender differences in patterns for screening and perceived medical discrimination warrant further investigation. PMID:18687583
Crawley, LaVera M.; Ahn, David K.; Winkleby, Marilyn A.
BACKGROUND Obesity is associated with increased colorectal cancer incidence and mortality. Previous studies using telephone survey data showed that obese women were less likely to receive colorectal cancer screening. It is unknown if this is true among patients in primary care practices. METHODS Retrospective chart reviews were conducted in 2003–2004 of men and women in 22 suburban New Jersey and Pennsylvania primary care practices. Data from patients age 50 and over (n=1297) were analyzed using hierarchical logistic regression. The outcome measure was receipt of colorectal cancer screening (fecal occult blood test within 1 year, sigmoidoscopy within 5 years, colonoscopy within 10 years, or barium enema within 5 years) among obese and non-obese patients. RESULTS Overall, 39% of patients were obese and 29% received colorectal cancer screening. After controlling for age, gender, total number of co-morbidities, number of visits in the past two years, and number of years in the practice, obese patients had 25% decreased odds of being screened for colorectal cancer compared to non-obese patients (OR 0.75, 95% CI, 0.62– 0.91). The relationship of obesity and colorectal cancer screening did not differ according to gender. Number of visits (OR 1.04, 95% CI, 1.01– 1.06) and male gender (OR 1.53, 95% CI, 1.19– 1.97) was associated with increased odds of receiving colorectal cancer screening. CONCLUSION Identification of physician and patient barriers to colorectal cancer screening is needed, particularly in obese patients, so that effective interventions may be developed to increase screening in this high-risk group. Condensed abstract Obese patients are less likely than non-obese patients to be screened for colorectal cancer. Identification of physician and patient barriers is needed. PMID:17067753
Ferrante, Jeanne M.; Ohman-Strickland, Pamela; Hudson, Shawna V.; Hahn, Karissa A.; Scott, John G.; Crabtree, Benjamin F.
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. In 2000, approximately 130,200 new cases of colorectal cancer will be diagnosed, and 56,300 persons will die from the disease (Greenlee, Murray, Boldan, & Wingo, 2000). A survey conducted for the National Colorectal Cancer Roundtable by the Gallup Organization, found that 47% of people over 50 are not being screened. The National Colorectal Cancer Awareness Month, which began in March 2000, will educate Americans age 50 and older and prescribe physicians about the importance of colorectal cancer screening tests. The effect of increased education and directing physicians to include colorectal screening for their patients will create a need for non-physician endoscopists to meet the screening needs of the population. A colorectal cancer screening center was developed at a large Midwestern teaching hospital utilizing nurse endoscopists. The purpose of this article is to provide information for institutions to develop and implement a colorectal cancer screening center utilizing nurse endoscopists. PMID:11847716
Eisemon, N; Stucky-Marshall, L; Talamonti, M S
Although cervical cancer is one of the most commonly diagnosed cancers among Vietnamese American women (VAW) and Korean American women (KAW), both groups consistently report much lower rates of cervical cancer screening compared with other Asian ethnic subgroups and non-Hispanic Whites. This study aimed to explore multilevel factors that may underlie low screening rates among VAW and KAW living in a city where their ethnic communities are relatively small. The socioecological model was used as a conceptual framework. Thirty participants were conveniently recruited from ethnic beauty salons run by VA and KA cosmetologists in Albuquerque, New Mexico. The participants' average age was 44.6 years (SD = .50; range = 21-60). Most participants were married (80 %) and employed (73.3 %), and had health insurance (83.3 %). A qualitative interview was conducted in Vietnamese or Korean and transcribed verbatim. A thematic content analysis was used to identify major codes, categories, and patterns across the transcripts. The study identified several factors at the individual (e.g., pregnancy, poverty, personality), interpersonal (e.g., family responsibility, mother as influential referent), and community (e.g., lack of availability, community size) levels. The study sheds light on four major areas that must be taken into consideration in the development of culturally appropriate, community-based interventions aimed to reduce disparities in cervical cancer screening among ethnic minority women in the United States: (1) ethnic community size and geographic location; (2) cross-cultural similarities and dissimilarities; (3) targeting of not only unmarried young women, but also close referents; and (4) utilization of trusted resources within social networks. PMID:24863746
Lee, Jongwon; Carvallo, Mauricio
PURPOSE: To assess factors associated with perceptions of prostate cancer screening among African-American men aged > or = 55 years based upon items developed using the Preventive Health model (PHM). RESEARCH APPROACH: Focus group research and thematic coding using content analysis. SETTING: A large midwestern, private, nonprofit health system. PARTICIPANTS: African-American men aged > or = 55 years. Focus group 1 included 10 men who ranged in age from 55-87 years, with a mean age of 73.4 years. The 11 participants in focus group 2 ranged in age from 55-81 years, with a mean age of 68.7 years. METHODOLOGICAL APPROACH: Focus group questions were developed based on the conceptual framework of the PHM. African-American men aged > or = 55 years were randomly selected from the patient population of the healthcare system to participate in one of two focus groups. Content analysis was used to code the focus group transcripts. MAIN RESEARCH VARIABLES: Self-reported perceptions of prostate cancer screening. FINDINGS: Major themes emerging from the focus groups related to prostate cancer screening include: lack of knowledge regarding cancer, fear of cancer, confusion between prostate cancer screening and prostate cancer diagnostic tests, encouragement by others as motivation for cancer screening, intergenerational transfer of health information, lack of health insurance coverage as a barrier to prostate cancer screening and treatment, and limited availability of screening clinic hours during nonworking hours. INTERPRETATION: The information gained from this study could be used to develop interventions promoting informed and shared decision-making by patients and their providers regarding prostate cancer screening. PMID:16623062
Ford, Marvella E.; Vernon, Sally W.; Havstad, Suzanne L.; Thomas, Shirley A.; Davis, Shawna D.
The tendency to resist evidence that doesn't support our own beliefs is a type of confirmation bias. Recent changes to recommendations for breast cancer screening underscore the need for nurses to maintain awareness of most recent and reliable evidence, evaluate women's family histories and encourage women to mitigate modifiable risks and make well-informed decisions. When advising women about breast cancer screening, nurses can employ an approach based on the four Cs: (1) commit to staying up-to-date with evidence; (2) convey understanding; (3) communicate the evidence and answer questions; and (4) collaborate with women on their plan for breast cancer screening. PMID:24548494
Guimond, Mary Elizabeth
Rates of screening for colorectal cancer are consistently lower than those for other types of cancer, particularly breast and cervical. Although the screening rates in the target population--adults over age 50--have increased from 20-30 percent in 1997 to nearly 55 percetn in 2008--the rates are still too low. An NIH state-of-the-science panel was convened this week to identify ways to further increase the use and quality of colorectal cancer screening in the United States.
A new type of holographic screen used to display projected 3-dimensional (3D) images with large viewing angle and relatively high brightness is presented. The screen is 2-dimensional hexagonal lattice relief in micron-scale lattice period, fabricated in plastic sheet using holographic technique and pattern replication method so that the fabrication of the screen is fast and cost effective and large-size screen
Xiangsu Zhang; Shou Liu; Xuechang Ren
ABSTRACT OBJECTIVE To investigate the rates of cervical cancer screening among female patients with psychosis compared with similar patients without psychosis, as an indicator of the quality of primary preventive health care. DESIGN A retrospective cohort study using medical records between November 1, 2004, and November 1, 2007. SETTING Two urban family medicine clinics associated with an academic hospital in Toronto, Ont. PARTICIPANTS A random sample of female patients with and without psychosis between the ages of 20 and 69 years. MAIN OUTCOME MEASURES Number of Papanicolaou tests in a 3-year period. RESULTS Charts for 51 female patients with psychosis and 118 female patients without psychosis were reviewed. Of those women with psychosis, 62.7% were diagnosed with schizophrenia, 19.6% with bipolar disorder, 17.6% with schizoaffective disorder, and 29.4% with other psychotic disorders. Women in both groups were similar in age, rate of comorbidities, and number of full physical examinations. Women with psychosis were significantly more likely to smoke (P < .0001), to have more primary care appointments (P = .035), and to miss appointments (P = .0002) than women without psychosis. After adjustment for age, other psychiatric illnesses, number of physical examinations, number of missed appointments, and having a gynecologist, women with psychosis were significantly less likely to have had a Pap test in the previous 3 years compared with women without psychosis (47.1% vs 73.7%, respectively; odds ratio 0.19, 95% confidence interval 0.06 to 0.58). CONCLUSION Women with psychosis are more than 5 times less likely to receive adequate Pap screening compared with the general population despite their increased rates of smoking and increased number of primary care visits. PMID:20393098
Tilbrook, Devon; Polsky, Jane; Lofters, Aisha
PURPOSE Prostate cancer screening with prostate-specific antigen (PSA) is a controversial issue. The present study aimed to explore physician behaviors during an unannounced standardized patient encounter that was part of a randomized controlled trial to educate physicians using a prostate cancer screening, interactive, Web-based module. METHODS Participants included 118 internal medicine and family medicine physicians from 5 health systems in California, in 2007–2008. Control physicians received usual education about prostate cancer screening (brochures from the Center for Disease Control and Prevention). Intervention physicians participated in the prostate cancer screening module. Within 3 months, all physicians saw unannounced standardized patients who prompted prostate cancer screening discussions in clinic. The encounter was audio-recorded, and the recordings were transcribed. Authors analyzed physician behaviors around screening: (1) engagement after prompting, (2) degree of shared decision making, and (3) final recommendations for prostate cancer screening. RESULTS After prompting, 90% of physicians discussed prostate cancer screening. In comparison with control physicians, intervention physicians showed somewhat more shared decision making behaviors (intervention 14 items vs control 11 items, P <.05), were more likely to mention no screening as an option (intervention 63% vs control 26%, P <.05), to encourage patients to consider different screening options (intervention 62% vs control 39%, P <.05) and seeking input from others (intervention 25% vs control 7%, P<.05). CONCLUSIONS A brief Web-based interactive educational intervention can improve shared decision making, neutrality in recommendation, and reduce PSA test ordering. Engaging patients in discussion of the uses and limitations of tests with uncertain value can decrease utilization of the tests. PMID:23835817
Feng, Bo; Srinivasan, Malathi; Hoffman, Jerome R.; Rainwater, Julie A.; Griffin, Erin; Dragojevic, Marko; Day, Frank C.; Wilkes, Michael S.
Lung cancer is currently one of the most common malignant diseases and is responsible for substantial mortality worldwide. Compared with never smokers, former smokers remain at relatively high risk for lung cancer, accounting for approximately half of all newly diagnosed cases in the US. Screening offers former smokers the best opportunity to reduce their risk of advanced stage lung cancer and there is now evidence that annual screening using low-dose computed tomography (LDCT) is effective in preventing mortality. Studies are being conducted to evaluate whether the benefits of LDCT screening outweigh its costs and potential harms and to determine the most appropriate workup for patients with screen-detected lung nodules. Program efficiency would be optimized by targeting high-risk current smokers, but low uptake among this group is a concern. Former smokers may be invited for screening; however, if fewer long-term current smokers and more former smokers with long quit duration elect to attend, this could have very adverse effects on cost and screening test parameters. To illustrate this point, we present three possible screening scenarios with lung cancer prevalence ranging from between 0.62 and 5.0 %. In summary, cost-effectiveness of lung cancer screening may be improved if linked to successful smoking cessation programs and if better approaches are developed to reach very high-risk patients, e.g., long-term current smokers or others based on more accurate risk prediction models. PMID:24153450
Tota, Joseph E; Ramanakumar, Agnihotram V; Franco, Eduardo L
Introduction A randomized trial has demonstrated that lung cancer screening reduces mortality. Identifying participant and program characteristics that influence the cost-effectiveness of screening will help translate trial results into benefits at the population level. Methods Six U.S. cohorts (males and females aged 50, 60, or 70) were simulated in an existing patient-level lung cancer model. Smoking histories reflected observed U.S. patterns. We simulated lifetime histories of 500,000 identical individuals per cohort in each scenario. Costs per quality-adjusted life-year gained ($/QALY) were estimated for each program: CT screening; stand-alone smoking cessation therapies (4–30% 1-year abstinence); and combined programs. Results Annual screening of current and former smokers aged 50–74 cost between $126,000–$169,000/QALY (minimum 20 pack-years of smoking) or $110,000–$166,000/QALY (40 pack-year minimum), compared to no screening and assuming background quit rates. Screening was beneficial but had a higher cost per QALY when the model included radiation-induced lung cancers. If screen participation doubled background quit rates, the cost of annual screening (at age 50, 20 pack-year minimum) was below $75,000/QALY. If screen participation halved background quit rates, benefits from screening were nearly erased. If screening had no effect on quit rates, annual screening cost more but provided fewer QALYs than annual cessation therapies. Annual combined screening/cessation therapy programs at age 50 cost $130,500–$159,700/QALY, compared to annual stand-alone cessation. Conclusions The cost-effectiveness of CT screening will likely be strongly linked to achievable smoking cessation rates. Trials and further modeling should explore the consequences of relationships between smoking behaviors and screen participation. PMID:21892105
McMahon, Pamela M.; Kong, Chung Yin; Bouzan, Colleen; Weinstein, Milton C.; Cipriano, Lauren E.; Tramontano, Angela C.; Johnson, Bruce E.; Weeks, Jane C.; Gazelle, G. Scott
Cervical cancer is the second most common cause of cancer mortality among women with the vast majority of patients in developing countries. Bhutanese refugees in the United States are from South Central Asia, the 4th leading region of the world for cervical cancer incidence. Over the past few years, Bhutanese refugees have increased significantly in Nebraska. This study evaluates current knowledge of cervical cancer and screening practices among the Bhutanese refugee women in Omaha, Nebraska. The study aimed to investigate cervical cancer and screening knowledge and perceptions about the susceptibility and severity of cervical cancer and perceived benefits and barriers to screening. Self-administered questionnaires and focus groups based on the Health Belief Model were conducted among 42 healthy women from the Bhutanese refugee community in Omaha. The study revealed a significant lack of knowledge in this community regarding cervical cancer and screening practices, with only 22.2 % reporting ever hearing of a Pap test and 13.9 % reporting ever having one. Only 33.3 % of women were in agreement with their own perceived susceptibility to cervical cancer. Women who reported ever hearing about the Pap test tended to believe more strongly about curability of the disease if discovered early than women who never heard about the test (71.4 vs. 45.0 %, for the two groups. respectively). Refugee populations in the United States are in need for tailored cancer education programs especially when being resettled from countries with high risk for cancer. PMID:25060231
Haworth, Rebecca J.; Margalit, Ruth; Ross, Christine; Nepal, Tikka
Evaluating its change over time, CA-125, the protein long-recognized for predicting ovarian cancer recurrence, now shows promise as a screening tool for early-stage disease, according to researchers at The University of Texas MD Anderson Cancer Center. The updated findings are published in Cancer; preliminary data were first presented at the 2010 American Society of Clinical Oncology (ASCO) annual meeting. If a larger study shows survival benefit, the simple blood test could offer a much-needed screening tool to detect ovarian cancer in its early stages – even in the most aggressive forms – in post-menopausal women at average risk for the disease.
We explored the potential impact of human papillomavirus (HPV) testing on women's intentions to be screened for cervical cancer in a cohort of Canadian women. Participants aged 25-65 years from an ongoing trial were sent a questionnaire to assess women's intentions to be screened for cervical cancer with HPV testing instead of Pap smears and to be screened every 4 years or after 25 years of age. We created scales for attitudes about HPV testing, perceived behavioral control, and direct and indirect subjective norms. Demographic data and scales that were significantly different (p < 0.1) between women who intended to be screened with HPV and those who did not intend were included in a stepwise logistic regression model. Of the 2,016 invitations emailed, 1,538 were received, and 981 completed surveys for a response rate of 63% (981/1,538). Eighty-four percent of women (826/981) responded that they intended to attend for HPV-based cervical cancer screening, which decreased to 54.2% when the screening interval was extended, and decreased further to 51.4% when screening start was delayed to age of 25. Predictors of intentions to undergo screening were attitudes (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.15, 1.30), indirect subjective norms (OR: 1.02; 95% CI: 1.01, 1.03) and perceived behavioral control (OR: 1.16; 95% CI: 1.10; 1.22). Intentions to be screened for cervical cancer with HPV testing decreased substantially when the screening interval was extended and screening started at age of 25. Use of primary HPV testing may optimize the screening paradigm, but programs should ensure robust planning and education to mitigate any negative impact on screening attendance rates. PMID:23754203
Ogilvie, Gina S; Smith, Laurie W; van Niekerk, Dirk J; Khurshed, Fareeza; Krajden, Mel; Saraiya, Mona; Goel, Vivek; Rimer, Barbara K; Greene, Sandra B; Hobbs, Suzanne; Coldman, Andrew J; Franco, Eduardo L
Fecal immunochemical tests for hemoglobin (FIT) are changing the manner in which colorectal cancer (CRC) is screened. Although these tests are being performed worldwide, why is this test different from its predecessors? What evidence supports its adoption? How can this evidence best be used? This review addresses these questions and provides an understanding of FIT theory and practices to expedite international efforts to implement the use of FIT in CRC screening. PMID:24672652
Fraser, Callum G.; Halloran, Stephen P.; Young, Graeme P.
Fecal immunochemical tests for hemoglobin (FIT) are changing the manner in which colorectal cancer (CRC) is screened. Although these tests are being performed worldwide, why is this test different from its predecessors? What evidence supports its adoption? How can this evidence best be used? This review addresses these questions and provides an understanding of FIT theory and practices to expedite international efforts to implement the use of FIT in CRC screening. PMID:24672652
Allison, James E; Fraser, Callum G; Halloran, Stephen P; Young, Graeme P
Currently little is known about Portuguese women's knowledge and beliefs about cervical cancer screening, so this information is crucial to the success of cervical cancer screening programs. The intention of this study was to describe the knowledge and beliefs of women in Portugal. In-depth, face-to-face, individual interviews were conducted. Twenty-five females were recruited, the age range was 30 to 60. The results showed a lack of knowledge on cervical cancer and the Pap smear test. From a public policy point of view, it may be important to further explore the extent to which perceived barriers to screening will affect screening uptake when a national screening program is implemented. PMID:23461350
Laranjeira, Carlos António
Following BRCA testing, many women who are non-BRCA carriers undergo risk-reducing procedures and additional ovarian cancer screenings, despite limited data to determine the effectiveness of these interventions among the general population.
Despite considerable research devoted to identifying biomarkers for ovarian cancer, no screening method is currently available for routine early detection of the disease. While highly treatable in its early stages, a lack of symptoms early...
Huckabay, Heath Aaron
USING RISK FOR ADVANCED PROXIMAL COLONIC NEOPLASIA TO TAILOR ENDOSCOPIC SCREENING FOR COLORECTAL CANCER Thomas F. Imperiale, MD, Ching Y Lin, BS, Indiana University School of Medicine; David R. Wagner, MS, James D. Rogge, MD, Indianapolis Gastroenterology
The authors conduct a systematic review of the literature to identify interventions designed to enhance breast cancer screening, diagnosis, and treatment among minority women. Most trials in this area have focused on breast cancer screening, while relatively few have addressed diagnostic testing or breast cancer treatment. Among patient-targeted screening interventions, those that are culturally tailored or addressed financial or logistical barriers are generally more effective than reminder-based interventions, especially among women with fewer financial resources and those without previous mammography. Chart-based reminders increase physician adherence to mammography guidelines but are less effective at increasing clinical breast examination. Several trials demonstrate that case management is an effective strategy for expediting diagnostic testing after screening abnormalities have been found. Additional support for these and other proven health care organization-based interventions appears justified and may be necessary to eliminate racial and ethnic breast cancer disparities. PMID:17881627
Masi, Christopher M.; Blackman, Dionne J.; Peek, Monica E.
Researchers with UCLA’s Jonsson Comprehensive Cancer Center have developed and used a high-throughput molecular screening approach that identifies and characterizes chemical compounds that can target the stem cells that are responsible for creating deadly brain tumors.
A study of nearly 1,300 primary care physicians in the United States found that only about 20 percent of those doctors recommend colorectal cancer (CRC) screenings tests to their patients in accordance with current practice guidelines.
invasive cervical cancer compared with the Papanicolaou (Pap) test, a cytology-based screening method cervical cancer compared with a cytology-based test. The results of the individual trials showed that women with cytology in detecting high-grade cervical lesion precursors, classified as cervical intraepithelial
An Oct. 19, 2010, science writers' seminar to discuss new research findings and future directions in HPV-related cancer research. Among the topics discussed will be the natural history of HPV and related cancers, advances in screening techniques and tools, the role of vaccines and microbicides in prevention, both nationally and internationally, and future research directions.
Fred Hutchinson Cancer Institute researchers have developed a nomogram that incorporates age, Gleason score, and prostate-specific antigen (PSA) level at diagnosis, so that an individual's risk that a screen-detected prostate cancer has been overdiagnosed can be estimated.
Screening women for cervical cancer can save lives. However, among young women, cervical cancer is relatively rare, and too-frequent screening can lead to high costs and adverse events associated with overtreatment. Before 2012, cervical cancer screening guidelines of the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and U.S. Preventive Services Task Force (USPSTF) differed on age to start and how often to get screened for cervical cancer. In 2012, however, all three organizations recommended that 1) screening by Papanicolau (Pap) test should not be used for women aged <21 years, regardless of initiation of sexual activity, and 2) a screening interval of 3 years should be maintained for women aged 21-30 years. ACS and ACOG explicitly recommend against yearly screening. To assess trends in Pap testing before the new guidelines were introduced, CDC analyzed 2000-2010 data from the Behavioral Risk Factor Surveillance System (BRFSS) for women aged 18-30 years. CDC found that, among women aged 18-21 years, the percentage reporting never having been screened increased from 26.3% in 2000 to 47.5% in 2010, and the proportion reporting having had a Pap test in the past 12 months decreased from 65.0% to 41.5%. Among those aged 22-30 years, the proportion reporting having had a Pap test within the preceding 12 months decreased from 78.1% to 67.0%. These findings showed that Pap testing practices for young women have been moving toward the latest guidelines. However, the data also showed a concerning trend: among women aged 22-30 years, who should be screened every 3 years, the proportion who reported never having had a Pap test increased from 6.6% to 9.0%. More effort is needed to promote acceptance of the latest evidence-based recommendations so that all women receive the maximal benefits of cervical cancer screening. PMID:23282861
PURPOSE Interventions tailored to sociopsychological factors associated with health behaviors have promise for reducing colorectal cancer screening disparities, but limited research has assessed their impact in multiethnic populations. We examined whether an interactive multimedia computer program (IMCP) tailored to expanded health belief model sociopsychological factors could promote colorectal cancer screening in a multiethnic sample. METHODS We undertook a randomized controlled trial, comparing an IMCP tailored to colorectal cancer screening self-efficacy, knowledge, barriers, readiness, test preference, and experiences with a nontailored informational program, both delivered before office visits. The primary outcome was record-documented colorectal cancer screening during a 12-month follow-up period. Secondary outcomes included postvisit sociopsychological factor status and discussion, as well as clinician recommendation of screening during office visits. We enrolled 1,164 patients stratified by ethnicity and language (49.3% non-Hispanic, 27.2% Hispanic/English, 23.4% Hispanic/Spanish) from 26 offices around 5 centers (Sacramento, California; Rochester and the Bronx, New York; Denver, Colorado; and San Antonio, Texas). RESULTS Adjusting for ethnicity/language, study center, and the previsit value of the dependent variable, compared with control patients, the IMCP led to significantly greater colorectal cancer screening knowledge, self-efficacy, readiness, test preference specificity, discussion, and recommendation. During the followup period, 132 (23%) IMCP and 123 (22%) control patients received screening (adjusted difference = 0.5 percentage points, 95% CI ?4.3 to 5.3). IMCP effects did not differ significantly by ethnicity/language. CONCLUSIONS Sociopsychological factor tailoring was no more effective than nontailored information in encouraging colorectal cancer screening in a multiethnic sample, despite enhancing sociopsychological factors and visit behaviors associated with screening. The utility of sociopsychological tailoring in addressing screening disparities remains uncertain. PMID:24821891
Jerant, Anthony; Kravitz, Richard L.; Sohler, Nancy; Fiscella, Kevin; Romero, Raquel L.; Parnes, Bennett; Tancredi, Daniel J.; Aguilar-Gaxiola, Sergio; Slee, Christina; Dvorak, Simon; Turner, Charles; Hudnut, Andrew; Prieto, Francisco; Franks, Peter
The purpose of this paper is to assess breast cancer screening rates and explore factors related to all three measures of\\u000a breast cancer screening, mammography, clinical breast examination (CBE), and breast self-examination (BSE), among Korean immigrants\\u000a in the United States. A telephone survey was conducted with 189 Korean women aged 40 and older in Cook County, Illinois. Of\\u000a this group,
Eunice E. Lee; Louis F. Fogg; Georgia R. Sadler
Screening tests for colon, cervical and breast cancer remain underutilized despite their proven effectiveness in reducing\\u000a morbidity and mortality. Stone et al. concluded that cancer screening is most likely to improve when a health organization\\u000a supports performance through organizational changes (OC) in staffing and clinical procedures. OC interventions include the\\u000a use of separate clinics devoted to prevention, use of a
Ana Maria ArroyaveEribeth; Eribeth K. Penaranda; Carmen L. Lewis
This study elucidates the perspective of low-income HIV-positive African American women who have not received cervical cancer screening for five or more years, on the barriers they face in accessing and using reproductive health care. We focused on how women who live in a severely economically depressed and racially segregated neighborhood experience barriers to cervical cancer screening. Andersenâ€™s Behavioral Model
Rachel Rose Deidre Pereira Michele Peake Andrasik; Mike Antoni
This paper synthesizes the perspectives from behavioral science and medical anthropology to discuss factors affecting prostate\\u000a cancer screenings among African American men. It argues that the hegemonic health behavior model historically used to frame\\u000a prostate cancer screenings without considering the context in which African American men are embedded. By the same token,\\u000a the sociocultural perspective tends to articulate the cultural
Breast and cervical cancer, though less common in Mexican-American than in Anglo women, are more likely to go undetected in Mexican-American women, leaving them more vulnerable to advanced disease and death. Although highly effective screening tests--the Pap smear and the mammogram--can detect these cancers early, many Mexican-American women do not regularly undergo these preventive screening tests.^ To explore the differential
Annette Catarina Seibt
Background & Aims: The relative efficacy and effectiveness of different colon screening programs has not been assessed. The purpose of this analysis was to provide a model for comparing several colon screening programs and to determine the key variables that impact program effectiveness. Methods: Five screening programs were compared: annual fecal occult blood test (FOBT) alone, flexible sigmoidoscopy, flexible sigmoidoscopy
David A. Lieberman
BackgroundBecause of limited resources and common barriers to widespread screening, the Surgery Service of the Indianapolis Veterans Affairs Medical Center has focused its colorectal screening program on patients undergoing hernia repair. Our objective was to examine the success, safety, pathology results, and educational benefit of this nontraditional screening program.
Brian J Winkleman; David E Matthews; Eric A Wiebke
With increasing evidence of the effectiveness of mass screening in reducing mortality from breast cancer, the Breast Cancer Screening Study of the Health Insurance Plan of Greater New York is reviewed for its impact on increased efforts to gain participation among its target population. Initial contact efforts brought a 47% response rate, and further efforts increased this to 65%. The additional contact efforts increased response rates among most demographic groups. Women requiring minimum contact efforts were appreciably more likely than the increased effort group to participate in the full set of four screenings. Among those requiring increased efforts, more than 40% had the full set of screening examinations, and about 80% had at least one screening examination in addition to the baseline. Differences in breast cancer detection rates among contact effort groups were small, and there was little difference in mortality from breast cancer. Mortality rates from other causes, however, were higher among reluctant participants and highest among women who refused screening. Efforts to increase participation in screening for breast cancer should be linked to women's concerns with other health problems and to their medical care system. PMID:2187496
Fink, R; Shapiro, S
NCG 4.0 is the latest update of the Network of Cancer Genes, a web-based repository of systems-level properties of cancer genes. In its current version, the database collects information on 537 known (i.e. experimentally supported) and 1463 candidate (i.e. inferred using statistical methods) cancer genes. Candidate cancer genes derive from the manual revision of 67 original publications describing the mutational screening of 3460 human exomes and genomes in 23 different cancer types. For all 2000 cancer genes, duplicability, evolutionary origin, expression, functional annotation, interaction network with other human proteins and with microRNAs are reported. In addition to providing a substantial update of cancer-related information, NCG 4.0 also introduces two new features. The first is the annotation of possible false-positive cancer drivers, defined as candidate cancer genes inferred from large-scale screenings whose association with cancer is likely to be spurious. The second is the description of the systems-level properties of 64 human microRNAs that are causally involved in cancer progression (oncomiRs). Owing to the manual revision of all information, NCG 4.0 constitutes a complete and reliable resource on human coding and non-coding genes whose deregulation drives cancer onset and/or progression. NCG 4.0 can also be downloaded as a free application for Android smart phones. Database URL: http://bio.ieo.eu/ncg/ PMID:24608173
An, Omer; Pendino, Vera; D'Antonio, Matteo; Ratti, Emanuele; Gentilini, Marco; Ciccarelli, Francesca D.