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Skip to Main Content Search International CancerScreening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Collaborative Projects: Participation Rates
Skip to Main Content Search International CancerScreening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer: Mortality Rates | Organization
Skip to Main Content Search International CancerScreening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Cervical Cancer (Archived Tables): Home Organization
Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening ... Colon cancerscreening can detect polyps and early cancers in the intestines. This type of screening can find ...
Abstract Objectives We explored self-reported rates of individual on-schedule breast, cervical, and colorectal cancerscreenings, as well as an aggregate measure of comprehensive screenings, among unmarried women aged 40–75 years. We compared women who partner with women (WPW) or with women and men (WPWM) to women who partner exclusively with men (WPM). We also compared barriers to on-schedule cancerscreenings between WPW/WPWM and WPM. Methods Comparable targeted and respondent-driven sampling methods were used to enroll 213 WPW/WPWM and 417 WPM (n?=?630). Logistic regression models were computed to determine if partner gender was associated with each measure of on-schedule screening after controlling for demographic characteristics, health behaviors, and cancer-related experiences. Results Overall, 74.3% of women reported on-schedule breast screening, 78.3% reported on-schedule cervical screening, 66.5% reported on-schedule colorectal screening, and 56.7% reported being on-schedule for comprehensive screening. Partner gender was not associated with any of the measures of on-schedule screening in multivariable analyses. However, women who reported ever putting off, avoiding, or changing the place of screenings because of sexual orientation were less likely to be on-schedule for comprehensive screening. Women who reported barriers associated with taking time from work and body image concerns were also less likely to be on-schedule for comprehensive screening. Conclusions Barriers to cancerscreening were comparable across types of examinations as well as between WPW/WPWM and WPM. Developing health promotion programs for unmarried women that address concomitant detection and prevention behaviors may improve the efficiency and effectiveness of healthcare delivery and ultimately assist in reducing multiple disease risks.
Rogers, Michelle L.; Armstrong, Gene F.; Rakowski, William; Bowen, Deborah J.; Hughes, Tonda; McGarry, Kelly A.
Objective To define embarrassment and develop an understanding of the role of embarrassment in relation to cervical cancerscreening and self-collected human papillomavirus (HPV) DNA testing in Uganda. Design Cross-sectional, qualitative study using semistructured one-to-one interviews and focus groups. Participants 6 key-informant health workers and 16 local women, purposively sampled. Key informant inclusion criteria: Ugandan members of the project team. Focus group inclusion criteria: woman age 30–69?years, Luganda or Swahili speaking, living or working in the target Ugandan community. Exclusion criteria: unwillingness to sign informed consent. Setting Primary and tertiary low-resource setting in Kampala, Uganda. Results In Luganda, embarrassment relating to cervical cancer is described in two forms. ‘Community embarrassment’ describes discomfort based on how a person may be perceived by others. ‘Personal embarrassment’ relates to shyness or discomfort with her own genitalia. Community embarrassment was described in themes relating to place of study recruitment, amount of privacy in dwellings, personal relationship with health workers, handling of the vaginal swab and misunderstanding of HPV self-collection as HIV testing. Themes of personal embarrassment related to lack of knowledge, age and novelty of the self-collection swab. Overall, embarrassment was a barrier to screening at the outset and diminished over time through education and knowledge. Fatalism regarding cervical cancer diagnosis, worry about results and stigma associated with a cervical cancer diagnosis were other psychosocial barriers described. Overcoming psychosocial barriers to screening can include peer-to-peer education, drama and media campaigns. Conclusions Embarrassment and other psychosocial barriers may play a large role at the onset of a screening programme, but over time as education and knowledge increase, and the social norms around screening evolve, its role diminishes. The role of peer-to-peer education and community authorities on healthcare cannot be overlooked and can have a major impact in overcoming psychosocial and social barriers to screening.
Teng, Flora F; Mitchell, Sheona M; Sekikubo, Musa; Biryabarema, Christine; Byamugisha, Josaphat K; Steinberg, Malcolm; Money, Deborah M; Ogilvie, Gina S
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.
Skip to Main Content Search International CancerScreening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Breast Cancer: Mortality Rates | Screening
In heavy cigarette smokers and former smokers who have accumulated a high risk of lung carcinoma, a primary objective is early detection. Annual chest x-ray screening is a readily available, low cost method to detect asymptomatic lung carcinoma at an early stage (stage I) and, after radical resection, to improve the 5-year survival rate. A project of annual chest x-ray screening, named PRE.DI.CA. was started, for the early diagnosis of asymptomatic lung cancer in the high risk population of heavy cigarette smokers and former smokers, males and females, aged 45-75 years, in the province of Varese. Over a 7-year period, 4.598 heavy smokers enrolled in the PRE.DI.CA. lung project underwent 14.461 chest x-ray examinations. 45 asymptomatic lung cancers were detected and defined histologically. In the province of Varese it was possible to establish early diagnosis of lung carcinoma with annual chest x-ray screening of asymptomatic high risk smokers. 52% stage I diagnosis was achieved at the incidence screening. PMID:15852724
... the disease is found and treated at an early stage . There is no standard or routine screening test for esophageal cancer. Screening for esophageal cancer is under study with screening clinical trials taking place in many parts of the ...
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Distress remains a pervasive experience of patients with cancer. As a result, a quality improvement project was conducted in the breast cancer clinic of a university cancer center in the midwestern United States. Nurses identified a need to increase identification of distress over a six-month period when they made only eight referrals for distress support during 1,291 patient encounters. The eight referrals were the result of patient exhibitions of severe distress in the clinic. To increase identification of distress, as well as referrals for support before patients exhibited severe distress, the National Comprehensive Cancer Network's Distress Thermometer screening tool was implemented in the clinic from June 1 through July 6, 2010. The instrument was completed by each participant during a patient encounter, followed by a review of the responses with a nurse. Referrals for support were offered by nurses when responses indicated a significant level of distress. Nurses increased identification of distress by using the instrument. In addition, referrals for support increased before patients exhibited severe distress. Nurses are positioned to improve care by identifying distress and making referrals for support. PMID:23022932
... rectum small intestine colon (large intestine) What Is Colorectal Cancer? Colorectal cancer is cancer that occurs in the ... or older, start getting screened now. Who Gets Colorectal Cancer? • Both men and women can get it. • It ...
Lung cancer is the leading cause of cancer death. Although smoking prevention and cessation programs have decreased lung cancer mortality, there remains a large at-risk population. Dismal long-term survival rates persist despite improvements in diagnosis, staging, and treatment. Early efforts to identify an effective screening test have been unsuccessful. Recent advances in multidetector computed tomography have allowed screening studies using low-dose computed tomography (LDCT) to be performed. This set the stage for the National Lung Screening Trial that found that annual LDCT screening benefits individuals at high risk for lung cancer. An understanding of the harmful effects of lung cancerscreening is required to help maximize the benefits and decrease the risks of a lung cancerscreening program. Although many questions remain regarding LDCT screening, a comprehensive lung cancerscreening program of high-risk individuals will increase detection of preclinical and potentially curable disease, creating a new model of lung cancer surveillance and management.
Screening for Prostate Cancer: A Guidance Statement From the Clinical Guidelines Committee of the American College of Physicians The full report is titled “Screening for Prostate Cancer: A Guidance Statement From the Clinical Guidelines ...
The result of a lung cancerscreening program should be fewer lung cancer-specific deaths in the screened population. studies\\u000a evaluating chest imaging as a screening tool for lung cancer have not shown a reduction in lung cancer-specific mortality\\u000a to date. The ability of institutions using chest imaging to meet the criteria for successful screening programs has also been\\u000a debated. Contentious
... health history can affect the risk of developing colon cancer. Anything that increases a person's chance of getting ... as familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer (HNPCC; Lynch Syndrome). Colorectal CancerScreening Tests are ...
... ongoing clinical trials is available from the NCI Web site . Three tests are used by health care providers to screen ... ongoing clinical trials is available from the NCI Web site . Risks of Breast CancerScreeningScreening tests have risks. Decisions about screening tests can be ...
... ongoing clinical trials is available from the NCI Web site . Three tests are used by health care providers to screen ... ongoing clinical trials is available from the NCI Web site . Risks of Breast CancerScreeningScreening tests have risks. Decisions about screening tests can be ...
Colorectal cancer (CRC) was the third-leading cause of cancer death in Taiwan in 2008. The natural history of CRC provides a chance for screening and prevention. Most CRC develops from adenomatous polyps. This progression takes at least 10 years in most people. About 90% of CRC develops after 50 years of age. Screening tests can identify cancers, usually at an
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.
Mazzone, Peter J.; Naidich, David P.; Bach, Peter B.
Universal screening for prostate cancer (Pca) using prostate-specific antigen-based testing is not recommended, as the potential harms of screening (overdiagnosis and overtreatment) outweigh potential benefits. The case for Pca screening requires a paradigm shift, which emphasizes the risks of screening over the risks of undetected cancer. Physicians are encouraged to use shared decision making with patients who express an interest in Pca screening, taking into account both the patient's screening preferences and individual risk profile. New models of care informed by the Patient Protection and Affordable Care Act are intended to assist clinicians in providing recommended preventive services. PMID:24830612
Ragsdale, John W; Halstater, Brian; Martinez-Bianchi, Viviana
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 CancerScreening Trial, a 17-year project of the NCI. The PLCO was designed to provide answers about the effectiveness of prostate cancerscreening.
... dying from the disease. For some types of cancer, finding and treating the disease at an early stage may result in a better chance of recovery . Clinical trials that study cancerscreening methods are taking ...
There has been a gradual paradigm shift in the area of screening and early detection of diseases. For many years, the sole focus of public health policies was increasing the uptake rates in screening programs. However, today there is an increasing awareness of the importance of informed decision making -- particularly in the area of screening. The provision of high-quality, evidence-based, and comprehensive information on benefit and harm is an important approach in achieving this objective. The current paper presents a project that was funded by the Federal Ministry of Health. It examines whether existing information material is appropriate to support informed decision making. In the first phase of the project, different screening procedures were assessed systematically and compared using several indicators. Based on the results of an expert workshop, the subsequent research activities focused on colorectal cancer (CRC) screening as one example. Phase II included the systematic search and assessment of print media, e.g., flyers and brochures, while phase III applied the same methods to websites on CRC screening. The information material was analyzed with a mix of methods, involving both experts and users. Finally, the results were presented and discussed with the authors/providers of the information material. Based on the results of this project, the Federal Center for Health Education developed a module on CRC screening for an Internet platform on women's health that is currently being evaluated. In sum, this research project contributes to the development of evidence-based and balanced information as well as informed decision making. PMID:24562711
... causes cervical cancer. To learn more about these tests and what happens during them, visit the Web sites listed at the end of this fact ... statement. To learn more, visit the Task Force Web site. USPSTF Recommendation Grades ... Happens During Screening Tests Screening for Cervical Cancer Get Tested for Cervical ...
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
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... women who have or are at risk for hereditary non-polyposis colon cancer , experts suggest yearly screening with transvaginal ultrasound, beginning as early as age 25. The use of tamoxifen to treat or prevent breast cancer increases the risk of endometrial cancer. TVU ...
Background External validation of existing lung cancer risk prediction models is limited. Using such models in clinical practice to guide the referral of patients for computed tomography (CT) screening for lung cancer depends on external validation and evidence of predicted clinical benefit. Objective To evaluate the discrimination of the Liverpool Lung Project (LLP) risk model and demonstrate its predicted benefit for stratifying patients for CT screening by using data from 3 independent studies from Europe and North America. Design Case–control and prospective cohort study. Setting Europe and North America. Patients Participants in the European Early Lung Cancer (EUELC) and Harvard case–control studies and the LLP population-based prospective cohort (LLPC) study. Measurements 5-year absolute risks for lung cancer predicted by the LLP model. Results The LLP risk model had good discrimination in both the Harvard (area under the receiver-operating characteristic curve [AUC], 0.76 [95% CI, 0.75 to 0.78]) and the LLPC (AUC, 0.82 [CI, 0.80 to 0.85]) studies and modest discrimination in the EUELC (AUC, 0.67 [CI, 0.64 to 0.69]) study. The decision utility analysis, which incorporates the harms and benefit of using a risk model to make clinical decisions, indicates that the LLP risk model performed better than smoking duration or family history alone in stratifying high-risk patients for lung cancer CT screening. Limitations The model cannot assess whether including other risk factors, such as lung function or genetic markers, would improve accuracy. Lack of information on asbestos exposure in the LLPC limited the ability to validate the complete LLP risk model. Conclusion Validation of the LLP risk model in 3 independent external data sets demonstrated good discrimination and evidence of predicted benefits for stratifying patients for lung cancer CT screening. Further studies are needed to prospectively evaluate model performance and evaluate the optimal population risk thresholds for initiating lung cancerscreening. Primary Funding Source Roy Castle Lung Cancer Foundation.
Raji, Olaide Y.; Duffy, Stephen W.; Agbaje, Olorunshola F.; Baker, Stuart G.; Christiani, David C.; Cassidy, Adrian; Field, John K.
... for cancer may have serious side effects . False-negative test results can occur. Screening test results may ... is present. A woman who receives a false-negative test result (one that shows there is no ...
... 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. Upper endoscopy may cause the following ...
... service covered? Search Medicare.gov for covered items Prostate cancerscreenings How often is it covered? Medicare ... covers: Digital rectal exam: Once every 12 months Prostate Specific Antigen (PSA) test: Once every 12 months ...
A review of the literature regarding the screening strategies for colorectal cancer (CRC), particularly for average risk individuals, is analysed. The advantages and disadvantages or limitations of screening modalities for CRC, such as faecal occult blood testing (FOBT) with guaiac-based tests or the new faecal deoxyribonucleic acid tests, endoscopic screening by flexible sigmoidoscopy, colonoscopy, or CT-colonography and double contrast barium enema examination, are reported. The efficacy and cost of the screening tests are evaluated, and it is found that any of the suggested tests is more cost effective than other medical intervention or treatment as compared with no screening. The reported compliance to any form of screening test was 30-40%, a rate that is low enough. The experience of our surgical department of a screening programme, based on FOBT, on 4189 individuals over 50 years old, and application of colonoscopy in positive subjects, is reported. PMID:15655587
Colorectal cancer is one of the neoplasms most suitable for preventive measures, especially screening. Several cost-effective screening strategies are available: detection of fecal occult bleeding through chemical (guaiac tests) or immunological tests and endoscopic procedures such as flexible sigmoidoscopy or colonoscopy. This article reviews the most important studies on colorectal cancerscreening presented at the annual congress of the American Gastroenterological Association, held in San Diego in May 2012, with special emphasis on its effectiveness in reducing the incidence and/or mortality associated with this neoplasm. PMID:23018010
... the disease is found and treated at an early stage . Clinical trials that study cancerscreening methods are taking place in many parts ... levels. Specific tumor markers that may lead to early detection of liver cancer are ... about ongoing clinical trials is available from the NCI Web site . ...
... Regarding Genetic Testing Cancers Diagnosed at Late Stages African American Women and Mass Media Campaign Public Service Announcements Public ... Differences in knowledge of breast cancerscreening among African American, Arab American, and Latina ... of survey responses and black-white disparity ...
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
Adults aged 65 and older represent an increasingly important segment of the US population. Cancer is an important cause of death in this group. Screening for cancer can significantly reduce cancer incidence and mortality. In this review I address screening for breast, cervical, prostate, lung, colorectal, and ovarian cancer in older Americans. Decisions about screening for cancer must consider the effects of screening, diagnostic evaluations, and treatments on the quality of life of each person.
Despite improvements in the clinical and surgical management of pancreatic cancer, limited strides have been made in the early detection of this highly lethal malignancy. The majority of localized pancreatic tumors are asymptomatic, and the recognized presenting symptoms of pancreatic adenocarcinoma are often vague and heterogeneous in nature. These factors, coupled with the lack of a sensitive and noninvasive screening method, have made population-based screening for pancreatic cancer impossible. Nevertheless, at least two large institutions have performed multimodality-screening protocols for individuals with high risk of pancreatic cancer based on genetic predisposition and strong family history. Abnormalities noted during these screening protocols prompted further investigation or surgery that resulted in the discovery of benign, potentially malignant, and malignant pancreatic lesions. In addition to ductal epithelial pancreatic intraepithelial neoplasia, greater sensitivity has recently been achieved in the identification and characterization of precancerous mucinous pancreatic tumors. Advancements in proteomics and DNA microarray technology may confirm serum-based biomarkers that could be incorporated into future screening algorithms for pancreatic cancer.
... Health history and certain medicines can affect the risk of developing endometrial cancer. Anything that increases your ... have abnormal vaginal bleeding, check with your doctor. Risks of Endometrial CancerScreeningScreening tests have risks. ...
... is available from the NCI Web site . Three tests are used by health care providers to screen for breast cancer: Mammogram Mammography is the most common screening test for breast cancer . A mammogram is an x- ...
... Related Links Glossary Buttons and Badges Cancer Home Colorectal CancerScreening Tests Several screening tests can be used to ... Tests The U.S. Preventive Services Task Force recommends colorectal cancerscreening for men and women aged 50–75 using ...
Prostate cancerscreening has been a controversial for decades. The recently published findings of large trials have further intensified the debate. The prospect of reducing mortality from prostate cancer is measured against the risk of over-diagnosing the disease. In individual cases, the trade-off between possible benefits and harms is possible to ascertain, so general recommendations in favor of or against PSA tests for individuals cannot be made. The majority of men, however, are not well-informed on the possible advantages and drawbacks of screening. This situation urgently needs to be corrected. The PSA test is promoted to healthy men, who need to be provided with especially detailed information. If not provided with clear and unbiased information on the risks associated with the test (above all over-diagnosis and over-treatment), these men cannot be considered to be fully informed. PMID:23535548
... cancer symptoms. There are different kinds of screening tests. Screening tests include the following: Physical exam and ... are linked to some types of cancer. Screening tests have risks. Not all screening tests are helpful ...
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
This chapter focuses on the special issues that need to be considered when making decisions to screen older persons for cancer.\\u000a Specifically, while there is substantial evidence that screening for colorectal, breast, and cervical cancer reduces cancer\\u000a mortality among persons in their 50s and 60s [1–6], few screening trials included persons over age 70. Therefore, clinicians\\u000a must assess whether to
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.
... Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin . 2012;62(3):147- ...
... These are called diagnostic tests . General Information About Colorectal Cancer Colorectal cancer is a disease in which malignant (cancer) cells ... Treatment Rectal Cancer Treatment Genetics of Colorectal Cancer Colorectal cancer is the second leading cause of death from ...
Abstract The Dutch-Belgian Randomized Lung CancerScreening Trial (Dutch acronym: NELSON study) was designed to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk subjects will lead to a decrease in 10-year lung cancer mortality of at least 25% compared with a control group without screening. Since the start of the NELSON study in 2003, 7557 participants underwent CT screening, with scan rounds in years 1, 2, 4 and 6. In the current review, the design of the NELSON study including participant selection and the lung nodule management protocol, as well as results on validation of CT screening and first results on lung cancerscreening are described.
Zhao, Ying Ru; Xie, Xueqian; de Koning, Harry J; Mali, Willem P; Vliegenthart, Rozemarijn
The Dutch-Belgian Randomized Lung CancerScreening Trial (Dutch acronym: NELSON study) was designed to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk subjects will lead to a decrease in 10-year lung cancer mortality of at least 25% compared with a control group without screening. Since the start of the NELSON study in 2003, 7557 participants underwent CT screening, with scan rounds in years 1, 2, 4 and 6. In the current review, the design of the NELSON study including participant selection and the lung nodule management protocol, as well as results on validation of CT screening and first results on lung cancerscreening are described. PMID:22185865
Ru Zhao, Ying; Xie, Xueqian; de Koning, Harry J; Mali, Willem P; Vliegenthart, Rozemarijn; Oudkerk, Matthijs
... used to detect or screen for lung cancer. Neuroblastoma Screening (PDQ®) [ patient ] [ health professional ] Expert-reviewed information ... about tests used to detect or screen for neuroblastoma. Oral CancerScreening (PDQ®) [ patient ] [ health professional ] Expert- ...
... 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 ...
An apparatus and method for improving the contrast between incident projected light and ambient light reflected from a projectionscreen are described. The efficiency of the projectionscreen for reflection of the projected light remains high, while permitting the projectionscreen to be utilized in a brightly lighted room. Light power requirements from the projection system utilized may be reduced.
Sweatt, William C. (Albuquerque, NM) [Albuquerque, NM
Projection systems continue to be the best method to produce large (1 meter and larger) displays. However, in order to produce a large display, considerable volume is typically required. The Polyplanar Optic Display (POD) is a novel type of projection display screen, which for the first time, makes it possible to produce a large projection system that is self-contained and only inches thick. In addition, this display screen is matte black in appearance allowing it to be used in high ambient light conditions. This screen is also interactive and can be remotely controlled via an infrared optical pointer resulting in mouse-like control of the display. Furthermore, this display need not be flat since it can be made curved to wrap around a viewer as well as being flexible.
International Cancer International CancerScreening Network (ICSN) Screening Network (ICSN) Rachel Ballard-Barbash, MD, MPH for the NCI ICSN Team Applied Research Program National Cancer Institute Bethesda, MD USA http://appliedresearch.cancer.gov Background
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The goal of this project is to better understand the psychosocial and cultural factors affecting prostate cancerscreening among African American and White men. It is a community-based participatory research project, which involves participation of local ...
... for cancer may have serious side effects . False-negative test results can occur. Screening test results may ... is present. A woman who receives a false-negative test result (one that shows there is no ...
... These are called diagnostic tests . General Information About Prostate Cancer Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male ...
... These are called diagnostic tests . General Information About Prostate Cancer Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male ...
Colorectal cancerscreening tests have been shown to achieve accurate detection of adenomatous polyps and early-stage cancer. However, there is a lack of consensus concerning the choice of screening and surveillance tests and appropriate screening and sur...
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The International CancerScreening Network (ICSN) is a voluntary consortium of countries that have active population-based cancerscreening programs and active efforts to evaluate and improve the processes and outcomes from cancerscreening in practice. The ICSN includes efforts to evaluate cancerscreening for a number of cancers where screening has been demonstrated to be effective, including breast, colorectal, cervical, and lung. These programs can be national or subnational in scope, and established or pilot-based.
Cervical screening has been one of the most successful public health prevention programmes. For 50 years, cytology formed the basis for screening, and detected cervical intraepithelial lesions (CIN) were treated surgically to prevent progression to cancer. In a high-risk country as Denmark, screening decreased the incidence of cervical cancer from 34 to 11 per 100 000, age-standardized rate (World Standard Population). Screening is, however, also expensive; Denmark (population: 5.6 million) undertakes close to half a million tests per year, and has 6-8 CIN-treated women for each prevented cancer case. The discovery of human papillomavirus (HPV) as the cause of cervical cancer dramatically changed perspectives for disease control. Screening with HPV testing was launched around 1990, and preventive HPV vaccination was licensed in 2006. Long-term randomized controlled trials (RCT) demonstrated that HPV testing provides better protection against cervical cancer than cytology, but it requires extra repeated testing. HPV vaccination RCTs, furthermore, have proved that HPV vaccination protects against vaccine-type high-grade CIN in women vaccinated prior to sexual activity, but less so in women vaccinated later. The challenge now is therefore to find an algorithm for screening of a heterogeneous population including non-vaccinated women; women vaccinated prior to start of sexual activity; and women vaccinated later. PMID:25046198
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.
... United States than in other parts of the world. Liver cancer is uncommon in the United States, ... is the fourth most common cancer in the world. In the United States, men, especially Chinese American ...
... may not improve health or help a person live longer. Some cancers never cause symptoms or become ... if treatment of these cancers would help you live longer than if no treatment were given, and ...
\\u000a Cancer is a devastating and debilitating disease. Each year more than 1.4 million people are diagnosed with non-skin cancers\\u000a and 565,650 lives are lost in the United States . Primary prevention of cancer through behavioral modifications in risk\\u000a factors such as tobacco use, sun exposure, obesity, physical inactivity, unhealthy diet, and alcohol consumption can reduce\\u000a the burden of cancer tremendously
... independent group of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, ...
The goal of this project has been to develop and characterize an electrochemical microsystem for the rapid point-of-care genetic screening of breast-cancer. We introduced new electrical DNA biosensing routes for genetic screening of breast-cancer. These i...
STUDY OBJECTIVE--The aim of the study was to determine whether thermography could be used to identify women with breast cancer or women at risk of developing the disease within five years. DESIGN--Women were screened for breast cancer and a documentary follow up was conducted five years later through general practitioner records. SETTING--The project involved Women resident in the Bath District Health Authority area, who were invited to attend a breast screening clinic. SUBJECTS--10,238 women aged between 40 and 65 were screened. Of these, 4284 accepted personal letters of invitation from their general practitioners and 5954 volunteered to take part in the project in response to publicity; 9819 (96.5%) were traced after five years. MEASUREMENTS AND MAIN RESULTS--All the women had a thermographic and clinical examination of their breasts. If either examination was abnormal they were referred for mammography. Sensitivity of thermography was found to be 61% and specificity 74%. A documentary follow up of each woman was conducted five years later, when it was found that 71.6% of the women who developed breast cancer had had a normal thermogram at the time of examination, as did 73% of those who did not. CONCLUSIONS--Thermography is not sufficiently sensitive to be used as a screening test for breast cancer, nor is it useful as an indicator of risk of developing the disease within five years.
Williams, K L; Phillips, B H; Jones, P A; Beaman, S A; Fleming, P J
... condition called cryptorchidism (an undescended testicle) is a risk factor for testicular cancer. Anything that increases the chance of getting a ... if you think you may be at risk. Risk factors for testicular cancer include the following: Having cryptorchidism (an undescended testicle). ...
... lesions in the mouth are coated with a blue dye. Areas that stain darker are more likely to be cancer or become cancer. Fluorescence staining: A procedure in which lesions in the mouth are viewed using a special light. After the patient uses a fluorescent mouth rinse, ...
Colorectal CancerScreening Implementation of a public health programme An Expert Group on Colorectal CancerScreeningCancer Society of Finland, Finnish Cancer Registry, Mass Screening Registry Aims of colorectal cancerscreening • The main aim is
It’s one of the pressing questions of cancer research: Does screening reduce mortality? In 1993, the National Cancer Institute launched one of the largest cancerscreening trials ever planned in the United States, in an effort to answer the question of screening efficacy in four cancers: prostate, lung, colorectal, and ovarian.
Breast cancerscreening programmes have been integrated in a systematic way into the public health policies of numerous countries. Breast cancer is indeed one of the (rare) health issues which answers the criteria necessary to organize a screening on a large scale. The different methods of diagnosis and the results of various strategies (based on randomized controlled trials and meta-analysis) are described and compared. This reveals that the Belgian policy in this matter is and remains founded today: a standardized mammotest every 2 years for all women from 50 to 69. PMID:19899372
Breast cancerscreening programmes have been integrated in a systematic way into the public health policies of numerous countries. Breast cancer is indeed one of the (rare) health issues which answers the criteria necessary to organize a screening on a large scale. The different methods of diagnosis and the results of various strategies (based on randomized controlled trials and meta-analysis) are described and compared. This reveals that the Belgian policy in this matter is and remains founded today: a standardized mammotest every 2 years for all women from 50 to 69. PMID:18705598
... dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage . Information about ongoing clinical trials is available from the NCI Web site . ...
... the body's largest organ . It protects against heat, sunlight, injury, and infection . Skin also helps control body ... cancer risk factors include: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...
... often in black women than in white women. Human papillomavirus (HPV) infection is the major risk factor ... Although most women with cervical cancer have the human papillomavirus (HPV) infection , not all women with an ...
... often in black women than in white women. Human papillomavirus (HPV) infection is the major risk factor ... Although most women with cervical cancer have the human papillomavirus (HPV) infection , not all women with an ...
In 1974 a non-randomised study of the effect of mass screening by physical examination and xeromammography on mortality from breast cancer was started. Of the 20 555 eligible women in the city of Utrecht born between 1911 and 1925 (aged 50-64 at the start of the study), 14 796 attended for screening. Four rounds of screening were carried out. The
F. de Waard; H. J. A. Collette; J. J. Rombach; N. E. Day
Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Many, if not most, cases arise from premalignant lesions (adenomas) which may be identified and removed prior to becoming frankly malignant. For over a decade, colonoscopy has been the preferred modality for both CRC screening and prevention in the US. Early reports suggested that colonoscopic screening imparted a 90% risk reduction for colorectal cancer. Subsequent studies showed that estimate to be overly optimistic. While still an outstanding CRC screening and detection tool, colonoscopy has several important limitations. Some of these limitations relate to the mechanics of the procedure such as the risk of colonic perforation, bleeding, adverse consequences of sedation, and the inability to detect all colonic polyps. Other limitations reflect issues with patient perception regarding colonoscopy which, at least in part, drive patient non-adherence to recommended testing. This review examines the literature to address several important issues. First, we analyze the effect of colonoscopy on CRC incidence and mortality. Second, we consider the patient-based, periprocedural, and intraprocedural factors which may limit colonoscopy as a screening modality. Third, we explore new techniques and technologies which may enhance the efficacy of colonoscopy for adenoma detection. Finally, we discuss the short and long-term future of colonoscopy for CRC screening and the factors which may affect this future.
Dr. Barry Kramer summaries the results of the Prostate, Lung, Colorectal and Ovarian CancerScreening Trial. Dr. Christine Berg discuss the results of the colorectal cancer arm of the Prostate, Lung, Colorectal and Ovarian CancerScreening Trial.
Researchers are working on developing effective methods to screen for prostate cancer. However, it has not yet been shown that screening for prostate cancer decreases the chances of dying from prostate cancer.
Background Despite evidence that several colorectal cancer (CRC) screening strategies can reduce CRC mortality, screening rates remain low. This study aimed to determine whether the approach by which screening is recommended influences adherence. Methods We used a cluster randomization design with clinic time block as the unit of randomization. Persons at average risk for development of CRC in a racially/ethnically diverse urban setting were randomized to receive recommendation for screening by fecal occult blood testing (FOBT), colonoscopy, or their choice of FOBT or colonoscopy. The primary outcome was completion of CRC screening within 12 months after enrollment, defined as performance of colonoscopy, or 3 FOBT cards plus colonoscopy for any positive FOBT result. Secondary analyses evaluated sociodemographic factors associated with completion of screening. Results A total of 997 participants were enrolled; 58% completed the CRC screening strategy they were assigned or chose. However, participants who were recommended colonoscopy completed screening at a significantly lower rate (38%) than participants who were recommended FOBT (67%) (P< .001) or given a choice between FOBT or colonoscopy (69%) (P< .001). Latinos and Asians (primarily Chinese) completed screening more often than African Americans. Moreover, non-white participants adhered more often to FOBT, while white participants adhered more often to colonoscopy. Conclusions The common practice of universally recommending colonoscopy may reduce adherence to CRC screening, especially among racial/ethnic minorities. Significant variation in overall and strategy-specific adherence exists between racial/ethnic groups; however, this may be a proxy for health beliefs and/or language. These results suggest that patient preferences should be considered when making CRC screening recommendations. Trial Registration clinicals.gov Identifier: NCT00705731
Inadomi, John M.; Vijan, Sandeep; Janz, Nancy K.; Fagerlin, Angela; Thomas, Jennifer P.; Lin, Yunghui V.; Munoz, Roxana; Lau, Chim; Somsouk, Ma; El-Nachef, Najwa; Hayward, Rodney A.
A CONTROVERSIAL SUBJECT: Several large randomised studies have demonstrated a reduction in mortality due to breast cancer of around 30% in women aged over 50, with the development of systematic mammography. There are data also suggesting an identical benefit in women aged 40 to 49, when screening is intensified. A recent meta-analysis has contradicted the results of randomised studies on screening, but this study is clearly debatable. THE SITUATION IN FRANCE: No randomised study has been organised. A national program is aimed at screening 7 400 000 women aged 50 to 74. THE KEY TO SUCCESS: The active participation of women, health professionals and public authorities is the fundamental condition for a well-organised mass screening. PMID:12610384
Cottu, Paul-Henri; Cuvier, Caroline; Perret, Francine; Gorins, André; Espié, Marc
Colorectal cancer is Europe's most frequent malignancy with an annual incidence of more than 430000 cases and a mortality approaching 50%. Fecal blood tests (guaiac fecal occult blood tests, fecal immunological tests) are primarily designed for early cancer detection. They lack sensitivity and have to be repeated annually to be effective. Optical colonoscopy allows the detection and endoscopic removal of precancerous lesions and early cancer. Hence, it represents the most comprehensive and complete--albeit invasive and expensive--screening tool available to date. More sensitive DNA-based stool and blood tests are currently under evaluation and may have the potential to influence a future screening programme, yet to be implemented in our country. PMID:23659152
Low-dose computed tomography (LDCT) screening has been shown to result in detection of earlier-stage lung cancers, with a 20% reduction in cancer-related deaths. LDCT screening offers significant potential benefits to selected patients; however, many questions remain, including questions about the applicability of lung cancerscreening in clinical practice.
This article presents an overview of the challenges that men encounter in making decisions about prostate cancerscreening, including complex affective and cognitive factors and controversies in the interpretation of the evidence on prostate cancerscreening. Shared decision making involving patient decision aids are discussed as approaches that can be used to improve the quality of prostate cancerscreening decisions, including a close alignment between a man's values, goals, and preferences and his choice about screening. PMID:24725488
Non–AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancerscreening is now an important component\\u000a of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an\\u000a assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the\\u000a screening test and its potential outcome.
Keith Sigel; Robert Dubrow; Michael Silverberg; Kristina Crothers; Scott Braithwaite; Amy Justice
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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.
Kazak, Anne E.; Brier, Moriah; Alderfer, Melissa A.; Reilly, Anne; Parker, Stephanie Fooks; Rogerwick, Stephanie; Ditaranto, Susan; Barakat, Lamia P.
Researchers are working on developing effective methods to screen for lung cancer. Currently, however, there is no generally accepted screening test for lung cancer. Several lung cancerscreening methods being studied include tests of sputum (mucus brought up from the lungs by coughing), chest x-rays, and spiral (helical) CT scans.
NCI has comprehensive research-based information on cancer prevention, screening, diagnosis, treatment, genetics and supportive care. Our information specialists can answer questions related to cancer, including cervical cancerscreening and treatment. You can contact us by phone, online chat, or e-mail.
Objectives: Unmarried women are less likely than married women to receive recommended cancerscreenings. Patient-provider communication is a consistent predictor of cancerscreening among women. The purpose of this study was to investigate the relationship between patient-provider communication, barriers to cancerscreening, and on-schedule breast and cervical cancerscreening (BCCS) among unmarried women. Methods: Data were from the CancerScreeningProject for Women, a 2003-2005 survey examining cancerscreening practices. We computed polytomous logistic regression models to examine the relationship between communication (communication about tests, communication about sexual and intimate relationships), barriers to screening, and on-schedule BCCS among unmarried women. Results: A total of 630 women were enrolled, and 605 women completed the baseline questionnaire. Overall, more than 60% reported on-schedule BCCS. More than half reported that their providers communicated about BCCS most or all of the time. Fewer than half communicated about sexual history and intimate relationships. Women who reported that their providers communicated about screening tests and their sexual and intimate relationships were more likely to be on-schedule for BCCS. Conclusion: Patient-provider communication in multiple areas may encourage women to remain on-schedule for their recommended cancerscreenings. Longitudinal research should be conducted to examine whether communication predicts BCCS, and to examine how patient and provider characteristics may influence communication in order to promote adherence to screening guidelines for unmarried women. Practice Implications: Comprehensive communication that goes beyond information about screening tests may impact adherence to cancerscreening guidelines.
Politi, Mary C.; Clark, Melissa A.; Rogers, Michelle L.; McGarry, Kelly; Sciamanna, Chris N.
... you love): What Women Need to Know about Colon CancerScreening March is National Colorectal Cancer Awareness Month ... screened for colorectal cancer. Test Your Knowledge About Colorectal Cancer (CRC) Screening If you think the answer is ...
This paper discusses axial holographic speckle screens for projecting images recorded in a volume photosensitive material based on dichromated gelatin. It is shown that, when speckle screens are recorded with radiation in the sensitivity region of dichromated gelatin at a wavelength of 442?nm, it is possible to reconstruct images with radiation of another region of the spectrum, including with white light. The projective properties of the screens are investigated, and the effect of light concentration by means of the screen in the region of the visibility zone is demonstrated.
Ganzherli, N. M.; Denisyuk, Yu. N.; Maurer, I. A.; Chernykh, D. F.
In 2005, there were 9264 deaths from prostate cancer, accounting for 4.7% of the total number of cancer deaths in Japan. As the population continues to age, interest in prostate cancerscreening has increased, and opportunistic screening for prostate cancer has been conducted worldwide. The guideline for prostate cancerscreening was developed based on the established method. The efficacies of prostate-specific antigen (PSA) and digital rectal examination (DRE) were evaluated. Based on the balance of the benefits and harms, recommendations for population-based and opportunistic screening were formulated. Two methods of prostate cancerscreening were evaluated. Based on the analytic framework involving key questions, 1186 articles published from January 1985 to October 2006 were selected using MEDLINE and other methods. After the systematic literature review, 28 articles were identified as providing evidence of mortality reduction from prostate cancer, including 5 observational studies for DRE screening, 1 meta-analysis, 3 randomized controlled trials and 19 observational studies for PSA screening. Although several studies showed that PSA screening had a beneficial effect, the results of the selected studies were inconsistent. Overall, the evidence that screening reduced mortality from prostate cancer was insufficient. Furthermore, prostate cancerscreening is associated with serious harms, including overdiagnosis, adverse effects of needle biopsy and adverse effects of local prostatectomy. At present, the evidence for the effect of prostate cancerscreening is insufficient. Both PSA and DRE were not recommended for population-based screening programs, but they could be conducted as individual-based screening if basic requirements were met. PMID:19346535
The Prostate, Lung, Colorectal and Ovarian (PLCO) CancerScreening Trial, sponsored by the National Cancer Institute (NCI), reached a significant milestone last month with the enrollment of its final participant
Editor's Note: This is the first of a 2-part series focused on quality improvement in cancerscreening. The first part highlights screening specific to breast and colon cancer. The second part will review some theories of health behavior that can be applied to motivate patients to adopt regular screening behavior and will emphasize risk assessment, decision support for patients, and
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 cancerscreening. Fact Sheet
Cervical cancer is the 11th leading cause of death from cancer for females in Japan. In 2005, there were 2486 deaths from cervical cancer, accounting for 1.8% of the total number of cancer deaths in Japan. Cervical cancerscreening using conventional cytology has been conducted worldwide. The guideline for cervical cancerscreening was developed based on the established method. The efficacies of conventional and liquid-based cytology, human papillomavirus testing alone and two combination methods were evaluated. On the basis of the balance of the benefits and harms, recommendations for population-based and opportunistic screening were formulated. Five methods of cervical cancerscreening were evaluated. On the basis of the analytic framework involving key questions, 3450 articles published from January 1985 to October 2007 were selected using MEDLINE and other methods. After the systematic literature review, 66 articles were confirmed. The results of 33 studies were consistent, and the evidence was sufficient to evaluate the effect of conventional cytology screening. The accuracy of liquid-based cytology was almost equal to that of conventional cytology. Although human papillomavirus testing and combination methods showed high sensitivity, no study has evaluated the reduction in mortality from cervical cancer. Except for the possibility of overdiagnosis, no serious adverse effects of cervical cancerscreening were found. Cervical cancerscreening using conventional and liquid-based cytology is recommended for population-based and opportunistic screening due to sufficient evidence. Cervical cancerscreening using either human papillomavirus testing alone or two combination methods is not recommended for population-based screening due to insufficient evidence. PMID:20436034
Breast cancerscreening is a highly complex and more recently a controversial topic. Conventional screening includes breast self-examination, clinical breast examination, and screening mammography. Several newer imaging modalities have been introduced into the screening armamentarium including breast magnetic resonance imaging and whole-breast automated ultrasound. Novel imaging techniques like positron emission mammography are currently under clinical investigation in the hopes of improving the sensitivity of breast cancerscreening. In addition, the development of biochemical assays, which employ minimally invasive sampling are also promising. PMID:22828098
Feldman, Elizabeth D; Oppong, Bridget A; Willey, Shawna C
Other than skin cancer, prostate cancer is the most frequently diagnosed cancer in men, and it is the second leading cause of cancer-related death for males in the United States. Screening for prostate cancer using prostate-specific antigen testing became widely used by the late 1980s, augmenting the digital rectal exam. This led to a decline in the percentage of prostate cancer cases that were metastatic at diagnosis and a decrease in prostate cancer mortality. But some argued it led to overtreatment of prostate cancers as well. Recently, the U.S. Preventive Services Task Force (USPSTF) issued recommendations against routine prostate cancerscreening in asymptomatic patients. The recent recommendations have created much controversy among medical professionals, patient advocate groups, and the general public. Most prostate cancerscreening recommendations from professional organizations agree that an informed discussion and review of each individual patient’s clinical situation should drive the decision to screen or not to screen, but the current USPSTF recommendations largely remove patient and provider autonomy in this regard. They do not contribute toward personalized screening based on individualized patient risk profiles, characteristics, and preferences.
Quality assurance is a key issue in colorectal cancerscreening, because effective screening is able to improve primary prevention of the cancer. The quality measure may be described in terms: how well the screening test tells who truly has a disease (sensitivity) and who truly does not have a disease (specificity). This paper raises concerns about identification of the optimal screening test for colorectal cancer. Colonoscopy vs flexible sigmoidoscopy in colorectal cancerscreening has been a source of ongoing debate. A multicentre randomised controlled trial comparing flexible sigmoidoscopy with usual care showed that flexible sigmoidoscopy screening is able to diminish the incidence of distal and proximal colorectal cancer, and also mortality related to the distal colorectal cancer. However, colonoscopy provides a more complete examination and remains the more sensitive exam than flexible sigmoidoscopy. Moreover, colonoscopy with polypectomy significantly reduces colorectal cancer incidence and colorectal cancer-related mortality in the general population. The article considers the relative merits of both methods and stresses an ethical aspect of patient's involvement in decision-making. Patients should be informed not only about tests tolerability and risk of endoscopy complications, but also that different screening tests for bowel cancer have different strength to exclude colonic cancer and polyps. The authorities calculate effectiveness and costs of the screening tests, but patients may not be interested in statistics regarding flexible sigmoidoscopy screening and from an ethical point of view, they have the right to chose colonoscopy, which is able to exclude a cancer and precancerous lesions in the whole large bowel. PMID:23516135
OBJECTIVE--To assess the efficacy of visual screening for cervical cancer in the maternal and child health setting. DESIGN--Clinical and cytological screening. SETTING--Maternal and child health centres, Delhi. SUBJECTS--44,970 women attending the centres from May 1988 to March 1991. RESULTS--238 cancers in early stages (0-IIa) were detected cytologically and proved through biopsy. Prevalence of cancer in women defined as high risk
Background Data from Egyptian studies provide widely varying estimates on the prevalence of pre-malignant and malignant cervical abnormalities and human papilloma virus (HPVs) infection. To define the prevalence and risk factors of pre-invasive and invasive cervical cancer (cacx), a community based full-scale cross sectional, household survey including 5453 women aged between 35 and 60 years was conducted. Methods The study period was between February 2000 and December 2002. Initially, conventional Papanicolaou (Pap) smears were evaluated using the Bethesda system (TBS), followed by colposcopic guided biopsy (CGB) for all epithelial abnormalities (EA). In a third step, HPV was tested on all EA by in-situ hybridization (ISH) using first the broad spectrum HPV probe recognizing HPVs 6, 11, 16, 18, 30, 31, 35, 45, 51 and 52 followed by subtyping with probes 6/11, 16/18 and 31/33. Lastly, unequivocal cases were immunostained for herpes simplex type-2 (HSV-2), cytomegalovirus (CMV), and human immunodeficiency virus (HIV). Results EA representing 7.8% (424/5453), were categorized into atypical squamous cell of undetermined significance (ASCUS) (34.4%), atypical glandular cell of undetermined significance (AGCUS) (15.3%), combined ASCUS and AGCUS (3.1%), low grade squamous intraepithelial lesions (SIL) (41.0%), high grade SIL (5.2%) and invasive lesions (1%). CGB of EA (n = 281) showed non neoplastic lesions (12.8%), atypical squamous metaplasia (ASM) (19.2%), cervical intraepithelial neoplasia I (CIN) (44.4%), CIN II (4.4%), CINIII (2.8%), endocervical lesions (5.2%), combined squamous and endocervical lesions (10.0%), invasive squamous cell carcinoma (SCC) (0.02%) and extranodal marginal zone B cell lymphoma (MZBCL) (0.02%). The overall predictive value of cytology was 87% while the predictive value for high grade lesions was 80%. On histological basis, HPVs were present in 94.3% of squamous lesions while it was difficult to be identified in endocervical ones. ISH revealed positivity for pan HPV in 65.9% of the studied biopsies (n = 217), with incorporation of the viral genome HPV 6/11, 16/18 and 31/33 in 11.1%, 33.3% and 17.1% respectively. Multiple HPVs infections were identified in 0.02%. Conclusion Pre-invasive high grade lesions and invasive cervical carcinoma represent 0.5% and 0.04% respectively in Egyptian women. HPV mostly 16/18 as a risk factor (p < 0.001), was frequently associated with mixed infections (p < 0.001) and bilharzial infestation (p < 0.001).
Abd El All, Howayda S; Refaat, Amany; Dandash, Khadiga
As part of the strategic planning for increasing participation by community residents in cancerscreening, a survey about life style and attitudes toward cancerscreening was carried out in Samukawa town, Kanagawa Prefecture. Subjects were males 40 years old or over, and females 30 years old or over selected by random sampling from residents. Number of subjects was 1,916 (822 males, 1,094 females). Self administered anonymous questionnaires were sent and returned by mail. The response rate was 73%. The results were as follows: (1) The reported participation rates for cancerscreening under "the Health and Medical Services Law for the Aged" did not reflect the actual participation rate of residents. (2) The major reason for not participation in screening was lack of interest in cancer prevention. (3) Socio-economic status of regular participants in screening was different from persons who did not participate. (4) Persons who did not participate in screening were more passive with regard to obtaining knowledge of cancer than regular participants. (5) Results of this study show that cancer prevention education at various levels such as by clinical offices, TV and radio programs, and newspapers may be effective. In order to increase participation in screening programs, health education that considers the life style characteristics of persons who do not participate in the screening programs is vitally important. PMID:2132383
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
A stage-shift cancerscreening model is developed in the context of a randomized controlled trial (RCT) of cancerscreening. In the model, detection by screening causes the time of diagnosis of the cancer to be advanced so that either the stage at diagnosis is shifted from one stage to the next lower one or the stage of diagnosis is unchanged but the cancer is diagnosed earlier in the stage. These are called external and internal stage shifts, respectively. At each stage the extent of the external and internal shifts and any associated mortality benefits are estimated. Further, the model allows the interrelationships of these benefits within and between stages to be delineated. This then allows us to better understand the results of the RCT. Data from a completed breast cancerscreening RCT are used to illustrate the application of the model and its value in improving our understanding of the trial's results. PMID:2681551
Breast cancer is one of the most prevalent forms of cancer in the world today. The search for effective treatment and screening methods is a highly active area of research. The digital image-based elastotomography (DIET) project is a new breast cancerscreening system under development, where surface motion from the mechanically actuated breast is measured in 3D, and used as
The controversial recent recommendation by the United States Preventive Services Task Force (USPSTF) against prostate-specific antigen (PSA) screening for early-stage prostate cancer has caused much debate. Whereas USPSTF recommendations against routine screening mammography in younger women resulted in fierce public outcry and eventual alteration in the language of the recommendation, the same public and political response has not been seen with PSA screening for prostate cancer. It is of paramount importance to ensure improved efficiency and transparency of the USPSTF recommendation process, and resolution of concerns with the current USPSTF recommendation against PSA screening for all ages. PMID:24725487
Background The 5-year overall survival rate of lung cancer patients is approximately 15%. Most patients are diagnosed with advanced-stage disease and have shorter survival rates than patients with early-stage disease. Although screening for lung cancer has the potential to increase early diagnosis, it has not been shown to reduce lung cancer mortality rates. In 1993, the Prostate, Lung, Colorectal, and Ovarian (PLCO) CancerScreening Trial was initiated specifically to determine whether screening would reduce mortality rates from PLCO cancers. Methods A total of 77?464 participants, aged 55–74 years, were randomly assigned to the intervention arm of the PLCO CancerScreening Trial between November 8, 1993, and July 2, 2001. Participants received a baseline chest radiograph (CXR), followed by three annual single-view CXRs at the 10 US screening centers. Cancers were classified as screen detected and nonscreen detected (interval or never screened) and according to tumor histology. The positivity rates of screen-detected cancers and positive predictive values (PPVs) were calculated. Because 51.6% of the participants were current or former smokers, logistic regression analysis was performed to control for smoking status. All statistical tests were two-sided. Results Compliance with screening decreased from 86.6% at baseline to 78.9% at the last screening. Overall positivity rates were 8.9% at baseline and 6.6%–7.1% at subsequent screenings; positivity rates increased modestly with smoking risk categories (Ptrend < .001). The PPVs for all participants were 2.0% at baseline and 1.1%, 1.5%, and 2.4% at years 1, 2, and 3, respectively; PPVs in current smokers were 5.9% at baseline and 3.3%, 4.2%, and 5.6% at years 1, 2, and 3, respectively. A total of 564 lung cancers were diagnosed, of which 306 (54%) were screen-detected cancers and 87% were non–small cell lung cancers. Among non–small cell lung cancers, 59.6% of screen-detected cancers and 33.3% of interval cancers were early (I–II) stage. Conclusions The PLCO CancerScreening Trial demonstrated the ability to recruit, retain, and screen a large population over multiple years at multiple centers. A higher proportion of screen-detected lung cancers were early stage, but a conclusion on the effectiveness of CXR screening must await final PLCO results, which are anticipated at the end of 2015.
Hu, Ping; Oken, Martin M.; Winslow, Stephen D.; Kvale, Paul A.; Prorok, Philip C.; Ragard, Lawrence R.; Commins, John; Lynch, David A.; Andriole, Gerald L.; Buys, Saundra S.; Fouad, Mona N.; Fuhrman, Carl R.; Isaacs, Claudine; Yokochi, Lance A.; Riley, Thomas L.; Pinsky, Paul F.; Gohagan, John K.; Berg, Christine D.
Background: Early detection of skin cancers by screening could be very beneficial to decrease their morbidity or mortality. There is limited study about skin cancerscreening in Iran. Aim: This essay was planned as a pilot skin cancerscreening campaign in Tehran, Iran to evaluate its profit and failure and further design large-scale screening program more definitely. Materials and Methods: Thirty one public health centers of Shahid Beheshti Medical University were selected in different areas of Tehran. The project was announced via media and invited all the people above 40 years old to come for the whole-body skin examination in a one-week period. Patients with any suspected lesions were referred to the dermatology clinics of the university. Results: 1314 patients, 194 males (14.8%) and 120 females (85.2%), with mean age of 51.81 ± 10.28 years participated in this screening campaign. Physicians found suspected lesions in 182 (13.85%) of participants. The diagnosis of skin cancer was confirmed in 15 (1.14%) patients. These malignancies included 10 (0.76%) cases of basal cell carcinoma, 2 (0.15%) cases of squamous cell carcinoma and 3 (0.23%) cases of malignant melanoma. Conclusion: Skin cancerscreening seems to be valuable to detect skin malignancies in their early course. Regarding the considerable amount of facilities needed to perform skin cancerscreening program, it might be more beneficial to perform the targeted screening programs for the high-risk groups or emphasis more on public education of skin cancer risk factors and their early signs.
Worldwide, colorectal (CRC) is the third most common form of cancer, after lung and breast cancer, and the fourth most common cause of cancer death, although in developed countries CRC incidence is higher and it accounts for an even higher proportion of cancer deaths. Successful treatment of early-stage CRC confers substantial survival advantage, and there is now overwhelming evidence that screening average-risk individuals for CRC reduces the incidence and disease-specific mortality. In spite of considerable research for new biomarkers for CRC, the detection of blood in faeces remains the most effective screening tool. The best evidence to date for population-based CRC screening comes from randomised-controlled trials that used a guaiac-based faecal occult blood test (gFOBt) as the first-line screening modality, whereby test-positive individuals are referred for follow-up investigations, usually colonoscopy. A major innovation in the last ten years or so has been the development of other more analytically sensitive and specific screening techniques for blood in faeces. The faecal immunochemical test for haemoglobin (FIT) confers substantial benefits over gFOBt in terms of analytical sensitivity, specificity and practicality and FIT are now recommended for CRC screening by the European guidelines for quality assurance in colorectal cancerscreening and diagnosis. The challenge internationally is to develop high quality CRC screening programmes for which uptake is high. This is especially important for developing countries witnessing an increase in the incidence of CRC as populations adopt more westernised lifestyles. This review describes the tests available for CRC screening and how they are being used worldwide. The reader will gain an understanding of developments in CRC screening and issues that arise in choosing the most appropriate screening test (or tests) for organised population-based screening internationally and optimising the performance of the chosen test (or tests). Whilst a wide range of literature has been cited, this is not a systematic review. The authors provide FOBT CRC screening for a population of 14.6 million in the south of England and the senior author (SPH) was the lead author of the European guidelines for quality assurance in colorectal cancerscreening and diagnosis and leads the World Endoscopy Organization Colorectal Cancer Committee's Expert Working Group on 'FIT for Screening'. PMID:24769265
Carroll, Magdalen R R; Seaman, Helen E; Halloran, Stephen P
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.
... usually caused by conditions other than cancer. False-negative test results can occur. Screening test results may ... is present. A person who receives a false-negative test result (one that shows there is no ...
... These are called diagnostic tests . General Information About Lung Cancer Lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung. The lungs are a pair of cone-shaped ...
Colorectal cancer (CRC) screening in asymptomatic, average-risk populations can reduce mortality and incidence of CRC. The United States Preventive Services Task Force, the American Cancer Society, and the Multi-Society Task Force all recommend initiation of screening at the age of 50 yr for men and women of all races, with an identical menu of screening options. However, there are important differences in risk based on gender, race, and ethnicity. These differences could influence the timing of initiation of screening, and the most optimal form of screening test. This commentary discusses the basis for these differences, and proposes that we should consider customization of screening based on gender, race, and ethnicity. PMID:16393231
OBJECTIVE A high quality screening mammography program should find breast cancer when it exists, when it’s small, and ensure that suspicious findings receive prompt follow-up. The Mammography Quality Standards Act (MQSA) guidelines related to tracking outcomes are insufficient for assessing quality of care. We used data from a quality improvement project to determine whether mammography screening facilities could show that they met certain quality benchmarks beyond those required by MQSA. METHODS Participating facilities (N=52) provided aggregate data on screening mammograms conducted in calendar year 2009 and corresponding diagnostic follow-up, including lost to follow-up and timing of diagnostic imaging and biopsy, cancer detection rates, and the proportion of cancers detected as minimal and early stage tumors. RESULTS The percentage of institutions meeting each benchmark varied from 27% to 83%. Facilities with American College of Surgeons or National Comprehensive Cancer Network designation were more likely to meet benchmarks pertaining to cancer detection and early detection, and Disproportionate Share facilities were less likely to meet benchmarks pertaining to timeliness of care. CONCLUSIONS Results suggest a combination of care quality issues and incomplete tracking of patients. To accurately measure quality of the breast cancerscreening process, it is critical that there be complete tracking of patients with abnormal screening mammograms so that results can be interpreted solely in terms of quality of care. The Mammography Quality Standards Act guidelines for tracking outcomes and measuring quality indicators should be strengthened to better assess quality of care.
Rauscher, Garth H.; Murphy, Anne Marie; Orsi, Jennifer M.; Dupuy, Danielle M.; Grabler, Paula M.; Weldon, Christine B.
Using spiral computed tomography (CT) to screen people at increased risk for lung cancer can detect the disease at an early stage and may increase the number of people who can be cured, according to the Oct. 26, 2006, New England Journal of Medicine. However, it is too soon to say whether such screening actually helps people live longer.
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) CancerScreening Trial, it is possible to evaluate several screening tests and cancers in the same trial to preserve resources.
The aim of this study was to review the evidence in the literature for organised cancerscreening programmes. A Medline search for publications related to organised cancerscreening programmes and their components was done. While there is a broad descriptive literature on various cancerscreening programmes, there are few published studies that evaluate the impact of organised cancerscreening. Most
Cancer is the second leading cause of death in the United States, and is projected to overtake cardiovascular diseases as the number one cause of mortality in adults within a decade. Cancerscreening offers an opportunity to detect cancer precursor lesions at early stages, and hence preemptively manage and prevent development of frank cancers. Despite tremendous technological advances over last decade, which allow us to study genomic/epigenomic and proteomic profile of cells with unprecedented details, it has been difficult to develop non-invasive biomarkers with high sensitivity and specificity that can have clinical applications. Dysplasia, which requires histopathological examination of the tissue, remains the best marker of propensity to develop cancer, and hence the best available surrogate biomarker. However, procuring tissues for detection of dysplasia is highly invasive and economically unviable for most visceral malignancies. Therefore, there is emphasis on developing circulating biomarkers through a consortium approach where high-performing biomarkers in basic research are tested in large collaborative clinical settings to assess their clinical efficacy. In this review, we have discussed fundamental principles of cancerscreening, difficulties in developing novel and effective biomarkers, continuing reliance on dysplasia as best available surrogate marker for cancerscreening, as well as briefly highlighted newer screening modalities. PMID:24910362
Khunger, Monica; Kumar, Ujjwal; Roy, Hemant K; Tiwari, Ashish K
We aim to define which patients make up the populations with high and intermediate risk of developing breast cancer, to review the studies of screening with magnetic resonance imaging in addition to mammography in high risk patients (describing the imaging characteristics of the cancers in this group), to review the studies of screening with magnetic resonance imaging in patients with intermediate risk, and to update the guidelines for screening in patients with high or intermediate risk (based on the recent recommendations of the main scientific societies/American and European guidelines). PMID:22579381
Alonso Roca, S; Jiménez Arranz, S; Delgado Laguna, A B; Quintana Checa, V; Grifol Clar, E
This study investigates empirically how past screening behaviour, individual and household characteristics affect the current uptake of cervical cancerscreening in UK. For the conceptual framework, we use a modified Grossman model which is extended for non-economic factors. A dynamic version of a random effects panel probit model with initial conditions is estimated on the balanced sub-sample of the data. The analysis sample is restricted to women of age 16 and older and grouped into different age categories with respect to the NHS Cervical Screening Programme (NHSCSP). As dataset a balanced panel data of 857 women with 11,998 observations from the British Household Panel Study (BHPS) for the period from 1992 to 2008 is used for the analysis. Results suggest show that previous screening uptake, age, partner status, employment status and a previous GP visit have a significant influence on the likelihood of the uptake of cervical cancerscreening. PMID:23917486
This study investigates empirically how past screening behaviour, individual and household characteristics affect the current uptake of cervical cancerscreening in UK. For the conceptual framework, we use a modified Grossman model which is extended for non-economic factors. A dynamic version of a random effects panel probit model with initial conditions is estimated on the balanced sub-sample of the data. The analysis sample is restricted to women of age 16 and older and grouped into different age categories with respect to the NHS Cervical Screening Programme (NHSCSP). As dataset a balanced panel data of 857 women with 11,998 observations from the British Household Panel Study (BHPS) for the period from 1992 to 2008 is used for the analysis. Results suggest show that previous screening uptake, age, partner status, employment status and a previous GP visit have a significant influence on the likelihood of the uptake of cervical cancerscreening.
... 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 ...
... cancer) cells form in the tissues of the colon or the rectum. The colon and rectum are ... health history can affect the risk of developing colon cancer. Anything that increases a person's chance of ...
... Cancer , Lung Cancer - Non-Small Cell , Prostate Cancer Why We Screen for Some Cancers and Not Others ... additional tests that also carry risks. This is why the American Cancer Society uses scientific evidence to ...
Importance Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancerscreening too frequently, there is little information about patients’ perceptions regarding cessation of cancerscreening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening. Objective To obtain a deeper understanding of older adults’ perspectives on screening cessation and their experiences communicating with clinicians about this topic. Design Semistructured interview study. Setting Senior health center affiliated with an urban hospital. Participants We interviewed 33 older adults presenting to a senior health center. Their median age was 76 years (range, 63–91 years). Of the 33 participants, 27 were women; 15 were African American, 16 were white, 1 was Asian, and 1 was American Indian. Main Outcome Measures We transcribed audio recordings of interviews and analyzed them using methods of grounded theory to identify themes and illustrative quotes. Results Undergoing screening tests was perceived by participants as morally obligatory. Although many saw continued screening as a habit or custom not involving any decision, cessation of screening would require a major decision. Many asserted that they had never discussed screening cessation with their physicians or considered stopping on their own; some reported being upset when their physician recommended stopping. Although some would accept a physician’s strong recommendation to stop, others thought that such a physician’s recommendation would threaten trust or lead them to get another opinion. Participants were skeptical about the role of statistics and the recommendations of government panels in screening decisions but were more favorable toward stopping because of the balance of risks and benefits, complications, or test burdens. Conclusions and Relevance For many older adults, stopping screening is a major decision, but continuing screening is not. A physician’s recommendation to stop may threaten patient trust. Effective strategies to reduce nonbeneficial screening may include discussion of the balance of risks and benefits, complications, or burdens.
Torke, Alexia M.; Schwartz, Peter H.; Holtz, Laura R.; Montz, Kianna; Sachs, Greg A.
In its first two years of funding, the "Risk-Based Breast CancerScreening in Community Settings" (BCSC-P01) program project achieved major advances in understanding breast cancer risk, effectiveness of screening mammography in women at elevated risk, and use of breast magnetic resonance imaging (MRI). The studies summarized below represent the first time these findings have been reported in scientific journals.
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
Although faecal and endoscopic tests appear to be effective in reducing colorectal cancer incidence and mortality, further technological and organizational advances are expected to improve the performance and acceptability of these tests. Several attempts to improve endoscopic technology have been made in order to improve the detection rate of neoplasia, especially in the proximal colon. Based on the latest evidence on the long-term efficacy of screening tests, new strategies including endoscopic and faecal modalities have also been proposed in order to improve participation and the diagnostic yield of programmatic screening. Overall, several factors in terms of both efficacy and costs of screening strategies, including the high cost of biological therapy for advanced colorectal cancer, are likely to affect the cost-effectiveness of CRC screening in the future.
Haemoccult screening for colorectal tumours was carried out in Hungary in small cities and villages around Budapest. Haemoccult slides were supplied to 17,662 individuals over 40 years of age, and 15,431 (87%) were returned. Of these, 346 (2.2%) were positive and 18 colorectal carcinomas were detected. Additionally, 24 patients with one or more polyps greater than 1 cm diameter were found. Of the screened cases of cancer 39% were in Dukes' stage A and B, a rate twice as good as when screening was not done. The cost per tumour detected amounted to about three times more than one monthly income, indicating that the costs of screening for colorectal cancer are relatively much higher in Hungary than in Western countries. All expenses were met from state funds.
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-cancerscreening. 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) CancerScreening 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.
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.
Colorectal cancer (CRC) is still one of the leading causes of cancer-related death in Western countries, despite major improvements in its treatment. The dramatically high social and economic impact of CRC on human health makes the identification of a reliable screening tool of paramount importance. Current screening methods, such as the fecal occult blood test and colonoscopy do not adequately meet the ideal requisites of a screening test because, even if they are effective, they are limited first by too low specificity and sensitivity, or second by high invasiveness, costs and risk. Nowadays extended efforts are made by researchers to look for more reliable and effective screening tests based on a systems biology approach, using biological samples easily available, such as urine, breath, serum and feces. The effectiveness and reliability of several new attempts to screen these patients by non-invasive analysis of their biological samples using genomic (genetic and epigenetic alteration), transcriptomic (miRNA), proteomic (cancer-related antigens, new antibodies against tumor-associated antigens, mutated proteins) and metabolomic (volatile organic metabolites) methods are discussed in this review. Among the most interesting new screening tools, fecal fluorescent long-DNA, fecal miRNA and metabolomic evaluation in breath and/or serum seem to be most promising.
Di Lena, Maria; Travaglio, Elisabetta; Altomare, Donato F
Screening for prostate cancer has been the subject of a new controversy in 2012, because of the updated and contradictory results of the two large randomized trials of prostate cancer and while the United States Preventive Services Task Force (USPSTF) recommended not use PSA in screening, because of the risk of overdiagnosis and overtreatment especially. However, this new thinking about PSA and screening may mislead the public and create a health risk. Media pressure must be an opportunity to remind the individual screening recommendations, but also to encourage innovation for better detection and better assess prostate cancer stage. New biomarkers and MRI are promising to improve screening with the PSA and DRE. The assessment of the value of PSA around 50 years is a predictor of the risk of prostate cancer and rhythm monitoring depends on the initial value and the velocity of PSA. The challenge of the coming years will be to identify patients to be treated regarding age, life expectancy and tumor aggressiveness and to identify clearly those who can benefit of active surveillance. PMID:23682467
Donor transmitted malignancy is a real disastrous risk when dealing with expanded criteria donors. As donor age is increasing, guidelines for cancerscreening of the elderly brain dead organ donors must be evidence-based but systematic review of such is sparse. Based on a review of published literature and our 20 years' experience, we propose a new series of guidelines concerning screening for the four most common malignancies: breast colon, lung and prostate cancer. Prospective testing of the efficacy of such protocol will then follow. PMID:24841765
Colorectal cancer (CRC) is a major health problem worldwide. Although population-based CRC screening is strongly recommended in average-risk population, compliance rates are still far from the desirable rates. High levels of screening uptake are necessary for the success of any screening program. Therefore, the investigation of factors influencing participation is crucial prior to design and launches a population-based organized screening campaign. Several studies have identified screening behaviour factors related to potential participants, providers, or health care system. These influencing factors can also be classified in non-modifiable (i.e., demographic factors, education, health insurance, or income) and modifiable factors (i.e., knowledge about CRC and screening, patient and provider attitudes or structural barriers for screening). Modifiable determinants are of great interest as they are plausible targets for interventions. Interventions at different levels (patient, providers or health care system) have been tested across the studies with different results. This paper analyzes factors related to CRC screening behaviour and potential interventions designed to improve screening uptake.
Summary Screening and early detection of pancreatic cancer has the potential to substantially impact outcomes in this deadly disease. Over the last ten years several cohort studies have been conducted and report on the yield of screening in high risk populations. With better understanding of the cellular compartments and the genetic and epigenetic changes that occur, biomarkers have also emerged as promising means of early detection. In this paper we summarize the results of the latest screening cohort and highlight a novel proteomic approach that may be used in future biomarker studies.
Gonda, Tamas A; Lucas, Aimee; Saif, Muhammad Wasif
... the body's largest organ . It protects against heat, sunlight, injury, and infection . Skin also helps control body ... cancer risk factors include: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...
On the other hand, there are some downsides. There can be false positives. That happens quite commonly with a variety of screening tests. So the person without cancer actually has a positive test, and therefore they have to go through the fear, the false alarm, and the anxiety of going through workups in the fear that they may actually have cancer when they don’t.
Mammography is the recommended method for breast cancerscreening of women in the general population. However, mammography alone does not perform as well as mammography plus supplemental screening in high-risk women. Therefore, supplemental screening with MRI or ultrasound is recommended in selected high-risk populations. Screening breast MRI is recommended in women at high risk for breast cancer on the basis of family history or genetic predisposition. Ultrasound is an option for those high-risk women who cannot undergo MRI. Recent literature also supports the use of breast MRI in some women of intermediate risk, and ultrasound may be an option for intermediate-risk women with dense breasts. There is insufficient evidence to support the use of other imaging modalities, such as thermography, breast-specific gamma imaging, positron emission mammography, and optical imaging, for breast cancerscreening. 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 includes 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 in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:23290667
Mainiero, Martha B; Lourenco, Ana; Mahoney, Mary C; Newell, Mary S; Bailey, Lisa; Barke, Lora D; D'Orsi, Carl; Harvey, Jennifer A; Hayes, Mary K; Huynh, Phan Tuong; Jokich, Peter M; Lee, Su-Ju; Lehman, Constance D; Mankoff, David A; Nepute, Joshua A; Patel, Samir B; Reynolds, Handel E; Sutherland, M Linda; Haffty, Bruce G
Purpose: To identify women's sources of information about cervical cancerscreening, information which women report receiving during Pap consultations, information they would like to receive, and the relationships between perceived information needs, personal characteristics and information sources. Design/methodology/approach: Logistic regression…
Whynes, David K.; Clarke, Katherine; Philips, Zoe; Avis, Mark
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…
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 cancerscreening 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 cancerscreening 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
... continuing until age 75 years. When Should I Begin to Get Screened? You should begin screening for colorectal cancer soon after turning 50, ... Speak with your doctor about when you should begin screening and how often you should be tested. ...
The homeless population is a medically vulnerable patient population in our communities. Of particular concern to dermatologists is the risk for the development of skin cancer in the homeless, in light of their chronic sun exposure and suboptimal sun protection behaviors. Two free skin cancerscreenings conducted at the Fourth Street Clinic in Salt Lake City, Utah, in 2011 and 2012, resulted in the diagnosis of 13 skin cancers in 62 patients. These events also highlighted that many homeless patients had suboptimal skin cancer prevention behaviors. We believe that education, awareness, and disease prevention can be relatively easily accomplished by local homeless clinics as a first line of defense against skin cancer in the homeless population. PMID:23374956
Wilde, Megan; Jones, Benjamin; Lewis, Bethany K; Hull, Christopher M
Although prostate cancer has immense human and financial costs, there is great uncertainty about how to best screen for and treat prostate cancer. This project uses data from existing studies of prostate cancer to develop a decision model to estimate the ...
Part 2. Attitudes Toward and Training In Colorectal CancerScreening We are interested in your opinions about and training in colorectal cancerscreening in this section. 12. In the U.S. today, many adults over the age of 50 are not screened for colorectal cancer.
This document is the first update of the American College of Gastroenterology (ACG) colorectal cancer (CRC) screening recommendations since 2000. The CRC screening tests are now grouped into cancer prevention tests and cancer detection tests. Colonoscopy every 10 years, beginning at age 50, remains the preferred CRC screening strategy. It is recognized that colonoscopy is not available in every clinical
Douglas K Rex; David A Johnson; Joseph C Anderson; Phillip S Schoenfeld; Carol A Burke; John M Inadomi
Background: Adjustment for stage at diagnosis markedly reduces USA versus European colorectal cancer survival differences and a screening bias was therefore suspected. Moreover, little is known about colorectal cancerscreening habits in European primary care and the history of guidelines implementation. The purpose of the study was to index the overall colorectal cancerscreening attitudes of European physicians involved in
Breast cancer is one of the most prevalent forms of cancer in the world today. The search for effective treatment and screening methods is a highly active area of research. The Digital Image-based ElastoTomography (DIET) project is a new breast cancerscreening system under development, where surface motion from the mechanically actuated breast is measured in 3D, and used as
Richard G. Brown; Christopher E. Hann; J. Geoffrey Chase
OBJECTIVE: To examine patient and physician preferences in regard to 5 colorectal cancerscreening alternatives endorsed by a 1997 expert\\u000a panel, determine the impact of patient and physician values regarding certain test features on screening preference, and assess\\u000a physicians’ perceptions of patients’ values.\\u000a \\u000a \\u000a DESIGN: Cross-sectional survey.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: A general internal medicine practice at an academic medical center in 1998.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS:
Bruce S. Ling; Mark A. Moskowitz; David Wachs; Brad Pearson; Paul C. Schroy
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 cancerscreening in a large sample of Native Americans from the Northern Plains. Methods A survey was administered orally to 975 individuals in 2004â2006 from three reservations and among the urban Native American community in the service region of the Rapid City Regional Hospital. Data analysis was conducted in 2007â2008. Results Forty-four percent of individuals reported ever receiving any cancerscreening. Particularly low levels were found in breast, cervical, prostate, and colon cancerscreening. In multivariate analyses, the strongest determinant of receiving cancerscreening overall or cancerscreening for a specific cancer site was recommendation for screening by a doctor or nurse. Other determinants associated with increased likelihood of ever having cancerscreening included older age, female gender, and receiving physical exams more than once a year. Increased age was a determinant of breast cancerscreening and receiving physical exams was associated with cervical cancerscreening. Conclusions Cancerscreening was markedly underutilized in this sample of Native Americans from the Northern Plains. Future research should evaluate the potential for improving cancerscreening.
Pandhi, Nancy; Guadagnolo, B. Ashleigh; Kanekar, Shalini; Petereit, Daniel G.; Smith, Maureen A.
It is common belief that in families with hereditary prostate cancer (HPC), unaffected men should be screened periodically with PSA, but little is known about the effects of such screening. We studied test and tumor characteristics in unaffected 50-75-year-old screenees from HPC families. In the Netherlands, 153 verified HPC families are registered; 132 unaffected men in these families were not under surveillance for prostate cancer and gave informed consent for PSA testing by their GP and referral to a urologist in the case of a PSA level >or= 3.0 ng/ml. Results were compared to published data from the Rotterdam and Göteborg sections of the European Randomized Study of Screening for Prostate Cancer (ERSPC). A PSA >or= 3.0 ng/ml was found in 20 men: referral rate, 15.1% (ERSPC Rotterdam: 20.1%; ERSPC Göteborg: 12.0%). Only 3 cases of prostate cancer were diagnosed in these men: detection rate in the first screening round 2.3% (ERSPC Rotterdam: 5.3%; ERSPC Göteborg: 2.3%). Frequent opportunistic PSA testing made it impossible to estimate the detection rates in subsequent screening rounds. In the first and subsequent PSA screening rounds, 11 cases of cancer were detected. All but 1 had favorable tumor characteristics (cT1c/pT2; Gleason < 7). These results raise the question as to whether men from all HPC families should be considered at high-risk. We suggest that the same PSA testing guidelines should apply to HPC families and the general population. A more aggressive screening policy in HPC families does not seem to be justified. PMID:17957791
Kiemeney, Lambertus A; Broeders, Mireille J; Pelger, Marjon; Kil, Paul J; Schröder, Fritz H; Witjes, Johannes A; Vasen, Hans F
It is common belief that in families with hereditary prostate cancer (HPC), unaffected men should be screened periodically with PSA, but little is known about the effects of such screening. We studied test and tumor characteristics in unaffected 50-75-year-old screenees from HPC families. In the Netherlands, 153 verified HPC families are registered; 132 unaffected men in these families were not
Lambertus A. Kiemeney; Mireille J. Broeders; Marjon Pelger; Paul J. Kil; F. H. Schroder; Johannes A. Witjes; Hans F. Vasen
Premalignant diseases of the gastrointestinal tract, such as Barrett's esophagus, long-standing ulcerative colitis, and adenomatous polyps, have a significantly increased risk for development of adenocarcinoma, most often through an intermediate stage of dysplasia. Adenocarcinoma of the colon is the second most common cancer in the United States. Because patients with colorectal cancer often present with advanced disease, the outcomes are associated with significant morbidity and mortality. Effective methods of early detection are essential. As non-polypoid dysplasia is not visible using conventional endoscopy, surveillance of patients with Barrett's esophagus and ulcerative colitis is performed via a system in which multiple random biopsies are obtained at prescribed intervals. Sampling error and missed diagnoses occur frequently and render current screening methods inadequate. Also, the examination of a tissue biopsy is time consuming and costly, and significant intra- and inter-observer variation may occur. The newer methods discussed herein demonstrate the potential to solve these problems by early detection of disease with high sensitivity and specificity. Conventional endoscopy is based on the observation of white light reflected off the tissue surface. Subtle changes in color and shadow reveal structural changes. New developments in optical imaging go beyond white light, exploiting other properties of light. Several promising methods will be discussed at this meeting and shall be briefly discussed below. However, few such imaging modalities have arrived at our clinical practice. Some much more practical methods to improve colorectal cancerscreening are currently being evaluated for their clinical impact. These methods seek to overcome limitations other than those of detecting dysplasia not visible under white light endoscopy. The current standard practice of colorectal cancerscreening utilizes colonoscopy, an uncomfortable, sometimes difficult medical procedure. Efforts to improve the practice of colonoscopy will be described. Another limitation of the current practice is the inability to detect polypoid neoplasia that is hidden from view under white light imaging by the natural folds that occur within the colon. A device to overcome this limitation will also be described. Efforts to improve colorectal cancerscreening (and thereby decrease the death rate of this second leading cause of cancer death in the United States) are progressing in many arenas. The researcher, basic or clinical, should maintain an up to date overview of the field and how each new technological advance is likely to have a role in the screening and early detection of colorectal cancer.
Screening is defined as identification of individuals within an asymptomatic population who have specified disease at a time when intervention may result in improvement of prognosis of the disease. Identification of the disease at the earlier phases of progression improves prognosis. All kinds of cancerscreening may not have same benefit. Screening for breast cancer has been found to be beneficial. Randomized controlled trials and meta-analysis have shown that screening by mammography reduces breast cancer by 25% and can significantly reduce mortality from breast cancer. This article reviews methodology and bias, modalities, benefits, problems, results and current guidelines of breast cancerscreening. PMID:22561789
Rural Appalachia has significantly higher overall cancer mortality compared with national rates, and lack of cancerscreening is believed to be one of the contributing factors. Reducing the cancer disparity in this region must include strategies to address suboptimal cancerscreening practices by rural Appalachian primary care providers (PCPs). To…
Prostate cancer (PCa) is the leading cancer diagnosis among men and the second leading cause of male cancer death. However, screening asymptomatic men remains controversial, as early diagnosis and treatment of PCa has not yet demonstrated reduced disease-...
Targeted Prevention Programs Branch Canberra, ACT, Australia Following the successful pilot program that ran from 2002-2004, a National Bowel CancerScreening 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: Comprehensive analyses have shown that screening for cancer\\u000a usually induces net costs. In this study, the possible costs and savings\\u000a of endoscopic colorectal cancerscreening are explored to investigate\\u000a whether the induced savings may compensate for the costs of screening.\\u000a METHODS: A simulation model for evaluation of colorectal cancerscreening,\\u000a MISCAN-COLON, is used to predict costs and savings for
Franka Loeve; Martin L. Brown; Rob Boer; Marjolein van Ballegooijen; Oortmarssen van G. J; J. D. F. Habbema
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.
Despite multiple screening techniques, including colonoscopy, flexible sigmoidoscopy, radiological imaging, and fecal occult blood testing, colorectal cancer remains a leading cause of death. As these techniques improve, their sensitivity to detect malignant lesions is increasing; however, detection of precursor lesions remains problematic and has generated a lack of general acceptance for their widespread usage. Early detection by an accurate, noninvasive, cost-effective, simple-to-use screening technique is central to decreasing the incidence and mortality of this disease. Recent advances in the development of molecular markers in faecal specimens are encouraging for its use as a screening tool. Genetic mutations and epigenetic alterations that result from the carcinogenetic process can be detected by coprocytobiology in the colonocytes exfoliated from the lesion into the fecal matter. These markers have shown promising sensitivity and specificity in the detection of both malignant and premalignant lesions and are gaining popularity as a noninvasive technique that is representative of the entire colon. In this paper, we summarize the genetic and epigenetic fecal molecular markers that have been identified as potential targets in the screening of colorectal cancer.
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…
In a population-based mammography screening, 129,731 examinations were carried out among 36,000 women aged 40-74 in the city of Turku, Finland, in the period 1987-94. Women older than 50 were screened at 2-year intervals, and those younger than 50 at either 1-year or 3-year intervals, depending on their year of birth. Screen-detected breast cancers numbered 385 and, during the same time period, 154 women were diagnosed with breast cancer outside screening in the same age group in the same city, and 100 interval cancers were detected. Two hundred and fifty (67%) of the screen-detected cancers were of post-surgical stage I compared with 45 (45%) of the interval cancers and 52 (34%) of the cancers found outside screening (P<0.0001). However, among women aged 40-49 the frequency of stage I cancers did not differ significantly among screen-detected cancers, interval cancers and cancers found outside screening (50%, 42% and 44% respectively; P=0.73). Invasive interval cancers were more frequent among women aged 40-49 if screening was done at either 1-year (27%) or 3-year intervals (39%) than in older women screened at 2-year intervals (18%; P=0.08 and P=0.0009 respectively). Even if adjusted for the primary tumour size, screen-detected cancers had smaller S-phase fractions than interval cancers or control cancers (P=0.01), but no difference in the S-phase fraction size was found between cancers of women younger than 50 and those older than this (P=0.13). We conclude that more interval cancers were found among women younger than 50 than among those older than 50 and that this could not be explained by the rate of cancer cell proliferation.
Klemi, P. J.; Toikkanen, S.; Rasanen, O.; Parvinen, I.; Joensuu, H.
The Prostate, Lung, Colorectal, and Ovarian (PLCO) CancerScreening Trial is a large-scale clinical trial to determine whether certain cancerscreening 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.
BackgroundIncreasing evidence supporting the value of screening women for cervical cancer once in their lifetime, coupled with mounting interest in scaling up successful screening demonstration projects, present challenges to public health decision makers seeking to take full advantage of the single-visit opportunity to provide additional services. We present an analytic framework for packaging multiple interventions during a single point of
Jane J Kim; Joshua A Salomon; Milton C Weinstein; Sue J Goldie
: Skin cancerscreening (SCS) promotes early detection and improves treatment. Primary care providers are strategically positioned to provide screenings, yet the frequency is low. Strategies to improve SCS include increasing skin cancer awareness, targeting high-risk patient populations, and advocating for primary care providers to conduct screenings. PMID:24739432
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 cancerscreening 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.
This paper uses the concept of triage as a basis for screening for distress among cancer patients. In addition, critical contributions in the practice of psychosocial screening are detailed as well as an appropriate theoretical foundation to support screening programs. Other pertinent issues such as guidelines, recommendations, and standards are discussed. Finally, future issues related to screening such as new
Study subjects were participants in the Breast Cancer Detection Demonstration Project (BCDDP), a breast cancerscreening program conducted between 1973 and 1980. Sponsored by the American Cancer Society and the NCI, the BCDDP provided up to five annual breast examinations to 283,222 women at 29 screening centers in 27 cities throughout the United States.
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
Objectives—Assessment of the features of primary operable breast carcinomas aris- ing in women known to subsequently develop metastatic disease, to show for which invasive breast cancers earlier detection by mammographic screening is potentially beneficial. These data were applied to a separate series of screen detected cancers. Methods—Features associated with the development of metastatic disease after a previous operable breast cancer
A J Evans; S E Pinder; H C Burrell; I O Ellis; A R M Wilson
This review focuses on the aspects of biopsychosocial screening that have specific and significant implications for supportive care related to cancer care and research. There is a robust literature relating to the unmet supportive care needs of cancer patients and their families and the clinical interventions needed to effectively manage many of their problems. The Zeitgeist movement, which promotes the idea that the resources of this planet are the inherent right of all peoples, is also uniquely aligned to see supportive care services in oncology bringing significant value (cost and quality) to a health care system that is experiencing great uncertainty. Overall, there is a broadening of perspective within the supportive care community that there needs to be greater levels of interdisciplinary integration. More significantly, there is a growing realization that for cancer care to be truly patient and family centered and even minimally efficient, disease-directed care and supportive care need to be integrated from the time of diagnosis. The coordination of these services should not be based on the stage of the disease but rather tailored to the needs of the patient, family, and social context. Biopsychosocial screening programs have the potential to be the connective tissue of these patient- and family-centered systems. PMID:24051615
Loscalzo, Matthew; Clark, Karen; Pal, Sumanta; Pirl, William F
OBJECTIVE: To measure patient preferences for four different screening strategies: annual fecal occult blood testing (FOBT) alone; flexible\\u000a sigmoidoscopy (FSIG) every 5 years alone; both annual FOBT and FSIG every 5 years; or no screening.\\u000a \\u000a \\u000a DESIGN: Survey.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: University internal medicine clinic.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS: Convenience sample of 146 adults (aged 50–75 years) with no previous history of colon cancer.\\u000a \\u000a \\u000a \\u000a \\u000a INTERVENTION: Three-part
Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancerscreening 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 cancerscreening 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 cancerscreening 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 cancerscreening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancerscreening and interventions targeting participants for increasing screening uptake.
Answer questions and earn CME/CNE Each year the American Cancer Society publishes a summary of its guidelines for early cancer detection, a report on data and trends in cancerscreening rates, and select issues related to cancerscreening. In this issue of the journal, we summarize current American Cancer Society cancerscreening guidelines. In addition, the latest data on the use of cancerscreening from the National Health Interview Survey is described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act, including the expansion of the Medicaid program. PMID:24408568
Smith, Robert A; Manassaram-Baptiste, Deana; Brooks, Durado; Cokkinides, Vilma; Doroshenk, Mary; Saslow, Debbie; Wender, Richard C; Brawley, Otis W
STUDY OBJECTIVE: To assess the performance of breast cancerscreening 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.
Otten, J D; van Dijck, J A; Peer, P G; Straatman, H; Verbeek, A L; Mravunac, M; Hendriks, J H; Holland, R
Cervical cancerscreening has become more complex with the addition of HPV testing to pap testing. This chapter covers evidence based national recommendations for managing abnormal cervical cancerscreening tests. PMID:24785417
Discussion of screening for cervical cancer and it precursors, management of abnormal cervical cancerscreening test, and evidence-based management of women with cervical intraepithelial neoplasia. PMID:24785416
Boisen, Michelle; Diedrich, Justin T; Lonky, Neal M; Guido, Richard
Form approved: OMB No. 0925-xxxx Expires: ____/____/____ The Survey of Colorectal CancerScreening Practices, sponsored by the National Cancer Institute in collaboration with the Centers for Disease Control and Prevention and Health Care Financing
In 1989 a voluntary melanoma/skin cancerscreening clinic was held in Oss, the Netherlands. The campaign was carried out according to the free clinics conducted since 1985 in the USA. Our experiences with the first clinic urged us to improve on the organization of the screen. This produced a better yield of the second screen, conducted in 1990 in Arnhem. In this paper we present the practical and organizational implications of melanoma/skin cancerscreening based on both screening exercises. It is emphasized that only dermatologists should screen. Concomitant public education will enhance self-selection of people at risk for melanoma/skin cancer. There should be ample provider time, sufficient auxiliary personnel and abundant examination rooms. Total-body skin examination is optional. Follow-up of positive screenees is mandatory. It is concluded that melanoma/skin cancerscreening is feasible, particularly in countries with a high dermatologist-to-patient ratio. PMID:1392110
Evidence of a mortality benefit continues to elude ovarian cancer (OC) screening. Data from the US Prostate, Lung, Colorectal and Ovarian (PLCO) CancerScreening 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 CancerScreening (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.
Menon, Usha; Griffin, Michelle; Gentry-Maharaj, Aleksandra
BC Cancer Agency CARE & RESEARCH Breast Cancer Mortality After Screening Mammography in British Columbia Women Andrew J. Coldman, Ph.D. Norm Phillips, M.Sc. Lisa Kan, M.Sc. Linda Warren, M.D. Population & Preventive Oncology BC Cancer Agency BC Cancer
Introduction: Over the past decade the United States (US) has seen a decrease in advanced cancer diagnoses. There has also been an increase in the number of cancer survivors returning to work. Cancerscreening behaviors among survivors may play an important role in their return-to-work process. Adherence to a post-treatment cancerscreening protocol increases early detection of secondary tumors and reduces potentially limiting side-effects. We compared screening trends among all cancer survivors, working survivors, and the general population over the last decade. Materials and Methods: Trends in adherence to recommended screening were analyzed by site-specific cancer. We used the Healthy People goals as a measure of desired adherence. We selected participants 18+ years from 1997 to 2010 National Health Interview Survey for years where detailed cancerscreening information was available. Using the recommendations of the American Cancer Society as a guide, we assessed adherence to cancerscreening across the decade. There were 174,393 participants. Analyses included 7,528 working cancer survivors representing 3.8 million US workers, and 119,374 adults representing more than 100 million working Americans with no cancer history. Results: The US population met the Healthy People 2010 goal for colorectal screening, but declined in all other recommended cancerscreening. Cancer survivors met and maintained the HP2010 goal for all, except cervical cancerscreening. Survivors had higher screening rates than the general population. Among survivors, white-collar and service occupations had higher screening rates than blue-collar survivors. Conclusion: Cancer survivors report higher screening rates than the general population. Nevertheless, national screening rates are lower than desired, and disparities exist by cancer history and occupation. Understanding existing disparities, and the impact of cancerscreening on survivors is crucial as the number of working survivors increases.
Clarke, Tainya C.; Soler-Vila, Hosanna; Fleming, Lora E.; Christ, Sharon L.; Lee, David J.; Arheart, Kristopher L.
The scope of this article is to describe persons with disabilities (PwD) being subjected to cancerscreening and the relationship between some social variables and inequalities in performing these tests. A cross-sectional study of cancerscreening among PwD was conducted in 2007 with 333 participants interviewed in residence in 4 cities of São Paulo. Variables in the practice of cancerscreening, 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 cancerscreening 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 cancerscreening more frequently than those between 80 and 97 years of age. The outcomes indicate that PwD have different attitudes toward cancerscreening according to the type of disability, gender, and age, which were the variables that directly influenced cancerscreening exams. PMID:24263886
de Castro, Shamyr Sulyvan; Cieza, Alarcos; Cesar, Chester Luiz Galvão
Lung cancer is the leading cause of cancer death worldwide. Age and smoking are the primary risk factors for lung cancer. Treatment based on surgical removal in the early stages of the disease results in better survival. Screening programmes for early detection that used chest radiography and sputum cytology failed to attain reduction of lung cancer mortality. Screening by low-dose computed tomography (CT) demonstrated high rates of early-stage lung cancer detection in a high-risk population. Nevertheless, no mortality advantage was manifested in small randomised control trials. A large randomised control trial in the USA, the National Lung Screening Trial (NLST), showed a significant relative reduction of 20% in lung cancer mortality and 6.7% reduction in total mortality, yet no reduction was evidenced in the late-stage prevalence. Screening for lung cancer by low-dose CT reveals a high level of false-positive lesions, which necessitates further noninvasive and invasive evaluations. Based primarily on the NLST eligible criteria, new guidelines have recently been developed by major relevant organisations. The overall recommendation coming out of this collective work calls for lung cancerscreening by low-dose CT to be performed in medical centres manned by specialised multidisciplinary teams, as well as for a mandatory, pre-screening, comprehensive discussion with the patient about the risks and advantages involved in the process. Lung cancerscreening is on the threshold of a new era, with ever more questions still left open to challenge future studies. PMID:24525442
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 cancerscreening 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 cancerscreening 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 cancerscreening programs in EU States as of July 2013. PMID:24530610
Altobelli, E; Lattanzi, A; Paduano, R; Varassi, G; di Orio, F
Background: Understanding how "health issues" are socially constructed may be useful for creating culturally relevant programs for Hispanic/Latino populations. Purpose: We explored the constructed meanings of cervical cancer and cervical cancerscreening among Panamanian women, as well as socio-cultural factors that deter or encourage screening…
Calvo, Arlene; Brown, Kelli McCormack; McDermott, Robert J.; Bryant, Carol A.; Coreil, Jeanine; Loseke, Donileen
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.
This cross-sectional survey explored the association between functional health literacy and knowledge of, beliefs and attitudes about, and reported usage of colorectal cancerscreening tests. The results indicate that functional health literacy, as assessed by the Short Test of Functional Health Literacy in Adults (STOFHLA), is not an independent predictor of colorectal cancerscreening knowledge, beliefs, attitudes, or behavior. Latino
Carmen E. Guerra; Francisco Dominguez; Judy A. Shea
A major limitation of existing projection display sys- tems is that they rely on a high quality screen for pro- jecting images. We believe that relaxing this restriction will make projectors more useful and widely applicable. The fundamental problem with using an arbitrary sur- face for a screen is that the surface is bound to have its own colors and
Shree K. Nayar; Harish Peri; Michael D. Grossberg; Peter N. Belhumeur
A stereoscopic projection display using a curved directional reflection screen (CDR) is proposed. The CDR is composed of a corner reflection mirror sheet for horizontal focusing and a lenticular lens sheet for vertical diffusion. The vertically curved shape has been introduced to expand the observable range of the screen. The prototype CDR 3D display provides clear stereoscopic images and shows
Screen permits front surface projection of collimated light beam under conditions of high extraneous illumination. Screen has high reflective efficiency over any desired viewing area. Its optical properties are maintained when moisture droplets are present on the external front planar surface. Surface is easily cleaned and maintained.
The production and evaluation of a magnetic focus image tube for astronomical photography that has an intagliated phosphor screen is described. The modulation transfer function of such a tube was measured by electronic means and by film tests, and the results compared with tubes of more conventional construction. The physical properties of the image tube and film combination, the analytical model of the optical interface, and the salient features of the intagliated screen tube are described. The results of electronic MTF tests of the intagliated image tube and of the densitometry of the tube and film test samples are presented. It is concluded that the intagliated screen is a help, but that the thickness of the photographic film is also important.
Early detection and removal of colorectal polyps have been proven to reduce mortality from colorectal carcinoma (CRC), the second leading cause of cancer deaths in the United States. Unfortunately, traditional techniques for CRC examination (i.e., barium enema, sigmoidoscopy, and colonoscopy) are unsuitable for mass screening because of either low accuracy or poor public acceptance, costs, and risks. Virtual colonoscopy (VC) is a minimally invasive alternative that is based on tomographic scanning of the colon. After a patient's bowel is optimally cleansed and distended with gas, a fast tomographic scan, typically helical computed tomography (CT), of the abdomen is performed during a single breath-hold acquisition. Two-dimensional (2D) slices and three-dimensional (3D) rendered views of the colon lumen generated from the tomographic data are then examined for colorectal polyps. Recent clinical studies conducted at several institutions including ours have shown great potential for this technology to be an effective CRC screening tool. In this paper, we describe new methods to improve bowel preparation, colon lumen visualization, colon segmentation, and polyp detection. Our initial results show that VC with the new bowel preparation and imaging protocol is capable of achieving accuracy comparable to conventional colonoscopy and our new algorithms for image analysis contribute to increased accuracy and efficiency in VC examinations.
Ge, Yaorong; Vining, David J.; Ahn, David K.; Stelts, David R.
Background:Data collection for screen-detected breast cancer in the United Kingdom is fully funded, which has led to improvements in clinical practice. However, data on symptomatic cancer are deficient, and the aim of this project was to monitor the current practice.Methods:A data set was designed together with surrogate outcome measures to reflect best practice. Data from cancer registries initially required the
T Bates; O Kearins; I Monypenny; C Lagord; G Lawrence
In 2007 alone, close to 1.5 million new cancer cases and over half of a million deaths from cancer are projected to occur in US. In general, cancer is much easier to be successfully treated before metastasis; the five-year survival rates for most of the cancers in the metastatic stage are lower than 10%. The origin of cancer is due to genomic instability; however, the genomics or proteomics studies focus on this phenomenon cannot thoroughly elucidate how cancer metastasis proceeds. During this process, cancer cells protrude and conquer their physical barriers, resist shear stress, establish anchorages and finally settle in a new environment. Each development in this process involves mechanical forces. Thus, whether force generation and cancer cells' mechanical properties can be integrated into the current mainstream of cancer research and offer new insight is worthy of being investigated. To measure the change of cell mechanics, specifically intracellular mechanics, a tool that least disrupts the probed cell's behavior and, simultaneously, can obtain real time quantitative measurement is necessary. To satisfy these criteria, we have developed a technique, ballistic intracellular nanorheology (BIN), in which we trace and analyze the trajectories of nanospheres that have been ballistically bombarded into the cytoplasm of individual cells. This technique allows us to probe the effects of chemical or mechanical stimuli on intracellular mechanics in various types of cells, on culture dishes or in a three-dimensional matrix. BIN is, currently, the first and only method available that can be applied to perform such tasks. Using this technique, we have gained detailed information about how the cytoskeletal remodeling pathways control the intracellular mechanics. We have also obtained information on the tempo-correlation between agonists and intracellular mechanics and how cells utilize their intracellular mechanics to react extracellular shear stress. These studies have set the framework for us to understand the mechanical mechanism of cancer cell metastasis on a molecular level. In this talk, I will describe the working principal using this technique to screencancer drugs that prevent cancer metastasis.
There is a need for sensitive and specific diagnostic molecular markers that can be used to monitor early patterns of gene expression in non-invasive exfoliated colonocytes shed in the stool, and in situ in adenoma-carcinoma epithelium of the colon. RNA-based detection methods are more comprehensive than either DNA-, protein- or methylation-based screening methods. By routinely and systematically being able to perform quantitative gene expression studies on these samples using less than ten colon cancer genes selected by the enormous resources of the National Cancer Institute's Cancer Genome Anatomy Project, we were able to monitor changes at various stages in the neoplastic process, allowing for reliable diagnostic screening of colon cancer particularly at the early, pre-malignant stages. Although the expression of some of the genes tested in tissue showed less variability in normal or cancerous patients than in stool, the stool by itself is suitable for screening. Thus, a transcriptomic approach using stool or tissue samples promises to offer more sensitivity and specificity than currently used molecular screening methods for colon cancer. A larger prospective clinical study utilizing stool and tissue samples derived from many control and colon cancer patients, to allow for a statistically valid analysis, is now urgently required to determine the true sensitivity and specificity of the transcriptomic screening approach for this preventable cancer. PMID:17726236
Ahmed, Farid E; Vos, Paul; iJames, Stephanie; Lysle, Donald T; Allison, Ron R; Flake, Gordon; Sinar, Dennis R; Naziri, Wade; Marcuard, Stefan P; Pennington, Rodney
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 cancerscreening in 2003. Multidisciplinary, evidence-based European Guidelines for quality assurance in colorectal cancerscreening 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 cancerscreening and diagnosis is presented here in order to promote international discussion and collaboration leading to improvements in colorectal cancerscreening and diagnosis by making the principles and standards recommended in the new EU Guidelines known to a wider scientific community.
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 cancerscreening. However, it is not a perfect test, and many women are asked to come back for additional testing that often turns out not to show cancer. These additional screening tests increase patient anxiety.
Prostate cancer is the most commonly diagnosed nonskin cancer in men, with 233,000 new cases estimated for 2014. Nearly 30,000 deaths are predicted for 2014, second only to lung and bronchial cancer deaths. Early diagnosis is key to improving patient survival rates. Screening efforts have dramatically increased the detection rate, and now, 90% of new diagnoses are caught at the early stage of disease. However, new data are driving controversial changes to screening and treatment recommendations. PMID:24988136
The UK Lung Screen (UKLS) is a randomised controlled trial of the use of low-dose multidetector CT for lung cancerscreening. It completed the Health Technology Appraisal (HTA)-funded feasibility stage in October 2009 and the pilot UKLS will be initiated in early 2011. The pilot will randomise 4000 subjects to either low-dose CT screening or no screening. The full study, due to start in September 2012, if progression criteria are met, will randomise a further 28?000 subjects from seven centres in the UK. Subjects will be selected if they have sufficient risk of developing lung cancer according to the Liverpool Lung Project risk model. The UKLS employs the ‘Wald Single Screen Design’, which was modelled in the UKLS feasibility study. This paper describes the modelling of nodule management in UKLS by using volumetric analysis with a single initial screen design and follow-up period of 10 years. This modelling has resulted in the development and adoption of the UKLS care pathway, which will be implemented in the planned CT screening trial in the UK.
IntroductionMultiple resident-related factors contribute to ‘missed opportunities’ in providing comprehensive preventive care for female patients, including comfort level, knowledge and experience—all of which are compounded by resident turnover rates. Of particular concern among Internal Medicine (IM) residents is their knowledge and comfort level in performing pelvic exams.AimTo evaluate the impact of a quality improvement project of implementing a Women's Preventive
Lung cancer is the leading cause of death from cancer. It is often diagnosed at an advanced stage when curative treatment is no longer possible. Does organised screening reduce overall mortality andlor lung cancer mortality, especially in current smokers or former heavy smokers? To answer this question, we reviewed the literature using the standard Prescrire methodology. According to a meta-analysis of seven trials, and a large randomised trial (the PLCO study) involving 155 000 persons, screening the general population by means of plain chest radiography does not reduce mortality from lung cancer but carries a high risk of false-positive findings. In 2013, results from four randomised controlled trials evaluating low-dose computed tomography (CT) for lung cancerscreening are available. The NLST trial, in 53000 individuals at high risk of cancer, showed a reduction in mortality from lung cancer after 6.5 years of follow-up (1.3% with annual low-dose CT screening versus 1.7% with plain chest radiography). Interim analyses of the Dante, Dlsct and Mild studies, in respectively 2470, 4100 and 4099 persons at high risk of cancer, showed no reduction in lung cancer mortality after low-dose CT screening. Low-dose CT screening carries a risk of adverse effects, including false-positive results in about 20% of patients, and about 90% of the nodules discovered are false-positives. This screening method also carries a risk of invasive diagnostic procedures, and repeated irradiation. In 2013, the harm-benefit balance of lung cancerscreening with low-dose CT has not been adequately evaluated to justify its use in individuals with no signs or symptoms suggestive of lung cancer. PMID:24516909
... HealthDay News) -- More than 500,000 cases of colon and rectal cancer may have been prevented with cancerscreening tests ... number of men and women underwent these procedures, colon and rectal cancer rates dropped dramatically, the study revealed. The study, ...
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 screencancer cells for genes that, when silenced, cause cancer cells to die or stop dividing.
Now colorectal cancer is the second most common cancer in males and the fourth most common cancer in females in Korea. Since most of colorectal cancers occur after the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancerscreening and polyp detection. The guideline was developed by the Korean Multi-Society Take Force and we tried to establish the guideline by evidence-based methods. Parts of the statements were draw by systematic reviews and meta-analyses. Herein we discussed epidemiology of colorectal cancers and adenomas in Korea and optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.
Lee, Bo-In; Hong, Sung Pil; Kim, Seong-Eun; Kim, Se Hyung; Hong, Sung Noh; Yang, Dong-Hoon; Shin, Sung Jae; Lee, Suck-Ho; Park, Dong Il; Kim, Young-Ho; Kim, Hyun Jung; Yang, Suk-Kyun; Kim, Hyo Jong; Jeon, Hae Jeong
Objective To evaluate the effectiveness of contemporary mammography screening using individual information about screening history and breast cancer mortality from public screening programmes. Design Prospective cohort study of Norwegian women who were followed between 1986 and 2009. Within that period (1995-2005), a national mammography screening programme was gradually implemented, with biennial invitations sent to women aged 50-69 years. Participants All Norwegian women aged 50-79 between 1986 and 2009. Main outcome measures Multiple Poisson regression analysis was used to estimate breast cancer mortality rate ratios comparing women who were invited to screening (intention to screen) with women who were not invited, with a clear distinction between cases of breast cancer diagnosed before (without potential for screening effect) and after (with potential for screening effect) the first invitation for screening. We took competing causes of death into account by censoring women from further follow-up who died from other causes. Based on the observed mortality reduction combined with the all cause and breast cancer specific mortality in Norway in 2009, we used the CISNET (Cancer Intervention and Surveillance Modeling Network) Stanford simulation model to estimate how many women would need to be invited to biennial mammography screening in the age group 50-69 years to prevent one breast cancer death during their lifetime. Results During 15?193?034 person years of observation (1986-2009), deaths from breast cancer occurred in 1175 women with a diagnosis after being invited to screening and 8996 women who had not been invited before diagnosis. After adjustment for age, birth cohort, county of residence, and national trends in deaths from breast cancer, the mortality rate ratio associated with being invited to mammography screening was 0.72 (95% confidence interval 0.64 to 0.79). To prevent one death from breast cancer, 368 (95% confidence interval 266 to 508) women would need to be invited to screening. Conclusion Invitation to modern mammography screening may reduce deaths from breast cancer by about 28%.
Human immunodeficiency virus (HIV)-infected women are at increased risk of invasive cervical cancer; however, screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancerscreening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multidisciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancerscreening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancerscreening (p < 0.01). Factors associated with lack of screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p < 0.01). A multidisciplinary quality improvement intervention was successful in overcoming barriers and increasing cervical cancerscreening rates in an urban academic HIV clinic. PMID:24625234
Cross, Sara L; Suharwardy, Sanaa H; Bodavula, Phani; Schechtman, Kenneth; Overton, E Turner; Onen, Nur F; Lane, Michael A
Background The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancerscreening among Chinese American women. Methods A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancerscreening. Results Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancerscreening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor. Conclusion This model highlights the significance of sociocultural factors in relation to cervical cancerscreening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical cancerscreening. Community organizations may play a role in assisting Chinese American women, which could enhance cervical cancerscreening rates.
Ma, Grace X; Wang, Min Qi; Ma, Xiang S; Shive, Steven E; Tan, Yin; Toubbeh, Jamil I
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 and Purpose Women who have not had a Papanicolaou test in five years or more have increased risk of developing invasive cervical cancer. This study compares Appalachian women whose last screening was more than one year ago but less than five years ago with those not screened for the previous five years or more. Methods Using PRECEDE/PROCEED as a guide, factors related to obtaining Pap tests were examined using cross-sectional data from 345 Appalachian Kentucky women. Bivariate and multivariate analyses were conducted to identify predictors of screening. Results Thirty-four percent of participants were rarely- or never-screened. In multiple logistic regression analyses, several factors increased those odds, including belief that cervical cancer has symptoms, and not having a regular source of medical care. Conclusion The findings from this study may lead to the development of effective intervention and policies that increase cervical cancerscreening in this population.
Hatcher, Jennifer; Studts, Christina R.; Dignan, Mark; Turner, Lisa M.; Schoenberg, Nancy E.
Breast cancerscreening remains a subject of intense and, at times, passionate debate. Mammography has long been the mainstay of breast cancer detection and is the only screening test proven to reduce mortality. Although it remains the gold standard of breast cancerscreening, there is increasing awareness of subpopulations of women for whom mammography has reduced sensitivity. Mammography 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 cancerscreening 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 cancerscreening will ultimately require a personalized approach based on metrics of cancer risk with selective application of specific screening technologies best suited to the individual’s age, risk, and breast density.
Drukteinis, Jennifer S.; Mooney, Blaise P.; Flowers, Chris I.; Gatenby, Robert A
Cancerscreening procedures have brought great benefit to the public’s health. However, the science of cancerscreening and the evidence arising from research in this field as it is applied to policy is complex and has been difficult to communicate, especially on the national stage. We explore how epidemiologists have contributed to this evidence base and to its translation into policy. Our essay focuses on breast and lung cancerscreening to identify commonalities of experience by epidemiologists across two different cancer sites and describe how epidemiologists interact with evolving scientific and policy environments. We describe the roles and challenges that epidemiologists encounter according to the maturity of the data, stakeholders, and the related political context. We also explore the unique position of cancerscreening as influenced by the legislative landscape where, due to recent healthcare reform, cancerscreening research plays directly into national policy. In the complex landscape for cancerscreening policy, epidemiologists can increase their impact by learning from past experiences, being well prepared and communicating effectively.
Deppen, Stephen A.; Aldrich, Melinda C.; Hartge, Patricia; Berg, Christine D.; Colditz, Graham A.; Petitti, Diana B.; Hiatt, Robert A.
Background Colorectal cancer (CRC) is the third leading cause of cancer death for men and women in the United States. CRC screening can save lives by detecting precancerous polyps that are then removed or by detecting cancer early when treatment is most effective. Community Context CRC screening participation in Montana is low. To increase screening participation among Montanans with health insurance, the Montana Cancer Control Programs (MCCP) partnered with a small association health organization (AHO). This partnership implemented a postcard campaign to increase CRC screening participation among the AHO’s enrollees. Methods Postcards were sent to 1,011 people insured through the AHO; 504 people were mailed 1 postcard and 507 people were mailed 2 postcards. Evaluation of the campaign assessed recall of the campaign among people who received 1 postcard versus people who received 2 postcards. Outcome Women were 60% more likely to recall receiving the postcards than were men. People who received 2 postcards were 2.3 times as likely to recall receiving them as were people who received 1 postcard. Interpretation The MCCP considers this collaborative project with an AHO a promising approach to implementing evidence-based colorectal cancerscreening interventions. The MCCP plans to partner with additional AHOs in Montana to evaluate CRC screening participation among their enrollees.
Williamson, Laura L.; Merchant, Leah; Lengerich, Eugene J.
Pancreatic cancer is difficult to diagnose at an early stage and is associated with a very poor survival. Ten percent of pancreatic cancers result from genetic susceptibility and/or familial aggregation. Individuals from families with multiple affected first-degree relatives and those with a known cancer-causing genetic mutation have been shown to be at much higher risk of developing pancreatic cancer. Recent efforts have focused on detecting disease at an earlier stage to improve survival in these high-risk groups. This article reviews high-risk groups, screening methods, and current screening programs and their results.
The use of computed tomography (CT) in lung cancerscreening may not reduce deaths from the disease and may expose some individuals to invasive and unnecessary treatments, according to the March 6, 2007, Journal of the American Medical Association.
ICSN Biennial Meeting 2008 Helsingør, Denmark Attendance Rate (2003-2005) of the Hungarian Organized, Nation-Wide Cervical CancerScreening Program Authors: I Boncz, A Sebestyén Affiliation: Department of Health Economics, Policy & Management, University
ICSN Biennial Meeting 2008 Helsingør, Denmark Quality Indicators of Colorectal CancerScreening Programme in Catalonia (Spain) Authors: M Peris, G Binefa, M Navarro, M Garcia, JA Espinàs, JM Borràs Affiliation: Catalan Institute of Oncology
Approximately 90 million people in the United States lack basic literacy skills, which affect health behaviors. Cervical cancer is preventable and treatable, yet few older Hispanic women seek screening and continue to be a high-risk group for cervical cancer. A literature review was conducted to address the relationship between cervical cancerscreening, health literacy, and older Hispanic women. Eighty studies were reviewed, and nine addressed health literacy and Hispanic women. One study addressed the association between functional health literacy and Pap smear screening among older Hispanic women. Few studies have explored the association between preventive cervical cancerscreening and health literacy among older Hispanic women. Nurses must assess health literacy and be prepared to provide care, which is culturally, and linguistically appropriate to improve health outcomes. Further research is needed to be inclusive of all populations including older Hispanic women. PMID:23729023
Evaluation of: Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N. Engl. J. Med. 377, 1998-2005 (2012). Mammography screening must advance the time of diagnosis of breast cancer to be able to reduce the rate of death from breast cancer. This article examined the temporal effects of mammography on the stage-specific incidence of breast cancer in the USA from 1976 through to 2008. Despite substantial increases in the number of cases of early-stage breast cancer, only a marginal reduction was observed in the number of cases presenting with late-stage breast cancer. These results provide convincing evidence that mammography screening entails a substantial risk of detecting tumors that would not have become symptomatic during a woman's lifetime if no screening had taken place. To improve the effectiveness of screening mammography, more knowledge is needed on the natural history of breast cancer, especially the risk of progression from in situ to invasive breast cancer. PMID:24236553
We reviewed 134 patients with breast cancer (screen detected = 85, interval = 49) who had been reported as negative at previous mammographic screening in the Florence District Programme. At prior mammograms review, 12% of the cases were classified as 'screening error' (suspicious signs missed owing to misperception or poor imaging technique), 26% as 'minimal signs present', 54% as 'radiographically occult' and 7% as 'radiographically occult at diagnosis'. These results are quite consistent with those recently reported for the Nijmegen screening programme. Screening errors may be reduced either by reducing the risk of misperception (double reading) or by improving imaging quality, but this would achieve earlier detection in a minority of cancer cases. Minimal signs of cancer were present 2 years before the diagnosis in over one-third of screen-detected cancers. Increasing screening frequency (from biennial to annual) may advance detection time of most 'screening errors' and of some cancers in the 'minimal signs present' and 'mammographically occult' categories, but this would almost double screening costs, and the benefit would probably be inferior to that obtained by doubling the population invited to biennial screening. Adopting less stringent criteria for referral to diagnostic assessment would probably lead to the detection of some cases in the 'minimal signs present' category. This seems to us a more convenient policy to adopt to advance cancer detection time, although it will also sharply increase referral rates and costs. As diagnostic assessment of minimal lesions is far from being 100% accurate, this policy would also considerably increase the frequency of unnecessary benign biopsies. All these negative effects might turn out to be unacceptable.
Investigators for the Prostate, Lung, Colorectal and Ovarian (PLCO) CancerScreening Trial describe quality control procedures for the digital rectal examination, ovarian palpation examination, transvaginal ultrasound, chest X-ray, and flexible sigmoidoscopy. These cancerscreening tests are subjective and difficult to standardize. PLCO quality control procedures aim to measure and, where possible, reduce variation, across examiner and screening center, with respect to cancerscreening test performance. Initial protocols stressed examiner qualifications, experience, and training; equipment specifications; examination procedures; and definitions for positive tests. The PLCO quality assurance subcommittee developed a final quality assurance plan, which included central approval and registration of PLCO examiners, direct observation of screening test performance during periodic site visits by the National Cancer Institute and coordinating center auditors, periodic analysis of screening test data, and procedures for independently duplicating or reviewing selected examinations. For each modality, the periodic data analyses examine the test-positive and the test-inadequate proportions and aim to identify divergent centers or examiners. Procedures for duplicating examinations specify feasible sample sizes for precise estimates of agreement between examiners, at each center, for each screening test modality, and over a 1-year period. These quality control procedures will help characterize the consistency and reliability of the PLCO cancerscreening tests. PMID:11189690
Colorectal cancer remains the second leading cause of cancer death in the United States. To fully realize the benefits of early detection of colorectal cancer, screening rates must improve. This study assessed differences in beliefs (from the Health Belief Model) by stage of screening behavior adoption (based on the Transtheoretical Model of Change) as a foundation for intervention development. More people were in the precontemplation stage (not thinking about having the screening test) for fecal occult blood test and sigmoidoscopy versus contemplation (thinking about having the test) or action (adherent with screening). Those in precontemplation stage for fecal occult blood test had lower perceived risk than those in contemplation, lower perceived benefits than those in action, and higher barriers than both those in contemplation and those in action. For sigmoidoscopy stage of readiness, again, precontemplators had lower perceived risk and self-efficacy than contemplators and higher barriers than both contemplators and actors. Given the popularity of the transtheoretical model and the success of stage-based interventions to increase other cancerscreening, especially mammography, we should begin to translate such effective interventions to colorectal cancerscreening. As such, this study is one of very few to quantify beliefs across stages of colorectal cancer and identify significant differences across stages, laying the foundation for the development and testing of stage-based interventions.
Menon, Usha; Belue, Rhonda; Skinner, Celette Sugg; Rothwell, B. Erin; Champion, Victoria
The RNAi Screening Facility at the Cancer Research UK Beatson Institute combines siRNA genome-wide screening with drug screening coupled with High Content Imaging and fluorescence-based phenotypic assays to target multiple types of cancer. Here, we describe the infrastructure of the Facility and the approaches we utilise. We also share our experiences in running such a facility and developing and executing screening campaigns, with particular regard to high content multiparametric analysis, data management and statistical analysis. PMID:24661213
A study of cancerscreening by internal medicine residents in an inner-city clinic revealed that screening was more frequent for male patients, and breast examinations and Pap smears were performed on less than a third of female patients, suggesting a need for more intensive early-detection education of residents. (MSE)
Introduction: The military health system (MHS) a unique setting to analyze implementation programs as well as outcomes for colorectal cancer (CRC). Here we look at the efficacy of different CRC screening methods, attributes and results within the MHS, and current barriers to increase compliance. Materials and Methods: A literature search was conducted utilizing PubMed and the Cochrane library. Key-word combinations included colorectal cancerscreening, racial disparity, risk factors, colorectal cancer, screening modalities, and randomized control trials. Directed searches were also performed of embedded references. Results: Despite screening guidelines from several national organizations, extensive barriers to widespread screening remain, especially for minority populations. These barriers are diverse, ranging from education and access problems to personal beliefs. Screening rates in MHS have been reported to be generally higher at 71% compared to national averages of 50-65%. Conclusion: CRC screening can be highly effective at improving detection of both pre-malignant and early cancers. Improved patient education and directed efforts are needed to improve CRC screening both nationally and within the MHS.
From September 15, 1977 to April 15, 1978 450,477 persons over the age of 7 were screened for schistosomiasis and 198,950 over the age of 30 were screened for colorectal cancer. 75 cases of colorectal malignant tumor were discovered, a positive rate of 37...
The 28-item GHQ was used to assess psychiatric morbidity in 302 women attending for routine breast cancerscreening, 300 women attending for further investigation of a positive screening result and 150 women referred for investigation of breast symptoms. The GHQ-28 was administered on arrival at the relevant clinic and three months later. Medical records were used to determine the outcome
R Ellman; N Angeli; A Christians; S Moss; J Chamberlain; P Maguire
Objective: This article reports findings from the National Study of Women with Physical Disabilities about rates of screening for breast and cervical cancer and factors associated with regular screening in a large sample of women with a variety of physical disabilities and a comparison group of women without disabilities.Design: Case-comparison study using written survey. Data were analyzed using measures of
Many urologists in North America are increasingly enthusiastic about prostatic cancerscreening. Annual digital rectal examination is almost universally endorsed, and prostate-specific antigen testing is favored by most. But doctors really should not screen by either method without patients' informed consent. However, the information required for informed consent is complex and contradictory, difficult for physicians to give and for patients to absorb.
Lack of sensitivity and specificity of image-based breast cancerscreening has urged the exploration of alternate screening modalities. Nipple fluid, which contains breast epithelial cells, is produced in small amounts in the breast ducts of nonlactating women and can be collected by noninvasive vacuum aspiration. After administration of nasal oxytocin, nipple aspiration yields sufficient material for molecular analysis in the
Karijn P. M. Suijkerbuijk; Elsken van der Wall; Marc Vooijs; Paul J. van Diest
OBJECTIVE To compare the infl uence of physicians' recommendations and patients' anxiety or expectations on the decision to order four cancerscreening tests in clinical situations where guidelines were equivocal: screening for prostate cancer with prostate-specifi c antigen for men older than 50; breast cancerscreening with mammography for women 40 to 49; colorectal cancerscreening with fecal occult blood
Jeannie Haggerty; Fred Tudiver; Judith Belle Brown; Carol Herbert; Antonio Ciampi; Remi Guibert
Pancreatic cancer is the fourth most common cause of cancer mortality in the United States, with 5 year survival rates for patients with resectable tumors ranging from 15 - 20%. However, most patients present with distant metastases, are not resectable, and have a 5-year survival of close to 0%. This demonstrates a need for improved screening to identify pancreatic cancer while the tumor is localized and amenable to surgical resection. Studies of patients with pancreatic tumors incidentally diagnosed demonstrate longer median survival as compared with tumors discovered only when the patient is symptomatic, suggesting that early detection may improve outcome. Recent evidence from genomic sequencing indicates a 15 year interval for genetic progression of pancreatic cancer from initiation to the metastatic stage, suggesting a sufficient window for early detection. Still, many challenges remain in implementing effective screening. Early diagnosis of pancreatic cancer relies on developing screening methodologies with highly sensitive and specific biomarkers and imaging modalities. It also depends on a better understanding of the risk factors and natural history of the disease in order to accurately identify high risk groups that would be best served by screening. This review summarizes our current understanding of the biology of pancreatic cancer relevant to methods available for screening. At this time, given the lack of proven benefit in this disease, screening efforts should probably be undertaken in the context of prospective trials.
Poruk, Katherine E.; Firpo, Matthew A.; Adler, Douglas G.; Mulvihill, Sean J.
MRI is used widely both for screening women who are at increased risk of breast cancer and for treatment selection. Prospective studies confirm that MRI screening of women with known or suspected genetic mutation results in a higher sensitivity for cancer detection than does mammography. However, survival data are not available. In women with breast cancer, MRI detects cancer not identified with other types of screening. In two randomised trials, this increased sensitivity did not translate into improved selection of surgical treatment or a reduction in the number of operations. Data for longer-term outcomes such as ipsilateral breast tumour recurrence rates and contralateral breast cancer incidence are scarce, but to date do not show clear benefit for MRI. MRI is better than other methods of assessing the response to neoadjuvant chemotherapy, and is helpful in identifying the primary tumour in patients who present with axillary adenopathy. PMID:22098853
In the Screening Older Minority Women project, the authors applied a community capacity-enhancement approach to promoting breast and cervical cancerscreening among older women of color. Members of informal support networks were recruited for this health promotion intervention to empower Latina and African American women to engage in positive…
Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. Objective To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide whether to participate in cervical cancerscreening. Study design The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels of analysis: naive reading, structural analysis and critical interpretation. Results These revealed that women were unprepared for screening results showing cervical cell changes, since they had no symptoms. When diagnosed, participants believed that they had early-stage cancer, leading to feelings of vulnerability and an increased need to care for themselves. Later on, an understanding of HPV as the basis for diagnosis and the realization that disease might not be accompanied by symptoms developed. The outcome for participants was a life experience, which they used to encourage others to participate in screening and to suggest ways that information about screening and HPV might reach a wider Greenlandic population. Conclusion Women living through the process of cervical disease, treatment and follow-up develop knowledge about HPV, cervical cell changes, cervical disease and their connection, which, if used to inform cervical screening programmes, will improve the quality of information about HPV, cervical cancer and screening participation. This includes that verbal and written information given at the point of screening and diagnosis needs to be complemented by visual imagery.
A new study led by a researcher at the Perelman School of Medicine at the University of Pennsylvania (home to the Abramson Cancer Center) adds support to current medical recommendations stating that screening colonoscopy substantially reduces an average-risk adult’s likelihood of being diagnosed with advanced colorectal cancer (CRC) in either the right or left side of the colon.
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
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)
Hessen is the seventh largest state in Germany. Approximately 60,000 children are born there annually. Hessen's Ministry of Social Affairs and the University Clinics for Phoniatrics and Pedaudiology in Frankfurt am Main and Marburg founded a study group to imple- ment general newborn hearing screening in Hessen. Two focuses of this model project will be presented. A multicentric study will
...risk for colorectal cancer, screening colonoscopies. (iv) Screening barium enemas...section but who has had a screening colonoscopy performed, payment may be made for...the month in which the last screening colonoscopy was performed. (f) Condition...
...risk for colorectal cancer, screening colonoscopies. (iv) Screening barium enemas...section but who has had a screening colonoscopy performed, payment may be made for...the month in which the last screening colonoscopy was performed. (f) Condition...
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancerscreening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on communication includes 35 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of screening programmes and services. PMID:23012120
Aim:To assess the effectiveness of annual ovarian cancerscreening (transvaginal ultrasound and serum CA125 estimation) in reducing mortality from ovarian cancer in women at increased genetic risk.Patients and methods:A cohort of 3532 women at increased risk of ovarian cancer was screened at five European centres between January 1991 and March 2007. Survival from diagnosis of ovarian cancer was calculated using
D G Evans; K N Gaarenstroom; D Stirling; A Shenton; L Maehle; A Dørum; M Steel; F Lalloo; J Apold; M E Porteous; H F A Vasen; C J van Asperen; P Moller
Objective: This study examined potential ethnic differences in prostate cancerscreening behavior and correlates of screening in an ethnically diverse sample of first-degree relatives of prostate cancer cases. Methods: The California Cancer Registry was used to identify a sample of prostate cancer cases who were contacted and invited to refer male first-degree relatives to the study. Telephone surveys with 1,029
Beth A. Glenn; Roshan Bastani; Annette E. Maxwell; Cynthia M. Mojica; Alison K. Herrmann; Nilsa V. Gallardo; Karen A. Swanson; L. Cindy Chang
Cancerscreening programs have the potential to decrease psychosocial wellbeing. This review investigates the evidence that anal cancerscreening has an impact on psychosocial functioning and outlines considerations for supporting participants. The review suggested that screening has no significant effect on general mental health but may increase cancer-specific worry. Having worse anal or HIV symptoms, being younger, higher baseline distress or worse histology results were predictive of greater worry. The findings suggest the need to increase education campaigns, particularly targeting those with HIV infection and men who have sex with men. There is a need to develop a consensus on measuring the psychosocial impact of screening and stepped care approaches for responding to any resulting distress. PMID:22958553
Colorectal cancer (CRC) is the second most common cancer in Europe and its incidence is steadily increasing. This trend could be reversed through timely secondary prevention (screening). In the last twenty years, CRC screening programs across Europe have experienced considerable improvements (fecal occult blood testing; transition from opportunistic to population based program settings). The Czech Republic is a typical example of a country with a long history of nationwide CRC screening programs in the face of very high CRC incidence and mortality rates. Each year, approximately 8000 people are diagnosed with CRC and some 4000 die from this malignancy. Twenty years ago, the first pilot studies on CRC screening led to the introduction of the opportunistic Czech National Colorectal CancerScreening Program in 2000. Originally, this program was based on the guaiac fecal occult blood test (FOBT) offered by general practitioners, followed by colonoscopy in cases of FOBT positivity. The program has continuously evolved, namely with the implementation of immunochemical FOBTs and screening colonoscopy, as well as the involvement of gynecologists. Since the establishment of the Czech CRC Screening Registry in 2006, 2405850 FOBTs have been performed and 104565 preventive colonoscopies recorded within the screening program. The overall program expanded to cover 25.0% of the target population by 2011. However, stagnation in the annual number of performed FOBTs lately has led to switching to the option of a population-based program with personal invitation, which is currently being prepared. PMID:24744575
Objectives To explore knowledge and attitudes about colorectal cancer (CRC) screening among African American patients age 45 and older at a community health center serving low-income and uninsured patients. Methods We conducted 7 focus groups and 17 additional semistructured interviews. Sessions were audio-recorded, transcribed, and analyzed using standard text analysis. Results Most participants who were age eligible for CRC screening were nonadherent according to national guidelines. Themes included low CRC knowledge, low perceived norms, high barriers, and other screening beliefs. Conclusion Lack of knowledge, low perceived risk, and attitudes about CRC screening may be important targets for interventions in low-income African American patients.
James, Aimee S.; Daley, Christine M.; Greiner, K. Allen
... Filed under: Prevention/Early Detection , Prostate Cancer Revised Prostate CancerScreening Guidelines: What Has—and Hasn't— ... Men should discuss the benefits and risks of prostate cancerscreening with their doctors, according to revised ...
Background Despite the existence of different screening methods, the response to cancerscreening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancerscreening and early diagnosis. Methods A qualitative methodology was used to collect in-depth information from cancer patients. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian) were approached. Twenty semi-structured interviews were conducted. All interviews were audiotaped, transcribed verbatim, and translated into English for thematic content analysis. Results Thematic content analysis yielded four major themes: awareness of cancerscreening, perceived benefits of cancerscreening, perceived barriers to cancerscreening, and cues to action. The majority of respondents had never heard of cancerscreening before their diagnosis. Some participants reported hearing about mammogram and Pap smear tests but did not undergo screening due to a lack of belief in personal susceptibility. Those who had negative results from screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constraints were reported as barriers to cancerscreening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including the role of mass media in disseminating the message ‘prevention is better than cure’. Conclusions Patients’ narratives revealed some significant issues that were in line with the Health Belief Model which could explain negative health behaviour. The description of the personal experiences of people with cancer could provide many cues to action for those who have never encountered this potentially deadly disease, if incorporated into health promotion activities.
Many different techniques for colon cancerscreening are available. The fecal immunochemical test is best for fecal-based screening, although the DNA investigation may be more specific when further developed. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but has limitations. The flexible sigmoidoscopic examination markedly decreases the incidence of cancer in the visualized segments, but colonoscopy is currently the best procedure for evaluating the large bowel. Techniques for retroflexion or backward view of the colon have been investigated, with all showing increased polyp detection. PMID:23735108
... United States than in other parts of the world. Liver cancer is uncommon in the United States, ... is the fourth most common cancer in the world. In the United States, men, especially Chinese American ...
Context Prostate cancerscreening with prostate-specific antigen (PSA) is frequently performed, counter to clinical practice guidelines. Background It was hypothesized that an e-mail–based intervention termed “spaced education” could reduce clinicians’ inappropriate screening for prostate cancer. Design The study was conducted as an RCT. Setting/participants The study involved 95 primary care clinicians in eight Veterans Affairs medical centers from January 2007 to February 2009. Intervention Participants were randomized into two cohorts: spaced education clinicians received four isomorphic cycles of nine e-mails over 36 weeks (zero to two e-mails per week), whereas control clinicians received no intervention. Each e-mail presented a clinical scenario and asked whether it was appropriate to obtain a PSA test. Participants received immediate feedback after submitting their answers. Main outcome measures The primary outcome was the number and percentage of inappropriate PSA screening tests ordered. Inappropriate testing was defined as use of PSA for prostate cancerscreening in patients aged >76 or <40 years. Appropriateness of screening was dichotomized based on patient age at time of screening. Patients with PSA testing for non-screening reasons were excluded using a validated protocol. Logistic regression with adjustment for patient clustering by clinician was performed. Analyses were conducted in 2009. Results During the intervention period (Weeks 1–36), clinicians receiving spaced education e-mails ordered significantly fewer inappropriate PSA screening tests than control clinicians (10.5% vs 14.2%, p=0.041). Over the 72-week period following the intervention (Weeks 37–108), spaced education clinicians continued to order fewer inappropriate tests compared to controls (7.8% vs 13.1%, respectively, p=0.011), representing a 40% relative reduction in inappropriate screening. Conclusions Spaced education durably improves the prostate cancerscreening behaviors of clinicians and represents a promising new methodology to improve patient care across healthcare systems.
Kerfoot, B. Price; Lawler, Elizabeth V.; Sokolovskaya, Galina; Gagnon, David; Conlin, Paul R.
Prostate-specific antigen (PSA) screening for prostate cancer may reduce mortality, but it incurs considerable risk of over diagnosis and potential harm to quality of life. Our objective was to evaluate the cost-effectiveness of PSA screening, with and without adjustment for quality of life, for the British Columbia (BC) population. We adapted an existing natural history model using BC incidence, treatment, cost and mortality patterns. The modeled mortality benefit of screening derives from a stage-shift mechanism, assuming mortality reduction consistent with the European Study of Randomized Screening for Prostate Cancer. The model projected outcomes for 40-year-old men under 14 combinations of screening ages and frequencies. Cost and utility estimates were explored with deterministic sensitivity analysis. The incremental cost-effectiveness of regular screening ranged from $36,300/LYG, for screening every four years from ages 55 to 69 years, to $588,300/LYG, for screening every two years from ages 40 to 74 years. The marginal benefits of increasing screening frequency to 2 years or starting screening at age 40 years were small and came at significant cost. After utility adjustment, all screening strategies resulted in a loss of quality-adjusted life years (QALYs); however, this result was very sensitive to utility estimates. Plausible outcomes under a range of screening strategies inform discussion of prostate cancerscreening policy in BC and similar jurisdictions. Screening may be cost-effective, but the sensitivity of results to utility values suggests individual preferences for quality versus quantity of life should be a key consideration. PMID:24443367
Pataky, Reka; Gulati, Roman; Etzioni, Ruth; Black, Peter; Chi, Kim N; Coldman, Andrew J; Pickles, Tom; Tyldesley, Scott; Peacock, Stuart
The publication of the new Cochrane review on screening for breast cancer with mamography has revived the debate on breats screening and raised some new topics. Whereas the Cochrane reviewers reasserted on their previous conclusion of the lack of efficacy of breast screening, the new review of the Swedish studies, the new systematic review of the Agency for Healthcare Research and Quality commissioned by the US Preventive Services Task Force, and the recent review of an IARC working group supported the efficacy of breast screening after carefully considering the methodological quality of trials. Nevertheless, the efficacy of breast screening for younger women remains controversial. The present controversy has raised other issues like the measure of the benefit in screening trials or the potential adverse effects of screening, particularly, overdiagnosis and its impact on therapy that are discussed in this papers. It also stresses of evaluating screening before introducing it and the need to inform the population about the benefits and the potential harms and about uncertainties about cancerscreening. PMID:12841988
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.
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
This paper investigates a method to remove hot spot speckle, which is produced by laser-long coherence, on a projectionscreen. The objective of the work has been to first create an image from a digital light processing (DLP) display system using an RGB laser source. We then successfully obtained a high-quality image with speckle contrast, which is less than 2%
Sung Chul Shin; Sin Sung Yoo; Sang Yeon Lee; Chan-Young Park; So-Yeon Park; Jae Wook Kwon; Seung-Gyu Lee
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.
In Argentina, the unequal distribution of the burden of cervical cancer is striking: the mortality rate of the province of Jujuy (15/100,000) is almost four times higher than that of the city of Buenos Aires (4/100,000). We aimed to establish the socio-demographic profile of women who were under-users of Pap smear screening, based on an analysis of a representative sample of Argentinean women from the First National Survey on Risk Factors in 2005. We found that in Argentina, women who are poor, unmarried, unemployed or inactive, with lower levels of education and reduced access to health care, and women over the age of 65, were under-users of screening. Screening must not remain opportunistic. Strategies must incorporate the needs and perceptions of socially disadvantaged women, and increase their access to screening. Of utmost importance is to provide good quality screening and treatment services that reach women who are at risk. Pilot projects using new, alternative technologies should be encouraged in less developed parts of the country. Promotion among health professionals of the scientific basis and effectiveness of each screening modality is essential to reduce wasteful practices such as annual screening and screening of young women that waste resources and fail to reduce cervical cancer incidence and mortality rates. PMID:19027622
Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data.
Large-scale epidemiologic studies have consistently demonstrated the effectiveness of mammographic screening programs, however the benefits are still subject to debate. We estimated the effect of the Dutch screening program on breast cancer mortality. In a large multi-region case-referent study, we identified all breast cancer deaths in 2004 and 2005 in women aged 50-75 who had been invited for screening (cases). Cases were individually matched to referents from the population invited to screening. Conditional logistic regression was used to estimate the odds ratio (OR) of breast cancer death according to individual screening history. The OR was adjusted for self-selection bias using regional correction factors for the difference in baseline risk for breast cancer death between screened and unscreened women. A total of 1233 cases and 2090 referents were included in this study. We found a 58% reduction in breast cancer mortality in screened versus unscreened women (adjusted OR = 0.42, 95% CI 0.33-0.53). Screening, i.e. early detection and treatment, has resulted in a substantial reduction in breast cancer mortality, indicating that the Dutch breast cancerscreening program is highly effective. PMID:24713277
Paap, Ellen; Verbeek, André L M; Botterweck, Anita A M; van Doorne-Nagtegaal, Heidi J; Imhof-Tas, Mechli; de Koning, Harry J; Otto, Suzie J; de Munck, Linda; van der Steen, Annemieke; Holland, Roland; den Heeten, Gerard J; Broeders, Mireille J M
Background & Aims: Identification of the hereditary nonpolyposis colorectal cancer (HNPCC) syndrome enables prevention of colorectal cancer (CRC) by means of colonoscopy and polypectomies. We evaluated the efficacy of screening in a controlled trial over 15 years. Methods: Incidence of CRC and survival were compared in 2 cohorts of at-risk members of 22 families with HNPCC. Colonic screening at 3-year
Heikki J. Järvinen; Markku Aarnio; Harri Mustonen; Lauri A. Aaltonen; Päivi Peltomäki; Albert De La Chapelle
Breast cancer is a common malignancy causing high mortality in women especially in developed countries. Due to the contribution of mammographic screening and improvements in therapy, the mortality rate from breast cancer has decreased considerably. An imaging-based early detection of breast cancer improves the treatment outcome. Mammography is generally established not only as diagnostic but also as screening tool, while breast ultrasound plays a major role in the diagnostic setting in distinguishing solid lesions from cysts and in guiding tissue sampling. Several indications are established for contrast-enhanced magnetic resonance imaging. Thermography was not validated as a screening tool and the only study performed long ago for evaluating this technology in the screening setting demonstrated very poor results. The conclusion that thermography might be feasible for screening cannot be derived from studies with small sample size, unclear selection of patients, and in which mammography and thermography were not blindly compared as screening modalities. Thermography can not be used to aspirate, biopsy or localize lesions preoperatively since no method so far was described to accurately transpose the thermographic location of the lesion to the mammogram or ultrasound and to surgical specimen. Thermography cannot be proclaimed as a screening method, without any evidence whatsoever. PMID:23941008
Brkljaci?, Boris; Mileti?, Damir; Sardanelli, Francesco
(1) A new comparative randomised trial of mammographic screening for breast cancer, involving about 160 000 women aged from 39 to 49, followed for more than 10 years, showed no significant reduction in breast cancer mortality. After seven screening mammograms, 23% of the women had at least one false-positive result. (2) The results of the Swedish Two-County trial were challenged after re-examination of cancer registries. (3) One study showed that nearly 25% of women in whom breast cancer was detected with mammography in the Malmo-1 study would otherwise have remained asymptomatic for 25 years. (4) An update of the Cochrane meta-analysis confirmed previous conclusions: no tangible benefits were found in the 3 most reliable trials. When 5 less reliable trials were also taken into account, screening was found to reduce breast cancer mortality after 13 years of follow-up. (5) In France, there are no data on the impact of screening on the frequency of surgery or chemotherapy, the detection of harmless tumours or carcinoma in situ, or the risk of over-diagnosis. (6) In practice, healthcare professionals must inform their patients of the uncertainties concerning mammographic screening. PMID:18383654
Cancer constitutes a heterogenic cellular system with a high level of spatio-temporal complexity. Recent discoveries by systems biologists have provided emerging evidence that cellular responses to anti-cancer modalities are stochastic in nature. To uncover the intricacies of cell-to-cell variability and its relevance to cancer therapy, new analytical screening technologies are needed. The last decade has brought forth spectacular innovations in the field of cytometry and single cell cytomics, opening new avenues for systems oncology and high-throughput real-time drug screening routines. The up-and-coming microfluidic Lab-on-a-Chip (LOC) technology and micro-total analysis systems (?TAS) are arguably the most promising platforms to address the inherent complexity of cellular systems with massive experimental parallelization and 4D analysis on a single cell level. The vast miniaturization of LOC systems and multiplexing enables innovative strategies to reduce drug screening expenditures while increasing throughput and content of information from a given sample. Small cell numbers and operational reagent volumes are sufficient for microfluidic analyzers and, as such, they enable next generation high-throughput and high-content screening of anti-cancer drugs on patient-derived specimens. Herein we highlight the selected advancements in this emerging field of bioengineering, and provide a snapshot of developments with relevance to anti-cancer drug screening routines.
Programs and Projects National Lung Screening Trial (NLST/LSS) Lung Screening Feasibility Study (LSS) Prostate, Lung, Colorectal and Ovarian CancerScreening Trial (PLCO) International Prostate Screening Trials Evaluation Group (IPSTEG) Early Detection
Background 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.
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.
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.
The SNP500Cancer is part of the Cancer Genome Anatomy Project and is specifically designed to generate resources for the identification and characterization of genetic variation in genes important in cancer. CGAP is dedicated to the development of technology, including both assays and utilization of technical platforms.
Screening programs for colorectal cancer have long been conducted in Japan using immunochemical fecal occult blood testing. The present issue with promotion of anti-colorectal-cancer strategy through cancerscreening is how we could reach the goal of mortality reduction. Construction of organized screening programs, which is the strategy for reducing cancer mortality through screening, is vital for the purpose. Development of new screening tests and risk stratification strategy are also important issues on this matter. PMID:24597343
BACKGROUND: Breast cancer has been the most prevalent cancer in Japan since the 1990s. The mortality from breast cancer is increasing in Japan, whereas in other industrialized countries it has been decreasing since 1990. On the other hand, Japan faces unparalleled growth in its aging population. The aim of this study was to report the mammography screening among Japanese women and the related upcoming changes in the population pyramid of Japan. DATA SOURCES AND METHODS: The reference data for our study were obtained from the Center for Cancer Control and Information Services, Japan Ministry of Internal Affairs and Communications, Ministry of Health, Labour and Welfare, the Japanese Cancer Society, and the National Institute of Population and Social Security. The survey data were obtained from breast cancer and mammography screenings in the Tokyo Prefecture in 2008. The following parameters were analyzed: annual breast cancer incidence, current screening rates, average life-span, and predicted demographic statistics. RESULTS: Our results showed that breast cancer incidence and mortality have been increasing annually in Japan. The average age of breast cancer patients increased to 58.40 years in 2010. The incidence of breast cancer in women aged 65 years and older increased from 25.3 to 32.9 % in the last 10 years and is expected to continue to increase in the future. The check-up rate was 16.0-20.0 % for women aged 65-74 years and 43.0-46.0 % for women aged 40-54 years. According to our questionnaire survey, concerns about breast cancer and mammography screening were high in the young and low in the elderly women. The Japanese population aged 65 years and older was 30,740 (24.1 %) in 2012 and is estimated to increase by 40 % over the next 20 years despite Japan's declining population size. CONCLUSION: Breast cancer incidence has increased in Japan, even among patients aged 65 years and older. Breast cancer has become increasingly prevalent in older Japanese women. As the population pyramid of Japan changes, women aged 65 years and older, who think that there is no longer need to receive mammography screening and are not educated regarding self-examinations, should be encouraged to receive regular check-ups for breast cancer. PMID:23625276
Background: Colorectal cancer (CRC) screening is recommended for all adults 50-75 years old, yet only slightly more than one-half of eligible people are current with screening. Since CRC screening is usually initiated upon recommendations of primary care physicians, interventions in these settings are needed to improve screening. Objectives: To assess the impact of a quality improvement (QI) intervention combining electronic medical record (EMR) based audit and feedback, practice site visits for academic detailing and participatory planning, and “best-practice” dissemination on CRC screening in primary care practice. Research Design: Two year group-randomized trial. Subjects: Physicians, mid-level providers and clinical staff members in 32 primary care practices in 19 States caring for 68,150 patients 50 years of age or older. Measures: Proportion of active patients up to date (UTD) with CRC screening (colonoscopy within 10 years, sigmoidoscopy within 5 years, or at home fecal occult blood testing within 1 year) and having screening recommended within past year among those not UTD. Results: Patients 50-75 years in intervention practices exhibited significantly greater improvement (from 60.7% to 71.2%) in being UTD with CRC screening than patients in control practices (from 57.7% to 62.8%), the adjusted difference being 4.9% (95% CI: 3.8% to 6.1%). Recommendations for screening also increased more in intervention practices with the adjusted difference being 7.9% (95%CI: 6.3% to 9.5%). There was wide inter-practice variation in CRC screening throughout the intervention. Conclusions: A multi-component QI intervention in practices that use EMR can improve colorectal cancerscreening.
Ornstein, Steven; Nemeth, Lynne S.; Jenkins, Ruth G.; Nietert, Paul J.
Transvaginal ultrasonography (TVS) is an integral part of all major ovarian cancerscreening trials. TVS is accurate in detecting abnormalities in ovarian volume and morphology, but is less reliable in differentiating benign from malignant ovarian tumors. When used as the only screening test, TVS is sensitive, but has a low positive predictive value. Therefore, serum biomarkers and tumor morphology indexing are used together with TVS to identify ovarian tumors at high risk for malignancy. This allows preoperative triage of high-risk cases to major cancer centers for therapy while decreasing unnecessary surgery for benign disease. Ovarian cancerscreening has been associated with a decrease in stage at detection in most trials, thereby allowing treatment to be initiated when the disease is most curable. PMID:24379701
Overview of the European randomized lung cancer CT screening trials (EUCT) is presented with regard to the implementation of CT screening in Europe; post NLST. All seven principal investigators completed a questionnaire on the epidemiological, radiological, and nodule management aspects of their trials at August 2010, which included 32,000 people, inclusion of UKLS pilot trial will reach 36,000. An interim analysis is planned, but the final mortality data testing is scheduled for 2015. PMID:23893464
Field, John K; van Klaveren, Rob; Pedersen, Jesper H; Pastorino, Ugo; Paci, Eugino; Becker, Nikolauss; Infante, Maurizo; Oudkerk, Matthijs; de Koning, Harry J
Objective: The objective of this study was to examine the pattern of breast cancerscreening among Asian immigrant women aged 50–69 years and compare it with corresponding non-immigrant women in Canada. Methods: Data from the Canadian Community Health Survey cycle 2.1 (2003) were utilized. Self-reported screening histories were used as outcome variables: socioeconomic status and medical histories were used as
Zhuoyu Sun; Hui Xiong; Anne Kearney; Jin Zhang; Wei Liu; Guowei Huang; Peizhong Peter Wang
CT colonography (CTC) is a validated colorectal cancer test that provides an additional minimally-invasive screening option which is likely to be preferred by some patients. Important examination prerequisites include adequate colonic cleansing and distention. Tagging of residual material aids in the differentiation of true polyps from stool. Low radiation dose technique should be employed routinely for screening studies. Readers must be skilled in the use of both 2D and 3D interpretation methods. PMID:23459511
This paper describes the immersive sound field simulation technology that represents an interactive sound field in the multi-screenprojection display. In this method, convolution filters, that were calculated based on the wave equation, are replaced in real-time using the multi-channel digital signal processor, and the simulated sounds are displayed using the 16-channel speakers. In addition, compensation filters are used to
T. Ogi; T. Kayahara; M. Kato; H. Asayama; M. Hirose
Lung cancer is a major health problem due to its incidence and mortality. The risk factors, the existence of a preclinical phase, and the relationship between stage at diagnosis and survival are known. A number of strategies that aim to diagnose lung cancer in its earliest stages, based principally on imaging studies, are therefore being tested. Several drugs aimed at reducing the probability of developing lung cancer in the at-risk population are also under study. At the present time, the results obtained have not been encouraging and we do not have a clear strategy either for early diagnosis or for the use of chemopreventive agents. PMID:18490244
Gasent Blesa, J M; Esteban González, E; Alberola Candel, V
Although radiographic screening for gastric cancer has been conducted in Japan, it is anticipated that endoscopy will become a new screening method because of its high detection rate. The sensitivities of endoscopic and radiographic screening were calculated by the detection method and the incidence method based on the results of community-based screening in Japan. There were 56,676 screenings for gastric cancer using endoscopy and radiography from April 2002 to March 2007 in Yonago, Japan. The target age group was from 40 to 79 years. Screen-detected and interval cancers were investigated based on a screening database linked to the Tottori Cancer Registry. All gastric cancers diagnosed within 1 year after a negative screen were considered interval cancers. Based on the screening history, these were divided into prevalence screening and incidence screening. Prevalence screenings included 7,388 for endoscopic screening and 5,410 for radiographic screening, whereas incidence screenings included 18,021 for endoscopic screening and 11,417 for radiographic screening. The sensitivity of prevalence screening calculated by the incidence method was 0.886 (95% confidence interval [CI] = 0.698-0.976) for endoscopic screening and 0.831 (95% CI = 0.586-0.964) for radiographic screening; however, the difference was not significant (p = 0.626). The sensitivity of incidence screening calculated by the incidence method was 0.954 (95% CI = 0.842-0.994) for endoscopic screening and 0.855 (95% CI = 0.637-0.970) for radiographic screening (p = 0.177). Endoscopic screening for gastric cancer had a higher sensitivity than radiographic screening by the incidence method in both screening rounds. However, further study is needed to evaluate mortality reduction and to estimate overdiagnosis with endoscopic screening for gastric cancer. PMID:23364866
Purpose To examine whether patients with a documented family history of breast or colorectal cancer, either positive or negative, were more likely to receive breast or colorectal cancerscreening services than those with no documentation. Methods Medical record reviews were conducted on 3,433 patients aged 55 and older from four primary care practices in two rural Oregon communities. Data collected included patient demographic and risk information and receipt of screening mammography and/or one of four modalities to screen for colorectal cancer. Results Mammography and colorectal cancerscreening rates were low in these rural communities, with 50% of average risk women being up-to-date for mammography and 37% of women and 38% of men being up-to-date for colorectal cancerscreening according to their risk level. A positive family breast cancer history was associated with an increased likelihood of being up-to-date for mammography screening (OR 2.09, 95% CI 1.45-3.00 relative to a recorded negative history). A positive family history for colorectal cancer was associated with an increased likelihood of being up-to-date with colorectal cancerscreening according to U.S. Preventive Services Task Force (USPSTF) low risk guidelines for males (OR 2.89, 95% CI 1.15-7.29) and females (OR 2.47, 95% CI 1.32-4.64) relative to a recorded negative family history. Forty-four percent of the charts of female patients and 56% of the charts of male patients contained no documentation of a family cancer history having been taken. The absence of any recorded family cancer history was associated with a decreased likelihood of being up-to-date for mammography screening (OR 0.70, 95% CI 0.56-0.88 relative to recorded negative history) or for colorectal cancerscreening OR 0.75, 95% CI 060-0.96 in females, 0.68, 95% CI 0.53-0.88 in males relative to recorded negative history). Conclusion Recording family history of cancer was associated with up-to-date cancerscreening, even if the family history was negative. Establishing clinical routines to obtain family history could improve appropriate use of cancerscreening.
An estimated half a million cancers were prevented by colorectal cancerscreening in the United States from 1976 to 2009, report researchers from the Cancer Outcomes, Public Policy, and Effectiveness Research Center at Yale Cancer Center.
Background The aim of the current study was to investigate the pattern of cancerscreening behavior in adult retinoblastoma survivors, who are at high risk of developing second cancers. Methods Self-reported cancerscreening practices were investigated in a cohort of retinoblastoma survivors to evaluate whether they were receiving adequate screening for specific cancers and compare these rates with those of other adult survivors of childhood cancer and the general population. The prevalence of breast self-examination, clinical breast examination, mammography, Papanicolaou (Pap) test, testicular self-examination, and magnetic resonance imaging (MRI) or computed tomography (CT) scanning was determined from computer-aided telephone interviews with 836 retinoblastoma survivors aged >18 years. Results Among female survivors, 87% had a Pap test within the past 2 years, and 76% of females age >40 years reported having a mammogram within the past 2 years; 17.4% of male survivors had performed monthly testicular self-examinations. A significantly higher proportion of hereditary compared with nonhereditary survivors reported having undergone an MRI or CT scan in the past 5 years. Higher education, greater contact with the medical care system, and having a second cancer were found to be associated positively with most screening practices. Cancerscreening practices reported by retinoblastoma survivors were similar to national screening rates for breast, cervical, and testicular cancer. Conclusions To the authors' knowledge, the current study provides the first report of cancerscreening practices of retinoblastoma survivors. Survivors of hereditary retinoblastoma should be encouraged to maintain, if not increase, their current screening practices to ensure early detection of second cancers in this high-risk population.
Sheen, Victoria; Tucker, Margaret A.; Abramson, David H.; Seddon, Johanna M.; Kleinerman, Ruth A.
Background Colorectal cancerscreening (CRCS) is the only type of cancerscreening where both genders reduce risks by similar proportions with identical procedures. It is an important context for examining gender differences in disease-prevention, as CRCS significantly reduces mortality via early detection and prevention. In efforts to increase screening adherence, there is increasing acknowledgment that obstructive attitudes prevent CRCS uptake. Precise identification of the gender differences in obstructive attitudes is necessary to improve uptake promotion. This study randomly sampled unscreened, screening - eligible individuals in Ontario, employing semi-structured interviews to elicit key differences in attitudinal obstructions towards colorectal cancerscreening with the aim of deriving informative differences useful in planning promotions of screening uptake. Methods N = 81 participants (49 females, 32 males), 50 years and above, with no prior CRCS, were contacted via random-digit telephone dialing, and consented via phone-mail contact. Altogether, N = 4,459 calls were made to yield N = 85 participants (1.9% response rate) of which N = 4 participants did not complete interviews. All subjects were eligible for free-of-charge CRCS in Ontario, and each was classified, via standard interview by CRCS screening decision-stage. Telephone-based, semi-structured interviews (SSIs) were employed to investigate gender differences in CRCS attitudes, using questions focused on 5 attitudinal domains: 1) Screening experience at the time of interview; 2) Barriers to adherence; 3) Predictors of Adherence; 4) Pain-anxiety experiences related to CRCS; 5) Gender-specific experiences re: CRCS, addressing all three modalities accessible through Ontario’s program: a) fecal occult blood testing; b) flexible sigmoidoscopy; c) colonoscopy. Results Interview transcript analyses indicated divergent themes related to CRCS for each gender: 1) bodily intrusion, 2) perforation anxiety, and 3) embarrassment for females and; 1) avoidant procrastination with underlying fatalism, 2) unnecessary health care and 3) uncomfortable vulnerability for males. Respondents adopted similar attitudes towards fecal occult blood testing, flexible sigmoidoscopy and colonoscopy, and were comparable in decision stage across tests. Gender differences were neither closely tied to screening stage nor modality. Women had more consistent physician relationships, were more screening-knowledgeable and better able to articulate views on screening. Men reported less consistent physician relationships, were less knowledgeable and kept decision-making processes vague and emotionally distanced (i.e. at ‘arm’s length’). Conclusions Marked differences were observed in obstructive CRCS attitudes per gender. Females articulated reservations about CRCS-associated distress and males suppressed negative views while ambiguously procrastinating about the task of completing screening. Future interventions could seek to reduce CRCS-related stress (females) and address the need to overcome procrastination (males).
The first evidence that screening for colorectal cancer (CRC) could effectively reduce mortality dates back 20 years. However, actual population screening has, in many countries, halted at the level of individual testing and discussions on differences between screening tests. With a wealth of new evidence from various community-based studies looking at test uptake, screening-programme organization and the importance of quality assurance, population screening for CRC is now moving into a new realm, promising better results in terms of reducing CRC-specific morbidity and mortality. Such a shift in the paradigm requires a change from opportunistic, individual testing towards organized population screening with comprehensive monitoring and full-programme quality assurance. To achieve this, a combination of factors--including test characteristics, uptake, screenee autonomy, costs and capacity--must be considered. Thus, evidence from randomized trials comparing different tests must be supplemented by studies of acceptance and uptake to obtain the full picture of the effectiveness (in terms of morbidity, mortality and cost) the different strategies have. In this Review, we discuss a range of screening modalities and describe the factors to be considered to achieve a truly effective population CRC screening programme. PMID:23381005
Kuipers, Ernst J; Rösch, Thomas; Bretthauer, Michael
Objective To assess the impact of health care access and socioeconomic determinants on Pap smear screening in Latin America. Methods Individual-level data was collected from the Demographic and Health Surveys in Bolivia, Brazil, Dominican Republic, Ecuador, Guatemala, Nicaragua, Peru, and Trinidad and Tobago between 1987 and 2008. Multivariate logistic regression analyses were used to identify socioeconomic and health care determinants of two outcomes: knowledge of Pap smears and recent Pap smear screening. Results In all countries, the proportion of women with a recent Pap smear screening remained below 55%. Key determinants of knowledge of Pap smears were age, education, and recent doctor’s visit. For recent Pap smear screening, key determinants were wealth and recent doctor’s visit. Women were between 1.47 and 3.44 times more likely to have received a recent Pap smear if they had a recent doctor’s visit. Even the poorest women with a recent doctor’s visit were more likely to screen than the richest women without a recent visit. Conclusions These data suggest that visiting a doctor is an important determinant of cervical cancerscreening in Latin America. Because screening may coincide with other medical visits, physicians could effectively encourage screening.
BACKGROUND: Community social and economic resources influence colorectal (CRC) screening decisions by physicians and patients. The aim of this study is to systematically assess the differences in screening recommendations of primary care physicians within two urban communities that are distinct in socioeconomic characteristics. METHODS: Two-hundred-sixty-four primary care community (i.e., not hospital-based) physicians were stratified by community. Using self-report questionnaires, we examined primary care physicians' CRC screening practices, knowledge of risk factors and perceived physician and patient barriers to screening, Physicians practicing in upper-socioeconomic status (SES) communities were compared with those of participants practicing in lower SES communities. RESULTS: Physicians practicing in low-SES urban communities were significantly more likely to screen with fecal occult blood test than were physicians in upper-SES areas. Alternatively, upper-SES physicians were significantly more likely to recommend screening colonoscopy than were lower-SES physicians. The number of physicians (N=11) who screened for CRC using the double-contrast barium enema were few. CONCLUSIONS: Community-level SES influences physician cancerscreening practices. Further understanding of these relationships may guide the development of interventions targeted to specific neighborhoods within urban areas.
Gorin, Sherri Sheinfeld; Ashford, Alfred R.; Lantigua, Rafael; Hajiani, Farida; Franco, Rebeca; Heck, Julia E.; Gemson, Donald
A running screen method is applied to remove hot spot speckle on projectionscreen by a laser display system with one DLP panel. We have commercially displayed a projection image from a DLP (720 Pi) display system using a minimized RGB high power laser source. Then we successfully obtained a high-quality image with low speckle contrast as if hot spot
Sung Chul Shin; Sin Sung Yoo; Sang Yeon Lee; Chan-Young Park; So-Yeon Park; Jae Wook Kwon; Seung-Gyu Lee
Objectives To determine the types of, and the populations targeted by interventions implemented to increase breast cancerscreening rates in counties with large African American populations across different US regions. Methods A brief questionnaire was administered by e-mail to county representatives from 33 states from October 2008 through March 2009. Responses were obtained from 33% of 203 targeted counties. Results Most counties (>80%) reported interventions for African American women and for women with low income. Women were exposed to different kinds of interventions depending on where they lived. Most counties in the Northeast (93%), Southwest (82%) and Midwest (100%) implemented interventions that provided free or low cost mammograms. Counties in the Southeast (83%) were more likely to report education interventions. Counties from the Southwest reported using a variety of interventions to encourage breast cancerscreening. Conclusion In this selected group of counties, different types of interventions were used to increase breast cancerscreening in minority and disadvantaged women. Interventions implemented were similar to those shown in the literature to be effective in increasing screening rates in specific populations. Future research should examine the use of screening interventions in a larger sample of US counties.
Austin, Shamly; Martin, Michelle Y; Levine, Robert S.; Pisu, Maria
OBJECTIVE: To update current evidence for prostate-specific antigen (PSA) screening for prostate cancer and to give readers some practical information to discuss with patients. QUALITY OF EVIDENCE A MEDLINE: search revealed only three randomized studies, two of which are incomplete. Several controlled non-randomized studies were found. MAIN MESSAGE: Two ongoing studies have not yet reported survival data, but have added to evidence for screening intervals. One Canadian randomized study has been criticized for its design and conclusions. Non-randomized studies suggest that screening effectively identifies serious cancers and leads to earlier diagnosis. Mortality from prostate cancer has been falling in most western countries since 1992. This cannot be explained by PSA screening, which would probably not produce survival benefit until at least 10 years after its unofficial introduction in about 1990. CONCLUSION: Indirect evidence suggests that all men older than 45 with at least a 10-year life expectancy should be informed of the potential benefits and drawbacks of PSA screening so they can make an informed decision on whether to have the test.
ABSTRACT Each year, the American Cancer Society (ACS) publishes a summary of its rec- ommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancerscreen- ing rates for US adults. In 2006, there were no updates to ACS guidelines for early cancer detection.
Objective Early detection and early treatment are of vital importance to the successful treatment of various cancers. The development of a novel screening method that is as economical and non-invasive as the faecal occult blood test (FOBT) for early detection of colorectal cancer (CRC) is needed. A study was undertaken using canine scent detection to determine whether odour material can become an effective tool in CRC screening. Design Exhaled breath and watery stool samples were obtained from patients with CRC and from healthy controls prior to colonoscopy. Each test group consisted of one sample from a patient with CRC and four control samples from volunteers without cancer. These five samples were randomly and separately placed into five boxes. A Labrador retriever specially trained in scent detection of cancer and a handler cooperated in the tests. The dog first smelled a standard breath sample from a patient with CRC, then smelled each sample station and sat down in front of the station in which a cancer scent was detected. Results 33 and 37 groups of breath and watery stool samples, respectively, were tested. Among patients with CRC and controls, the sensitivity of canine scent detection of breath samples compared with conventional diagnosis by colonoscopy was 0.91 and the specificity was 0.99. The sensitivity of canine scent detection of stool samples was 0.97 and the specificity was 0.99. The accuracy of canine scent detection was high even for early cancer. Canine scent detection was not confounded by current smoking, benign colorectal disease or inflammatory disease. Conclusions This study shows that a specific cancer scent does indeed exist and that cancer-specific chemical compounds may be circulating throughout the body. These odour materials may become effective tools in CRC screening. In the future, studies designed to identify cancer-specific volatile organic compounds will be important for the development of new methods for early detection of CRC.
Objectives: To explore knowledge and attitudes about colorectal cancer (CRC) screening among African American patients age 45 and older at a community health center serving low-income and uninsured patients. Methods: We conducted 7 focus groups and 17 additional semistructured interviews. Sessions were audio-recorded, transcribed, and analyzed…
James, Aimee S.; Daley, Christine M.; Greiner, K. Allen
Given the continuing increase in mammary cancer incidence and in many cases also mortality across the world, as well as the difficulty with primary prevention, the question of whether screening for early detection is effective is of prime importance. If there is a real benefit in terms of reduced mortality then attention should clearly be focused on the modality which
Introduction Chinese American women have high rates of invasive cervical cancer, compared to the general population. However, little is known about the Pap testing behavior of ethnic Chinese immigrants. Methods We conducted a community-based survey of Chinese immigrants living in Seattle, Washington, during 1999. Two indicators of cervical cancerscreening participation were examined: at least one previous Pap smear and Pap testing in the last 2 years. Results The overall estimated response rate was 64%, and the cooperation rate was 72%. Our study sample for this analysis included 647 women. Nearly one quarter (24%) of the respondents had never had a Pap test, and only 60% had been screened recently. Factors independently associated with cervical cancerscreening use included marital status, housing type, and age at immigration. Conclusion Our findings confirm low levels of cervical cancerscreening among Chinese immigrants to North America. Culturally and linguistically appropriate Pap testing intervention programs for less acculturated Chinese women should be developed, implemented, and evaluated.
Do, H. Hoai; Taylor, Victoria M.; Yasui, Yutaka; Jackson, J. Carey; Tu, Shin-Ping
April 12, 2013 11:00 AM - 12:00 PM EPN Room CDEF + Add to Outlook Calendar Speaker: Mark W. Lingen, DDS, Ph.D., FRCPath.Professor, Departments of Pathology, Medicine and Radiation & Cellular OncologyUniversity of ChicagoTitle: Oral cancerscreening
... pay more to get the newer test. Robert Smith, PhD, American Cancer Society senior director of cancer ... all women should seek out 3-D mammograms. Smith said although the study showed an important improvement ...
Recent guidelines on cancerscreening 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.
Jimbo, Masahito; Rana, Gurpreet K.; Hawley, Sarah; Holmes-Rovner, Margaret; Kelly-Blake, Karen; Nease, Donald E.; Ruffin, Mack T.
Colorectal cancer (CRC) is the third most common non-skin cancer diagnosed in men and women in the USA and worldwide. While it has been clearly established that screening for CRC, using a variety of methods, is cost effective and has a significant impact on overall survival, screening rates have proven to be sub-optimal. It has been long conjectured that a simple blood-based test, with a specimen drawn at a routine doctor's office visit, would encourage those individuals who have refused or ignored screening recommendations to undergo screening. This article reviews the currently available blood-based screening tests for CRC, including the ColonSentry™ messenger RNA (mRNA) expression panel and the SEPT9 methylated DNA test, and explores newer biomarkers that are near clinical implementation. Also discussed are additional applications for blood-based CRC testing, such as assessing prognosis, disease surveillance, and expansion of screening tests to high-risk populations, such as the estimated 1.4 million individuals in the USA with inflammatory bowel disease. PMID:24307563
... Español FDA approves first human papillomavirus test for primary cervical cancerscreening The U.S. Food and Drug ... the safety and effectiveness when used as a primary screening tool for cervical cancer.” The FDA first ...
The Survey of Health Plan Policies and Programs for Colorectal CancerScreening is a nationwide study that will provide important information about how screening for colorectal cancer is being conducted in U.S. health plans.
Background Native Americans are disproportionately affected by cancer morbidity and mortality. This study examined intention to receive cancerscreening in a large sample of Native Americans from the Northern Plains, a region with high cancer mortality rates. Methods A survey was administered orally to 975 individuals in 2004–2006 from three reservations and among the urban Native American community in the service region of the Rapid City Regional Hospital. Data analysis was conducted in 2009. Results About 63% of the sample planned to receive cancerscreening. In multivariate analyses, individuals who planned to receive cancerscreening were women, responsible for four or more people, received physical examinations at least yearly and had received prior cancerscreening. They also were more likely to hold the belief that most people would go through cancer treatment even though these treatments can be emotionally or physically uncomfortable. About 90% of those who did not plan to receive cancerscreening would be more likely to intend to receive cancerscreening if additional resources were available. Conclusions In an area of high cancer morbidity and mortality, over one-third of screening eligible individuals did not plan to receive cancerscreening. Future research should evaluate the potential for improving cancerscreening rates through interventions that seek to facilitate increased knowledge about cancerscreening and access to cancerscreening services in the community.
Guadagnolo, B. Ashleigh; Kanekar, Shalini; Petereit, Daniel G.; Karki, Chitra; Smith, Maureen A.
Lung cancer is a major health burden and early detection only bears the possibility of curative treatment. Screening with computed tomography (CT) recently demonstrated a mortality reduction in selected patients and has been incorporated in clinical guidelines. Problems of screening with CT are the excessive number of false positive findings, costs, radiation burden and from a global point of view shortage of CT capacity. In contrast, chest radiography could be an ideal screening tool in the early detection of lung cancer. It is widely available, easy to perform, cheap, the radiation burden is negligible and there is only a low rate of false positive findings. Large randomized controlled trials could not show a mortality reduction, but different large population-based cohort studies have shown a lung cancer mortality reduction. It has been argued that community-based cohort studies are more closely reflecting the “real world” of everyday medicine. Radiologists should be aware of the found mortality reduction and realize that early detection of lung cancer is possible when reading their daily chest radiographs. Offering a chest radiograph in selected scenarios for the early detection of lung cancer is therefore still justified.
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 six out of ten trials focused on increasing fecal occult blood testing, four of seven trials focused on sigmoidoscopy or colonoscopy completion, and nine of 16 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.
Rawl, Susan M.; Menon, Usha; Burness, Allison; Breslau, Erica S.
This paper looks at Jordanian women's attitudes towards cervical screening and cervical cancer. The sample consisted of 600 women attending gynaecology clinics at King Hussein Medical Centre, Amman, Jordan. Seventy-five per cent of women had never had a smear before; however, the majority agreed that it is important; 34.5% of women did not know the significance of a positive cervical smear; 77% of women were not aware of causes of cervical cancer. Finally, when asked who would they like to take their cervical smear test, a clear preference was stated for a female doctor or a female nurse. These findings provide a useful background for developing strategies to increase the uptake of cervical smears among Jordanian women. It also emphasises the need to educate and promote awareness of women to risk factors for cervical cancer and to the need for screening programmes. PMID:12521469
The International Association for the Study of Lung Cancer (IASLC) Board of Directors convened a computed tomography (CT) Screening Task Force to develop an IASLC position statement, after the National Cancer Institute press statement from the National Lung Screening Trial showed that lung cancer deaths fell by 20%. The Task Force's Position Statement outlined a number of the major opportunities to further improve the CT screening in lung cancer approach, based on experience with cancerscreening from other organ sites.The IASLC CT Screening Workshop 2011 further developed these discussions, which are summarized in this report. The recommendation from the workshop, and supported by the IASLC Board of Directors, was to set up the Strategic CT Screening Advisory Committee (IASLC-SSAC). The Strategic CT Screening Advisory Committee is currently engaging professional societies and organizations who are stakeholders in lung cancer CT screening implementation across the globe, to focus on delivering guidelines and recommendations in six specific areas: (i) identification of high-risk individuals for lung cancer CT screening programs; (ii) develop radiological guidelines for use in developing national screening programs; (iii) develop guidelines for the clinical work-up of "indeterminate nodules" resulting from CT screening programmers; (iv) guidelines for pathology reporting of nodules from lung cancer CT screening programs; (v) recommendations for surgical and therapeutic interventions of suspicious nodules identified through lung cancer CT screening programs; and (vi) integration of smoking cessation practices into future national lung cancer CT screening programs. PMID:22173661
Field, John K; Smith, Robert A; Aberle, Denise R; Oudkerk, Matthijs; Baldwin, David R; Yankelevitz, David; Pedersen, Jesper Holst; Swanson, Scott James; Travis, William D; Wisbuba, Ignacio I; Noguchi, Masayuki; Mulshine, Jim L
This review summarizes and synthesizes research findings on risk perception and risk communication related to cancerscreening behaviors. The focus is on cancers for which there is evidence that screening reduces mortality, i.e., cervical, breast, and colorectal cancers. The following questions are addressed: 1) Is perceived risk associated with relevant can- cer screening behaviors? 2) What factors are associated with
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 cancerscreenings, 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 cancerscreening. METHODS: The CancerScreening 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 cancerscreening exams was consistently high in both cities, SJPR had higher rates, as compared to NYPR for all 10 site-specific cancerscreening 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 cancerscreening as compared to NYPR, were three-fold higher to participate in skin cancerscreening and were two-fold higher to participate in a cancerscreening where they have to be interviewed about their alcohol habits. These two observed differences might reflect the effect of acculturation in the NYPR.
Claudio, Cristina; Katz, Ralph V.; Green, B. Lee; Kressin, Nancy R.; Wang, Min Qi; Russell, Stefanie L.
Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancerscreening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancerscreening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the…
Muus, Kyle J.; Baker-Demaray, Twyla; McDonald, Leander R.; Ludtke, Richard L.; Allery, Alan J.; Bogart, T. Andy; Goldberg, Jack; Ramsey, Scott D.; Buchwald, Dedra S.
Background: The United Kingdom NHS Breast Screening Programme was established in 1988, and women aged between 50 and 70 are routinely invited at three yearly intervals. Expected United Kingdom interval cancer rates have been calculated previously, but this is the first publication from an exercise to collate individual-based interval cancer data at a national level. Methods: Interval cancer case ascertainment is achieved by the regular exchange of data between Regional Breast Screening Quality Assurance Reference Centres and Cancer Registries. The present analysis includes interval cancers identified in women screened between 1st April 1997 and 31st March 2003, who were aged between 50 and 64 at the time of their last routine screen. Results: In the periods >0–<12 months, 12–<24 months and 24–<36 months after a negative screen, we found overall interval cancer rates and regional ranges of 0.55 (0.43–0.76), 1.13 (0.92–1.47) and 1.22 (0.93–1.57) per 1000 women screened, respectively. Rates in the period 33–<36 months showed a decline, possibly associated with early re-screening or delayed presentation. Conclusions: Interval cancer rates were higher than the expected rates in the 24-month period after a negative screen, but were similar to published results from other countries. Increases in background incidence may mean that the expected rates are underestimated. It is also possible that, as a result of incomplete case ascertainment, interval cancers rates were underestimated in some regions in which rates were less than the expected.
Excellent recommendations exist for studying therapeutic and diagnostic questions. We observe that good guidelines on assessment of evidence for screening questions are currently lacking. Guidelines for diagnostic research (STARD), involving systematic application of the reference test (gold standard) to all subjects of large study populations, are not pertinent in situations of screening for disease that is currently not yet present. A five-step framework is proposed for assessing the potential use of a biomarker as a screening tool for cervical cancer: 1) correlation studies establishing a trend between the rate of biomarker expression and severity of neoplasia; 2) diagnostic studies in a clinical setting where all women are submitted to verification by the reference standard; 3) biobank-based studies with assessment in archived cytology samples of the biomarker in cervical cancer cases and controls; 4) prospective cohort studies with baseline assessment of the biomarker and monitoring of disease; 5) randomised intervention trials aiming to observe reduced incidence of cancer (or its surrogate, severe dysplasia) in the experimental arm at subsequent screening rounds. The 5-phases framework should guide researchers and test developers in planning assessment of new biomarkers and protect clinicians and stakeholders against premature claims for insufficiently evaluated products.
Arbyn, Marc; Ronco, Guglielmo; Cuzick, Jack; Wentzensen, Nicolas; Castle, Philip E.
Background. Hmong women are reported to have very low rates of breast and cervical cancerscreening compared to other Asian and White women in the USA. Reasons for low cancerscreening rates among this population are not well understood. Methods. This qualitative study (n=83) explored Hmong women and men's perceptions of breast and cervical cancer and cancerscreening, women's experiences with breast and cervical cancerscreening, and health care system barriers to screening. Results. Hmong women and men perceived breast cancer to be more severe than other types of cancers. Participants believed that breast cancer is curable if detected early. Cervical cancer was not well understood and was of greater concern than breast cancer because of its location within the body and its consequences for reproduction. In general, few participants had personal experiences with breast and/or cervical cancer. Overall, women and men had positive things to say about screenings for breast and cervical cancer, expressing that screenings offered a 'proof of illness.' The majority of women did not report any concerns with the exams themselves, although some discussed embarrassment, pain, and discomfort. Barriers to screening included lack of health insurance, making co-payments, language, and issues related to scheduling appointments. Barriers differed for younger and older women. Conclusion. Results of this study provide new insight into perceptions, experiences, and barriers to breast and cervical cancerscreening among Hmong women and men. These findings have implications for developing culturally appropriate interventions to increase breast and cervical cancerscreening in this population. PMID:23477387
High-content screening is important in drug discovery. The use of images of living cells as the basic unit for molecule discovery can aid the identification of small compounds altering cellular phenotypes. As such, efficient computational methods are required for the rate limiting task of cellular phenotype identification. In this paper we first investigate the effectiveness of a feature description approach by combining Haralick texture analysis with Curvelet transform and then propose a new ensemble approach for classification. The ensemble contains a set of base classifiers which are trained using random projection (RP) of original features onto higher-dimensional spaces. With Classification and Regression Tree (CART) as the base classifier, it has been empirically demonstrated that the proposed Random Projection Forest ensemble gives better classification results than those achieved by the Boosting, Bagging and Rotation Forest algorithms, offering a classification rate ~88% with smallest standard deviation, which compares sharply with the published result of 82%.
Extremely obese women are less likely than nonobese women to receive breast and cervical cancerscreening examinations. Reasons for this disparity are unclear and may stem from patient and/or physician barriers. This sequential mixed-methods study used individual in-depth interviews of 15 family physicians followed by a mail survey of 255 family physicians (53% response rate) to understand the barriers they faced in performing cancerscreening examinations in extremely obese women. Barriers fell into three main areas: (i) difficulty doing pelvic and breast exams; (ii) inadequate equipment; and (iii) challenges overcoming patient barriers and refusal. This led some physicians to avoid performing breast and pelvic examinations on extremely obese women. Having more knowledge about specific examination techniques was associated with less difficulty in palpating lumps on breast and pelvic examinations (P < 0.005). Physicians perceived that embarrassment, aversion to undressing, and avoidance of discussions related to their weight were the most frequent barriers extremely obese women had with getting physical examinations. Educating and/or motivating patients and addressing fears were strategies used most frequently when patients refused mammograms or Pap smears. Interventions focusing on physician barriers, such as educating them on specific examination techniques, obtaining adequate equipment and supplies, and providing resources to assist physicians in dealing with patient barriers and refusal, may be fruitful in increasing cancerscreening rates in extremely obese patients. Future research studies testing the effectiveness of these strategies are needed to improve cancer outcomes in this high-risk population.
Ferrante, Jeanne M.; Fyffe, Denise C.; Vega, Marielos L.; Piasecki, Alicja K.; Ohman-Strickland, Pamela A.; Crabtree, Benjamin F.
Background Asian American and Pacific Islander women represent a significant at-risk population for breast cancer, with their mortality rates rising while rates fall for all other racial groups. Methods This 3-year study employed a quasi-experimental design to test the influence of an intervention on screening rates among women age 50 years and older in Southern California compared to Northern California. Results Despite significant exposure of women to the educational elements in Southern California, the intervention did not increase women’s knowledge, attitudes, or screening behaviors. Conclusions We discuss several study design and implementation limitations that could have influenced the study’s results.
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Background U.S. cancerscreening guidelines communicate important information regarding the ages for which screening tests are appropriate. Little attention has been given to whether breast, colorectal and prostate cancerscreening test use is responsive to guideline age information regarding the age of screening initiation. Methods The 2006 Behavioral Risk Factor Social Survey and the 2003 National Health Interview Surveys were used to compute breast, colorectal and prostate cancerscreening test rates by single year of age. Graphical and logistic regression analyses were used to compare screening rates for individuals close to and on either side of the guideline recommended screening initiation ages. Results We identified large discrete shifts in the use of screening tests precisely at the ages where guidelines recommend that screening begin. Mammography screening in the last year increased from 22% [95% CI = 20, 25] at age 39 to 36% [95% CI = 33, 39] at age 40 and 47% [95% CI = 44, 51] at age 41. Adherence to the colorectal cancerscreening guidelines within the last year increased from 18% [95% CI = 15, 22] at age 49 to 19% [95% CI = 15, 23] at age 50 and 34% [95% CI = 28, 39] at age 51. Prostate specific antigen screening in the last year increased from 28% [95% CI = 25, 31] at age 49 to 33% [95% CI = 29, 36] and 42% [95% CI = 38, 46] at ages 50 and 51. These results are robust to multivariate analyses that adjust for age, sex, income, education, marital status and health insurance status. Conclusion The results from this study suggest that cancerscreening test utilization is consistent with guideline age information regarding the age of screening initiation. Screening test and adherence rates increased by approximately 100% at the breast and colorectal cancer guideline recommended ages compared to only a 50% increase in the screening test rate for prostate cancerscreening. Since information regarding the age of cancerscreening initiation varies across countries, results from this study also potentially have implications for cross-country comparisons of cancer incidence and survival statistics.
Purpose To examine whether body mass index is associated with reduced colorectal cancer (CRC) screening in a large population of black and white adults. Methods Cross-sectional data collected at baseline for 9,547 black males, 14,515 black females, 3,519 white males, and 7,245 white females age 50–79 enrolled in the Southern Community Cohort Study from 2002–2009 were used to examine odds ratios (OR) with 95% confidence internals (CI) for use of colonoscopy or sigmoidoscopy in relation to body mass index (BMI) categories (<18.5, 18.5–24.9 (referent), 25–29.9, 30–34.9, 35–39.9, and 40+ (extreme obesity), kg/m2) using logistic regression controlling for age, education, income, health insurance status, last physician visit, cigarette smoking, and alcohol consumption. Results Increased BMI was not associated with reduced CRC screening among whites (OR [95% CI] for BMI ? 40 = 1.02 [0.71–1.46] for white males and 0.99 [0.83–1.19] for white females), and odds of CRC screening were increased with high BMI among blacks (OR [95% CI] for BMI ? 40 = 1.34 [1.03–1.74] for black males and 1.13 [0.98–1.29] for black females). Extreme obesity was associated with reduced odds of CRC screening only among white women in subgroup analyses limited to those with health insurance or income ? $25,000/year. Conclusions Elevated BMI was not a deterrent to CRC screening overall in this population. In light of low overall screening rates for colorectal cancer nationally, efforts to increase screening in all individuals should remain the focus of public health initiatives.
Cohen, Sarah S; Murff, Harvey J; Signorello, Lisa B; Blot, William J
In 2000, Olsen and Gøtzsche raised doubt about the results of randomized controlled trials (RCT) on the effectiveness of mammography screening. The paper aroused much criticism, and on October 20, 2001, Olsen and Gøtzsche again published the results of meta-analysis on the effectiveness of screening for breast cancer using mammography. Their results suggested that there was no reliable evidence that mammography screening reduced mortality. Their article in 2001 created worldwide controversy on the effectiveness of screening for breast cancer using mammography. However, breast cancer mortality has declined after introducing the screening mammography in many Western nations, and the guidelines for breast cancerscreening were not changed in the countries. PMID:14997744
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 cancerscreening materials may contribute to disproportionately low levels of cancerscreening 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 cancerscreening, 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 cancerscreening. Participants included 150 Hmong (male participants?=?30 and female participants?=?120). Teach-back method was used to assess the participants' understanding of cancerscreening 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 cancerscreening. Nearly, all participants perceived an increased in their understanding, greater acceptance of cancerscreening, 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
BACKGROUND: Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancerscreening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel CancerScreening Program (NBCSP)
Aliki Christou; Judith M Katzenellenbogen; Sandra C Thompson
Immigrant populations in the United States (US) have lower cancerscreening rates compared to none immigrant populations. The purpose of this study was to assess the rates of cancerscreening and examine factors associated with cancerscreening behavior among African immigrant women in Minnesota. A cross sectional survey of a community based sample was conducted among African immigrants in the Twin Cities. Cancerscreening outcome measures were mammography and Papanicolau smear test. The revised theoretical model of health care access and utilization and the behavioral model for vulnerable populations were utilized to assess factors associated with cancerscreening. Only 61 and 52 % of the age eligible women in the sample had ever been screened for breast and cervical cancer respectively. Among these women, duration of residence in the US and ethnicity were significant determinants associated with non-screening. Programs to enhance screening rates among this population must begin to address barriers identified by the community. PMID:23334709
Background Cervical cancer is the primary cause of death due to cancer in women in Chuuk State, Federated States of Micronesia. The Chuukese population is the fastest growing segment of the Micronesian community in Hawai‘i. Little is known about the health beliefs or practices of this population in Hawai‘i. The purpose of this project was to describe the knowledge, attitudes, and beliefs of Chuukese women in Hawai‘i regarding cervical cancer prevention and screening. Methods Research assistants from the Chuukese community were recruited and trained as members of the research team. A culturally sensitive survey tool was developed and piloted by the research team and used to interview ten key informants from the Chuukese community in Honolulu, Hawai‘i. Results There is limited knowledge about cervical cancer, especially the association with human papillomavirus (HPV). This may be indicative of a lack of health information in general. Fear, privacy concerns, lack of awareness and cultural beliefs represent the main barriers mentioned when discussing cervical cancer. Education, done in a group setting with other women, is the most recommended method of informing this community and improving preventive and screening services for cervical cancer in these women.
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
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.
Bitter controversy surrounds the recommendation of mammographic breast-cancerscreening for women aged 40 and 49 years of average risk. This paper considers the case for screening women in their 40s with higher risk, specifically women who have one or more first-degree relatives with breast cancer. A review of the literature and of current knowledge suggests that screening such women is more cost-effective, in the sense of having a higher yield per mammogram and better predictive value, than screening women of average risk in this age group. However, there is no evidence that screening is more efficacious in reducing mortality in this subgroup than in other women in their 40s. Images p834-a
Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization\\u000a of cancerscreenings. 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 cancerscreening for
Background & aims: Colorectal cancerscreening is effective and cost-effective, but little data from health plan settings are available inform decision-makers regarding direct economic implications of colorectal cancerscreening programs. The purpose of this study was to compare the prediagnosis evaluation and first-year treatment costs of persons diagnosed with colorectal cancer, stratified by whether the cancer was detected by screening
Scott D Ramsey; Margaret T Mandelson; Kristin Berry; Ruth Etzioni; Robert Harrison
The shift from illness to disease has had a profound impact on modern medicine - particularly in the realm of cancerscreening. 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
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 cancerscreening 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 cancerscreening.
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
A non-invasive test that includes detection of the genetic abnormalities related to cancer could significantly improve the effectiveness of colon cancerscreening, according to research from the UNC School of Medicine and UNC Lineberger Comprehensive Cancer Center.
Extremely obese women are less likely than nonobese women to receive breast and cervical cancerscreening examinations. Reasons for this disparity are unclear and may stem from patient and\\/or physician barriers. This sequential mixed-methods study used individual in-depth interviews of 15 family physicians followed by a mail survey of 255 family physicians (53% response rate) to understand the barriers they
Jeanne M. Ferrante; Denise C. Fyffe; Marielos L. Vega; Alicja K. Piasecki; Pamela A. Ohman-Strickland; Benjamin F. Crabtree
The purpose of the project was to implement fish screens installation and maintenance program in the Scott River watershed which would supplement the diversion screening efforts of the California Department of Fish and Game (CDFG). The purpose of the prog...
This article reviews the current status of Mammographic screening in early detection of Breast cancer. A brief introduction\\u000a on the global breast cancer burden is followed by an overview of the data proving the benefits of screening mammography in\\u000a those countries where screening programs are in place. The screening recommendations, the benchmarks of a successful mammographic\\u000a screening program and an
Current indications for breast cancerscreening in the male population are lacking, although family history of breast cancer may be such an indication. The authors describe a man with a history of clinically diagnosed right breast cancer who subsequently tested positive for the breast cancer susceptibility gene BRCA2 and received a diagnosis of mammographically detected left breast cancer at screening. The authors discuss the clinical implications of this approach to detecting male breast cancer. PMID:14752193
Brenner, R James; Weitzel, Jeffrey N; Hansen, Nora; Boasberg, Peter
To reveal the role of key elements present in the hair of breast cancer patients on cancer development, the levels of a number of elements in scalp hair samples of 82 people including healthy individuals, people suffering from benign breast disease, and breast cancer patients were measured by PIXE analysis. Pellets of hair samples were prepared and bombarded by 2.2 MeV proton beam of a 3-MV Van de Graaff accelerator. The number of incident ions hitting the sample was indirectly measured using the RBS spectrum of a thin Ag film placed in the beam path. The concentrations of S, Cl, K, Ca, Fe, and Cu in the hair of healthy individuals were in agreement with those observed in the hair of hyperplasia and cancer patients within standard deviations. However, a lower average level of zinc was found in samples from hyperplasia and breast cancer patients. Strong positive correlations were found between iron and potassium as well as between calcium and potassium in the cancer patients. These results could be of significance in the screening for breast cancer. PMID:23625730
Gholizadeh, N; Kabiri, Z; Kakuee, O; Saleh-Kotahi, M; Changizi, V; Fathollahi, V; Oliaiy, P; Omranipour, R
Trinidad and Tobago (TT) experiences the highest breast cancer mortality in the Caribbean; the distribution of traditional breast cancer risk factors in this population has not been analyzed. Data on women who underwent breast cancerscreening at the TT Cancer Society between January 2009-December 2011(N = 2,689) were retrospectively collected. The screening detected 131 incident breast cancers; variables significantly associated with breast cancer diagnosis were, a positive family history of breast cancer (adjusted odds ratio [ORadj]: 1.55; 95% CI 1.00-2.41), presence of symptoms (ORadj: 1.91; 95% CI 1.25-2.92), and previous breast surgery (ORadj: 1.67; 95% CI 0.97-2.88). Breast cancer was significantly associated with increased breast density. Among healthy women, breast density was positively associated with nulliparity (ORadj: 1.46, 1.37, 2.52 respectively for density level 2, 3 and 4 vs. 1) and previous breast surgeries (ORadj: 2.27, 3.09 and 4.13 respectively for density level 2, 3 and 4 vs. 1). This analysis confirms that breast density is an important predictor of newly diagnosed breast cancer in this Caribbean population. Screening is still a diagnostic tool rather than a preventive measure in TT. PMID:23315045
D Joseph, Marlon; Thorpe, Lorna; Annandsingh, Carey; Laquis, George; Lee Young, Joycelyn; Kwasniewski, Jamie; Lee, Roy; Taioli, Emanuela
INTRODUCTION: Minority women, particularly immigrants, have lower cancerscreening rates than Caucasian women, but little else is known about cancerscreening among immigrant women. Our objective was to assess breast, cervical, and colorectal cancerscreening 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
As part of the San Joaquin River Restoration Program, the Arroyo Canal Fish Screen and Sack Dam Fish Passage Project implements two of the highest priority projects identified in the 2006 Settlement. The project includes a fish screen on the Arroyo Canal ...
Objectives Body image is a critical issue for cancer patients undergoing reconstructive surgery, as they can experience disfigurement and functional impairment. Distress related to appearance changes can lead to various psychosocial difficulties, and patients are often reluctant to discuss these issues with their healthcare team. Our goals were to design and evaluate a screening tool to aid providers in identifying patients who may benefit from referral for specialized psychosocial care to treat body image concerns. Methods We designed a brief 4-item instrument and administered it at a single time point to cancer patients who were undergoing reconstructive treatment. We used simple and multinomial regression models to evaluate whether survey responses, demographic, or clinical variables predicted interest and enrollment in counseling. Results Over 95% of the sample (n = 248) endorsed some concerns, preoccupation, or avoidance due to appearance changes. Approximately one-third of patients were interested in obtaining counseling or additional information to assist with body image distress. Each survey item significantly predicted interest and enrollment in counseling. Concern about future appearance changes was the single best predictor of counseling enrollment. Sex, age, and cancer type were not predictive of counseling interest or enrollment. Conclusions We present initial data supporting use of the Body Image Screener for Cancer Reconstruction. Our findings suggest benefits of administering this tool to patients presenting for reconstructive surgery. It is argued that screening and treatment for body image distress should be provided to this patient population at the earliest possible time point.
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
Following a retrospective review of tuberculosis cases reported from Ottawa County, Oklahoma, from 1969 through 1973, a selective tuberculosis screeningproject was implemented. Screening of a "target group" of the population, 519 former miners, greater than or equal to 50 years of age, resulted in the discovery of abnormal chest X-rays in 182; (103 with silicosis, 36 with silicotuberculosis, 12 with inactive tuberculosis, and 31 with other abnormalities). Eighty-five of these persons had positive tuberculin skin tests. Preventive therapy was recommended for 50, and 36 completed the prescribed course of treatment. Eight new bacteriologically confirmed cases of tuberculosis were found and treated. A large number of persons (1,904) residing in the same area who were not part of the target group were also screened for tuberculosis. This group contained a large number of positive tuberculin reactors but very few were candidates for isoniazid preventive therapy. Thirteen persons in this group had abnormal chest X-rays consistent with inactive tuberculosis but 12 had been identified and given preventive therapy before the project began. These data suggest that selective approaches to screening for tuberculosis in a community which are based on an in-depth retrospective review of the tuberculosis case register can be highly successful.
OBJECTIVE--To report the detection rate of interval cancers in women screened by the NHS breast screening programme. DESIGN--Detection of interval cancers by computer linkage of records held by the screening centres in the North Western Regional Health Authority with breast cancer registrations at the regional cancer registry. SETTING--North Western Regional Health Authority. SUBJECTS--137,421 women screened between 1 March 1988 and 31 March 1992 who had a negative screening result. RESULTS--297 invasive interval cancers were detected. The rate of detection of interval cancers expressed as a proportion of the underlying incidence was 31% in the first 12 months after screening, 52% between 12 and 24 months, and 82% between 24 and 36 months. CONCLUSION--The incidence of interval cancers in the third year after breast screening approaches that which would have been expected in the absence of screening and suggests that the three year interval between screens is too long.
Woodman, C. B.; Threlfall, A. G.; Boggis, C. R.; Prior, P.
IntroductionThe NHS bowel cancerscreening program (NHS BCSP) currently screens persons between the ages of 60 and 69 for bowel cancer (in the process of being extended to age 74). The aim is to detect early cancer and reduce mortality associated with CRC. The NHS BCSP began in 2006 in England and Nationwide coverage was achieved in 2010. Individuals are
P Patel; T Pirani; M Bouwe; R Leicester; A Poullis
Background Ovarian cancer stem cells are characterized by self-renewal capacity, ability to differentiate into distinct lineages, as well as higher invasiveness and resistance to many anticancer agents. Since they may be responsible for the recurrence of ovarian cancer after initial response to chemotherapy, development of new therapies targeting this special cellular subpopulation embedded within bulk ovarian cancers is warranted. Methods A high-throughput screening (HTS) campaign was performed with 825 compounds from the Mechanistic Set chemical library [Developmental Therapeutics Program (DTP)/National Cancer Institute (NCI)] against ovarian cancer stem-like cells (CSC) using a resazurin-based cell cytotoxicity assay. Identified sets of active compounds were projected onto self-organizing maps to identify their putative cellular response groups. Results From 793 screening compounds with evaluable data, 158 were found to have significant inhibitory effects on ovarian CSC. Computational analysis indicates that the majority of these compounds are associated with mitotic cellular responses. Conclusions Our HTS has uncovered a number of candidate compounds that may, after further testing, prove effective in targeting both ovarian CSC and their more differentiated progeny.
PurposeRecent media reports have advocated the use of colonoscopy for colorectal cancerscreening. However, colonoscopy is expensive compared with other screening modalities, such as fecal occult blood testing and flexible sigmoidoscopy. We sought to determine the cost effectiveness of different screening strategies for colorectal cancer at levels of compliance likely to be achieved in clinical practice.
Sandeep Vijan; Erica W Hwang; Timothy P Hofer; Rodney A Hayward
Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancerscreening. 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 cancerscreening…
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.
Cervical cancer is often the most common cancer among women in developing countries, yet cur- rent screening efforts have not been effective in reducing incidence and mortality rates in these settings. In an effort to increase knowledge about screening participation in low-resource settings, this study sought to identify key factors affecting women's participation in a cervical screening program in north
J. Winkler; A. Bingham; P. Coffey; W. Penn Handwerker
Changes of glycosylation pattern in serum proteins have been linked to various diseases including cancer, suggesting possible development of novel biomarkers based on the glycomic analysis. In this study, N-linked glycans from human serum were quantitatively profiled by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) and compared between healthy controls and ovarian cancer patients. A training set consisting of 40 healthy controls and 40 ovarian cancer cases demonstrated an inverse correlation between P value of ANOVA and area under the curve (AUC) of each candidate biomarker peak from MALDI-TOF MS, providing standards for the classification. A multibiomarker panel composed of 15 MALDI-TOF MS peaks resulted in AUC of 0.89, 80~90% sensitivity, and 70~83% specificity in the training set. The performance of the biomarker panel was validated in a separate blind test set composed of 23 healthy controls and 37 ovarian cancer patients, leading to 81~84% sensitivity and 83% specificity with cut-off values determined by the training set. Sensitivity of CA-125, the most widely used ovarian cancer marker, was 74% in the training set and 78% in the test set, respectively. These results indicate that MALDI-TOF MS-mediated serum N-glycan analysis could provide critical information for the screening of ovarian cancer. PMID:24648610
Kim, Jae-Han; Park, Chang Won; Um, Dalho; Baek, Ki Hwang; Jo, Yohahn; An, Hyunjoo; Kim, Yangsun; Kim, Tae Jin
ABSTRACT BACKGROUND Diabetes increases the risk of breast and colorectal cancers and has an undetermined relationship to cervical cancer. Improved screenings for these cancers are effective in reducing cancer mortality. OBJECTIVES To examine the prevalence of receiving recommended screenings for these cancers and to assess the trends in the screening rates over time among US women with diagnosed diabetes in comparison with women without diabetes. DESIGN Cross-sectional. PARTICIPANTS A total of 63,650 to 182,168 adult women participated in the 1996?2006 (biennially) Behavioral Risk Factor Surveillance System. METHODS The prevalence of receiving cancerscreenings was age-standardized to the 2000 US population. The adjusted prevalence and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated using logistic regression analyses. The linear trends in the screening rates were tested using orthogonal polynomial contrasts. RESULTS In 2006, women with diabetes had a lower adjusted prevalence (74% versus 79%, P?0.05) and the AOR (0.73, 95% CI: 0.66?0.81) for receiving cervical cancerscreenings, but had a higher adjusted prevalence (63% versus 60%, P?0.05) and the AOR (1.14, 95% CI: 1.04?1.24) for receiving colorectal cancerscreenings compared to those without. In both women with diabetes and those without, the screening rate for colorectal cancer increased linearly during 2002?2006, whereas the screening rates for breast and cervical cancers changed little during 1996?2006. CONCLUSION Women with diabetes were equally likely to be screened for breast cancer, less likely to be screened for cervical cancer, but more likely to be screened for colorectal cancer compared to those without. Overall, the screening rates in both groups remain below the recommended levels.
Ford, Earl S.; Ahluwalia, Indu B.; Li, Chaoyang; Mokdad, Ali H.
Prostate cancer is the most commonly diagnosed cancer in men in the U.S. and affects African Americans disproportionately when compared to other ethnic groups. There are unclear reasons for this disparity, but several factors may include race, nutrition, family history of cancer, and screening. With early detection of prostate cancer, survival is much better; thus screening may be helpful, especially for high-risk individuals. Prostate cancerscreening continues to be controversial. A paucity of data exist on what prostate cancerscreening means to African Americans, particularly in rural areas, and how they make the decision to undergo prostate cancerscreening or not. This study interviewed 17 African American men to explore how and when they decided about prostate cancerscreening. The majority of the men (n = 9) said that they had prostate cancerscreening. Three themes emerged from the data: 1) these men had information on prostate cancer; 2) family and friends played an important role in the men’s decision-making process; and 3) for screening, it was necessary for the men to have a trusting relationship with their healthcare provider. These findings confirm that the decision-making process is not a simple process. The study’s results can help healthcare providers understand some of the important decision-making factors in prostate cancerscreening for African American men.
Jones, Randy A.; Steeves, Richard; Williams, Ishan
The possible effect of prostate-specific antigen (PSA) testing on prostate cancer mortality has remained controversial, despite the test's widespread application. We examined age-specific mortality trends for prostate cancer in Austria before and after the introduction of (opportunistic) PSA testing, to ask whether PSA screening reduces prostate cancer mortality in a uniform cohort of men with equal access to health care. Prostate cancer mortality data covering all 9 federal states of Austria were analysed from 1970 to 2002. PSA testing became widely available in Austria not before 1989. Tyrol, one of the nine federal states of Austria, independently launched a mass prostate cancer prevention project in 1993. We applied join-point regression models to identify changes in the slope of age-specific mortality trends in selected age groups (50-59, 60-69, 70-79, and 80-89 years) and calculated the annual percent change (APC) in mortality between 1970 and 2002 for Tyrol and the rest of Austria separately. After 12 years of follow-up, we were not able to observe a significant reduction in prostate cancer mortality since the introduction of the PSA test in the age groups of 50-59, 60-69, and 80-89 years. A significant decrease was found in the age group of 70-79 (Austria without Tyrol 1989 through 2002: APC, -2.36; 95% CI, -3.38 to -1.34; Tyrol 1991 through 2002: APC, -6.42; 95% CI, -8.92 to -3.86). In this age group the join points 1989 and 1991 cannot be related to PSA testing. PSA screening does not appear to reduce prostate cancer mortality in a uniform cohort of men with equal access to health care. However, given the long lead-time for prostate cancer, even longer follow-up may still be needed to detect any important trends. PMID:16091872
Vutuc, Christian; Schernhammer, Eva S; Haidinger, Gerald; Waldhör, Thomas
Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancerscreening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on faecal occult blood testing includes 21 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of screening programmes and services. PMID:23012123
Background There is increasing ambiguity towards national mammographic screening programs due to varying publicized estimates of overdiagnosis, i.e., breast cancer that would not have been diagnosed in the women’s lifetime outside screening. This analysis compares the cumulative incidence of breast cancer in screened and unscreened women in Norway from the start of the fully implemented Norwegian Breast CancerScreening Program (NBCSP) in 2005. Methods Subjects were 53 363 women in the Norwegian Women and Cancer (NOWAC) study, aged 52–79 years, with follow-up through 2010. Mammogram and breast cancer risk factor information were taken from the most recent questionnaire (2002–07) before the start of individual follow-up. The analysis differentiated screening into incidence (52–69 years) and post screening (70–79 years). Relative risks (RR) were estimated by Poisson regression. Results The analysis failed to detect a significantly increased cumulative incidence rate in screened versus other women 52–79 years. RR of breast cancer among women outside the NBCSP, the “control group”, was non-significantly reduced by 7% (RR?=?0?93; 95% confidence interval 0?79 to 1?10) compared to those in the program. The RR was attenuated when adjusted for risk factors; RRadj?=?0?97 (0?82 to 1?15). The control group consisted of two subpopulations, those who only had a mammogram outside the program (RRadj =1?04; 0?86 to 1?26) and those who never had a mammogram (RRadj?=?0?77; 0?59 to 1?01). These groups differed significantly with respect to risk factors for breast cancer, partly as a consequence of the prescription rules for hormone therapy which indicate a mammogram. Conclusions In the fully implemented NBCSP, no significant difference was found in cumulative incidence rates of breast cancer between NOWAC women screened and not screened. Naïve comparisons of screened and unscreened women may be affected by important differences in risk factors. The current challenge for the screening program is to improve the diagnostics used at prevalence screenings (ages 50–51).
The use of DNA testing as an important component of breast cancer diagnosis has been increasing rapidly over the past decade. The goal of this project is to develop and characterize an electrochemical biosensing microsystem for the rapid point-of-care gen...
The use of DNA testing as an important component of breast cancer diagnosis has been increasing rapidly over the past decade. The goal of this project is to develop and characterize an electrochemical biosensing microsystem for the rapid point-of-care gen...
Introduction Southeast Asian women have low levels of Papanicolaou (Pap) testing participation. We conducted a group-randomized controlled trial to evaluate a cervical cancerscreening intervention program targeting Seattle’s Cambodian refugee community. Methods Women who completed a baseline, community-based survey were eligible for the trial. Neighborhoods were the unit of randomization. Three hundred and seventy survey participants living in 17 neighborhoods were randomized to intervention or control status. Intervention group women received home visits by outreach workers and were invited to group meetings in neighborhood settings. The primary outcome measure was self-reported Pap testing in the year prior to completing a follow-up survey. Results The proportion of women in the intervention group reporting recent cervical cancerscreening increased from 44% at baseline to 61% at follow-up (+17%). The corresponding proportions among the control group were 51 and 62% (+11%). These temporal increases were statistically significant in both the intervention (P < 0.001) and control (P = 0.027) groups. Discussion This study was unable to document an increase in Pap testing use specifically in the neighborhood-based outreach intervention group; rather, we found an increase in both intervention and control groups. A general awareness of the project among women and their health care providers as well as other ongoing cervical cancerscreening promotional efforts may all have contributed to increases in Pap testing rates.
Taylor, Victoria M.; Jackson, J. Carey; Yasui, Yutaka; Kuniyuki, Alan; Acorda, Elizabeth; Marchand, Ann; Schwartz, Stephen M.; Tu, Shin-Ping; Thompson, Beti
Ovarian cancer is the most overrepresented malignancy diagnosed in women with dermatomyositis. Unfortunately, screening with pelvic examination rarely detects this cancer prior to the development of metastatic disease. Our objective was to examine the use of serum CA-125 antigen levels in screening patients with dermatomyositis for ovarian cancer. A single blinded, case–control study was conducted in our institution of CA-125
S. Elizabeth Whitmore; Grant J. Anhalt; Thomas T. Provost; Howard A. Zacur; Ulrike M. Hamper; Kathy J. Helzlsouer; Neil B. Rosenshein
This study was conducted to identify the factors perceived by African-American men as influencing their behavior relative to prostate cancerscreening. 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 cancerscreening participation by African-American men were impediments to prostate cancerscreening; positive outcome beliefs associated with prostate cancerscreening; social influence; negative outcome beliefs associated with prostate cancerscreening; resources or opportunities that facilitate prostate cancerscreening; 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 cancerscreening 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 cancerscreening.
Population-based studies have shown that guaiac faecal occult blood testing followed by colonoscopy in case of positivity can reduce colorectal cancer mortality. However these tests have been criticised for their fairly low sensitivity. For this reason attention has been given to alternative tests. The aim of this paper is to review the evidence for screening for colorectal cancer using qualitative immunochemical faecal occult blood tests. For the complete range of tested cut-off values, immunochemical faecal occult blood tests lead to higher diagnostic yield, improved sensitivity and greater participation. The optimal number of samples and the optimal cut-off value has to suit local resources and the acceptability of missed cancers. All economic evaluations, despite some differences between studies, add further arguments to support the opinion that the immunochemical faecal occult blood test is currently the most cost-effective screening test for average-risk populations. These economic evaluations provide strong arguments in favour of the 1-sample strategy. With decreasing the cut-off value similar performances can be achieved with one-compared to two day sampling. Too few data are currently available to accurately compare existing qualitative tests. PMID:22898146
There are two major hereditary colorectal cancer syndromes: Adenomatous Polyposis, secondary to APC germline alterations (FAP, Familial Adenomatous Polyposis) or secondary to MUTYH germline alterations (MAP, MUTYH associated Polyposis), and Lynch syndrome, associated with germline mutations in mismatch repair genes (MLH1, MSH2, MSH6 and PMS2). The elucidation of their genetic basis has depicted an increasingly complex picture that has lead to the implementation of complex diagnostic algorithms that include both tumor profiling and germline analyses. A variety of techniques at the DNA, RNA and protein level are used to screen for molecular alterations both in tumor biopsies (microsatellite instability analysis, mismatch repair protein immunohistochemistry, BRAF-Val600Glu detection and MLH1 promoter hypermethylation analysis) and in the germline (point mutation screening, copy number assessment). Also functional tests are more often used to characterize variants of unknown significance. Methodological issues associated with the techniques analyzed, as well as the algorithms used, are discussed. PMID:19931546
Pineda, Marta; González, Sara; Lázaro, Conxi; Blanco, Ignacio; Capellá, Gabriel
The report presents an analysis of the cost-effectiveness of colorectal cancer (CRC) screening in average-risk adults beginning at age 50; examines the relative cost-effectiveness of competing CRC screening technologies and schedules.
The bill aims to amend title XVIII of the Social Security Act to waive coinsurance under Medicare for colorectal cancerscreening tests, regardless of whether therapeutic intervention is required during the screening. This would provide for full coverage
We evaluated knowledge of gynecologic cancerscreening recommendations, screening behaviors, and communication with providers among women with Lynch syndrome (LS). Women aged ?25?years who were at risk for LS-associated cancers completed a semi-structured interview and a questionnaire. Of 74 participants (mean age 40?years), 61% knew the appropriate age to begin screening, 75-80% correctly identified the recommended screening frequency, and 84% reported no previous screening endometrial biopsy. Women initiated discussions with their providers about their LS cancer risks, but many used nonspecific terms or relied on family history. Most were not offered high-risk screening options. While many women were aware of risk-appropriate LS screening guidelines, adherence was suboptimal. Improving communication between women and their providers regarding LS-related gynecologic cancer risk and screening options may help improve adherence. PMID:23906188
Burton-Chase, A M; Hovick, S R; Sun, C C; Boyd-Rogers, S; Lynch, P M; Lu, K H; Peterson, S K
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 cancerscreening is delayed or stopped? Elsebeth Lynge firstname.lastname@example.org DENMARK Opportunistic screening, 1969: • All smears paid by the national health insurance National guidelines for organisation,
Thirteen year follow-up data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancerscreening trial show higher incidence but similar mortality among men screened annually with the prostate-specific antigen (PSA) test and digital rectal examination (DRE).
H.R.1070 would amend title XVIII of the Social Security Act to waive coinsurance under Medicare for colorectal cancerscreening tests, regardless of whether therapeutic intervention is required during the screening. Rep. Charles Dent (R-PA) introduced
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.
Gordon, Thomas F.; Ruzek, Sheryl Burt; Wolak, Caitlin; Ward, Stephanie; Paranjape, Anuradha; Lin, Karen; Meyer, Brian; Ruggieri, Dominique G.
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 cancerscreening 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 cancerscreening patterns plus the barriers underlying lack of screening may move us closer to developing effective interventions that facilitate women’s use of screening.
Purpose/Objectives To examine perceptions, attitudes, and beliefs regarding barriers and facilitators to prostate cancerscreening, and to identify potential interventional strategies to promote prostate cancerscreening among Filipino men in Hawai’i. Design Exploratory, qualitative. Setting Community-based settings in Hawai’i. Sample 20 Filipino men, 40 years old or older Methods Focus group discussions were tape-recorded, transcribed, and content analysis performed for emergent themes. Main Research Variables Perceptions regarding prostate cancer, barriers and facilitators to prostate cancerscreening, and culturally-relevant interventional strategies Findings Perceptions of prostate cancer included fatalism, hopelessness, and dread. Misconceptions regarding causes of prostate cancer, such as frequency of sexual activity, were identified. Barriers to prostate cancerscreening included lack of awareness of the need for screening, reticence to seek healthcare when feeling well, fear of cancer diagnosis, financial issues, time constraints, and embarrassment. Presence of urinary symptoms, personal experience with family or friend who had cancer, and receiving recommendations from a healthcare provider regarding screening were facilitators for screening. Potential culturally-relevant interventional strategies to promote prostate cancerscreening included screening recommendations from health professionals and cancer survivors; radio/television commercials and newspaper articles targeted to the Filipino community; informational brochures in Tagalog, Ilocano and/or English; and interactive, educational forums facilitated by Filipino multilingual, male healthcare professionals. Conclusions Culturally-relevant interventions are needed that address barriers to prostate cancerscreening participation and misconceptions about causes of prostate cancer. Implications for Nursing Findings provide a foundation for future research regarding development of interventional strategies to promote prostate cancerscreening among Filipino men.
Conde, Francisco A.; Landier, Wendy; Ishida, Dianne; Bell, Rose; Cuaresma, Charlene F.; Misola, Jane
Although cervical cancerscreening 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 cancerscreening for under-screened women. This study examined women's preferences for cervical cancerscreening methods. Interviewer-administered questionnaires regarding cervical cancerscreening 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.Despite the high rate of prostate cancerscreening, the accuracy of male patients' self-reports of screening has not been investigated. This study assessed the concordance between patients' self-reports of prostate screening and the medical record.Methods.Focus groups were conducted to obtain male patients' perceptions of prostate cancerscreening and salient terminology. A sample of males (n= 276), 40 years of age
Timothy R. Jordan; James H. Price; Keith A. King; Tatiana Masyk; Archie W. Bedell
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
Background and Objective Due to relatively low incidence, bladder cancerscreening might have a better ratio of benefits and harms if restricted to a high-risk population. We used data from the PLCO study and applied simple decision analytic techniques to compare different eligibility criteria for a screening trial. Methods For a variety of possible eligibility criteria, we calculated the percentage of the population aged 55 – 74 classified as being at high risk for developing invasive or high-grade carcinoma and therefore likely to benefit from screening. We used regression models to calculate a risk score based on age, sex, smoking history and family history of bladder cancer. We then calculated the reduction in cases given hypothetical risk reductions associated with screening. The trade-off between people screened and tumors avoided was calculated as a net benefit. Results The five-year probability of being diagnosed with invasive bladder cancer was 0.24%. Using a risk score > 6 or >8 as the eligibility criterion for a trial was generally superior to including all older adults. In a typical scenario, a risk score > 6 would result in ~25% of the population being screened to prevent 57 invasive or high grade bladder cancers per 100,000; screening the entire population would prevent only an additional 38 cases. Conclusions Screening for bladder cancer can be optimized by restricting to a sub-group at elevated risk. Different eligibility criteria for a screening trial can be compared rationally using decision-analytic techniques.
Vickers, Andrew J.; Bennette, Caroline; Kibel, Adam S.; Black, Amanda; Izmirlian, Grant; Stephenson, Andrew J.; Bochner, Bernard
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.
The objectives of the Prostate, Lung, Colorectal and Ovarian CancerScreening 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 Prostate, Lung, Colorectal and Ovarian (PLCO) CancerScreening Trial is a large, randomized study to determine whether the use of certain screening tests will reduce the risk of dying of those four cancers. In addition to answering questions about the screening tests, the PLCO asked questions about many aspects of the study participants’ health and collected biospecimens (blood and some tissues) to answer many other questions about cancer.
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
This article examines the relationship between literacy and colorectal cancer (CRC) screening knowledge, beliefs, and experiences, with a focus on fecal occult blood tests (FOBTs). Participants were 975 patients in 8 Louisiana federally qualified health centers. Participants were 50 years of age or older and not up to date with CRC screening; approximately half (52%) had low literacy (less than a 9th-grade level). Participants with low literacy were less likely than were those with adequate literacy to be aware of advertisements promoting CRC screening (58.7% vs. 76.3%, p < .0001) or to believe it was very helpful to find CRC early (74.5% vs. 91.9%, p < .0001). The majority of participants had positive beliefs about the benefits of CRC screening using FOBTs. Participants with low literacy had more perceived barriers to FOBT completion and were more likely to strongly agree or agree that FOBTs would be confusing, embarrassing, or a lot of trouble; however, none of these remained significant in multivariate analyses controlling for relevant covariates. Confidence in being able to obtain an FOBT kit was high among those with low and adequate literacy (89.8% vs. 93.1%, respectively, p = .20); yet multivariate analyses revealed a significant difference in regard to literacy (p = .04) with low-literacy participants indicating less confidence. There was no significant difference by literacy in ever receiving a physician recommendation for CRC screening (38.4% low vs. 39.0% adequate, p = .79); however, multivariate analyses revealed significant differences in FOBT completion by literacy (p = .036). Overall, findings suggest that literacy is a factor in patients’ CRC knowledge, beliefs, and confidence in obtaining a FOBT.
ARNOLD, CONNIE L.; RADEMAKER, ALFRED; BAILEY, STACY COOPER; ESPARZA, JULIA M.; REYNOLDS, CRISTALYN; LIU, DACHAO; PLATT, DACI; DAVIS, TERRY C.
Colorectal cancer (CRC) is the third leading cause of cancer death in the United States, and is largely preventable by CRC screening (CRCS). Participation in CRCS, however, is much lower than participation in other forms of preventive care. Many reasons for low rates of participation have been identified, and can be generally divided into provider- and patient-specific issues. Lack of a provider recommendation is a well-established and widely reported patient barrier to CRCS. Numerous patient-specific issues have been identified, ranging from fear of CRCS test results to lack of knowledge about individual risk for CRC and inadequate resources to complete CRCS. This article discusses the impact of patient attitudes and issues toward CRCS, with particular attention to modifiable psychosocial factors, the importance of patient preferences for one CRCS test over another, knowledge of CRC risk, and the impact of educational tools on patient compliance with CRCS. PMID:24812136
Genome-wide pooled shRNA screens enable global identification of the genes essential for cancer cell survival and proliferation and provide a ‘functional genetic’ map of human cancer to complement genomic studies. Using a lentiviral shRNA library targeting approximately 16?000 human genes and a newly developed scoring approach, we identified essential gene profiles in more than 70 breast, pancreatic and ovarian cancer cell lines. We developed a web-accessible database system for capturing information from each step in our standardized screening pipeline and a gene-centric search tool for exploring shRNA activities within a given cell line or across multiple cell lines. The database consists of a laboratory information and management system for tracking each step of a pooled shRNA screen as well as a web interface for querying and visualization of shRNA and gene-level performance across multiple cancer cell lines. COLT-Cancer Version 1.0 is currently accessible at http://colt.ccbr.utoronto.ca/cancer.
Koh, Judice L. Y.; Brown, Kevin R.; Sayad, Azin; Kasimer, Dahlia; Ketela, Troy; Moffat, Jason
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.
Quigg, Troy C.; Mahajerin, Arash; Sullivan, Paula D.; Pradhan, Kamnesh; Bauer, Nerissa S.
A group of 47 experts representing 23 professional societies, national and international health organizations, and federal agencies met in Bethesda, MD, September 14-15, 2012, to revise the 2006 American Society for Colposcopy and Cervical Pathology Consensus Guidelines. The group's goal was to provide revised evidence-based consensus guidelines for managing women with abnormal cervical cancerscreening tests, cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS) following adoption of cervical cancerscreening guidelines incorporating longer screening intervals and co-testing. In addition to literature review, data from almost 1.4 million women in the Kaiser Permanente Northern California Medical Care Plan provided evidence on risk after abnormal tests. Where data were available, guidelines prescribed similar management for women with similar risks for CIN 3, AIS, and cancer. Most prior guidelines were reaffirmed. Examples of updates include: Human papillomavirus-negative atypical squamous cells of undetermined significance results are followed with co-testing at 3 years before return to routine screening and are not sufficient for exiting women from screening at age 65 years; women aged 21-24 years need less invasive management, especially for minor abnormalities; postcolposcopy management strategies incorporate co-testing; endocervical sampling reported as CIN 1 should be managed as CIN 1; unsatisfactory cytology should be repeated in most circumstances, even when HPV results from co-testing are known, while most cases of negative cytology with absent or insufficient endocervical cells or transformation zone component can be managed without intensive follow-up. PMID:23635684
Massad, L Stewart; Einstein, Mark H; Huh, Warner K; Katki, Hormuzd A; Kinney, Walter K; Schiffman, Mark; Solomon, Diane; Wentzensen, Nicolas; Lawson, Herschel W
A group of 47 experts representing 23 professional societies, national and international health organizations, and federal agencies met in Bethesda, MD, September 14-15, 2012, to revise the 2006 American Society for Colposcopy and Cervical Pathology Consensus Guidelines. The group's goal was to provide revised evidence-based consensus guidelines for managing women with abnormal cervical cancerscreening tests, cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS) following adoption of cervical cancerscreening guidelines incorporating longer screening intervals and co-testing. In addition to literature review, data from almost 1.4 million women in the Kaiser Permanente Northern California Medical Care Plan provided evidence on risk after abnormal tests. Where data were available, guidelines prescribed similar management for women with similar risks for CIN 3, AIS, and cancer. Most prior guidelines were reaffirmed. Examples of updates include: Human papillomavirus-negative atypical squamous cells of undetermined significance results are followed with co-testing at 3 years before return to routine screening and are not sufficient for exiting women from screening at age 65 years; women aged 21-24 years need less invasive management, especially for minor abnormalities; postcolposcopy management strategies incorporate co-testing; endocervical sampling reported as CIN 1 should be managed as CIN 1; unsatisfactory cytology should be repeated in most circumstances, even when HPV results from co-testing are known, while most cases of negative cytology with absent or insufficient endocervical cells or transformation zone component can be managed without intensive follow-up. PMID:23519301
Massad, L Stewart; Einstein, Mark H; Huh, Warner K; Katki, Hormuzd A; Kinney, Walter K; Schiffman, Mark; Solomon, Diane; Wentzensen, Nicolas; Lawson, Herschel W
As with wide-spread use of prostate cancer (Pca) screening with prostate-specific antigen testing, overdetection has increasingly gained attention. The authors aimed to estimate absolute risk of overdetection (RO) in Pca screening with various interscreening intervals and ages at start of screening. We estimated age-specific preclinical incidence rates (per 100,000 person-years) for progressive cancer (from 128 for age group 55-58 years to 774 for age group 67-71 years) and nonprogressive cancer (from 40 for age group 55-58 years to 66 for age group 67-71 years), the mean sojourn time (7.72 years) and the sensitivity (42.8% at first screen and 59.8% at the second screen) by using a multistep epidemiological model with data from the Finnish randomized controlled trial. The overall number of screens for overdetection (NSO) was 29 (95% confidence interval (CI): 18, 48) for screenees aged 55-67 years, equivalent to 3.4 (95% CI: 2.1, 5.7) overdetected Pcas per 100 screenees. The NSO decreased from 63 (95% CI: 37, 109) at the first screen to 29 (95% CI: 18, 48) at the third screen and from 43 (95% CI: 36, 52) for age 55 years to 25 (95% CI: 8, 75) at age 67 years at the first screen. In conclusion, around 3.4 cases for every 100 screened men would be overdetected during three screen rounds (~ 13 years of follow-up) in the Finnish randomized controlled trial. Elucidating the absolute RO under various scenarios makes contribution for evaluating the benefit and harm of Pca screening. PMID:22052356
Objectives Pacific Islander women represent a significant at-risk population for cervical cancer, yet little is known about the modifiable factors associated with routine Pap testing. Therefore, the aims of this paper are to report and discuss the known and unknown factors associated with cervical cancerscreening among Chamorro women in California. Design This cross-sectional study explored the factors associated with receipt of regular Pap testing among Chamorro women age 18 years and older in California. A self-administered survey was designed and distributed to women in order to understand their knowledge, beliefs and behaviors regarding routine receipt of Pap tests. Results Only about two-thirds of women had received a Pap test within the past two years, which is below the U.S. average of 72%. Significant predictors included age, health insurance coverage, knowledge of screening frequency, and beliefs regarding risk groups. These factors, however, accounted for less than 16% of the variance in Pap testing behavior. Conclusion We discuss the poor predictive value of existing demographic and theoretical variables, and discuss potentially new areas of research that can aid in the development of future intervention studies. Study limitations and implications are also discussed.
Tanjasiri, Sora P.; Mouttapa, Michele; Sablan-Santos, Lola; Quitugua, Lourdes F.
Most studies reporting more favourable biological features of screen-detected breast cancers compared with symptomatic or interval cancers include initial or prevalent screens and therefore may not indicate the real benefit of screening on breast cancer mortality. We conducted case-case comparisons within a cohort of eligible women (N=771 715) who were aged 50-69 between 1 January 1995 and 31 December 2003. A randomly selected sample of breast cancers (N=1848) diagnosed among these women were compared by detection method. Tumour characteristics of interval cancers (N=362) diagnosed after 6-24 months of a negative screen or symptomatic breast cancers (N=491) were compared with subsequent screen-detected breast cancers diagnosed within 6 months of a positive screen (N=995) using polytomous logistic regression. Tumours were evaluated for clinical presentation, histology and expression of hormone receptors. Women with symptomatic detected [odds ratio (OR)=7.48, 95% confidence interval (CI)=5.38-10.38] and interval cancers (OR=2.20, 95% CI=1.56-3.10) were more often diagnosed at stage III-IV versus I than women with rescreen-detected cancers. After adjusting for tumour size, women with symptomatic cancers had tumours of higher grade (OR=1.50, 95% CI=1.05-2.15) and mitotic score (OR=1.69, 95% CI=1.15-2.49) and women with interval cancers had tumours of higher mitotic score (OR=1.52, 95% CI=1.01-2.28) compared with women diagnosed at screening. Subsequent screen-detected cancers are not only detected at an earlier stage but are also less aggressive, leading to a better prognosis. As long-term mortality reduction for breast screening may depend on subsequent screens, our study indicates that mammography screening can be effective in women aged 50-69. PMID:22273849
Chiarelli, Anna M; Edwards, Sarah A; Sheppard, Amanda J; Mirea, Lucia; Chong, Nelson; Paszat, Lawrence; Shumak, Rene S; O?malley, Frances P
Lung cancer is the most common cause of cancer-related death in the world. The Dutch-Belgian Randomized Lung CancerScreening Trial (Dutch acronym: NELSON) was launched to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk patients will lead to a decrease in lung cancer mortality. The NELSON lung nodule management is based on nodule volumetry and volume doubling time assessment. Evaluation of CT examinations in lung cancerscreening can also include assessment of coronary calcification, emphysema and airway wall thickness, biomarkers for major diseases that share risk factors with lung cancer. In this review, a practical approach to the radiological evaluation of CT lung cancerscreening examinations is described. PMID:24061210
Xie, Xueqian; Heuvelmans, Marjolein A; van Ooijen, Peter M A; Oudkerk, Matthijs; Vliegenthart, Rozemarijn
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
...Proposed Collection; Comment Request; Prostate, Lung, Colorectal and Ovarian Cancer...approval. Proposed Collection: Title: Prostate, Lung, Colorectal and Ovarian Cancer...designed to determine if screening for prostate, lung, colorectal and ovarian...
Form approved: OMB No. 0925-xxxx Expires: ____/____/____ The Survey of Colorectal CancerScreening Practices, sponsored by the National Cancer Institute in collaboration with the Centers for Disease Control and Prevention and Health Care Financing
Abstract Lung cancer is the most common cause of cancer-related death in the world. The Dutch-Belgian Randomized Lung CancerScreening Trial (Dutch acronym: NELSON) was launched to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk patients will lead to a decrease in lung cancer mortality. The NELSON lung nodule management is based on nodule volumetry and volume doubling time assessment. Evaluation of CT examinations in lung cancerscreening can also include assessment of coronary calcification, emphysema and airway wall thickness, biomarkers for major diseases that share risk factors with lung cancer. In this review, a practical approach to the radiological evaluation of CT lung cancerscreening examinations is described.
Xie, Xueqian; Heuvelmans, Marjolein A.; van Ooijen, Peter M.A.; Oudkerk, Matthijs
Narratives from similar others may be an effective way to increase important health behaviors. In this study, we used a narrative intervention to promote colorectal cancerscreening. Researchers have suggested that people may overestimate barriers to colorectal cancerscreening. We recruited participants from the US, ages 49–60 who had never previously been screened for colorectal cancer, to read an educational message about screening for the disease. One-half of participants were randomly assigned to also receive a narrative within the message (control participants did not receive a narrative). The narrative intervention was developed according to predictions of affective forecasting theory. Compared to participants who received only the educational message, participants who received the message along with a narrative reported that the barriers to screening would have less of an impact on a future screening experience. The narrative also increased risk perception for colorectal cancer and interest in screening in the next year.
Dillard, Amanda; Fagerlin, Angela; Cin, Sonya Dal; Zikmund-Fisher, Brian J; Ubel, Peter A
Colorectal cancer is the third most common cancer and the second leading cause of cancer-related deaths in the United States. Screening has been shown to be effective in reducing colorectal cancer incidence and mortality. Colonoscopy, sigmoidoscopy, and fecal occult blood tests are all recommended screening tests that have widespread availability. Nevertheless, many people do not receive the evidence-based recommended screening for colorectal cancer. Additional stool-based methods have been developed that offer more options for colorectal cancerscreening, including a variety of fecal DNA tests. The only fecal DNA test that is currently available commercially in the United States is ColoSure(TM), which is marketed as a non-invasive test that detects an epigenetic marker (methylated vimentin) associated with colorectal cancer and pre-cancerous adenomas. We examined the published literature on the analytic validity, clinical validity, and clinical utility of ColoSure and we briefly summarized the current colorectal cancerscreening guidelines regarding fecal DNA testing. We also addressed the public health implications of the test and contextual issues surrounding the integration of fecal DNA testing into current colorectal cancerscreening strategies. The primary goal was to provide a basic overview of ColoSure and identify gaps in knowledge and evidence that affect the recommendation and adoption of the test in colorectal cancerscreening strategies.
Ned, Renee M.; Melillo, Stephanie; Marrone, Michael
Objective This study addresses three questions posed by the United States Preventive Services Task Force (USPSTF): 1) At what age should screening for cervical cancer begin; 2) At what age should screening for cervical cancer end; and 3) How do the benefits and potential harms of screening strategies that use human papillomavirus (HPV) DNA testing in conjunction with cytology (co-testing) compare to those strategies that use cytology only? Methods A Markov model was updated and used to quantify clinical outcomes (i.e. colposcopies, cancers, life expectancy) associated with different screening strategies. Results Screening in the teenage years is associated with a high number of colposcopies small differences in cancers detected and, as a result, small gains in life expectancy. Screening women beginning in the early 20s provides a reasonable balance of the harms and benefits of screening. Among women who have been screened according to the current recommendations for cervical cancer (beginning at age 21, and conducted every 3 years with cytology), screening beyond age 65 is associated with small additional gains in life expectancy but large increases in colposcopies. In terms of co-testing, a strategy of cytology only conducted every 3 years, followed by co-testing conducted every 5 years (for women aged 30+ years) is associated with fewer colposcopies and greater gains in life-expectancy compared to screening with cytology-only conducted every 3 years. Conclusions The results of this modeling study support current USPSTF recommendations for cervical cancerscreening.
Kulasingam, Shalini L.; Havrilesky, Laura J.; Ghebre, Rahel; Myers, Evan R.
Background There are many test options available for colorectal cancerscreening. The choice of test relates to the objectives of those offering or considering screening. Discussion While all screening programs aim to detect disease early in order to improve the length and/or quality of life for the individual, some organizations and individuals prefer screening tests that offer the opportunity for cancer prevention. Others favor maximizing participation or the opportunity for shared decision-making, including discussion of information on test quality and availability. We propose three additional objectives for screening: minimizing harms, optimizing economic efficiency and maximizing equity of access to screening. Summary Applying these objectives to colorectal cancerscreening, we advocate the use of immunochemical FOBTs as the preferred screening strategy, as it satisfies all three of these important objectives.
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.
The purpose of this study was to reduce the radiation dosage associated with computed tomography (CT) lung cancerscreening while maintaining overall diagnostic image quality and definition of ground-glass opacities (GGOs). A lung screening phantom and a multipurpose chest phantom were used to quantitatively assess the performance of two iterative image reconstruction algorithms (adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR)) used in conjunction with reduced tube currents relative to a standard clinical lung cancerscreening protocol (51 effective mAs (3.9 mGy) and filtered back-projection (FBP) reconstruction). To further assess the algorithms' performances, qualitative image analysis was conducted (in the form of a reader study) using the multipurpose chest phantom, which was implanted with GGOs of two densities. Our quantitative image analysis indicated that tube current, and thus radiation dose, could be reduced by 40% or 80% from ASIR or MBIR, respectively, compared with conventional FBP, while maintaining similar image noise magnitude and contrast-to-noise ratio. The qualitative portion of our study, which assessed reader preference, yielded similar results, indicating that dose could be reduced by 60% (to 20 effective mAs (1.6 mGy)) with either ASIR or MBIR, while maintaining GGO definition. Additionally, the readers' preferences (as indicated by their ratings) regarding overall image quality were equal or better (for a given dose) when using ASIR or MBIR, compared with FBP. In conclusion, combining ASIR or MBIR with reduced tube current may allow for lower doses while maintaining overall diagnostic image quality, as well as GGO definition, during CT lung cancerscreening. PMID:24710436
Background Breast cancer is the leading cause of cancer death in women in Australia. Early detection provides the best chance of reducing mortality and morbidity from the disease. Mammographic screening is a population health strategy for the early detection of breast cancer in Australia. Recruitment strategies such as regular advertising and biannual screening invitations are exclusively targeted at women aged 50 – 69 years. Even though they can participate, women 70 years or over are not invited or actively encouraged to undertake screening. Research has found that a routine letter of invitation increases the number of women participating in breast cancerscreening. Methods Cancer data analysis and a literature and policy review was conducted to assess age specific breast cancer mortality rates and the legitimacy of rationale used to limit invitations for breast cancerscreening to women younger than 70 years. Results The proportion of women over 69 years participating in the BreastScreen program is significantly less than rate of screening in the target age range (50–69 years). Evidence and data indicate that common justifications for limiting screening reminders to the target age range including life expectancy, comorbidities, effectiveness, treatment and cost are, for many women, unreasonable. Conclusion There is now sufficient data to support a change in the targeted upper age range for breast cancerscreening to improve the existing suboptimal surveillance in women aged over 69 years.
Introduction: Organised, nationwide screening for breast cancer with mammography in the age group between 45 and 65 years with 2 years screening interval started in Hungary in January 2002. Aim: The aim of this study is to analyze the attendance rate of nationwide breast screening programme for the 2008-2009 years. Method: The data derive from the database of the National Health Insurance Fund Administration. The ratio of women in the age group 45-65 years was calculated having either a screening mammography or a diagnostic mammography in the 4th screening round of the programme. Results: In the years 2000-2001, 7.6% of the women had an opportunistic screening mammography while in 2008-2009 31.2% of the target population had screening mammography within the organized programme. During the same periods 20.2% (2000-2001) and 20.4% (2008-2009) of women had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.6% (2000-2001) to 50.1% (2008-2009). The attendance rate failed to change between 2002 and 2009. Conclusions: In order to decrease the mortality due to breast cancer, the attendance rate of mammography screening programme should be increased. Orv. Hetil., 154(50), 1975-1983. PMID:24317356
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Background. Underutilization of breast and cervical cancerscreening has been observed in many ethnic groups and underserved populations. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospects for survival.Methods. The Breast and Cervical Cancer Intervention Study was a controlled trial of three interventions in the San Francisco Bay Area from 1993 to 1996:
Robert A. Hiatt; Rena J. Pasick; Susan Stewart; Joan Bloom; Patricia Davis; Phillip Gardiner; Monica Johnston; Judith Luce; Kimberley Schorr; Wendel Brunner; Florence Stroud
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 cancerscreening. The rapidly evolving field of lung cancerscreening 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 cancerscreening, the field of biomarker development for early lung cancer detection, and the future of lung cancer chemoprevention. PMID:24840047
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 cancerscreening. The rapidly evolving field of lung cancerscreening 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 cancerscreening, the field of biomarker development for early lung cancer detection, and the future of lung cancer chemoprevention.
Describes the development, implementation, and evaluation of Pathways to Health, a breast cancer education program targeting American Indian women in California. Discusses initial focus group results concerning belief in breast cancer risk, barriers to cancerscreening and treatment, culturally sensitive issues, and illness beliefs. Describes…
Family history is an important breast cancer risk factor and is a common reason for referral to specialist breast clinics for consideration of breast screening. The aims of this study were to determine cancer detection rates and prognostic features of breast cancers identified in women aged less than 50 years at increased risk of breast cancer who attend a Family
J Kollias; D. M Sibbering; R. W Blamey; P. A. M Holland; Z Obuszko; A. R. M Wilson; A. J Evans; I. O Ellis; C. W Elston
Objectives To investigate the hypothesis that interval cancers arising soon after the previous screen and true interval cancers are biologically aggressive and have a relatively poor prognosis compared with other interval cancers, and to assess which prognostic features are relevant to interval cancers. Methods Analysis of prognostic pathological features (grade, lymph node stage, size, vascular invasion, oestrogen receptor (ER) status
Gareth J R Porter; A J Evans; H C Burrell; A H S Lee; I O Ellis; J Chakrabarti
This study investigated the proportion of first incident screen detected cancers diagnosable at prevalent round. The prevalent mammogram was classified as truly negative (no abnormality) or falsely negative (cancer diagnosable) after blinded review. Of 54 incident cancers, 63% were true and 26% false negatives. Five cancers were assessed at the prevalent round but dismissed as normal. The possible consequence of
D. C. Wheatley; L. J. Yeoman; H. Burrell; S. E. Pinder; A. J. Evans; A. R. M. Wilson; I. O. Ellis; C. W. Elston; J. F. R. Robertson; R. W. Blamey
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, cancerscreening 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