WorldWideScience

Sample records for cancer screening strategy

  1. Improving Screening Strategies for Prostate Cancer

    NARCIS (Netherlands)

    T. Wolters (Tineke)

    2010-01-01

    textabstractTh is thesis describes research on screening for prostate cancer. To improve understanding of the thesis, some background information will be provided in this introduction. First, a short description of the prostate and of prostate cancer will be given in Chapter 1, followed by more deta

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

    Directory of Open Access Journals (Sweden)

    Braithwaite D

    2016-02-01

    Full Text Available Dejana Braithwaite,1 Joshua Demb,1 Louise M Henderson2 1Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 2Department of Radiology, University of North Carolina, Chapel Hill, NC, USA Abstract: Breast cancer is a major cause of cancer-related deaths among older women, aged 65 years or older. Screening mammography has been shown to be effective in reducing breast cancer mortality in women aged 50–74 years but not among those aged 75 years or older. Given the large heterogeneity in comorbidity status and life expectancy among older women, controversy remains over screening mammography in this population. Diminished life expectancy with aging may decrease the potential screening benefit and increase the risk of harms. In this review, we summarize the evidence on screening mammography utilization, performance, and outcomes and highlight evidence gaps. Optimizing the screening strategy will involve separating older women who will benefit from screening from those who will not benefit by using information on comorbidity status and life expectancy. This review has identified areas related to screening mammography in older women that warrant additional research, including the need to evaluate emerging screening technologies, such as tomosynthesis among older women and precision cancer screening. In the absence of randomized controlled trials, the benefits and harms of continued screening mammography in older women need to be estimated using both population-based cohort data and simulation models. Keywords: aging, breast cancer, precision cancer screening

  3. CAN RAP: A Program to Help Patients Choose a Screening Strategy for Colon Cancer

    OpenAIRE

    Detmer, William M.; Gilbertson, David G.

    1993-01-01

    The CANcer Risk Assessment and Preference (CAN RAP) system is a prototype computer program that helps patients to select a screening strategy for colon cancer. CAN RAP uses demographic and risk-factor information to calculate the benefit and cost of various screening strategies. The system communicates to patients these benefits and costs, and elicits patient preferences using audio, text, and graphics.

  4. Cancer screening

    OpenAIRE

    Krishna Prasad

    1987-01-01

    Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung,  ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

  5. Feasible economic strategies to improve screening compliance for colorectal cancer in Korea

    Institute of Scientific and Technical Information of China (English)

    Sang Min Park; Young Ho Yun; Soonman Kwon

    2005-01-01

    AIM: While colorectal cancer (CRC) is an ideal target for population screening, physician and patient attitudes contribute to low levels of screening uptake. This study was carried out to find feasible economic strategies to improve the CRC screening compliance in Korea.METHODS: The natural history of a simulated cohort of 50-year-old Korean in the general population was modeled with CRC screening until the age of 80 years. Cases of positive results were worked up with colonoscopy. After polypectomy, colonoscopy was repeated every 3 years.Baseline screening compliance without insurance coverage by the national health insurance (NHI) was assumed to be 30% . If NHI covered the CRC screening or the reimbursement of screening to physicians increased, the compliance was assumed to increase. We evaluated 16different CRC screening strategies based on Markov model.RESULTS: When the NHI did not cover the screening and compliance was 30%, non-dominated strategies were colonoscopy every 5 years (COL5) and colonoscopy every 3 years (COL3). In all scenarios of various compliance rates with raised coverage of the NHI and increased reimbursement of colonoscopy, COL10, COL5 and COL3were non-dominated strategies, and COL10 had lower or minimal incremental medical cost and financial burden on the NHI than the strategy of no screening. These results were stable with sensitivity analyses.CONCLUSION: Economic strategies for promoting screening compliance can be accompanied by expanding insurance coverage by the NHI and by increasing reimbursement for CRC screening to providers. COL10was a cost-effective and cost saving screening strategy for CRC in Korea.

  6. Strategies to Improve Repeat Fecal Occult Blood Testing Cancer Screening

    Science.gov (United States)

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

    2013-01-01

    Background A comparative effectiveness intervention by this team improved initial fecal occult blood testing (FOBT) rates from 3% to 53% among community clinic patients. The purpose of this study was to evaluate the effectiveness and costs associated with a literacy-informed intervention on repeat FOBT testing. Methods Between 2008 and 2011, a three-arm quasi-experiential comparative effectiveness evaluation was conducted in 8 community clinics in Louisiana. Clinics were randomly assigned to receive: enhanced care, a screening recommendation and FOBT kit annually; a brief educational intervention where patients additionally received a literacy appropriate pamphlet and simplified FOBT instructions; or nurse support where a nurse manager provided the education and followed up with phone support. In year 2 all materials were mailed. The study consisted of 461 patients, ages 50–85, with a negative initial FOBT. Results Repeat FOBT rates were 38% enhanced care, 33% education, and 59% with nurse support (p=0.017). After adjusting for age, race, gender, and literacy, patients receiving nurse support were 1.46 times more likely to complete repeat FOBT screening than those receiving education (95% CI 1.14–1.06, p=0.002) and 1.45 times more likely than those in enhanced care but this was not significant (95% CI 0.93–2.26 p=0.10). The incremental cost per additional person screened was $2,450 for nurse over enhanced care. Conclusion A mailed pamphlet and FOBT with simplified instructions did not improve annual screening. Impact Telephone outreach by a nurse manager was effective in improving rates of repeat FOBT yet this may be too costly for community clinics. PMID:24192009

  7. Screening for colorectal cancer.

    Science.gov (United States)

    He, Jin; Efron, Jonathan E

    2011-01-01

    March is national colorectal cancer awareness month. It is estimated that as many as 60% of colorectal cancer deaths could be prevented if all men and women aged 50 years or older were screened routinely. In 2000, Katie Couric's televised colonoscopy led to a 20% increase in screening colonoscopies across America, a stunning rise called the "Katie Couric Effect". This event demonstrated how celebrity endorsement affects health behavior. Currently, discussion is ongoing about the optimal strategy for CRC screening, particularly the costs of screening colonoscopy. The current CRC screening guidelines are summarized in Table 2. Debates over the optimum CRC screening test continue in the face of evidence that 22 million Americans aged 50 to 75 years are not screened for CRC by any modality and 25,000 of those lives may have been saved if they had been screened for CRC. It is clear that improving screening rates and reducing disparities in underscreened communities and population subgroups could further reduce colorectal cancer morbidity and mortality. National Institutes of Health consensus identified the following priority areas to enhance the use and quality of colorectal cancer screening: Eliminate financial barriers to colorectal cancer screening and appropriate follow-up of positive results of colorectal cancer screening. Develop systems to ensure the high quality of colorectal cancer screening programs. Conduct studies to determine the comparative effectiveness of the various colorectal cancer screening methods in usual practice settings. Encouraging population adherence to screening tests and allowing patients to select the tests they prefer may do more good (as long as they choose something) than whatever procedure is chosen by the medical profession as the preferred test. PMID:21954677

  8. Lung Cancer Screening

    Science.gov (United States)

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

  9. Skin Cancer Screening

    Science.gov (United States)

    ... Genetics of Skin Cancer Skin Cancer Screening Research Skin Cancer Screening (PDQ®)–Patient Version What is screening? Go ... These are called diagnostic tests . General Information About Skin Cancer Key Points Skin cancer is a disease in ...

  10. Breast cancer screenings

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000837.htm Breast cancer screenings To use the sharing features on this page, please enable JavaScript. Breast cancer screenings can help find breast cancer early, before ...

  11. Prostate cancer screenings

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000846.htm Prostate cancer screenings To use the sharing features on this ... Intern Med . 2011;155(11):762-71. National Cancer Institute. Prostate Cancer Screening -- for health professionals. Revised April 2, ...

  12. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  13. Prostate Cancer Screening

    Science.gov (United States)

    ... man's bladder that produces fluid for semen. Cancer screening is looking for cancer before you have any ... be easier to treat. There is no standard screening test for prostate cancer. Researchers are studying different ...

  14. Improving population-based cervical cancer screening in general practice : effects of a national strategy

    NARCIS (Netherlands)

    Hermens, R P; Hak, E; Hulscher, M E; Mulder, J; Tacken, M A; Braspenning, J C; Grol, R P

    1999-01-01

    OBJECTIVE: To assess the effects of a Dutch national prevention programme, aimed at general practitioners (GPs), on the adherence to organizational guidelines for effective cervical cancer screening in general practice. To identify the characteristics of general practices determining success. DESIGN

  15. What is the most cost-effective strategy to screen for second primary colorectal cancers in male cancer survivors in Korea?

    Institute of Scientific and Technical Information of China (English)

    Sang Min Park; Sun-Young Kim; Craig C Earle; Seung-Yong Jeong; Young Ho Yun

    2009-01-01

    AIM: To identify a cost-effective strategy of second primary colorectal cancer (CRC) screening for cancer survivors in Korea using a decision-analytic model.METHODS: A Markov model estimated the clinical and economic consequences of a simulated 50-year-old male cancer survivors' cohort, and we compared the results of eight screening strategies: no screening, fecal occult blood test (FOBT) annually, FOBT every2 years, sigmoidoscopy every 5 years, double contrast barium enema every 5 years, and colonoscopy every 10 years (COL10), every 5 years (COL5), and every3 years (COL3). We included only direct medical costs, and our main outcome measures were discountedlifetime costs, life expectancy, and incremental cost-effectiveness ratio (ICER).RESULTS: In the base-case analysis, the non-dominated strategies in cancer survivors were COL5, and COL3. The ICER for COL3 in cancer survivors was $5593/life-year saved (LYS), and did not exceed $10000/LYS in one-way sensitivity analyses. If the risk of CRC in cancer survivors is at least two times higher than that in the general population, COL5 had an ICER of less than $10500/LYS among both good and poor prognosis of index cancer. If the age of cancer survivors starting CRC screening was decreased to 40 years, the ICER of COL5 was less than $7400/LYS regardless of screening compliance.CONCLUSION: Our study suggests that more strict and frequent recommendations for colonoscopy such as COL5 and COL3 could be considered as economically reasonable second primary CRC screening strategies for Korean male cancer survivors.

  16. Strategies for Increasing Cervical Cancer Screening Amongst First Nations Communities in Northwest Ontario, Canada.

    Science.gov (United States)

    Maar, Marion; Wakewich, Pamela; Wood, Brianne; Severini, Alberto; Little, Julian; Burchell, Ann N; Ogilvie, Gina; Zehbe, Ingeborg

    2016-04-01

    The high burden of cervical cancer in Indigenous populations worldwide is due to underscreening and inadequate follow-up. Using qualitative, participatory action research, we interviewed health care staff to identify ways to increase screening recruitment in First Nations communities in Northwest Ontario, Canada. Our findings suggest the value of a multilevel social-ecological model to promote behavioral changes at the community, health care service and stakeholder, and decision-maker level. Participants emphasized the central role of First Nations women as nurturers of life and for the well-being of their family members. They stressed the importance of building awareness and motivation for cervical cancer screening through various activities including continuous education, hosting screening events specifically for women, improving the attitude and service of health care providers, and promoting screening tools and policies that complement and are respectful of First Nations women. PMID:25375661

  17. New concepts on risk factors of HPV and novel screening strategies for cervical cancer precursors.

    Science.gov (United States)

    Syrjänen, K

    2008-01-01

    During the past several years, this author has been engaged in coordinating two major multicentre trials testing optional screening tools for cervical cancer (CC) in low-resource settings both in East Europe and in Latin America. These international trials include the NIS (New Independent States of the former Soviet Union) cohort (n = 3,187 women) and the LAMS (Latin American Screening) study (n = 12,114 women). In both studies, a sizeable cohort of women (887 and 1,011, respectively) have been prospectively followed-up to assess the natural history of high-risk human papillomavirus (HR-HPV) infections and the role of implicated risk factors as potential predictors of disease outcome (acquisition, persistence and clearance). In this communication some of the key observations recently reported from the NIS and LAMS studies will be discussed, with special emphasis on i) risk factors that are still controversial (i.e., oral contraception; OC, and smoking) or not previously studied (drug addiction), on ii) reproductive factors as potential cofactors of HPV infections in cervical carcinogenesis (i.e., age at menarche, menopause), and finally on iii) the performance of different screening strategies among young and older women. Although closely related to these topics, a detailed discussion on the dynamics of HPV infections (acquisition, persistence, clearance) and their predictive factors falls outside the scope of this communication, because they have been extensively discussed in a series of original reports and in a recent review of the author in this journal. The NIS cohort failed to establish OC as a risk factor of CC. In all future studies, the strong confounding effects from the lifestyle behavioural factors must be taken into account, while interpreting the data on OCs as potential risk factors of CC. Similarly, it now seems that the increased risk (if any) of CC among smokers seems to be attributed to the increased acquisition of HR-HPV infections, of which the

  18. Risks of Skin Cancer Screening

    Science.gov (United States)

    ... Genetics of Skin Cancer Skin Cancer Screening Research Skin Cancer Screening (PDQ®)–Patient Version What is screening? Go ... These are called diagnostic tests . General Information About Skin Cancer Key Points Skin cancer is a disease in ...

  19. The clinical utility of HPV DNA testing in cervical cancer screening strategies.

    Science.gov (United States)

    Bhatla, Neerja; Moda, Nidhi

    2009-09-01

    Cervical cancer continues to be the commonest cause of death among women in developing countries, largely due to the failure to the inability to sustain effective cytology-based screening programs. While this burden may come down following implementation of the human papillomavirus (HPV) vaccine, screening will still be required. HPV DNA testing is a promising new technology for cervical cancer prevention and is the most reproducible of all cervical cancer screening tests. Presently, the two assays most widely used for the detection of genital types are the polymerase chain reaction (PCR) and Hybrid Capture 2 assays (hc2). Rapid, affordable tests are expected to be available soon. HPV DNA testing can be used in a variety of clinical scenarios that include primary screening in women older than 30 yr; as an adjunctive test to cytology; in the triage of women with an equivocal cytologic report, e.g., ASC-US; or for follow-up post-treatment for cervical intraepithelial neoplasia (CIN). HPV DNA testing can also be performed on self-collected samples, which allows screening in remote areas and also in women who refuse gynecologic examination. PMID:19901435

  20. The clinical utility of HPV DNA testing in cervical cancer screening strategies.

    Science.gov (United States)

    Bhatla, Neerja; Moda, Nidhi

    2009-09-01

    Cervical cancer continues to be the commonest cause of death among women in developing countries, largely due to the failure to the inability to sustain effective cytology-based screening programs. While this burden may come down following implementation of the human papillomavirus (HPV) vaccine, screening will still be required. HPV DNA testing is a promising new technology for cervical cancer prevention and is the most reproducible of all cervical cancer screening tests. Presently, the two assays most widely used for the detection of genital types are the polymerase chain reaction (PCR) and Hybrid Capture 2 assays (hc2). Rapid, affordable tests are expected to be available soon. HPV DNA testing can be used in a variety of clinical scenarios that include primary screening in women older than 30 yr; as an adjunctive test to cytology; in the triage of women with an equivocal cytologic report, e.g., ASC-US; or for follow-up post-treatment for cervical intraepithelial neoplasia (CIN). HPV DNA testing can also be performed on self-collected samples, which allows screening in remote areas and also in women who refuse gynecologic examination.

  1. Lung cancer screening: radiological aspects

    NARCIS (Netherlands)

    de Hoop, B.J.

    2010-01-01

    Lung Cancer Screening: Radiological Aspects Multiple lung cancer screening studies are currently being conducted to study whether lung cancer screening with Computed Tomography (CT) can decrease lung cancer mortality. This thesis addresses radiological methods that can increase efficacy and efficien

  2. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  3. Lung Cancer Screening Update.

    Science.gov (United States)

    Ruchalski, Kathleen L; Brown, Kathleen

    2016-07-01

    Since the release of the US Preventive Services Task Force and Centers for Medicare and Medicaid Services recommendations for lung cancer screening, low-dose chest computed tomography screening has moved from the research arena to clinical practice. Lung cancer screening programs must reach beyond image acquisition and interpretation and engage in a multidisciplinary effort of clinical shared decision-making, standardization of imaging and nodule management, smoking cessation, and patient follow-up. Standardization of radiologic reports and nodule management will systematize patient care, provide quality assurance, further reduce harm, and contain health care costs. Although the National Lung Screening Trial results and eligibility criteria of a heavy smoking history are the foundation for the standard guidelines for low-dose chest computed tomography screening in the United States, currently only 27% of patients diagnosed with lung cancer would meet US lung cancer screening recommendations. Current and future efforts must be directed to better delineate those patients who would most benefit from screening and to ensure that the benefits of screening reach all socioeconomic strata and racial and ethnic minorities. Further optimization of lung cancer screening program design and patient eligibility will assure that lung cancer screening benefits will outweigh the potential risks to our patients. PMID:27306387

  4. Screening for colorectal cancer

    DEFF Research Database (Denmark)

    Nielsen, Hans J.; Jakobsen, Karen V.; Christensen, Ib J.;

    2011-01-01

    Emerging results indicate that screening improves survival of patients with colorectal cancer. Therefore, screening programs are already implemented or are being considered for implementation in Asia, Europe and North America. At present, a great variety of screening methods are available including...... into improvements of screening for colorectal cancer includes blood-based biological markers, such as proteins, DNA and RNA in combination with various demographically and clinically parameters into a "risk assessment evaluation" (RAE) test. It is assumed that such a test may lead to higher acceptance among...... procedures for colorectal cancer. Therefore, results of present research, validating RAE tests, are awaited with interest....

  5. Lung Cancer Screening.

    Science.gov (United States)

    Wu, Geena X; Raz, Dan J

    2016-01-01

    Lung cancer is the leading cause of cancer mortality in the United States and worldwide. Since lung cancer outcomes are dependent on stage at diagnosis with early disease resulting in longer survival, the goal of screening is to capture lung cancer in its early stages when it can be treated and cured. Multiple studies have evaluated the use of chest X-ray (CXR) with or without sputum cytologic examination for lung cancer screening, but none has demonstrated a mortality benefit. In contrast, the multicenter National Lung Screening Trial (NLST) from the United States found a 20 % reduction in lung cancer mortality following three consecutive screenings with low-dose computed tomography (LDCT) in high-risk current and former smokers. Data from European trials are not yet available. In addition to a mortality benefit, lung cancer screening with LDCT also offers a unique opportunity to promote smoking cessation and abstinence and may lead to the diagnoses of treatable chronic diseases, thus decreasing the overall disease burden. The risks of lung cancer screening include overdiagnosis, radiation exposure, and false-positive results leading to unnecessary testing and possible patient anxiety and distress. However, the reduction in lung cancer mortality is a benefit that outweighs the risks and major health organizations currently recommend lung cancer screening using age, smoking history, and quit time criteria derived from the NLST. Although more research is needed to clearly define and understand the application and utility of lung cancer screening in the general population, current data support that lung cancer screening is effective and should be offered to eligible beneficiaries. PMID:27535387

  6. Using Intervention Mapping as a Participatory Strategy: Development of a Cervical Cancer Screening Intervention for Hispanic Women

    Science.gov (United States)

    Byrd, Theresa L.; Wilson, Katherine M.; Smith, Judith Lee; Heckert, Andrea; Orians, Carlyn E.; Vernon, Sally W.; Fernandez-Esquer, Maria E.; Fernandez, Maria E.

    2012-01-01

    Cervical cancer is preventable with treatment of precancerous lesions and treatable at early stages. Hispanics have higher rates of cervical cancer and lower rates of screening. "Ayndando a las Mujeres con Informaccion, Guia, y Amor para su Salud" (AMIGAS) is an intervention to increase cervical cancer screening in U.S. women of Mexican origin.…

  7. Toward discovering new anti-cancer agents targeting topoisomerase IIα: a facile screening strategy adaptable to high throughput platform.

    Directory of Open Access Journals (Sweden)

    Yu-Shih Lin

    Full Text Available Topoisomerases are a family of vital enzymes capable of resolving topological problems in DNA during various genetic processes. Topoisomerase poisons, blocking reunion of cleaved DNA strands and stabilizing enzyme-mediated DNA cleavage complex, are clinically important antineoplastic and anti-microbial agents. However, the rapid rise of drug resistance that impedes the therapeutic efficacy of these life-saving drugs makes the discovering of new lead compounds ever more urgent. We report here a facile high throughput screening system for agents targeting human topoisomerase IIα (Top2α. The assay is based on the measurement of fluorescence anisotropy of a 29 bp fluorophore-labeled oligonucleotide duplex. Since drug-stabilized Top2α-bound DNA has a higher anisotropy compared with free DNA, this assay can work if one can use a dissociating agent to specifically disrupt the enzyme/DNA binary complexes but not the drug-stabilized ternary complexes. Here we demonstrate that NaClO4, a chaotropic agent, serves a critical role in our screening method to differentiate the drug-stabilized enzyme/DNA complexes from those that are not. With this strategy we screened a chemical library of 100,000 compounds and obtained 54 positive hits. We characterized three of them on this list and demonstrated their effects on the Top2α-mediated reactions. Our results suggest that this new screening strategy can be useful in discovering additional candidates of anti-cancer agents.

  8. An analysis of the duplicate testing strategy of an Irish immunochemical FOBT colorectal cancer screening programme.

    LENUS (Irish Health Repository)

    Kelley, Leanne

    2013-06-10

    AIM: This study examined the relevance of using a two sample quantitative immunochemical faecal occult blood test (iFOBT or FIT) at a high cut off stringency by the first population-based colorectal cancer (CRC) pilot screening programme in Ireland. METHOD: Approximately ten thousand individuals between the ages of 50-74 years were invited to perform two consecutive FITs. These were analysed in tandem using the OC-Sensor and participants with at least one positive result with a haemoglobin cut off for positivity at 100 ng\\/ml were offered colonoscopy. RESULTS: A total of 5023 (52%) (2177 (43%) male; 2846 (57%) female) individuals with a median age of 64 years participated. At least one positive FIT test was detected from 514 (10%) individuals. From the 419 (82%) patients who proceeded to colonoscopy 17 (4%) had CRC and 132(33%) had an advanced adenoma. The detection rate for these screen relevant lesions was 3% (95% CIs = 2.5% - 3.5%) and the FIT positive + colonoscopy detection rate was 36% (95% CI = 31% - 40%). The numbers needed to colonoscope to find an advanced lesion was 2.8. The two test system detected four (23.5%) additional patients with CRC and 37 (28%) with an advanced adenoma compared with a single test. CONCLUSION: The CRC miss rate estimated for a single test (23.5%) was unacceptably high when the goal was to maximize the discovery of advanced lesions in the initial screening round. We conclude that the two test protocol at a high cut off threshold is suitable to optimize FIT screening in Ireland. This article is protected by copyright. All rights reserved.

  9. Breast cancer screening

    OpenAIRE

    Skrabanek, P

    1988-01-01

    Consensus is still lacking on guidelines for breast-cancer screening with mammography: who should be screened, how frequently at what age, to what benefits and at what risks. American, Dutch, Swedish and Italian studies spanning the 1960s to the 1980s reveal a benefit from screening (reduced mortality from breast cancer) that occurs unambiguously only in women 50 years of age and over. Physicians who choose to screen mammographically their over-49-year-old female patients must do so with the ...

  10. Economic evaluation of three populational screening strategies for cervical cancer in the county of Valles Occidental: CRICERVA clinical trial

    Directory of Open Access Journals (Sweden)

    Bonet Josep M

    2011-10-01

    Full Text Available Abstract Background A high percentage of cervical cancer cases have not undergone cytological tests within 10 years prior to diagnosis. Different population interventions could improve coverage in the public system, although costs will also increase. The aim of this study was to compare the effectiveness and the costs of three types of population interventions to increase the number of female participants in the screening programmes for cancer of the cervix carried out by Primary Care in four basic health care areas. Methods/Design A cost-effectiveness analysis will be performed from the perspective of public health system including women from 30 to 70 years of age (n = 20,994 with incorrect screening criteria from four basic health care areas in the Valles Occidental, Barcelona, Spain. The patients will be randomly distributed into the control group and the three intervention groups (IG1: invitation letter to participate in the screening; IG2: invitation letter and informative leaflet; IG3: invitation letter, informative leaflet and a phone call reminder and followed for three years. Clinical effectiveness will be measured by the number of HPV, epithelial lesions and cancer of cervix cases detected. The number of deaths avoided will be secondary measures of effectiveness. The temporal horizon of the analysis will be the life expectancy of the female population in the study. Costs and effectiveness will be discounted at 3%. In addition, univariate and multivariate sensitivity analysis will be carried out. Discussion IG3 is expected to be more cost-effective intervention than IG1 and IG2, with greater detection of HPV infections, epithelial lesions and cancer than other strategies, albeit at a greater cost. Trial Registration Clinical Trials.gov Identifier NCT01373723

  11. Final screening round of the NELSON lung cancer screening trial : the effect of a 2.5-year screening interval

    NARCIS (Netherlands)

    Yousaf-Khan, Uraujh; van der Aalst, Carlijn; de Jong, Pim A; Heuvelmans, Marjolein; Scholten, Ernst; Lammers, Jan-Willem; van Ooijen, Peter; Nackaerts, Kristiaan; Weenink, Carla; Groen, Harry; Vliegenthart, Rozemarijn; Ten Haaf, Kevin; Oudkerk, Matthijs; de Koning, Harry

    2016-01-01

    BACKGROUND: In the USA annual lung cancer screening is recommended. However, the optimal screening strategy (eg, screening interval, screening rounds) is unknown. This study provides results of the fourth screening round after a 2.5-year interval in the Dutch-Belgian Lung Cancer Screening trial (NEL

  12. Screening for Prostate Cancer

    Science.gov (United States)

    ... absolute reduction in mortal- ity. Preliminary results from PIVOT (Prostate Cancer In- tervention Versus Observation Trial), in ... early PSA screening era, prelim- inary findings from PIVOT show that, after 12 years, in- tention to ...

  13. Colorectal Cancer Screening

    Science.gov (United States)

    ... laxatives to clear the colon, shows polyps clearly. DNA stool test This test checks DNA in stool cells for genetic changes that may be a sign of colorectal cancer. Screening clinical trials are taking place in many parts of the ... Screening tests have risks. False-negative test results can occur. ...

  14. Colorectal cancer screening

    Institute of Scientific and Technical Information of China (English)

    Ramona M McLoughlin; Colm A O'Morain

    2006-01-01

    Colorectal cancer is a major public health burden worldwide.There is clear-cut evidence that screening will reduce colorectal cancer mortality and the only contentious issue is which screening tool to use.Most evidence points towards screening with fecal occult blood testing.The immunochemical fecal occult blood tests have a higher sensitivity than the guaiac-based tests.In addition,their automation and haemoglobin quantification allows a threshold for colonoscopy to be selected that can be accommodated within individual health care systems.

  15. Screening for lung cancer

    DEFF Research Database (Denmark)

    Infante, Maurizio V; Pedersen, Jesper H

    2010-01-01

    In lung cancer screening with low-dose spiral computed tomography (LDCT), the proportion of stage I disease is 50-85%, and the survival rate for resected stage I disease can exceed 90%, but proof of real benefit in terms of lung cancer mortality reduction must come from the several randomized...

  16. Developments in Colorectal Cancer Screening

    Science.gov (United States)

    ... on. Feature: Colorectal Cancer Developments in Colorectal Cancer Screening Summer 2016 Table of Contents Dr. Asad Umar, ... know to help determine the best colon cancer screening test for them? Colonoscopy is considered the gold ...

  17. Lung cancer screening: Update

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyea Young [Dept. of Radiology, Center for Lung Cancer, National Cancer Center, Goyang (Korea, Republic of)

    2015-09-15

    Lung cancer is the leading cause of cancer deaths worldwide as well as in Korea. A recent National Lung Screening Trial in U.S. revealed that low-dose CT (LDCT) screening reduced lung cancer specific mortality by 20% in high risk individuals as compared to chest radiograph screening. Based on this evidence, several expert societies in U.S. and Korean multisociety collaborative committee developed guidelines for recommendation of lung cancer screening using annual LDCT in high risk populations. In most of the societies high risk groups are defined as persons aged 55 to 74 years, who are current smokers with history of smoking of more than 30 packs per year or ex-smokers, who quit smoking up to 15 or more years ago. The benefits of LDCT screening are modestly higher than the harms in high risk individuals. The harms included a high rate of false-positive findings, over-diagnosis and radiation-related deaths. Invasive diagnostic procedure due to false positive findings may lead to complications. LDCT should be performed in qualified hospitals and interpreted by expert radiologists. Recently, the American College of Radiology released the current version of Lung cancer CT screening Reporting and Data Systems. Education and actions to stop smoking must be offered to current smokers.

  18. How to improve colon cancer screening rates

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  19. Screening for Pancreatic Cancer.

    Science.gov (United States)

    Wada, Keita; Takaori, Kyoichi; Traverso, L William

    2015-10-01

    Neither extended surgery nor extended indication for surgery has improved survival in patients with pancreatic cancer. According to autopsy studies, presumably 90% are metastatic. The only cure is complete removal of the tumor at an early stage before it becomes a systemic disease or becomes invasive. Early detection and screening of individuals at risk is currently under way. This article reviews the evidence and methods for screening, either familial or sporadic. Indication for early-stage surgery and precursors are discussed. Surgeons should be familiar with screening because it may provide patients with a chance for cure by surgical resection.

  20. Screening for lung cancer

    DEFF Research Database (Denmark)

    Infante, Maurizio V; Pedersen, Jesper H

    2010-01-01

    In lung cancer screening with low-dose spiral computed tomography (LDCT), the proportion of stage I disease is 50-85%, and the survival rate for resected stage I disease can exceed 90%, but proof of real benefit in terms of lung cancer mortality reduction must come from the several randomized...... trials underway in Europe and in the USA. Our purpose is to update the readers on recent progress in medical knowledge in this field....

  1. Ovarian cancer screening in the general population.

    OpenAIRE

    Menon, U

    2007-01-01

    Despite significant improvements in therapy, ovarian cancer continues to be a leading cause of death amongst women with gynaecological malignancies. Advanced stage at diagnosis is thought to be a major contributor to mortality. Hence, there is considerable interest in early detection through screening. In the 1990s, Professor Jacobs pioneered the development of a multimodal ovarian cancer screening (OCS) strategy using serum CA125 as the first line screen and pelvic ultrasound as the second l...

  2. Evaluation of Human Papilloma Virus Communicative Education Strategies: A Pilot Screening Study for Cervical Cancer

    Science.gov (United States)

    Barrera-Clavijo, Lizeth K.; Wiesner-Ceballos, Carolina; Rincón-Martínez, Lina M.

    2016-01-01

    Background: High-risk human papilloma virus (HR-HPV) is highly prevalent in sexually active men and women; HR-HPV has been classified as a sexually transmitted infection (STI) and as a necessary, but not sufficient, causal agent for cervical cancer. Women who test positive for HPV often experience serious psychosocial consequences such as fear,…

  3. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Nielsen, Margrethe

    2009-01-01

    BACKGROUND: A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary. OBJECTIVES: To assess the effect of screening for breast cancer with mammography on mortality and morbidity. SEARCH STRATEGY: We searched Pub...... excluded a biased trial and included 600,000 women in the analyses. Three trials with adequate randomisation did not show a significant reduction in breast cancer mortality at 13 years (relative risk (RR) 0.90, 95% confidence interval (CI) 0.79 to 1.02); four trials with suboptimal randomisation showed...... a significant reduction in breast cancer mortality with an RR of 0.75 (95% CI 0.67 to 0.83). The RR for all seven trials combined was 0.81 (95% CI 0.74 to 0.87). We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential...

  4. Economic Evaluation of Screening Strategies Combined with HPV Vaccination of Preadolescent Girls for the Prevention of Cervical Cancer in Vientiane, Lao PDR

    Science.gov (United States)

    2016-01-01

    Background Several approaches to reduce the incidence of invasive cervical cancers exist. The approach adopted should take into account contextual factors that influence the cost-effectiveness of the available options. Objective To determine the cost-effectiveness of screening strategies combined with a vaccination program for 10-year old girls for cervical cancer prevention in Vientiane, Lao PDR. Methods A population-based dynamic compartment model was constructed. The interventions consisted of a 10-year old girl vaccination program only, or this program combined with screening strategies, i.e., visual inspection with acetic acid (VIA), cytology-based screening, rapid human papillomavirus (HPV) DNA testing, or combined VIA and cytology testing. Simulations were run over 100 years. In base-case scenario analyses, we assumed a 70% vaccination coverage with lifelong protection and a 50% screening coverage. The outcome of interest was the incremental cost per Disability-Adjusted Life Year (DALY) averted. Results In base-case scenarios, compared to the next best strategy, the model predicted that VIA screening of women aged 30–65 years old every three years, combined with vaccination, was the most attractive option, costing 2 544 international dollars (I$) per DALY averted. Meanwhile, rapid HPV DNA testing was predicted to be more attractive than cytology-based screening or its combination with VIA. Among cytology-based screening options, combined VIA with conventional cytology testing was predicted to be the most attractive option. Multi-way sensitivity analyses did not change the results. Compared to rapid HPV DNA testing, VIA had a probability of cost-effectiveness of 73%. Compared to the vaccination only option, the probability that a program consisting of screening women every five years would be cost-effective was around 60% and 80% if the willingness-to-pay threshold is fixed at one and three GDP per capita, respectively. Conclusions A VIA screening program

  5. Risks of Lung Cancer Screening

    Science.gov (United States)

    ... and former heavy smokers. Current smokers whose LDCT scan results show possible signs of cancer may be more likely to quit smoking. A Guide is available for patients and doctors to learn more about the benefits and harms of low-dose helical CT screening for lung cancer. Screening with chest x- ...

  6. Anal cancer and intraepithelial neoplasia screening: A review

    OpenAIRE

    Leeds, Ira L.; Fang, Sandy H

    2016-01-01

    This review focuses on the early diagnosis of anal cancer and its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors earl...

  7. Screening for colorectal cancer: what fits best?

    LENUS (Irish Health Repository)

    Lee, Chun Seng

    2012-06-01

    Colorectal cancer (CRC) screening has been shown to be effective in reducing CRC incidence and mortality. There are currently a number of screening modalities available for implementation into a population-based CRC screening program. Each screening method offers different strengths but also possesses its own limitations as a population-based screening strategy. We review the current evidence base for accepted CRC screening tools and evaluate their merits alongside their challenges in fulfilling their role in the detection of CRC. We also aim to provide an outlook on the demands of a low-risk population-based CRC screening program with a view to providing insight as to which modality would best suit current and future needs.

  8. Colon cancer screening

    Science.gov (United States)

    ... screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test ... called the fecal immunochemical test (FIT) and stool DNA test (sDNA). Sigmoidoscopy : This test uses a small flexible ...

  9. Risks of Colorectal Cancer Screening

    Science.gov (United States)

    ... laxatives to clear the colon, shows polyps clearly. DNA stool test This test checks DNA in stool cells for genetic changes that may be a sign of colorectal cancer. Screening clinical trials are taking place in many parts of the ... Screening tests have risks. False-negative test results can occur. ...

  10. Environmental scan of anal cancer screening practices: worldwide survey results

    OpenAIRE

    Patel, Jigisha; Salit, Irving E.; Berry, Michael J.; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey ...

  11. Risk Profiling May Improve Lung Cancer Screening

    Science.gov (United States)

    A new modeling study suggests that individualized, risk-based selection of ever-smokers for lung cancer screening may prevent more lung cancer deaths and improve the effectiveness and efficiency of screening compared with current screening recommendations

  12. Correlates of Cervical Cancer Screening among Vietnamese American Women

    Directory of Open Access Journals (Sweden)

    Grace X. Ma

    2012-01-01

    Full Text Available Objective. Vietnamese American women are at the greatest risk for cervical cancer but have the lowest cervical cancer screening rates. This study was to determine whether demographic and acculturation, healthcare access, and knowledge and beliefs are associated with a prior history of cervical cancer screening among Vietnamese women. Methods. Vietnamese women (n=1450 from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey participated in the study and completed baseline assessments. Logistic regression analyses were performed. Results. Overall levels of knowledge about cervical cancer screening and human papillomavirus (HPV are low. Factors in knowledge, attitude, and beliefs domains were significantly associated with Pap test behavior. In multivariate analyses, physician recommendation for screening and having health insurance were positively associated with prior screening. Conclusion. Understanding the factors that are associated with cervical cancer screening will inform the development of culturally appropriate intervention strategies that would potentially lead to increasing cervical cancer screening rates among Vietnamese women.

  13. Using lessons from breast, cervical, and colorectal cancer screening to inform the development of lung cancer screening programs.

    Science.gov (United States)

    Armstrong, Katrina; Kim, Jane J; Halm, Ethan A; Ballard, Rachel M; Schnall, Mitchell D

    2016-05-01

    Multiple advisory groups now recommend that high-risk smokers be screened for lung cancer by low-dose computed tomography. Given that the development of lung cancer screening programs will face many of the same issues that have challenged other cancer screening programs, the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium was used to identify lessons learned from the implementation of breast, cervical, and colorectal cancer screening that should inform the introduction of lung cancer screening. These lessons include the importance of developing systems for identifying and recruiting eligible individuals in primary care, ensuring that screening centers are qualified and performance is monitored, creating clear communication standards for reporting screening results to referring physicians and patients, ensuring follow-up is available for individuals with abnormal test results, avoiding overscreening, remembering primary prevention, and leveraging advances in cancer genetics and immunology. Overall, this experience emphasizes that effective cancer screening is a multistep activity that requires robust strategies to initiate, report, follow up, and track each step as well as a dynamic and ongoing oversight process to revise current screening practices as new evidence regarding screening is created, new screening technologies are developed, new biological markers are identified, and new approaches to health care delivery are disseminated. Cancer 2016;122:1338-1342. © 2016 American Cancer Society. PMID:26929386

  14. Screening for breast cancer with mammography

    International Nuclear Information System (INIS)

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

  15. Liver (Hepatocellular) Cancer Screening

    Science.gov (United States)

    ... cancer is present in the body. Alpha-fetoprotein (AFP) is the most widely used tumor marker for ... and other types of cancer, may also increase AFP levels. Specific tumor markers that may lead to ...

  16. Mammographic screening for breast cancer: A review

    OpenAIRE

    Lee, Warwick; Peters, Gudrun

    2013-01-01

    In 2011, BreastScreen Australia celebrated 20 years of mammographic screening for breast cancer in Australia. There has been a reduction in mortality from breast cancer over the last two decades, coincident with mammographic screening. However, there are concerns that mammographic screening may result in overdiagnosis of breast cancer and that the reduction in mortality from breast cancer is the result of better treatment rather than screening. This article reviews the evidence on which mammo...

  17. Making it work: health care provider perspectives on strategies to increase colorectal cancer screening in federally qualified health centers.

    Science.gov (United States)

    Gwede, Clement K; Davis, Stacy N; Quinn, Gwendolyn P; Koskan, Alexis M; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

    2013-12-01

    Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. A mixed methods design consisting of in-depth interviews, focus groups, and a short survey is used in this study. The participants of this study are 17 health care providers practicing in FQHCs in the Tampa Bay area. Test-specific patient impediments and motivations were identified including fear of abnormal findings, importance of offering less invasive fecal occult blood tests, and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education. Findings readily inform the design of educational materials and interventions to increase CRCS in FQHCs. PMID:23943277

  18. Anal cancer and intraepithelial neoplasia screening: A review.

    Science.gov (United States)

    Leeds, Ira L; Fang, Sandy H

    2016-01-27

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

  19. Methods for Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Tatiana Vargas-Revilla

    2014-12-01

    This article is divided in three sections: the first one focuses on the general impact of cervical cancer has hadin CostaRica, these condsection gathers information about different methodologies used around the world to detect this cancer and the third one makes reference to the current development of the screening devise in Mexico that works as a monitoring system and can used by women without external assistance.

  20. Cervical cancer screening at crossroads

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez-Prada;

    2014-01-01

    ) 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...... 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...... 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....

  1. Screening for prevention and early diagnosis of cancer.

    Science.gov (United States)

    Wardle, Jane; Robb, Kathryn; Vernon, Sally; Waller, Jo

    2015-01-01

    The poor outcomes for cancers diagnosed at an advanced stage have been the driver behind research into techniques to detect disease before symptoms are manifest. For cervical and colorectal cancer, detection and treatment of "precancers" can prevent the development of cancer, a form of primary prevention. For other cancers-breast, prostate, lung, and ovarian-screening is a form of secondary prevention, aiming to improve outcomes through earlier diagnosis. International and national expert organizations regularly assess the balance of benefits and harms of screening technologies, issuing clinical guidelines for population-wide implementation. Psychological research has made important contributions to this process, assessing the psychological costs and benefits of possible screening outcomes (e.g., the impact of false positive results) and public tolerance of overdiagnosis. Cervical, colorectal, and breast screening are currently recommended, and prostate, lung, and ovarian screening are under active review. Once technologies and guidelines are in place, delivery of screening is implemented according to the health care system of the country, with invitation systems and provider recommendations playing a key role. Behavioral scientists can then investigate how individuals make screening decisions, assessing the impact of knowledge, perceived cancer risk, worry, and normative beliefs about screening, and this information can be used to develop strategies to promote screening uptake. This article describes current cancer screening options, discusses behavioral research designed to reduce underscreening and minimize inequalities, and considers the issues that are being raised by informed decision making and the development of risk-stratified approaches to screening. PMID:25730719

  2. SCREENING FOR EARLY DETECTION OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    E. A. Rasskazova

    2014-01-01

    Full Text Available The article presents a brief overview of the main methods of breast cancer screening. Proven effectiveness of mammography as a screening method in reducing mortality from breast cancer, specified limits of the method. The main trend of increasing the effectiveness of screening is the transition to digital technologies. Properly organized screening with the active participation of the population reduces mortality from breast cancer by 30%.

  3. Colonoscopy in Colorectal Cancer Screening: Current Aspects.

    Science.gov (United States)

    Triantafillidis, John K; Vagianos, Constantine; Malgarinos, George

    2015-09-01

    Colonoscopy represents a very important diagnostic modality for screening for colorectal cancer, because it has the ability to both detect and effectively remove pro-malignant and malignant lesions. It is recommended by almost all international and national gastroenterology and cancer societies, as an initial screening modality or, following a positive fecal occult blood test, to be performed every 10 years in individuals of average risk starting from the age of 50. However, a significant problem is the so-called post-screening (interval) polyps and cancers found some years after the index colonoscopy. In order to reduce the rate of interval cancers it is extremely necessary to optimize the quality and effectiveness of colonoscopy. Bowel preparation is of paramount importance for both accurate diagnosis and subsequent treatment of lesions found on colonoscopy. The quality of bowel preparation could be significantly improved by splitting the dose regimens, a strategy that has been shown to be superior to single-dose regimen. A good endoscopic technique and optimal withdrawal time offering adequate time for inspection, would further optimize the rate of cecal intubation and the number of lesions detected. During the last years, sophisticated devices have been introduced that would further facilitate cecal intubation. The percentage of total colonoscopies is now super-passing the level of 95 % allowing the adenoma detection rate to be greater than the suggestive level of 25 % in men and 15 % in women. This review aims to provide the reader with the current knowledge concerning indications, usefulness, limitations and future perspectives of this probably most important screening technique for colorectal cancer available today. PMID:27217671

  4. In silico analysis and DHPLC screening strategy identifies novel apoptotic gene targets of aberrant promoter hypermethylation in prostate cancer.

    LENUS (Irish Health Repository)

    Murphy, Therese M

    2011-01-01

    Aberrant DNA methylation has been implicated as a key survival mechanism in cancer, whereby promoter hypermethylation silences genes essential for many cellular processes including apoptosis. Limited data is available on the methylation profile of apoptotic genes in prostate cancer (CaP). The aim of this study was to profile methylation of apoptotic-related genes in CaP using denaturing high performance liquid chromatography (DHPLC).

  5. Colon Cancer Screening in North Carolina.

    Science.gov (United States)

    Harvin, Glenn

    2016-01-01

    Colorectal cancer (CRC) is the 2nd leading cause of cancer death both in North Carolina and in the United States. The goal of CRC screening is early detection and prevention. This commentary reviews the evidence for screening, discusses current screening options, and explores which options are best suited for use in North Carolina. PMID:27154885

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

    Science.gov (United States)

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

    2015-10-01

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

  7. Celebrity endorsements of cancer screening.

    Science.gov (United States)

    Larson, Robin J; Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert

    2005-05-01

    Celebrities often promote cancer screening by relating personal anecdotes about their own diagnosis or that of a loved one. We used data obtained from a random-digit dialing survey conducted in the United States from December 2001 through July 2002 to examine the extent to which adults of screening age without a history of cancer had seen or heard or been influenced by celebrity endorsements of screening mammography, prostate-specific antigen (PSA) testing, or sigmoidoscopy or colonoscopy. The survey response rate was 72% among those known to be eligible and 51% among potentially eligible people accounting for those who could not be contacted. A total of 360 women aged 40 years or older and 140 men aged 50 years or older participated in the survey. Most respondents reported they "had seen or heard a celebrity talk about" mammography (73% of women aged 40 years or older), PSA testing (63% of men aged 50 years or older), or sigmoidoscopy or colonoscopy (52% of adults aged 50 years or older). At least one-fourth of respondents who had seen or heard a celebrity endorsement said that the endorsement made them more likely to undergo mammography (25%), PSA testing (31%), or sigmoidoscopy or colonoscopy (37%). PMID:15870440

  8. Cost-effectiveness of colorectal cancer screening

    NARCIS (Netherlands)

    I. Lansdorp-Vogelaar (Iris); A.B. Knudsen (Amy); H. Brenner (Hermann)

    2011-01-01

    textabstractColorectal cancer is an important public health problem. Several screening methods have been shown to be effective in reducing colorectal cancer mortality. The objective of this review was to assess the cost-effectiveness of the different colorectal cancer screening methods and to determ

  9. Lung cancer screening: promise and pitfalls.

    Science.gov (United States)

    Berg, Christine D; Aberle, Denise R; Wood, Douglas E

    2012-01-01

    The results of the National Lung Screening Trial (NLST) have provided the medical community and American public with considerable optimism about the potential to reduce lung cancer mortality with imaging-based screening. Designed as a randomized trial, the NLST has provided the first evidence of screening benefit by showing a 20% reduction in lung cancer mortality and a 6.7% reduction in all-cause mortality with low dose helical computed tomography (LDCT) screening relative to chest X-ray. The major harms of LDCT screening include the potential for radiation-induced carcinogenesis; high false-positivity rates in individuals without lung cancer, and overdiagnosis. Following the results of the NLST, the National Comprehensive Cancer Network (NCCN) published the first of multiple lung cancer screening guidelines under development by major medical organizations. These recommendations amalgamated screening cohorts, practices, interpretations, and diagnostic follow-up based on the NLST and other published studies to provide guidance for the implementation of LDCT screening. There are major areas of opportunity to optimize implementation. These include standardizing practices in the screening setting, optimizing risk profiles for screening and for managing diagnostic evaluation in individuals with indeterminate nodules, developing interdisciplinary screening programs in conjunction with smoking cessation, and approaching all stakeholders systematically to ensure the broadest education and dissemination of screening benefits relative to risks. The incorporation of validated biomarkers of risk and preclinical lung cancer can substantially enhance the effectiveness screening programs. PMID:24451779

  10. Breast cancer screening: ''reassuring'' the worried well?

    DEFF Research Database (Denmark)

    Brodersen, John; Siersma, Volkert; Ryle, Mette

    2011-01-01

    of women offered screening compared to a population of women not offered screening for breast cancer. METHODS: One thousand women, aged 50-69 years, were randomly drawn from the Danish Civil Registration System to receive part I of the questionnaire Consequences of Screening in Breast Cancer (COS-BC1......): the sample consisted of 500 women living in a geographical area where screening mammography had been offered for more than 10 years and 500 women living in an area where the public health authorities had never invited women to breast cancer screening. RESULTS: A total of 759 women returned the questionnaire....... Those living in areas where screening was not offered reported more negative psychosocial aspects compared to women living in areas where screening was offered. CONCLUSIONS: The results indicate that women tend to perceive breast cancer screening as a reassuring preventive initiative. Alternatively...

  11. Screening for Psychosocial Risk in Pediatric Cancer

    OpenAIRE

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

    2012-01-01

    Major professional organizations have called for psychosocial risk screening to identify specific psychosocial needs of children with cancer and their families and facilitate the delivery of appropriate evidence-based care to address these concerns. However, systematic screening of risk factors at diagnosis is rare in pediatric oncology practice. Subsequent to a brief summary of psychosocial risks in pediatric cancer and the rationale for screening, this review identified three screening mode...

  12. Cancer screening in the United States, 2013: a review of current American Cancer Society guidelines, current issues in cancer screening, and new guidance on cervical cancer screening and lung cancer screening.

    Science.gov (United States)

    Smith, Robert A; Brooks, Durado; Cokkinides, Vilma; Saslow, Debbie; Brawley, Otis W

    2013-01-01

    Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are updated guidelines on cervical cancer screening and lung cancer screening with low-dose helical computed tomography. The latest data on the use of cancer screening from the National Health Interview Survey also are described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act of 2010.

  13. Developing a typology of African Americans with limited literacy based on preventive health practice orientation: implications for colorectal cancer screening strategies.

    Science.gov (United States)

    Gordon, Thomas F; Bass, Sarah Bauerle; Ruzek, Sheryl B; Wolak, Caitlin; Rovito, Michael J; Ruggieri, Dominique G; Ward, Stephanie; Paranjape, Anuradha; Greener, Judith

    2014-01-01

    Preventive health messages are often tailored to reach broad sociodemographic groups. However, within groups, there may be considerable variation in perceptions of preventive health practices, such as colorectal cancer screening. Segmentation analysis provides a tool for crafting messages that are tailored more closely to the mental models of targeted individuals or subgroups. This study used cluster analysis, a psychosocial marketing segmentation technique, to develop a typology of colorectal cancer screening orientation among 102 African American clinic patients between the ages of 50 and 74 years with limited literacy. Patients were from a general internal medicine clinic in a large urban teaching hospital, a subpopulation known to have high rates of colorectal cancer and low rates of screening. Preventive screening orientation variables included the patients' responses to questions involving personal attitudes and preferences toward preventive screening and general prevention practices. A k-means cluster analysis yielded three clusters of patients on the basis of their screening orientation: ready screeners (50.0%), cautious screeners (30.4%), and fearful avoiders (19.6%). The resulting typology clearly defines important subgroups on the basis of their preventive health practice perceptions. The authors propose that the development of a validated typology of patients on the basis of their preventive health perceptions could be applicable to a variety of health concerns. Such a typology would serve to standardize how populations are characterized and would provide a more accurate view of their preventive health-related attitudes, values, concerns, preferences, and behaviors. Used with standardized assessment tools, it would provide an empirical basis for tailoring health messages and improving medical communication. PMID:24673248

  14. Screening for breast cancer with mammography

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Jørgensen, Karsten Juhl

    2013-01-01

    A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary.......A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary....

  15. Lung cancer screening: the European perspective.

    Science.gov (United States)

    Veronesi, Giulia

    2015-05-01

    European studies have contributed significantly to the understanding of lung cancer screening. Smoking within screening, quality of life, nodule management, minimally invasive treatments, cancer prevention programs, and risk models have been extensively investigated by European groups. Mortality data from European screening studies have not been encouraging so far, but long-term results of the NELSON study are eagerly awaited. Investigations on molecular markers of lung cancer are ongoing in Europe; preliminary results suggest they may become an important screening tool in the future.

  16. Patient-initiated breast cancer screening

    International Nuclear Information System (INIS)

    This paper reviews the results of a breast cancer screening program sponsored by organizations at workplace or community locations. A comprehensive mobile breast cancer screening program, including education, breast physical examination, and mammography, was provided to 89 local organizations at $50.00 per examination over an 18-month period. The examination was patient initiated, following the ACS screening guidelines. Estimates of eligible women were provided by each organization. A total of 5,030 women at 89 organizations were screened for breast cancer. Approximately 25,727 women were eligible

  17. Cervical cancer screening in the Faroe Islands

    DEFF Research Database (Denmark)

    Hammer, Turið; Lynge, Elsebeth; Djurhuus, Gisela W;

    2015-01-01

    aim was to provide the first description of cervical cancer screening, and to determine the screening history of women diagnosed with cervical cancer in the Faroe Islands. MATERIAL AND METHODS: Screening data from 1996 to 2012 were obtained from the Diagnostic Centre at the National Hospital......BACKGROUND: The Faroe Islands have had nationally organised cervical cancer screening since 1995. Women aged 25-60 years are invited every third year. Participation is free of charge. Although several European overviews on cervical screening are available, none have included the Faroe Islands. Our...... 1999. At present, 7.0% of samples have abnormal cytology. Of all ASCUS samples, 76-95% were tested for HPV. A total of 58% of women diagnosed with cervical cancer did not participate in screening prior to their diagnosis, and 32% had normal cytology in the previous four years. CONCLUSION: Despite...

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

    Science.gov (United States)

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

    2016-01-01

    Each year the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines, including the update of the breast cancer screening guideline, discuss quality issues in colorectal cancer screening and new developments in lung cancer screening, and provide the latest data on utilization of cancer screening from the National Health Interview Survey.

  19. Cervical cancer: screening, diagnosis and staging.

    Science.gov (United States)

    Tsikouras, Panagiotis; Zervoudis, Stefanos; Manav, Bachar; Tomara, Eirini; Iatrakis, George; Romanidis, Constantinos; Bothou, Anastasia; Galazios, George

    2016-01-01

    Purpose: Despite the widespread screening programs, cervical cancer remains the third most common cancer in developing countries. Based on the implementation of cervical screening programs with the referred adoption of improved screening methods in cervical cytology with the knowledge of the important role of the human papilloma virus (HPV) it's incidence is decreased in the developed world. Even if cervical HPV infection is incredibly common, cervical cancer is relatively rare. Depending on the rarity of invasive disease and the improvement of detection of pre-cancerous lesions due to the participation in screening programs, the goal of screening is to detect the cervical lesions early in order to be treated before cancer is developed. In populations with many preventive screening programs, a decrease in cervical cancer mortality of 50-75% is mentioned over the past 50 years. The preventive examination of vagina and cervix smear, Pap test, and the HPV DNA test are remarkable diagnostic tools according to the American Cancer Association guidelines, in the investigation of asymptomatic women and in the follow up of women after the treatment of pre-invasive cervical cancer. The treatment of cervical cancer is based on the FIGO 2009 cervical cancer staging.

  20. Continuous quality improvement of colorectal cancer screening

    Institute of Scientific and Technical Information of China (English)

    Mariusz; Madalinski

    2013-01-01

    Quality assurance is a key issue in colorectal cancer screening, 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 cancer screening 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.

  1. To screen or nor to screen: the prostate cancer dilemma

    Directory of Open Access Journals (Sweden)

    Nelson N Stone

    2015-02-01

    Full Text Available The European Randomized Study of Screening for Prostate (ERSPC has updated their previous seminal report on prostate cancer mortality comparing screened men to controls. Now with 13 years follow-up, the rate ratio of prostate cancer mortality was 0.79 favoring the screened population. The authors concluded that there was a "substantial reduction in prostate cancer mortality attributable to testing with prostate-specific antigen (PSA" but they also stated that a "quantification of harms" needed to be addressed. The issue of harms was not addressed by the ERSPC (at least not in this report and hence this additional statement most likely reflects the controversy currently surrounding the risks associated with over-diagnosis and treatment of indolent diseases inadvertently detected by a screening protocol. [1] In addition, the positive results from this trial conflict with those of the prostate, lung, colorectal and ovarian (PLCO [2] study and require further elaboration.

  2. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  3. Environmental scan of anal cancer screening practices: worldwide survey results.

    Science.gov (United States)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-08-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening. PMID:24740973

  4. Screening for breast cancer post reduction mammoplasty

    International Nuclear Information System (INIS)

    Aim: To investigate whether remodelling of the breast after breast reduction surgery has an effect on mammographic cancer detection. Methods and materials: For women who attended population-based screening between January 1998 to December 2007, data were extracted on their age, history of previous breast reduction, and the result of screening (recall for further assessment, cancer, or no cancer). The number of cancers detected, recalls per 1000 screens and the characteristics of the cancers detected in the two groups was compared. Results: In total 244,147 women with 736,219 screening episodes were reviewed. In the 4743 women who had a breast reduction, 51 breast cancers were detected [age standardized rate (ASR) of 4.28 per 1000 screening episodes; 95% CI 3.11-5.46], compared with 4342 breast cancers in 239 404 women screened in the non-reduction group (ASR of 5.99 per 1000 screening episodes; 95% CI 5.81-6.16). There were fewer cancers in the breast reduction group with a relative risk of 0.71. There was no significant difference in the rate of recall between the two groups, with a crude recall rate of 46.1 per 1000 screening episodes post-breast reduction compared with 50.7 per 1000 screening episodes for women without breast reduction. There was no significant difference in the pathological type or location of the cancer between the two groups of women. Conclusion: Postoperative breast changes following reduction mammoplasty do not significantly hinder analysis of the screening mammogram.

  5. Improving cervical cancer screening rates in an urban HIV clinic.

    Science.gov (United States)

    Cross, Sara L; Suharwardy, Sanaa H; Bodavula, Phani; Schechtman, Kenneth; Overton, E Turner; Onen, Nur F; Lane, Michael A

    2014-01-01

    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 cancer screening 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 cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p screening rates in an urban academic HIV clinic.

  6. Cost-effectiveness of different reading and referral strategies in mammography screening in the Netherlands.

    NARCIS (Netherlands)

    Groenewoud, J.H.; Otten, J.D.M.; Fracheboud, J.; Draisma, G.; Ineveld, B.M. van; Holland, R.; Verbeek, A.L.M.; Koning, H.J. de

    2007-01-01

    In mammography screening with double reading, different strategies can be used when the readers give discordant recommendations for referral. We investigated whether the results of the Dutch breast cancer screening programme can be optimised by replacing the standard referral strategy by consensus.

  7. Lung Cancer Screening with Low Dose CT

    Science.gov (United States)

    Caroline, Chiles

    2014-01-01

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

  8. Role of prevention and screening in epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Peddireddi Reddi Rani

    2015-08-01

    Full Text Available Epithelial ovarian carcinoma is a disease with poor prognosis and high mortality among gynaecological cancers due to inaccessibility of ovary for inspection or sampling and lack of proper screening methods. Strategies to detect early ovarian cancer include estimation of serum CA-125 and transvaginal ultrasound (TVS for morphological index. Studies have shown that screening of asymptomatic average risk post-menopausal women did not show any benefit and are associated with false positive results which may lead to unnecessary surgery and resultant morbidity. The risks outweigh benefits. Present recommendation is to screen high risk women especially hereditary cancers and offer risk reducing surgery when needed. Prophylactic salpingectomy/oophorectomy may offer the opportunity to prevent ovarian cancer. More trials and more research in newer biomarkers are needed. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 941-946

  9. Factors influencing participation in breast cancer screening.

    Science.gov (United States)

    Edgar, Lynne; Glackin, Marie; Hughes, Caroline; Rogers, Katherine Mary Ann

    Despite the efficacy of mammography and the widespread promotion of screening programmes, a significant number of eligible women still do not attend for regular breast screening. An integrative review methodology was considered the most appropriate means to critically analyse the available literature pertaining to factors which influence participation in breast cancer screening. From the extensive literature search, 12 selected core research papers met the inclusion criteria and were incorporated in the literature review. Four themes emerged from the literature which impact on participation in mammography screening: psychological and practical issues, ethnicity issues, influence of socioeconomic status and issues related to screening programmes. The recent Independent Review Panel on Breast Cancer Screening endorsed the importance of access to information which clearly communicates the harms and benefits of breast screening to enable women to make informed decisions about their health. The recommendations from the panel and others have been included in this review. PMID:24067312

  10. The politics of prostate cancer screening.

    Science.gov (United States)

    Kaffenberger, Samuel D; Penson, David F

    2014-05-01

    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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  13. Reducing inequities in colorectal cancer screening in North America

    Directory of Open Access Journals (Sweden)

    Kathleen M Decker

    2014-01-01

    Full Text Available Colorectal cancer (CRC is an important cause of mortality and morbidity in North America. Screening using a fecal occult blood test, flexible sigmoidoscopy, or colonoscopy reduces CRC mortality through the detection and treatment of precancerous polyps and early stage CRC. Although CRC screening participation has increased in recent years, large inequities still exist. Minorities, new immigrants, and those with lower levels of education or income are much less likely to be screened. This review provides an overview of the commonly used tests for CRC screening, disparities in CRC screening, and promising methods at the individual, provider, and system levels to reduce these disparities. Overall, to achieve high CRC participation rates and reduce the burden of CRC in the population, a multi-faceted approach that uses strategies at all levels to reduce CRC screening disparities is urgently required.

  14. [Lung cancer screening - risk stratification : Who should undergo screening?].

    Science.gov (United States)

    Beer, L; Prosch, H

    2016-09-01

    Lung cancer is one of the leading causes of deaths in Europa and the USA. In approximately 75 % of lung cancer patients, bronchogenic carcinoma is detected at an advanced tumor stage; therefore, therapeutic options which aim at curing the disease in these patients are limited and treatment is mostly palliative. A relatively good prognosis is reserved for the minority of patients where the tumor is detected at an early stage and treatment is potentially curative. For this reason, early diagnosis of lung cancer could save lives. Retrospective analyses of the US national lung screening trial (NLST) showed that especially high-risk populations (e. g. higher age, positive smoking history, overweight and a positive family history for lung cancer) benefit most from lung cancer screening. Thus, the effectiveness of computed tomography (CT) screening can be improved by focusing on high-risk populations. This review article summarizes the risk stratification models of the large European and American screening studies and discusses possible future biomarkers for risk stratification. PMID:27495786

  15. Breast cancer screening implementation and reassurance

    DEFF Research Database (Denmark)

    Østerø, J; Siersma, Volkert Dirk; Brodersen, John

    2013-01-01

    difference in reported psychosocial aspects had disappeared or been reduced because of the nationwide screening implementation. METHODS: The 1000 women included in the previous survey were posted part I of the questionnaire Consequences of Screening in Breast Cancer (COS-BC1) in August 2011, nearly 5 years...

  16. Screening for Lynch syndrome in colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    刘晓红

    2014-01-01

    Objective To evaluate the application of mismatch repair(MMR)genes proteins expression to screen for Lynch syndrome in colorectal cancer patients.Methods One hundred consecutive colorectal cancers cases collected from 2012 to 2013 were tested immunohistochemically for the protein expression of MLH1,MSH2,MSH6 and PMS2,and also by the ARMS method for the mutation

  17. Oral cancer screening: serum Raman spectroscopic approach

    Science.gov (United States)

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

    2015-11-01

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

  18. Pancreatic cancer screening: state of the art.

    Science.gov (United States)

    Gemmel, Christian; Eickhoff, Axel; Helmstädter, Lars; Riemann, Jürgen F

    2009-02-01

    Pancreatic cancer is a devastating disease with a median survival of approximately 6 months after diagnosis. Many factors are associated with a worse outcome; examples include late diagnosis, low resection rate, aggressive tumor behavior and a lack of an effective chemotherapy regimen. Owing to the low prevalence of pancreatic cancer relative to the diagnostic accuracy of present detection methods and the absence of promising treatment modalities, even in early stages, it is currently neither advisable nor cost effective to screen the general population. Efforts are focused on early screening of selected high-risk-cohorts, who account for approximately 10% of patients with pancreatic cancer. These include patients with chronic pancreatitis, individuals with a family history of pancreatic cancer, patients with hereditary pancreatitis, Peutz-Jeghers syndrome, cystic fibrosis or familial atypical multiple mole melanoma. At present, a multimodal-screening approach of endoscopic ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography appears to be the most effective method to screen for pancreatic cancer in high-risk patients. Continued efforts are needed to elucidate effective testing to identify patients with nonhereditary risk factors who will benefit from screening protocols. A combined approach of serum markers, genetic markers and specific imaging studies may prove to be the future of pancreatic screening. PMID:19210116

  19. Magnetic resonance imaging for lung cancer screen

    OpenAIRE

    Wang, Yi-Xiang J.; Lo, Gladys G.; Yuan, Jing; Larson, Peder E.Z.; Zhang, Xiaoliang

    2014-01-01

    Lung cancer is the leading cause of cancer related death throughout the world. Lung cancer is an example of a disease for which a large percentage of the high-risk population can be easily identified via a smoking history. This has led to the investigation of lung cancer screening with low-dose helical/multi-detector CT. Evidences suggest that early detection of lung cancer allow more timely therapeutic intervention and thus a more favorable prognosis for the patient. The positive relationshi...

  20. Cervical Cancer Screening with HPV Test

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Stewart Massad, a professor in the Division of Gynecologic Oncology at Washington University in Saint Louis and a board member of the American Society for Colposcopy and Cervical Cancer Prevention (ASCCP), talks about cotesting with human papillomavirus (HPV) as part of a cervical cancer screening program.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  1. Screening for prostatic cancer. Investigational models

    DEFF Research Database (Denmark)

    Iversen, P; Torp-Pedersen, S T

    1991-01-01

    Prostatic cancer has a long natural history and a significant preclinical period, during which the disease is detectable. Thus, this common malignancy in males fulfills some of the most important criteria for initiating screening programs. However, the still enigmatic epidemiology also includes...... features of the disease, which make the possible gain from screening programs questionable. Thus, before embarking on expensive community or national screening programs, the beneficial effect of such an effort on morbidity and mortality must be demonstrated in large-scale trials comparing a screened...

  2. Attendance in cancer screening programmes in Italy

    Directory of Open Access Journals (Sweden)

    Grazia Grazzini

    2008-06-01

    Full Text Available

    Background: The European Community recommends mammography, cervical and colorectal cancer screening programmes. In Italy, cancer screening programmes have been included in the Basic Healthcare Parameters (Livelli Essenziali di Assistenza since 2001. Full national coverage of a population-based organized screening programme has been planned for in Italy and is being implemented. Since 2005, the Ministry of Health - Department of Prevention has formally charged The National Centre for Screening Monitoring (Osservatorio Nazionale Screening –ONS- with monitoring and promoting screening programmes nationwide. Participation of target populations is a key indicator of the impact and efficacy of a screening programme in reducing cancer mortality.

    Methods: Attendance of invitees is one of the indicators calculated every year in the quality control of Italian screening programmes. Data collection is organized by means of a structured questionnaire, sent by ONS to the referent for data collection in each Region, who then returns the completed questionnaires to the Regional Centre. Questionnaires are then sent to the National Centre. Logical and epidemiologic checks are performed at both levels. Every year ONS publishes reports on the results of the surveys. A feasibility study for a National data warehouse based on individual records is in progress. The national survey “Multiscopo sulle famiglie” and the Passi Study (Progetti delle Aziende Sanitarie per la Salute in Italia provided additional information regarding spontaneous preventive health care activities in the Italian population.

    Results: Mammography screening: In 2006, 78.2% of Italian women aged 50-69 lived in areas where organised screening was in place (theoretical extension, however, the distribution of the screening activity is not uniform (higher in Northern/Central Italy compared with Southern

  3. Breast cancer screening in Canada: a review

    International Nuclear Information System (INIS)

    Organized screening for breast cancer in Canada began in 1988 and has been implemented in all provinces and 2 of the 3 territories. Quality initiatives are promoted through national guidelines which detail best practices in various areas, including achieving quality through a client-service approach, recruitment and capacity, retention, quality of mammography, reporting, communication of results, follow-up and diagnostic workup, and program evaluation; it also offers detailed guidelines for the pathological examination and reporting of breast specimens. The Canadian Breast Cancer Data Base is a national breast cancer screening surveillance system whose objective is to collect information from provincial-screening programs. These data are used to monitor and evaluate the performance of programs and allow comparison with national and international results. A series of standardized performance indicators and targets for the evaluation of performance and quality of organized breast cancer screening programs have been developed from the data base. Although health care is a provincial responsibility in Canada, the collective reporting and comparison of results both nationally and internationally is beneficial in evaluating and refining both screening programs and individual radiologist performance. The results of Canadian performance indicators compare favourably with those of other well-established international screening programs. There are variations in performance indicators across the provinces and territories, but these differences are not extreme. (author)

  4. Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening

    NARCIS (Netherlands)

    Scholten, E.T.; Horeweg, N.; Koning, H.J. de; Vliegenthart, R.; Oudkerk, M.; Mali, W.P.; Jong, P.A. de

    2015-01-01

    OBJECTIVES: To analyse computed tomography (CT) findings of interval and post-screen carcinomas in lung cancer screening. METHODS: Consecutive interval and post-screen carcinomas from the Dutch-Belgium lung cancer screening trial were included. The prior screening and the diagnostic chest CT were re

  5. Using hair to screen for breast cancer

    Science.gov (United States)

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

    1999-03-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

    Lung cancer is the leading cause of cancer-related death worldwide. In 2011, the largest lung cancer screening trial worldwide, the US National Lung Screening Trial, published a 20% decrease in lung cancer-specific mortality in the computed tomography (CT)-screened group, compared with the group scr

  7. Screening history in women with cervical cancer in a Danish population-based screening program

    DEFF Research Database (Denmark)

    Kirschner, Benny; Poll, Susanne; Junge, Jette;

    2011-01-01

    The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer.......The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer....

  8. Evolving Recommendations on Prostate Cancer Screening.

    Science.gov (United States)

    Brawley, Otis W; Thompson, Ian M; Grönberg, Henrik

    2016-01-01

    Results of a number of studies demonstrate that the serum prostate-specific antigen (PSA) in and of itself is an inadequate screening test. Today, one of the most pressing questions in prostate cancer medicine is how can screening be honed to identify those who have life-threatening disease and need aggressive treatment. A number of efforts are underway. One such effort is the assessment of men in the landmark Prostate Cancer Prevention Trial that has led to a prostate cancer risk calculator (PCPTRC), which is available online. PCPTRC version 2.0 predicts the probability of the diagnosis of no cancer, low-grade cancer, or high-grade cancer when variables such as PSA, age, race, family history, and physical findings are input. Modern biomarker development promises to provide tests with fewer false positives and improved ability to find high-grade cancers. Stockholm III (STHLM3) is a prospective, population-based, paired, screen-positive, prostate cancer diagnostic study assessing a combination of plasma protein biomarkers along with age, family history, previous biopsy, and prostate examination for prediction of prostate cancer. Multiparametric MRI incorporates anatomic and functional imaging to better characterize and predict future behavior of tumors within the prostate. After diagnosis of cancer, several genomic tests promise to better distinguish the cancers that need treatment versus those that need observation. Although the new technologies are promising, there is an urgent need for evaluation of these new tests in high-quality, large population-based studies. Until these technologies are proven, most professional organizations have evolved to a recommendation of informed or shared decision making in which there is a discussion between the doctor and patient. PMID:27249774

  9. Imaging and screening in lung cancer

    Directory of Open Access Journals (Sweden)

    Matteo Giaj Levra

    2008-12-01

    Full Text Available Lung cancer is the main cause of death for neoplasia in the world. Hence it’s growing the necessity to investigate screening tests to detect tumoral lesions at the early stages: several trials have been performed to establish the best method, target and frequence of the screening to offer. CT, X-ray, PET, sputum citology and CAD software are here analyzed, together with the associated statistics and bias.

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

    Science.gov (United States)

    Yates, Teri

    2015-01-01

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

  11. Factors Influencing Colorectal Cancer Screening Participation

    Directory of Open Access Journals (Sweden)

    Antonio Z. Gimeno García

    2012-01-01

    Full Text Available 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.

  12. Cervical Cancer Screening in Underserved Populations

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Lisa Flowers, a specialist in human papillovarius (HPV)-related diseases and Director of Colposcopy at Emory University School of Medicine, talks about cervical cancer screening in underinsured or uninsured women.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  13. Colorectal cancer development and advances in screening

    OpenAIRE

    Simon K

    2016-01-01

    Karen Simon Ventura County Gastroenterology Medical Group, Inc., Camarillo, CA, USA Abstract: Most colon tumors develop via a multistep process involving a series of histological, morphological, and genetic changes that accumulate over time. This has allowed for screening and detection of early-stage precancerous polyps before they become cancerous in individuals at average risk for colorectal cancer (CRC), which may lead to substantial decreases in the incidence of CRC. Despite the known b...

  14. Costs Associated with Cervical Cancer Screening

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Tom Cox, a practicing gynecologist and president of the American Society of Colposcopy and Cervical Pathology, provides a brief introduction to cervical cancer screening guidelines and human papillomavirus (HPV) DNA testing.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  15. Knowledge of Breast Cancer and Screening Practices

    Science.gov (United States)

    Vahabi, Mandana

    2005-01-01

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

  16. Screening for prostatic cancer. Investigational models

    DEFF Research Database (Denmark)

    Iversen, P; Torp-Pedersen, S T

    1991-01-01

    Prostatic cancer has a long natural history and a significant preclinical period, during which the disease is detectable. Thus, this common malignancy in males fulfills some of the most important criteria for initiating screening programs. However, the still enigmatic epidemiology also includes...

  17. Risk-based prostate cancer screening

    NARCIS (Netherlands)

    X.D. Zhu (Xiaoye); P.C. Albertsen (Peter); G.L. Andriole (Gerald); M.J. Roobol-Bouts (Monique); F.H. Schröder (Fritz); A.J. Vickers (Andrew)

    2012-01-01

    textabstractContext: Widespread mass screening of prostate cancer (PCa) is not recommended because the balance between benefits and harms is still not well established. The achieved mortality reduction comes with considerable harm such as unnecessary biopsies, overdiagnoses, and overtreatment. There

  18. Screening for distress in cancer patients

    DEFF Research Database (Denmark)

    Grassi, Luigi; Johansen, Christoffer; Annunziata, Maria Antonietta;

    2013-01-01

    Routine screening for distress is internationally recommended as a necessary standard for good cancer care, given its high prevalence and negative consequences on quality of life. The objective of the current study was to contribute to the Italian validation of the Distress Thermometer (DT...

  19. European Breast Cancer Service Screening Outcomes

    DEFF Research Database (Denmark)

    Paci, Eugenio; Broeders, Mireille; Hofvind, Solveig;

    2014-01-01

    A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast...... seven to nine breast cancer deaths are avoided, four cases are overdiagnosed, 170 women have at least one recall followed by noninvasive assessment with a negative result, and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of a breast cancer...

  20. Reducing Barriers to Use of Breast Cancer Screening

    Science.gov (United States)

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

  1. Breast cancer screening controversies: who, when, why, and how?

    Science.gov (United States)

    Chetlen, Alison; Mack, Julie; Chan, Tiffany

    2016-01-01

    Mammographic screening is effective in reducing mortality from breast cancer. The issue is not whether mammography is effective, but whether the false positive rate and false negative rates can be reduced. This review will discuss controversies including the reduction in breast cancer mortality, overdiagnosis, the ideal screening candidate, and the optimal imaging modality for breast cancer screening. The article will compare and contrast screening mammography, tomosynthesis, whole-breast screening ultrasound, magnetic resonance imaging, and molecular breast imaging. Though supplemental imaging modalities are being utilized to improve breast cancer diagnosis, mammography still remains the gold standard for breast cancer screening.

  2. Prostate Cancer – To screen, or not to screen, is that the question?

    Directory of Open Access Journals (Sweden)

    Rosser Charles J

    2008-12-01

    Full Text Available Abstract There continues to be controversy regarding serum Prostate-Specific Antigen (PSA and prostate cancer screening. We anxiously await the results of two large prospective randomized clinical trials (Prostate, Lung, Colon, and Ovary-PCLO screening trial in the US and European Randomized Study of Screening for Prostate Cancer-ERSPC in Europe assessing the benefits of prostate cancer screening. However the true question to answer may be which cancer to treat and when should we treat it.

  3. Screening spectroscopy of prostate cancer

    Science.gov (United States)

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

    2015-11-01

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

  4. Screening history in women with cervical cancer in a Danish population-based screening program

    DEFF Research Database (Denmark)

    Kirschner, Benny; Poll, Susanne; Rygaard, Carsten;

    2011-01-01

    The aim of this study was to explore the screening histories of all cervical cancers in a Danish screening population. The intention was to decide suboptimal sides of the screening program and to evaluate the significance of routine screening in the development of cervical cancer....

  5. An Overview of Current Screening and Management Approaches for Prostate Cancer.

    Science.gov (United States)

    Akram, Omar N; Mushtaq, Gohar; Kamal, Mohammad Amjad

    2015-01-01

    Prostate cancer is the fourth leading cause of mortality in Australian men. The prevalence and incidence is increasing in both developed and developing nations, thus there is a need for better screening and management of this disorder. While there is no direct known cause of prostate cancer, management is largely focused on early detection and treatment strategies. Of particular concern is advanced prostate cancer which can manifest as castrate resistant prostate cancer characterized by therapy resistance. This short review outlines the global epidemiology of prostate cancer, clinical manifestations, risk factors, current screening strategies including first line clinical screening as well as the use of circulating biomarkers, and treatment of prostate cancer through mainstream therapeutics as well as the cutting edge peptide and nano-technology based therapeutics that are being implemented or in the process of development to overcome therapeutic obstacles in the treatment of prostate cancer.

  6. Cancer screening: Should cancer screening be essential component of primary health care in developing countries?

    Directory of Open Access Journals (Sweden)

    Saurabh Bobdey

    2015-01-01

    Conclusions: Our study highlights the availability and success of visual screening tools in early detection and mortality reduction of major neoplasia in resource-poor health care settings and recommends implementation of oral and cervical cancer screening as part of assured primary health care package in developing countries.

  7. Optimization of nodule management in CT lung cancer screening

    NARCIS (Netherlands)

    Heuvelmans, Marjolein Anne

    2015-01-01

    Lung cancer is the leading cancer-related cause of death. Through computed tomography (CT) screening, cancer can be detected at the earliest stage, with a much greater probability of cure. After the positive outcome of the US National Lung Screening Trial (NLST), screening with low-dose CT in heavy

  8. Photocarcinogenesis and Skin Cancer Prevention Strategies.

    Science.gov (United States)

    Seebode, Christina; Lehmann, Janin; Emmert, Steffen

    2016-03-01

    In this review the basic principles of UV-induced carcinogenesis are summarized and the state of the art diagnosis and therapeutic strategies are discussed. The prevalent keratinocyte-derived neoplasms of the skin are basal cell and squamous cell carcinomas. Cutaneous melanoma is less frequent but associated with high mortality. Common risk factors for all three tumor entities include sun exposure and DNA-repair deficiencies. Photocarcinogenesis follows a multistep model of cancer development in which ultraviolet-induced DNA damage leads to mutations resulting in activation of oncogenes or silencing of tumor-suppressor genes. This ends in a cellular mutator phenotype even more prone to mutation acquisition. DNA repair, especially the nucleotide excision repair (NER) pathway, counteracts mutation formation and skin cancer development. This is vividly demonstrated by the NER-defective disorder xeroderma pigmentosum. Primary skin cancer preventative strategies, therefore, include reduction of DNA photodamage by protection from the sun. Secondary preventative strategies include skin cancer screening. This implies standard examination techniques with the naked eye, an epiluminescence microscope, or digital epiluminescence microscopy. More advanced techniques include confocal laser scan microscopy. PMID:26977038

  9. Protein flexibility oriented virtual screening strategy for JAK2 inhibitors

    Science.gov (United States)

    Xiong, Xiao; Yuan, Haoliang; Zhang, Yanmin; Xu, Jinxing; Ran, Ting; Liu, Haichun; Lu, Shuai; Xu, Anyang; Li, Hongmei; Jiang, Yulei; Lu, Tao; Chen, Yadong

    2015-10-01

    JAK2 has been considered as an important target for the development of anti-cancer agents. In this study, considering the flexibility of its binding site, an integrated strategy combining Bayesian categorization modeling and ensemble docking was established. Four representative crystal structures were selected for ensemble docking by the hierarchical clustering of 34 crystal structures according to the volume overlaps of each structure. A retrospective virtual screening was performed to validate this integrated strategy. As the preliminary filtration, the Bayesian model enhanced the ratio of actives by reducing the large amount of decoys. After docking the remaining compounds, the comparison between the ensemble and individual results showed that the enrichment of ensemble docking improved significantly. The results of analysis on conformational changes of two top ranked active inhibitors when docking into different proteins indicated that compounds with flexible conformations well fitted the different binding site shapes were more likely to be potential JAK2 inhibitors. This high efficient strategy will facilitate virtual screening for novel JAK2 inhibitors and could be even applied in drug discovery against other targets.

  10. Genetic Screening for Familial Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Oliveira Carla

    2004-05-01

    Full Text Available Abstract Approximately 10% of gastric cancer cases show familial clustering but only 1-3% of gastric carcinomas arise as a result of inherited gastric cancer predisposition syndromes. Direct proof that Hereditary Gastric Cancer a genetic disease with a germline gene defect has come from the demonstration of co-segregation of germline E-cadherin (CDH1 mutations with early onset diffuse gastric cancer in families with an autosomal dominant pattern of inheritance (HDGC. E-cadherin is a transmembrane calcium-dependent cell-adhesion molecule involved in cell-junction formation and the maintenance of epithelial integrity. In this review, we describe frequency and type of CDH1 mutations in sporadic and familial gastric cancer. Further we demonstrate the functional significance of some CDH1 germline missense mutations found in HDGC. We also discuss the CDH1 polymorphisms that have been associated to gastric cancer. We report other types of malignancies associated to HDGC, besides diffuse gastric cancer. Moreover, we review the data available on putative alternative candidate genes screened in familial gastric cancer. Finally, we briefly discuss the role of low-penetrance genes and Helicobacter pylori in gastric cancer. This knowledge is a fundamental step towards accurate genetic counselling, in which a highly specialised pre-symptomatic therapeutic intervention should be offered.

  11. Personalized prostate cancer care: from screening to treatment.

    Science.gov (United States)

    Conran, Carly A; Brendler, Charles B; Xu, Jianfeng

    2016-01-01

    Unprecedented progress has been made in genomic personalized medicine in the last several years, allowing for more individualized healthcare assessments and recommendations than ever before. However, most of this progress in prostate cancer (PCa) care has focused on developing and selecting therapies for late-stage disease. To address this issue of limited focus, we propose a model for incorporating genomic-based personalized medicine into all levels of PCa care, from prevention and screening to diagnosis, and ultimately to the treatment of both early-stage and late-stage cancers. We have termed this strategy the "Pyramid Model" of personalized cancer care. In this perspective paper, our objective is to demonstrate the potential application of the Pyramid Model to PCa care. This proactive and comprehensive personalized cancer care approach has the potential to achieve three important medical goals: reducing mortality, improving quality of life and decreasing both individual and societal healthcare costs. PMID:27184548

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

    Directory of Open Access Journals (Sweden)

    Lent Barbara

    2011-09-01

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

  13. Fecal DNA Screening in Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Suzanne Richter

    2008-01-01

    Full Text Available Colorectal cancer (CRC is the third most common type of cancer diagnosed in Canada, and is the leading cause of cancer-related deaths in nonsmokers. Although CRC is considered to be 90% curable if detected early, the majority of patients present with advanced stage III or IV disease. An effective screening test may significantly decrease disease burden. The present paper examines the rationale and potential of fecal DNA testing as an alternative and adjunct to other CRC screening tests. The most efficacious fecal DNA test developed to date has a sensitivity and specificity of 87.5% and 82%, respectively. The approach has a higher positive predictive value than the currently used fecal occult blood test and offers a noninvasive option to patients. It is not reliant on the presence of bleeding, which may be intermittent or altogether absent. The test is now commercially available and is supported by a number of American insurers. Current challenges include cost reduction and demonstration of mortality benefit in a rigorous clinical trial. Despite current challenges, fecal DNA testing is worth pursuing. Both the American Gastroenterological Society and the American Cancer Society maintain that molecular testing is in its infancy but is promising. Fecal DNA testing has the potential to be an exciting addition to the current armament of CRC screening options.

  14. Arab women's breast cancer screening practices: a literature review.

    Science.gov (United States)

    Donnelly, Tam Truong; Khater, Al-Hareth Al; Al-Bader, Salha Bujassoum; Al Kuwari, Mohammed Ghaith; Al-Meer, Nabila; Malik, Mariam; Singh, Rajvir; Jong, Floor Christie-de

    2013-01-01

    Breast cancer incidence and mortality rates are increasing in the Arab world and the involved women are often diagnosed at advanced stages of breast cancer. This literature review explores factors influencing Arab women's breast cancer screening behavior. Searched databases were: Medline, PubMed, Cochrane Database of Systematic Reviews, CINAHL Plus, Google Scholar, Index Medicus for WHO Eastern Mediterranean, and Asian Pacific Journal of Cancer Prevention. Breast cancer screening participation rates are low. Screening programs are opportunistic and relatively new to the region. Knowledge amongst women and health care providers, professional recommendation, socio-demographic factors, cultural traditions, beliefs, religious, social support, accessibility and perceived effectiveness of screening influence screening behavior.

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

    Science.gov (United States)

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

    2015-03-01

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

  16. Stewardship and cancer screening programs in Italy

    OpenAIRE

    Cristine Marie Novinskey; Antonio Federici

    2011-01-01

    As one of the four major functions of health systems, Stewardship is on the health agenda of several countries worldwide. There is, however, little empirical evidence to support or guide its implementation. To help bridge this gap, the paper aims to contribute to the empirical evidence for health system stewardship and, importantly, to offer implementers an explanatory example of what it could mean in practice. It achieves this by analyzing the experience of the Italian Cancer Screening Progr...

  17. Fecal Molecular Markers for Colorectal Cancer Screening

    Directory of Open Access Journals (Sweden)

    Rani Kanthan

    2012-01-01

    Full Text Available 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.

  18. Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

    Institute of Scientific and Technical Information of China (English)

    Juan Yang; Wen-Qiang Wei; Jin Niu; Zhi-Cai Liu; Chun-Xia Yang; You-Lin Qiao

    2012-01-01

    AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer (EC) in high-risk areas of China.METHODS:Markov model-based analyses were conducted to compare the net present values (NPVs) and the benefit-cost ratios (BCRs) of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data.RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV (international dollar-I$55 million) and BCR (2.52).Screening six times between 40-70 years at a 5-year interval [i.e.,six times(40)f-strategy] yielded the highest NPV (I$99 million) and BCR (3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR.CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.

  19. Spatial Heterogeneity in Cancer Control Planning and Cancer Screening Behavior.

    Science.gov (United States)

    Mobley, Lee R; Kuo, Tzy-Mey; Urato, Matthew; Subramanian, Sujha; Watson, Lisa; Anselin, Luc

    2012-01-01

    Each state is autonomous in its comprehensive cancer control (CCC) program, and considerable heterogeneity exists in the program plans. However, researchers often focus on the concept of nationally representative data and pool observations across states using regression analysis to come up with average effects when interpreting results. Due to considerable state autonomy and heterogeneity in various dimensions-including culture, politics, historical precedent, regulatory environment, and CCC efforts-it is important to examine states separately and to use geographic analysis to translate findings in place and time. We used 100 percent population data for Medicare-insured persons aged 65 or older and examined predictors of breast cancer (BC) and colorectal cancer (CRC) screening from 2001-2005. Examining BC and CRC screening behavior separately in each state, we performed 100 multilevel regressions. We summarize the state-specific findings of racial disparities in screening for either cancer in a single bivariate map of the 50 states, producing a separate map for African American and for Hispanic disparities in each state relative to whites. The maps serve to spatially translate the voluminous regression findings regarding statistically significant disparities between whites and minorities in cancer screening within states. Qualitative comparisons can be made of the states' disparity environments or for a state against a national benchmark using the bivariate maps. We find that African Americans in Michigan and Hispanics in New Jersey are significantly more likely than whites to utilize CRC screening and that Hispanics in 6 states are significantly and persistently more likely to utilize mammography than whites. We stress the importance of spatial translation research for informing and evaluating CCC activities within states and over time. PMID:24944346

  20. The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

    NARCIS (Netherlands)

    Heuvelmans, Marjolein A.; Oudkerk, Matthijs; de Jong, Pim A.; Mali, Willem P.; Groen, Harry J. M.; Vliegenthart, Rozemarijn

    2015-01-01

    OBJECTIVE: To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. METHODS: In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust s

  1. Cost-effectiveness of cervical cancer screening: comparison of screening policies

    NARCIS (Netherlands)

    M.E. van den Akker-van Marle; M. van Ballegooijen (Marjolein); G.J. van Oortmarssen (Gerrit); R. Boer (Rob); J.D.F. Habbema (Dik)

    2002-01-01

    textabstractBACKGROUND: Recommended screening policies for cervical cancer differ widely among countries with respect to targeted age range, screening interval, and total number of scheduled screening examinations (i.e., Pap smears). We compared the efficiency of cervical cancer-sc

  2. Randomization to screening for prostate, lung, colorectal and ovarian cancers and thyroid cancer incidence in two large cancer screening trials.

    Directory of Open Access Journals (Sweden)

    Thomas J O'Grady

    Full Text Available Thyroid cancer incidence has increased significantly over the past three decades due, in part, to incidental detection. We examined the association between randomization to screening for lung, prostate, colorectal and/or ovarian cancers and thyroid cancer incidence in two large prospective randomized screening trials.We assessed the association between randomization to low-dose helical CT scan versus chest x-ray for lung cancer screening and risk of thyroid cancer in the National Lung Screening Trial (NLST. In the Prostate Lung Colorectal and Ovarian Cancer Screening Trial (PLCO, we assessed the association between randomization to regular screening for said cancers versus usual medical care and thyroid cancer risk. Over a median 6 and 11 years of follow-up in NLST and PLCO, respectively, we identified 60 incident and 234 incident thyroid cancer cases. Cox proportional hazards regression was used to calculate the cause specific hazard ratios (HR and 95% confidence intervals (CI for thyroid cancer.In NLST, randomization to lung CT scan was associated with a non-significant increase in thyroid cancer risk (HR = 1.61; 95% CI: 0.96-2.71. This association was stronger during the first 3 years of follow-up, during which participants were actively screened (HR = 2.19; 95% CI: 1.07-4.47, but not subsequently (HR = 1.08; 95% CI: 0.49-2.37. In PLCO, randomization to cancer screening compared with usual care was associated with a significant decrease in thyroid cancer risk for men (HR = 0.61; 95% CI: 0.49-0.95 but not women (HR = 0.91; 95% CI: 0.66-1.26. Similar results were observed when restricting to papillary thyroid cancer in both NLST and PLCO.Our study suggests that certain medical encounters, such as those using low-dose helical CT scan for lung cancer screening, may increase the detection of incidental thyroid cancer.

  3. Randomization to Screening for Prostate, Lung, Colorectal and Ovarian Cancers and Thyroid Cancer Incidence in Two Large Cancer Screening Trials

    Science.gov (United States)

    O'Grady, Thomas J.; Kitahara, Cari M.; DiRienzo, A. Gregory; Boscoe, Francis P.; Gates, Margaret A.

    2014-01-01

    Background Thyroid cancer incidence has increased significantly over the past three decades due, in part, to incidental detection. We examined the association between randomization to screening for lung, prostate, colorectal and/or ovarian cancers and thyroid cancer incidence in two large prospective randomized screening trials. Methods We assessed the association between randomization to low-dose helical CT scan versus chest x-ray for lung cancer screening and risk of thyroid cancer in the National Lung Screening Trial (NLST). In the Prostate Lung Colorectal and Ovarian Cancer Screening Trial (PLCO), we assessed the association between randomization to regular screening for said cancers versus usual medical care and thyroid cancer risk. Over a median 6 and 11 years of follow-up in NLST and PLCO, respectively, we identified 60 incident and 234 incident thyroid cancer cases. Cox proportional hazards regression was used to calculate the cause specific hazard ratios (HR) and 95% confidence intervals (CI) for thyroid cancer. Results In NLST, randomization to lung CT scan was associated with a non-significant increase in thyroid cancer risk (HR  = 1.61; 95% CI: 0.96–2.71). This association was stronger during the first 3 years of follow-up, during which participants were actively screened (HR  = 2.19; 95% CI: 1.07–4.47), but not subsequently (HR  = 1.08; 95% CI: 0.49–2.37). In PLCO, randomization to cancer screening compared with usual care was associated with a significant decrease in thyroid cancer risk for men (HR  = 0.61; 95% CI: 0.49–0.95) but not women (HR  = 0.91; 95% CI: 0.66–1.26). Similar results were observed when restricting to papillary thyroid cancer in both NLST and PLCO. Conclusion Our study suggests that certain medical encounters, such as those using low-dose helical CT scan for lung cancer screening, may increase the detection of incidental thyroid cancer. PMID:25192282

  4. Obesity and Cancer Screening according to Race and Gender

    Directory of Open Access Journals (Sweden)

    Heather Bittner Fagan

    2011-01-01

    Full Text Available The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC screening, the relationship between weight and screening in men is inconsistent, while there is a trend towards lower CRC screening in higher weight women.

  5. Prostate cancer screening with PSA: new data, old debate

    Directory of Open Access Journals (Sweden)

    Stefania Sciallero

    2011-12-01

    Full Text Available Two prostate cancer screening randomised controlled trials from Europe (European Randomised Study of Screening for Prostate Cancer—ERSPC and U.S. (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Program— PLCO have been published earlier this year...

  6. Overdiagnosis in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

    Puliti, Donella; Duffy, Stephen W; Miccinesi, Guido;

    2012-01-01

    Overdiagnosis, the detection through screening of a breast cancer that would never have been identified in the lifetime of the woman, is an adverse outcome of screening. We aimed to determine an estimate range for overdiagnosis of breast cancer in European mammographic service screening programmes....

  7. [Cervical cancer screening in Switzerland - current practice and future challenges].

    Science.gov (United States)

    Untiet, Sarah; Schmidt, Nicole; Low, Nicola; Petignat, Patrick

    2013-04-01

    At the beginning of the 20th Century, cervical cancer was the leading cause of death from cancer in women. A marked decline in cervical cancer has been observed since the 1960s, in parallel with the introduction of the Papanicolau (Pap) test as a cytological screening method. Today, Pap smear screening is still the most widely used tool for cervical cancer prevention. Testing for human papillomavirus (HPV) in cervical specimens or a combination of Pap and HPV testing are also now available. In this article we compare current guidelines for cervical cancer screening in Switzerland with those in other European countries. In view of the opportunities offered by HPV testing and, since 2008, HPV vaccination, current guidelines for cervical cancer screening should be updated. Both the choice of screening tests and general organization of cervical cancer screening should be reviewed.

  8. Media Use and the Cancer Communication Strategies of Cancer Survivors

    Science.gov (United States)

    Yoon, Heesoo; Sohn, Minsung; Jung, Minsoo

    2016-01-01

    Communication related to health not only substantially affects perceptions and behaviors related to health but is also positively associated with the extent of health-information seeking and the practice of preventive behavior. Despite the fact that the number of cancer survivors has increased dramatically, there are few studies of the lack of health information, factors which act as barriers, and the difficulties in follow-up care experienced by cancer survivors. Therefore, we reviewed media utilization and the types of media used by cancer survivors with regard to risk communication and suggested appropriate strategies for cancer communication. According to the results, health communication contributed to health promotion by providing health-related information, consolidating social support factors such as social solidarity and trust, and reducing anxiety. In particular, participatory health communication may establish preventive programs which reflect the needs of communities, expand accessibility to better quality healthcare, and intensify healthy living by reducing health inequalities. Therefore, when people do not have an intention to obtain cancer screening, we need to intervene to change their behavior, norms, and degrees of self-efficacy. The findings of this study may help those involved in building partnerships by assisting in their efforts to understand and communicate with the public.

  9. Population-based screening for cancer: hope and hype.

    Science.gov (United States)

    Shieh, Yiwey; Eklund, Martin; Sawaya, George F; Black, William C; Kramer, Barnett S; Esserman, Laura J

    2016-09-01

    Several important lessons have been learnt from our experiences in screening for various cancers. Screening programmes for cervical and colorectal cancers have had the greatest success, probably because these cancers are relatively homogenous, slow-growing, and have identifiable precursors that can be detected and removed; however, identifying the true obligate precursors of invasive disease remains a challenge. With regard to screening for breast cancer and for prostate cancer, which focus on early detection of invasive cancer, preferential detection of slower-growing, localized cancers has occurred, which has led to concerns about overdiagnosis and overtreatment; programmes for early detection of invasive lung cancers are emerging, and have faced similar challenges. A crucial consideration in screening for breast, prostate, and lung cancers is their remarkable phenotypic heterogeneity, ranging from indolent to highly aggressive. Efforts have been made to address the limitations of cancer-screening programmes, providing an opportunity for cross-disciplinary learning and further advancement of the science. Current innovations are aimed at identifying the individuals who are most likely to benefit from screening, increasing the yield of consequential cancers on screening and biopsy, and using molecular tests to improve our understanding of disease biology and to tailor treatment. We discuss each of these concepts and outline a dynamic framework for continuous improvements in the field of cancer screening. PMID:27071351

  10. Lung cancer screening by low-dose spiral computed tomography

    NARCIS (Netherlands)

    van Klaveren, RJ; Habbema, JDF; Pedersen, JH; de Koning, HJ; Oudkerk, M; Hoogsteden, HC

    2001-01-01

    The poor prognosis of lung cancer has barely changed in the last decades, but the prognosis is better when the disease is detected earlier. Lung cancer screening by chest radiography did not lead to a decrease in lung cancer mortality, presumably because the chest radiograph is a poor screening tool

  11. Breast cancer mortality in mammographic screening in Europe

    DEFF Research Database (Denmark)

    Njor, Sisse Helle; Nyström, Lennarth; Moss, Sue;

    2012-01-01

    To estimate the impact of service mammography screening on breast cancer mortality using European incidence-based mortality (IBM) studies (or refined mortality studies). IBM studies include only breast cancer deaths occurring in women with breast cancer diagnosed after their first invitation to...... screening....

  12. Population based screening for prostate cancer : tumor characteristics

    NARCIS (Netherlands)

    I.W. van der Cruijsen (Ingrid W)

    2008-01-01

    markdownabstract__Abstract__ The European Randomized study of Screening for Prostate Cancer is a multi-centre randomized controlled trial to examine whether screening for prostate cancer has an effect on prostate cancer mortality. The total study cohort consists of 268.000 men in eight different Eu

  13. Radiation doses to screened women in the Norwegian Breast Cancer Screening Program in 2005 and 2006

    International Nuclear Information System (INIS)

    The radiographers report exposure data for approximately 50 women annually to the Norwegian Radiation Protection Authority. Based on reported data from all laboratories involved in the Norwegian Breast Cancer Screening Program average glandular dose (AGD) to the screened. (author)

  14. Most Breast Cancer Screening Trials Have a Flawed Design

    OpenAIRE

    Gurnani, Nishant; Srivastava, Anurag

    2011-01-01

    In the present article, we discuss that why most breast cancer screening trials have a flawed origin. We suggest some solutions to correct these flaws so that more valid and reliable screening trials can be conducted in the future.

  15. Data on Medicare eligibility and cancer screening utilization

    Directory of Open Access Journals (Sweden)

    Christian P. Meyer

    2016-06-01

    Full Text Available Health insurance is associated with increased utilization of cancer screening services. Data on breast, prostate and colorectal cancer screening were abstracted from the 2012 Behavioral Risk Factor and Surveillance System. This data in brief includes two sets of analyses: (i the use of cancer screening in individuals within the low-income bracket and (ii determinants for each of the three approaches to colorectal cancer screening (fecal occult blood test, colonoscopy and sigmoidoscopy+fecal occult blood test. Covariates included education attainment, residency, and access to health care provider. The data supplement our original research article on the effect of Medicare eligibility on cancer screening utilization “The impact of Medicare eligibility on cancer screening behaviors” [1].

  16. Patient–provider discussions about lung cancer screening: Results from the 2012/2013 Kansas Adult Tobacco Survey

    Directory of Open Access Journals (Sweden)

    Austin R. Rogers

    2015-01-01

    Conclusions: The current study is unique as it is the first to assess patient–provider discussions about lung cancer screening using a statewide survey. These results may inform strategies to increase patient–provider discussions about lung cancer screening among high risk Kansans.

  17. The Effect of National Cancer Screening on Disparity Reduction in Cancer Stage at Diagnosis by Income Level.

    Directory of Open Access Journals (Sweden)

    Hye-Min Jung

    Full Text Available Early detection of cancer is an effective and efficient cancer management strategy. In South Korea, the National Health Insurance administers the National Cancer Screening Program to its beneficiaries. We examined the impact of the National Cancer Screening Program on socioeconomic disparities in cancer stage at diagnosis.Cancer patients registered in the Korean Central Cancer Registry from January 1, 2010 to December 31, 2010 with a diagnosis of gastric cancer (n = 22,470, colon cancer (n = 16,323, breast cancer (n = 10,076, or uterine cervical cancer (n = 2,447 were included. Income level was divided into three groups according to their monthly contribution of National Health Insurance. We employed absolute (age-standardized prevalence rate, slope index of inequality and relative (relative index of inequality measures to separately examine social disparities among participants and non-participants of the National Cancer Screening Program in terms of the early-stage rate.Age-standardized prevalence rates of early-stage by income group were always higher in participants than in non-participants. Furthermore, the age-standardized prevalence rate of early-stage in the low income group of the participants was also higher than that of the high income group of the non-participants. The sizes of disparities (both slope index of inequality and relative index of inequality are smaller in participants compared to non-participants.National Cancer Screening Program participation reduced income disparity in cancer stage at diagnosis. Population-based cancer screening programs can be used as an effective measure to reduce income disparity in cancer care.

  18. European randomized lung cancer screening trials: Post NLST

    DEFF Research Database (Denmark)

    Field, JK; Klaveren, R; Pedersen, JH;

    2013-01-01

    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 ......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...

  19. Intermittent attendance at breast cancer screening

    Directory of Open Access Journals (Sweden)

    Padraic Fleming

    2013-09-01

    Full Text Available Background. To determine why women skip rounds and factors influencing return of previous non attenders (PNAs to breast screening. Design and methods. Retrospective, quantitative, structured questionnaire posted to 2500 women. First PNAs did not attend their first screening appointment in 2007/2008 but then attended in 2010; First Controls first attended in 2010 without missed previous appointments. Women who attended screening in 2006 or earlier then skipped a round but returned in 2010 were Subsequent PNAs; Subsequent Controls attended all appointments.Results. More First Controls than First PNAs had family history of cancer (72.7% vs 63.2%; P=0.003; breast cancer (31.3% vs 24.8%; P=0.04. More PNAs lived rurally; more First PNAs had 3rd level education (33.2% vs 23.6%; P=0.002 and fewer had private insurance than First Controls (57.7% vs 64.8%; P=0.04. Excellent/good health was reported in First PNAs and First Controls (82.9% vs 83.2%, but fewer Subsequent PNAs than Subsequent Controls (72.7% vs 84.9%; P=0.000. Common considerations at time of missed appointment were had mammogram elsewhere (33% First PNA and postponed to next round (16% First PNA, 18.8% Subsequent PNA. Considerations when returning to screening were similar for First PNAs and Subsequent PNAs: I am older (35.4%, 29.6%, I made sure I remembered (29%, 23.6%, could reschedule (17.6%, 20.6%, illness of more concern (16.5%, 19%. More First PNAs stated my family/friends advised (22.3% vs 15.2% or my GP (12.6% vs 4.6% advised me to attend, heard good things about BreastCheck (28.8% vs 13.6%.Conclusions. Intermittent attenders do not fit socio-demographic patterns of non-attenders; GP recommendation and word of mouth were important in women’s return to screening. Fear and anxiety seem to act as a screening facilitator rather than an inhibitor.

  20. Public Awareness of Colorectal Cancer Screening: Knowledge, Attitudes, and Interventions for Increasing Screening Uptake

    Science.gov (United States)

    Gimeno Garcia, Antonio Z.; Hernandez Alvarez Buylla, Noemi; Nicolas-Perez, David; Quintero, Enrique

    2014-01-01

    Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancer screening has proven its benefit in terms of incidence and mortality reduction in randomized controlled trials. In fact, it has been recommended by medical organizations either in average-risk or family-risk populations. Success of a screening campaign highly depends on how compliant the target population is. Several factors influence colorectal cancer screening uptake including sociodemographics, provider and healthcare system factors, and psychosocial factors. Awareness of the target population of colorectal cancer and screening is crucial in order to increase screening participation rates. Knowledge about this disease and its prevention has been used across studies as a measurement of public awareness. Some studies found a positive relationship between knowledge about colorectal cancer, risk perception, and attitudes (perceived benefits and barriers against screening) and willingness to participate in a colorectal cancer screening campaign. The mentioned factors are modifiable and therefore susceptible of intervention. In fact, interventional studies focused on average-risk population have tried to increase colorectal cancer screening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancer screening and interventions targeting participants for increasing screening uptake. PMID:24729896

  1. Cost-effective mammography screening in Korea. High incidence of breast cancer in young women

    International Nuclear Information System (INIS)

    The epidemiological characteristics of breast cancer in Korean women are different from the characteristics reported in Western women. The highest incidence rate occurs in Korean women in their 40s. The purpose of this study was to determine the most cost-effective screening interval and target age range for Korean women from the perspective of the national healthcare system. A stochastic model was used to simulate breast cancer screenings by varying both the screening intervals and the age ranges. The effectiveness of mammography screening was defined as the probability of detecting breast cancer in the preclinical state and the cost was based on the direct cost of mammography screening and the confirmative tests. The age-specific mean sojourn times and the sensitivity of the mammography were applied in the stochastic model. An optimal cost-effectiveness was determined by the incremental cost-effectiveness ratio and lifetime schedule sensitivity. Sensitivity analyses were undertaken to assess parameter uncertainty. The selected cost-effective strategies were: the current biennial mammography screenings for women who are at least 40 years old; biennial screening for women between the ages of 35 and 75 years; and a combination strategy consisting of biennial screening for women aged between 45 and 54 years, and 3-year interval screening for women aged between 40 and 44 years and 55 and 65 years. Further studies should follow to investigate the effectiveness of mammography screening in women younger than 40 years in Asia as well as in Korea. (author)

  2. Genetic alterations in sporadic and hereditary colorectal cancer: implementations for screening and follow-up.

    Science.gov (United States)

    Souglakos, John

    2007-01-01

    The genetics underlying an inherited predisposition to cancer are rapidly being uncovered. This fact may ultimately lead to the routine use of molecular tools to diagnose these disorders, and establish interventions to prevent the development of cancer. Among the multiple cancer family syndromes, several are known to be associated with the development of colon cancer. These disorders may be diagnosed during evaluation of the index patient or during screening of family members who are at risk. Although the effectiveness of screening and surveillance strategies is unproven in controlled clinical trials for any of these syndromes, the high cancer risk warrants screening, and reasonable recommendations can be made. Several other genetic syndromes are associated with gastrointestinal polyposis. The risk of colon cancer in these diseases is uncertain, and may not be increased and they are not mentioned in this review. Examples include Cowden disease, intestinal ganglioneuromatosis, Ruvalcaba-Myhre-Smith syndrome, Devon family syndrome, and Cronkite-Canada syndrome. PMID:17384504

  3. Colorectal cancer screening awareness among physicians in Greece

    Directory of Open Access Journals (Sweden)

    Chatzimichalis Georgios

    2006-06-01

    Full Text Available Abstract Background Data comparison between SEER and EUROCARE database provided evidence that colorectal cancer survival in USA is higher than in European countries. Since adjustment for stage at diagnosis markedly reduces the survival differences, a screening bias was hypothesized. Considering the important role of primary care in screening activities, the purpose of the study was to investigate the colorectal cancer screening awareness among Hellenic physicians. Methods 211 primary care physicians were surveyed by mean of a self-reported prescription-habits questionnaire. Both physicians' colorectal cancer screening behaviors and colorectal cancer screening recommendations during usual check-up visits were analyzed. Results Only 50% of physicians were found to recommend screening for colorectal cancer during usual check-up visits, and only 25% prescribed cost-effective procedures. The percentage of physicians recommending stool occult blood test and sigmoidoscopy was 24% and 4% respectively. Only 48% and 23% of physicians recognized a cancer screening value for stool occult blood test and sigmoidoscopy. Colorectal screening recommendations were statistically lower among physicians aged 30 or less (p = 0.012. No differences were found when gender, level and type of specialization were analyzed, even though specialists in general practice showed a trend for better prescription (p = 0.054. Conclusion Contemporary recommendations for colorectal cancer screening are not followed by implementation in primary care setting. Education on presymptomatic control and screening practice monitoring are required if primary care is to make a major impact on colorectal cancer mortality.

  4. Pancreatic Cancer and Cancer Screening Programs: From Nihilism to Hope

    Directory of Open Access Journals (Sweden)

    Raffaele Pezzilli

    2010-11-01

    Full Text Available The most common incipit of papers published regarding exocrine pancreatic neoplasms is that pancreatic cancer is one of the most lethal cancers, with a rate of incidence equal to that of mortality. Pancreatic cancer is a heterogeneous group of neoplasms in which pancreatic ductal adenocarcinoma is the most common. For the most part, the problems related to the early diagnosis of pancreatic adenocarcinoma are three: 1 to better understand the biology of this tumor; 2 to better investigate the precursors of this tumor; and 3 to plan projects for pancreatic cancer screening in high-risk individuals. Recently, Yachida et al. [1] performed rapid autopsies on seven individuals with Stage IV pancreatic cancer and they found that the clonal populations which give rise to distant metastases are represented within the primary carcinoma, but these clones are genetically evolved from the original parental, non-metastatic clone. Thus, the genetic heterogeneity of the metastases reflects that of the primary carcinoma. Most important, when the authors performed a quantitative analysis of the timing of the genetic evolution of pancreatic cancer, they found that there was at least a decade between the occurrence of the initial mutation and the birth of the parental, non-metastatic founder cell. At least five more years are required for the acquisition of metastatic ability and patients die an average two years thereafter. As underscored by the authors, these data have an important implication in planning population screening for the purpose of preventing pancreatic cancer deaths: in fact, quantitative analysis indicated a large window, of at least a decade, in which the disease could be diagnosed while it is still in the curative stage. This model also predicts an average of 6.8 years between the birth of the cell giving rise to the parental clone and the seeding of the index metastasis.

  5. Are Fewer Cervical Cancer Screenings Needed After HPV Vaccine?

    Science.gov (United States)

    ... html Are Fewer Cervical Cancer Screenings Needed After HPV Vaccine? Less testing could reduce risk of false positives ... said. Women vaccinated with earlier versions of the HPV vaccine -- which protect against the two worst cancer-causing ...

  6. Epidemiology, aetiology, diagnosis and screening of lung cancer

    International Nuclear Information System (INIS)

    Lung cancer is the leading cause of cancer death globally. Smoking causes about 90 % of all lung cancer cases. Passive, i.e. involuntary smoking has been confirmed to enhance the risk of lung cancer in exposed people. Individual susceptibility is one of important factors in lung cancer formation. New knowledge in epidemiology and aetiology of lung cancer gives new possibilities in diagnostic and screening of this disease. Results of large randomised trials aimed at new technologies in lung cancer screening will be available in a few years. (author)

  7. Breast cancer screening in British Columbia: implications of diagnostic trajectories

    OpenAIRE

    McKay, Rachel

    2008-01-01

    Despite reductions in mortality rates, breast cancer remains the most common cancer and the second most common cause of cancer death in Canadian women. Organized screening programs have contributed to the decrease in breast cancer mortality by allowing for early diagnosis and treatment. The diagnostic phase following an abnormal screen has implications for patient well-being, clinical practice, and resource management in health care. We present data from British Columbia that show that improv...

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

    Directory of Open Access Journals (Sweden)

    Belinda F. Morrison

    2016-01-01

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

  9. Results and analysis of screening for breast cancer

    International Nuclear Information System (INIS)

    Breast cancer is the most frequent cause of death in most countries of the world. Screening of asymptomatic women can detect a large percentage of cancers at an early stage. This is the basis for a possible cure or at least a prolongation of the survival time. The percentage of minimal cancers (smaller than 1 cm without dissemination) may be as high as 48% depending on the screening modality (10% without screening), axillary lymph node involvement can be reduced to 20% (40% without screening), and the percentage of stage II to IV cancers can be reduced to 8-20% (60% without screening). Mortality in the study group over age 50 years was reduced by 30%. Disadvantages of screening are: high cost; biopsies prompted by false positive results; psychological stress for the patients; radiation hazards which have, however, become almost negligible thanks to improved technique (2 cancers in 1 million mammographies and year). (Author)

  10. Hereditary pancreatitis and secondary screening for early pancreatic cancer.

    Science.gov (United States)

    Vitone, L J; Greenhalf, W; Howes, N R; Neoptolemos, J P

    2005-01-01

    Hereditary pancreatitis is an autosomal dominant disease with incomplete penetrance (80%), accounting for approximately 1% of all cases of pancreatitis. It is characterized by the onset of recurrent attacks of acute pancreatitis in childhood and frequent progression to chronic pancreatitis. Whitcomb et al. identified the cationic trypsinogen gene (PRSS1) on chromosome 7q35 as the site of the mutation that causes hereditary pancreatitis. The European registry of hereditary pancreatitis and familial pancreatic cancer (EUROPAC) aims to identify and make provisions for those affected by hereditary pancreatitis and familial pancreatic cancer. The most common mutations in hereditary pancreatitis are R122H, N29I and A16V but many families have been described with clinically defined hereditary pancreatitis where there is no PRSS1 mutation. It is known that the cumulative lifetime risk (to age 70 years) of pancreatic cancer is 40% in individuals with hereditary pancreatitis. This subset of individuals form an ideal group for the development of a screening programme aimed at detecting pancreatic cancer at an early stage in an attempt to improve the presently poor long-term survival. Current screening strategies involve multimodality imaging (computed tomography, endoluminal ultrasound) and endoscopic retrograde cholangiopancreatography for pancreatic juice collection followed by molecular analysis of the DNA extracted from the juice. The potential benefit of screening (curative resection) must be balanced against the associated morbidity and mortality of surgery. Philosophically, the individual's best interest must be sought in light of the latest advances in medicine and science following discussions with a multidisciplinary team in specialist pancreatic centres.

  11. The Effects of New Screening Tests in the Dutch Cervical Cancer Screening Programme

    NARCIS (Netherlands)

    K. Rozemeijer (Kirsten)

    2016-01-01

    markdownabstractCervical cancer is the fourth most common cancer in women all over the world, mainly affecting young women. As cervical cancer is easy to prevent by early detection and treatment of the disease, screening was introduced in the Netherlands in the 1970s. The number of cervical cancer c

  12. Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA screening

    Directory of Open Access Journals (Sweden)

    Black Amanda

    2011-04-01

    Full Text Available Abstract Background Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Discussion Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM or shared decision making (SDM approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA

  13. Interventions to Enhance Breast Cancer Screening, Diagnosis, and Treatment among Racial and Ethnic Minority Women

    Science.gov (United States)

    Masi, Christopher M.; Blackman, Dionne J.; Peek, Monica E.

    2009-01-01

    The authors conduct a systematic review of the literature to identify interventions designed to enhance breast cancer screening, diagnosis, and treatment among minority women. Most trials in this area have focused on breast cancer screening, while relatively few have addressed diagnostic testing or breast cancer treatment. Among patient-targeted screening interventions, those that are culturally tailored or addressed financial or logistical barriers are generally more effective than reminder-based interventions, especially among women with fewer financial resources and those without previous mammography. Chart-based reminders increase physician adherence to mammography guidelines but are less effective at increasing clinical breast examination. Several trials demonstrate that case management is an effective strategy for expediting diagnostic testing after screening abnormalities have been found. Additional support for these and other proven health care organization-based interventions appears justified and may be necessary to eliminate racial and ethnic breast cancer disparities. PMID:17881627

  14. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening.

    Science.gov (United States)

    Smith, Robert A; Manassaram-Baptiste, Deana; Brooks, Durado; Doroshenk, Mary; Fedewa, Stacey; Saslow, Debbie; Brawley, Otis W; Wender, Richard

    2015-01-01

    Each year, the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection along with a report on data and trends in cancer screening rates and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines. The latest data on utilization of cancer screening from the National Health Interview Survey (NHIS) also is described, as are several issues related to screening coverage under the Affordable Care Act, including the expansion of the Medicaid program.

  15. Targeted Cancer Screening in Average-Risk Individuals.

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Colorectal cancer screening among Korean American immigrants: unraveling the influence of culture.

    Science.gov (United States)

    Lee, Hee Yun; Im, Hyojin

    2013-05-01

    Screening for colorectal cancer (CRC) is underutilized among ethnic minority groups, particularly among Korean American immigrants. To explore the role of cultural and health beliefs in CRC screening, a structured questionnaire was administered to 281 Korean American immigrants aged between 50 and 88 in the New York metropolitan area. Results showed that 20% of the sample had undergone a fecal occult blood test within the past year, and 35% of the respondents had received a sigmoidoscopy and/or colonoscopy within the previous five years. Binary logistic regression analyses revealed significant predictors including health belief constructs, such as perceived seriousness of cancer and confidence in screening uptake, and gender-specific cultural beliefs and attitudes about CRC screening. Perceived helplessness lowered CRC screening among the women, while fatalism lowered it among the men. The findings reinforce a need for cultural-and gender-specific intervention strategies to increase CRC screening in this particularly vulnerable population.

  18. The patient's subjective attitude towards screening for breast cancer. Should screening be extended to other forms of cancer?

    OpenAIRE

    Taylor, T V; Rimmer, S.; Forrest, A P

    1980-01-01

    A sample of 500 consecutive women without symptoms of breast disease attending a breast screening clinic were investigated regarding their attitude to breast screening and to the extension of the screening programme to other forms of cancer. Attendance at the screening clinic was found to be reassuring by 94.2%, and 96.4% felt that the screening programme should be extended to include other forms of malignancy. There was a history of either respiratory or alimentary tract symptoms, and of smo...

  19. Big screens with small RNAs : loss of function genetic screens to identify novel cancer genes

    NARCIS (Netherlands)

    Mullenders, J.

    2009-01-01

    This thesis described the construction and screening of one of the first large scale RNAi libraries for use in human cells. Functional genetic screens with this library have led to the identification of novel cancer genes. These cancer genes function in several pathways including the p53 tumor suppr

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Cancer Screening in Women with Intellectual Disabilities: An Irish perspective

    Science.gov (United States)

    Reidy, Mary; Denieffe, Suzanne; Foran, Sinéad

    2014-01-01

    In the Republic of Ireland, more than 8000 women with intellectual disabilities (IDs), aged 20 years and over, are registered for service provision. Their health needs challenge preventative health services including breast and cervical cancer screening programmes. This review explores the literature about cancer screening participation rates and…

  2. The Danish randomized lung cancer CT screening trial

    DEFF Research Database (Denmark)

    Pedersen, Jesper H; Ashraf, Haseem; Dirksen, Asger;

    2009-01-01

    INTRODUCTION: Lung cancer screening with low dose computed tomography (CT) has not yet been evaluated in randomized clinical trials, although several are underway. METHODS: In The Danish Lung Cancer Screening Trial, 4104 smokers and previous smokers from 2004 to 2006 were randomized to either...

  3. Breast and cervical cancer screening programme implementation in 16 countries

    DEFF Research Database (Denmark)

    Dowling, Emily C; Klabunde, Carrie; Patnick, Julietta;

    2010-01-01

    There is a continuing need to monitor and evaluate the impact of organized screening programmes on cancer incidence and mortality. We report results from a programme assessment conducted within the International Cancer Screening Network (ICSN) to understand the characteristics of cervical screeni...

  4. Evaluation of cancer service screening: case referent studies recommended.

    NARCIS (Netherlands)

    Verbeek, A.L.M.; Broeders, M.J.M.

    2010-01-01

    Various cancer screening trials, randomised or otherwise controlled, have demonstrated reductions in cancer mortality. As a consequence, population screening programmes have been implemented. In the mean time, major advances are being made in early detection and treatment modalities of specific canc

  5. European cervical cancer screening:experiences and results

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Europe has devoted great efforts to cervical cancer screening over 30 years.The mortality was generally declining although incidence rates of cervical cancer among young women have been increasing in many countries of Europe.The efficiency of screening,however,needs to be addressed by planners for an improved cost-effectiveness in the future.

  6. Communicating the balance sheet in breast cancer screening

    DEFF Research Database (Denmark)

    Giordano, Livia; Cogo, Carla; Patnick, Julietta;

    2012-01-01

    Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening.......Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening....

  7. Screening for lung cancer: time for large-scale screening by chest computed tomography.

    Science.gov (United States)

    Shlomi, Dekel; Ben-Avi, Ronny; Balmor, Gingy Ronen; Onn, Amir; Peled, Nir

    2014-07-01

    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 U.S.A., 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 cancer screening 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 cancer screening is on the threshold of a new era, with ever more questions still left open to challenge future studies.

  8. Prostate Cancer Screening (Beyond the Basics)

    Science.gov (United States)

    ... best in your individual situation. WHAT IS PROSTATE CANCER? — Prostate cancer is a cancer of the prostate, a ... most of them do not die from their cancer. Prostate cancer often grows so slowly that many men ...

  9. Sociocultural Barriers to Lung Cancer Screening Among Korean Immigrant Men.

    Science.gov (United States)

    Sin, Mo-Kyung; Ha, Ara; Taylor, Vicky

    2016-08-01

    Lung cancer is a commonly occurring cancer among Korean American men. Korean Americans have lower rates of cancer screening participation than other Asian American sub-groups. However, little is known about factors that influence the cancer screening behavior of Korean immigrants. The purpose of this study was to explore facilitators of and barriers to lung cancer screening (i.e., low dose CT of the chest) among Korean immigrant men, using qualitative individual interviews and focus groups. A convenience sample of 24 Korean men who were immigrants, Washington State residents, able to speak Korean, aged 55-79, and eligible for lung cancer screening (based on current guidelines) were recruited from Korean churches and senior centers. Five focus groups (that included between two and five men) and nine individual interviews were conducted. Content analysis was used to analyze the qualitative data. Facilitators of lung cancer screening included perceptions about positive aspects of the health care system in South Korea, recommendations from others (physicians, family members, and community organizations), existing health problems and respiratory symptoms, interest in health, and the health consequences of aging. Barriers included costs of health care in the US, lack of time, lack of knowledge (about lung cancer and screening), attitudes about prevention, and lack of physician recommendation. This study adds new knowledge to a field where little information is available. It also lays the groundwork for developing culturally relevant lung cancer screening interventions for Korean Americans and the health care providers who serve them. PMID:26846627

  10. PRESSING MORTALITY RATE THROUGH SCREENING oral cancer

    Directory of Open Access Journals (Sweden)

    L. K. Widnyani Wulan Laksmi

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Based on World Health Organization (WHO data, oral cancer is one of malignancy with the highest mortality. In USA, there are more than 30.000 new cases every year. We can find many risk factors of oral cancer in our daily living. Moreover, it’s easy to find the main risk factors in our society, they are smoking, alcohol consumption, tobacco consumtion, viral infection, and bad oral hygiene. For the early stadium, Five-years survival rate is about 82% and 61% for all stadium. But, more than 50% of oral cancer has been distributed (metastatic regionally and also into the other organ far away from the oral itself when it’s detected. It will decrease 5-years survival rate to be less than 50%. So that, it’s really important to detect the oral cancer at the earlier stadium. Screening is the way to find the earlier stadium. Screening is done by some methods, start from the anamnesis, physical examination, toluidine blue staining, endoscopy, cytology, telomerase examination, and also PET-scan if it’s possible (because of the financial reasons. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  11. Social support and non-participation in breast cancer screening

    DEFF Research Database (Denmark)

    Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit;

    2015-01-01

    BACKGROUND: Social support may have an impact on screening participation. We studied the association between social support in 2006, defined as frequencies of contacts, instrumental support and emotional support and participation in breast cancer screening in 2008-09. METHODS: This population...... likely not to participate in screening in 2008-09 [prevalence ratio (PR) 1.69, 95% confidence interval (CI) 1.26-2.26, P-value time...... with non-participation in breast cancer screening in 2008-09. Targeted social interventions may, therefore, have an impact on future screening behaviour, which calls for further research....

  12. Stewardship and cancer screening programs in Italy

    Directory of Open Access Journals (Sweden)

    Cristine Marie Novinskey

    2011-06-01

    Full Text Available As one of the four major functions of health systems, Stewardship is on the health agenda of several countries worldwide. There is, however, little empirical evidence to support or guide its implementation. To help bridge this gap, the paper aims to contribute to the empirical evidence for health system stewardship and, importantly, to offer implementers an explanatory example of what it could mean in practice. It achieves this by analyzing the experience of the Italian Cancer Screening Programs (from 2004-2009 within a comprehensive framework for health system stewardship. The analysis is largely based on primary and secondary qualitative data, using information collected from an in-depth interview, official documents, and scientific and grey literature. We describe the framework and sub-functions of stewardship, identify the stewardship activities that were carried out by the Programs, and reflect upon the operability of the framework as well as the activities that the Programs have not implemented but would benefit from doing so. The general experience and activities of the Italian Cancer Screening Programs fit well into the stewardship framework, despite not having followed it a priori. Overall, the Programs managed to implement most activities under each sub-function. As an empirical case study, they corroborated the theoretical framework and demonstrated how it could be translated into certain activities on an operational platform. Ultimately, the analysis showed that the framework of stewardship is useful for structuring and prioritizing the most important activities of a steward and, thus, provides a good benchmark for implementers.

  13. [Breast cancer screening in Austria: Key figures, age limits, screening intervals and evidence].

    Science.gov (United States)

    Jeitler, Klaus; Semlitsch, Thomas; Posch, Nicole; Siebenhofer, Andrea; Horvath, Karl

    2015-01-01

    In January 2014, the first nationwide quality-assured breast cancer screening program addressing women aged ≥ 40 years was introduced in Austria. As part of the process of developing a patient information leaflet, the Evidence Based Medicine (EBM) Review Center of the Medical University of Graz was charged with the task of assessing the potential benefits and harms of breast cancer screening from the available evidence. Based on these results, key figures were derived for mortality, false-positive and false-negative mammography results, and overdiagnosis, considering Austria-specific incidence rates for breast cancer and breast cancer mortality. Furthermore, the current evidence regarding age limits and screening interval, which were the subjects of controversial public discussions, was analyzed. A systematic search for primary and secondary literature was performed and additional evidence was screened, e. g., evaluation reports of European breast cancer screening programs. On the basis of the available evidence and of the Austrian breast cancer mortality and incidence rates, it can be assumed that - depending on the age group - 1 to 4 breast cancer deaths can be avoided per 1,000 women screened in a structured breast cancer screening program, while the overall mortality remains unchanged. On the other hand, 150 to 200 of these 1,000 women will be affected by false-positive results and 1 to 9 women by overdiagnosis due to the structured breast cancer screening. Therefore, the overall benefit-harm balance is uncertain. If women from 40 to 44 or above 70 years of age are considered, who can also participate in the Austrian screening program, even a negative benefit-harm balance seems possible. However, with the implementation of quality standards in breast cancer screening and the dissemination of a patient information leaflet, an improvement in the medical treatment situation, specifically in terms of informed decision-making, can be expected.

  14. [Breast cancer screening in Austria: Key figures, age limits, screening intervals and evidence].

    Science.gov (United States)

    Jeitler, Klaus; Semlitsch, Thomas; Posch, Nicole; Siebenhofer, Andrea; Horvath, Karl

    2015-01-01

    In January 2014, the first nationwide quality-assured breast cancer screening program addressing women aged ≥ 40 years was introduced in Austria. As part of the process of developing a patient information leaflet, the Evidence Based Medicine (EBM) Review Center of the Medical University of Graz was charged with the task of assessing the potential benefits and harms of breast cancer screening from the available evidence. Based on these results, key figures were derived for mortality, false-positive and false-negative mammography results, and overdiagnosis, considering Austria-specific incidence rates for breast cancer and breast cancer mortality. Furthermore, the current evidence regarding age limits and screening interval, which were the subjects of controversial public discussions, was analyzed. A systematic search for primary and secondary literature was performed and additional evidence was screened, e. g., evaluation reports of European breast cancer screening programs. On the basis of the available evidence and of the Austrian breast cancer mortality and incidence rates, it can be assumed that - depending on the age group - 1 to 4 breast cancer deaths can be avoided per 1,000 women screened in a structured breast cancer screening program, while the overall mortality remains unchanged. On the other hand, 150 to 200 of these 1,000 women will be affected by false-positive results and 1 to 9 women by overdiagnosis due to the structured breast cancer screening. Therefore, the overall benefit-harm balance is uncertain. If women from 40 to 44 or above 70 years of age are considered, who can also participate in the Austrian screening program, even a negative benefit-harm balance seems possible. However, with the implementation of quality standards in breast cancer screening and the dissemination of a patient information leaflet, an improvement in the medical treatment situation, specifically in terms of informed decision-making, can be expected. PMID:26354136

  15. Lung Cancer Screening and clinical implications

    NARCIS (Netherlands)

    S.C. van 't Westeinde (Susan)

    2012-01-01

    textabstractLung cancer is the most frequently diagnosed major cancer worldwide and the leading cause of death from cancer. Lung cancer is divided into two subgroups: small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC), accounting for 10-20% and 75% of lung cancer cases, respectivel

  16. Screening for cervical cancer: when theory meets reality

    Directory of Open Access Journals (Sweden)

    Nygård Mari

    2011-06-01

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

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

    Science.gov (United States)

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

    2015-08-15

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

  18. Effectiveness of ultrasound for breast cancer screening

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of ultrasound (US) for breast cancer screening, we conducted a retrospective survey of 856 breast cancer patients who were preoperatively examined by mammography (MMG) and US. Their average age was 54.7 years, with a range of 24 to 92 years. MMG revealed positive findings in 771 patients (90.1%), and negative findings in the remaining 85 patients (9.9%). Likewise, US revealed positive findings in 835 patients (97.5%), and negative findings in the remaining 21 patients (2.5%). Accordingly, the proportion of positive finding in US was significantly higher than that in MMG (chi-square test, p<0.0001). The incidence of negative findings with MMG was inversely related to age: 5.8% for patients in their 70s, 5.7% for those in their 60s, 8.3% for those in their 50s, 11.1% for those in their 40s, and 26.2% for those in their 30s or younger, because of the higher breast density in younger women (chi-square test, p<0.0001). The incidence of positive findings was 99.4% for tumors 2.1 to 3.0 cm in size, 96.3% for those measuring 1.6 to 2.0 cm, 94.3% for those measuring 1.1 to 1.5 cm, and 75.4% for those less than or equal to 1.0 cm (chi-square test, p<0.0001). Among the 85 patients with negative findings by MMG, 70(82.4%) were positive and 15 (17.6%) were negative by US. As findings of calcification by US, high echo spots plus a tumor lesion were observed in 59 patients (71.1%), high echo spots only were noted in 22 patients (26.5%), and high echo spots were not seen in 2 patients (2.4%). In conclusion, parallel use of MMG and US is recommended for breast cancer screening, especially for women in their 50s or younger, to reduce the incidence of misdiagnosis. (author)

  19. Cervical Cancer Screening in Partly HPV Vaccinated Cohorts - A Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Steffie K Naber

    Full Text Available Vaccination against the oncogenic human papillomavirus (HPV types 16 and 18 will reduce the prevalence of these types, thereby also reducing cervical cancer risk in unvaccinated women. This (measurable herd effect will be limited at first, but is expected to increase over time. At a certain herd immunity level, tailoring screening to vaccination status may no longer be worth the additional effort. Moreover, uniform screening may be the only viable option. We therefore investigated at what level of herd immunity it is cost-effective to also reduce screening intensity in unvaccinated women.We used the MISCAN-Cervix model to determine the optimal screening strategy for a pre-vaccination population and for vaccinated women (~80% decreased risk, assuming a willingness-to-pay of €50,000 per quality-adjusted life year gained. We considered HPV testing, cytology testing and co-testing and varied the start age of screening, the screening interval and the number of lifetime screens. We then calculated the incremental cost-effectiveness ratio (ICER of screening unvaccinated women with the strategy optimized to the pre-vaccination population as compared to with the strategy optimized to vaccinated women, assuming different herd immunity levels.Primary HPV screening with cytology triage was the optimal strategy, with 8 lifetime screens for the pre-vaccination population and 3 for vaccinated women. The ICER of screening unvaccinated women 8 times instead of 3 was €28,085 in the absence of herd immunity. At around 50% herd immunity, the ICER reached €50,000.From a herd immunity level of 50% onwards, screening intensity based on the pre-vaccination risk level becomes cost-ineffective for unvaccinated women. Reducing the screening intensity of uniform screening may then be considered.

  20. The associations between objective numeracy and colorectal cancer screening knowledge, attitudes and defensive processing in a deprived community sample.

    Science.gov (United States)

    Smith, Samuel G; Kobayashi, Lindsay C; Wolf, Michael S; Raine, Rosalind; Wardle, Jane; von Wagner, Christian

    2016-08-01

    We examined associations between numeracy and sociocognitive factors associated with colorectal cancer screening uptake (n = 964). Nearly half (45.7%) of the respondents incorrectly answered a numeracy question (low numeracy). Low numeracy respondents were less knowledgeable about colorectal cancer (p processing of cancer information (p = .001). Sociocognitive factors fully mediated the relationship between numeracy and screening intention. Addressing numeracy issues may reduce inequalities in CRC screening participation, but communication strategies could be limited by the tendency process cancer information defensively. PMID:25512199

  1. Point: cervical cancer screening guidelines should consider observational data on screening efficacy in older women.

    Science.gov (United States)

    Rustagi, Alison S; Kamineni, Aruna; Weiss, Noel S

    2013-10-01

    Recent guidelines from the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology recommend cessation of cervical cancer screening at age 65 years for women with an "adequate" history of negative Papanicolaou smears. In our view, those who formulated these guidelines did not consider a growing body of evidence from nonrandomized studies that provides insight into the efficacy of cervical cancer screening among older women. First, older women are not at indefinitely low risk following negative screening results. Second, recent data from the United States, the United Kingdom, and Sweden suggest that screening of older women is associated with substantial reductions in cervical cancer incidence and mortality, even among previously screened women. It may be that after consideration of the reduced incidence of (and reduced mortality from) cervical cancer that may result from screening older women, the harms and economic costs of screening will be judged to outweigh its benefits. However, it is essential to consider the now-documented benefits of cervical screening when formulating screening guidelines for older women, and recommendations that do not do so will lack an evidence base.

  2. SubSolid Nodules in lung cancer screening

    NARCIS (Netherlands)

    Scholten, E.Th.

    2014-01-01

    With eight million deaths in 2012 lung cancer is the most common cause of cancer death in the world, and the problem is still growing. As long as the goal of a total ban on smoking tobacco is not fulfilled, lung cancer screening as a means of secondary prevention has great potential. The aim of lung

  3. The Impact of Breast Cancer Screening on Population Health

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien)

    2013-01-01

    textabstractBreast cancer is an important public health problem with an estimated number of 1.38 million breast cancer cases and 458,000 deaths from the disease yearly worldwide. Randomized trials have shown that mammography screening significantly reduces breast cancer mortality. Besides the benefi

  4. Computed tomographic characteristics of interval and post screen carcinomas in lung cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Scholten, Ernst T. [University Medical Centre, Department of Radiology, Utrecht (Netherlands); Kennemer Gasthuis, Department of Radiology, Haarlem (Netherlands); Horeweg, Nanda [Erasmus University Medical Centre, Department of Public Health, Rotterdam (Netherlands); Erasmus University Medical Centre, Department of Pulmonary Medicine, Rotterdam (Netherlands); Koning, Harry J. de [Erasmus University Medical Centre, Department of Public Health, Rotterdam (Netherlands); Vliegenthart, Rozemarijn [University of Groningen, University Medical Centre Groningen, Department of Radiology, Groningen (Netherlands); University of Groningen, University Medical Centre Groningen, Center for Medical Imaging-North East Netherlands, Groningen (Netherlands); Oudkerk, Matthijs [University of Groningen, University Medical Centre Groningen, Center for Medical Imaging-North East Netherlands, Groningen (Netherlands); Mali, Willem P.T.M.; Jong, Pim A. de [University Medical Centre, Department of Radiology, Utrecht (Netherlands)

    2015-01-15

    To analyse computed tomography (CT) findings of interval and post-screen carcinomas in lung cancer screening. Consecutive interval and post-screen carcinomas from the Dutch-Belgium lung cancer screening trial were included. The prior screening and the diagnostic chest CT were reviewed by two experienced radiologists in consensus with knowledge of the tumour location on the diagnostic CT. Sixty-one participants (53 men) were diagnosed with an interval or post-screen carcinoma. Twenty-two (36 %) were in retrospect visible on the prior screening CT. Detection error occurred in 20 cancers and interpretation error in two cancers. Errors involved intrabronchial tumour (n = 5), bulla with wall thickening (n = 5), lymphadenopathy (n = 3), pleural effusion (n = 1) and intraparenchymal solid nodules (n = 8). These were missed because of a broad pleural attachment (n = 4), extensive reticulation surrounding a nodule (n = 1) and extensive scarring (n = 1). No definite explanation other than human error was found in two cases. None of the interval or post-screen carcinomas involved a subsolid nodule. Interval or post-screen carcinomas that were visible in retrospect were mostly due to detection errors of solid nodules, bulla wall thickening or endobronchial lesions. Interval or post-screen carcinomas without explanation other than human errors are rare. (orig.)

  5. Comparing mass screening techniques for gastric cancer in Japan

    Institute of Scientific and Technical Information of China (English)

    Atsushi Tashiro; Masatoshi Sano; Koichi Kinameri; Kazutaka Fujita; Yutaka Takeuchi

    2006-01-01

    AIM: To discuss the efficacy of endoscopic mass screening for gastric cancer. METHODS: The data used in this study were the results of mass screening programs for gastric cancer in Niigata City from 2002 to 2004. The number of participants was 35089 in 2002, 34557 in 2003 and 36600 in 2004. The finding ratio referred to the final diagnosis of gastric cancer after a double check of endoscopic files and histological findings. The costs of identifying one case of gastric cancer were calculated based on the total expense for each screening program and additional close examinations. RESULTS: From the analysis of individual screening program with endoscopy, individual screening program with X-ray (ISX) and mass screening program with photofluorography (MSP) in reference to the finding ratio of gastric cancer, endoscopic examination was the best for detecting early gastric cancer, the finding ratio was 0.87% in 2004, approximately 2.7 and 4.6 times higher than those of the ISX and MSP groups. In addition, this novel method was the cheapest means regarding the cost of identifying one case of gastric cancer, which was estimated to be 1 608000 Japanese yen in 2004. CONCLUSION: Endoscopic mass screening is a promising method and can be effectively applied if a sufficient number of skilled endoscopists become available to staff the system and if city offices support it.

  6. The association between general practitioners’ attitudes towards breast cancer screening and women’s screening participation

    Directory of Open Access Journals (Sweden)

    Jensen Line

    2012-06-01

    Full Text Available Abstract Background Breast cancer screening in Denmark is organised by the health services in the five regions. Although general practitioners (GPs are not directly involved in the screening process, they are often the first point of contact to the health care system and thus play an important advisory role. No previous studies, in a health care setting like the Danish system, have investigated the association between GPs’ attitudes towards breast cancer screening and women’s participation in the screening programme. Methods Data on women’s screening participation was obtained from the regional screening authorities. Data on GPs’ attitudes towards breast cancer screening was taken from a previous survey among GPs in the Central Denmark Region. This study included women aged 50-69 years who were registered with a singlehanded GP who had participated in the survey. Results The survey involved 67 singlehanded GPs with a total of 13,288 women on their lists. Five GPs (7% had a negative attitude towards breast cancer screening. Among registered women, 81% participated in the first screening round. Multivariate analyses revealed that women registered with a GP with a negative attitude towards breast cancer screening were 17% (95% CI: 2-34% more likely to be non-participants compared with women registered with a GP with a positive attitude towards breast cancer screening. Conclusion The GPs' attitudes may influence the participation rate even in a system where GPs are not directly involved in the screening process. However, further studies are needed to investigate this association.

  7. Cost-Effectiveness of Total Colonoscopy in Screening of Colorectal Cancer in Japan

    Directory of Open Access Journals (Sweden)

    Masau Sekiguchi

    2012-01-01

    Full Text Available Introduction. In Japan, the cost-effectiveness of total colonoscopy (TCS for primary screening of colorectal cancer (CRC is unclear. We compared the cost of identifying a patient with CRC using two primary screening strategies: TCS (strategy 1 and the immunochemical fecal test (FIT (strategy 2. Materials and Methods. We retrospectively analyzed the TCS screening database at our institution from February 2004 to August 2010 (strategy 1, =15,348 and the Japanese nationwide survey of CRC screening in 2008 (strategy 2, =5,267,443. Results. 112 and 6,838 CRC cases were detected in strategies 1 and 2, costing 2,124,000 JPY and 1,629,000 JPY, respectively. The rate of earlier-stage CRC was higher in strategy 1. Conclusions. The cost was higher using TCS as a primary screening procedure. However, the difference was not excessive, and considering the increased rate of detecting earlier CRC, the use of TCS as a primary screening tool may be cost-effective.

  8. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

    2014-09-15

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  9. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    International Nuclear Information System (INIS)

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  10. [Overview of current modalities of colorectal cancer screening].

    Science.gov (United States)

    Kajzrlíková, Ivana Mikoviny; Vítek, Petr

    2016-04-01

    There are one-step and two-steps programs for colorectal cancer screening. The aim of all screening examinations is to detect early stage of the disease in asymptomatic patient. The aim of this article is actual review of current screening modalities such as fecal occult blood test, flexible sigmoideoscopy, colonoscopy, CT colonography, capsule endoscopy, blood-based tests and stool DNA tests. Colonoscopy still remains the gold standard for detection of colorectal neoplasias. In majority of countries worldwide programs for colorectal cancer screening are based on immunochemical fecal occult blood test followed by colonoscopy when positive.

  11. Breast cancer screening in Korean woman with dense breast tissue

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hee Jung [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Ko, Eun Sook [Dept. of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Yi, Ann [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-11-15

    Asian women, including Korean, have a relatively higher incidence of dense breast tissue, compared with western women. Dense breast tissue has a lower sensitivity for the detection of breast cancer and a higher relative risk for breast cancer, compared with fatty breast tissue. Thus, there were limitations in the mammographic screening for women with dense breast tissue, and many studies for the supplemental screening methods. This review included appropriate screening methods for Korean women with dense breasts. We also reviewed the application and limitation of supplemental screening methods, including breast ultrasound, digital breast tomosynthesis, and breast magnetic resonance imaging; and furthermore investigated the guidelines, as well as the study results.

  12. Screening study on new tumor marker periplakin for lung cancer

    Institute of Scientific and Technical Information of China (English)

    Shuqin Dai; Wei Li; Mian Kong; Yuzhen Zheng; Shuying Chen; Junye Wang; Linquan Zang

    2013-01-01

    Objective: The aim of this study was to use lung cancer targeting binding polypeptide ZS-9 to screen cDNA library of human lung cancer and obtain ZS-9 specific ligand to confirm tumor marker of non small-cell lung cancer. Methods: Artificially synthesize biotin labeled peptide ZS-9, anchored ZS-9 in the enzyme label plate coupled by avidin, used ZS-9 as probe to screen cDNA library of human lung cancer, after screening, obtained bacteriophage clone specifically binding with anchored polypeptide ZS-9. Extracted plasmid of bacteriophage and performed sequencing after amplified by PCR. Results: It was demonstrated by bioinformatic analysis on the sequence of ligand binded by lung cancer specific peptide ZS-9 that the ligand was the cytoskeletal protein periplakin on the surface of lung cancer cells, suggesting that periplakin might be a new marker for non-small-cell lung cancer in lung cancer. Conclusion: Use specific lung cancer binding peptide to screen new tumor marker periplakin in lung cancer and further studies on its biologic functions in genesis and development of lung cancer are still needed.

  13. Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study

    Directory of Open Access Journals (Sweden)

    Victoria K Fort

    2011-03-01

    Full Text Available Victoria K Fort1, Mary Sue Makin2, Aaron J Siegler1, Kevin Ault3, Roger Rochat11Rollins School of Public Health, Atlanta, Georgia, USA; 2Mulanje Mission Hospital, Mulanje, Malawi; 3Emory University Medical School, Atlanta, Georgia, USABackground: In Malawi, cervical cancer is the most prevalent form of cancer among women, with an 80% mortality rate. The Mulanje Mission Hospital has offered free cervical cancer screening for eight years; however, patients primarily seek medical help for gynecologic complaints after the disease is inoperable.Methods: We investigated how women in rural Malawi make health-seeking decisions regarding cervical cancer screening using qualitative research methods. The study was conducted between May and August of 2009 in Mulanje, Malawi.Results: This study found that the primary cue to action for cervical cancer screening was symptoms of cervical cancer. Major barriers to seeking preventative screening included low knowledge levels, low perceived susceptibility and low perceived benefits from the service. Study participants did not view cervical cancer screening as critical health care. Interviews suggested that use of the service could increase if women are recruited while visiting the hospital for a different service.Conclusion: This study recommends that health care providers and health educators target aspects of perceived susceptibility among their patients, including knowledge levels and personal risk assessment. We believe that continued support and advertisement of cervical cancer screening programs along with innovative recruitment strategies will increase usage density and decrease unnecessary deaths from cervical cancer in Malawi.Keywords: cervical cancer, interviews, health care, Mulanje Mission Hospital

  14. Dynamic infrared imaging for skin cancer screening

    Science.gov (United States)

    Godoy, Sebastián E.; Ramirez, David A.; Myers, Stephen A.; von Winckel, Greg; Krishna, Sanchita; Berwick, Marianne; Padilla, R. Steven; Sen, Pradeep; Krishna, Sanjay

    2015-05-01

    Dynamic thermal imaging (DTI) with infrared cameras is a non-invasive technique with the ability to detect the most common types of skin cancer. We discuss and propose a standardized analysis method for DTI of actual patient data, which achieves high levels of sensitivity and specificity by judiciously selecting pixels with the same initial temperature. This process compensates the intrinsic limitations of the cooling unit and is the key enabling tool in the DTI data analysis. We have extensively tested the methodology on human subjects using thermal infrared image sequences from a pilot study conducted jointly with the University of New Mexico Dermatology Clinic in Albuquerque, New Mexico (ClinicalTrials ID number NCT02154451). All individuals were adult subjects who were scheduled for biopsy or adult volunteers with clinically diagnosed benign condition. The sample size was 102 subjects for the present study. Statistically significant results were obtained that allowed us to distinguish between benign and malignant skin conditions. The sensitivity and specificity was 95% (with a 95% confidence interval of [87.8% 100.0%]) and 83% (with a 95% confidence interval of [73.4% 92.5%]), respectively, and with an area under the curve of 95%. Our results lead us to conclude that the DTI approach in conjunction with the judicious selection of pixels has the potential to provide a fast, accurate, non-contact, and non-invasive way to screen for common types of skin cancer. As such, it has the potential to significantly reduce the number of biopsies performed on suspicious lesions.

  15. Study of mammography in mass screening for breast cancer

    International Nuclear Information System (INIS)

    In order to examine the rate of correct diagnosis by mammography at initial mass screening for breast cancer, we carried out a retrospective study of mammography findings in 267 cases of breast cancer detected at Asahikawa Cancer Screening Center. The screening was performed by physical examination, and in cases where disease was suspected, mammography, ultrasonography, and needle biopsy were done. Mammographically, 172 cases (64.4%) were cancer-positive, 58 cases (21.7%) were suspicious for cancer, and 37 cases (13.9%) were cancer-negative. Patients below 50 years of age and those with tumors of small diameter (<20 mm) showed a significantly lower rate of cancer positivity than patients aged 50 years or more and those with tumors 20 mm or more in diameter. Mammographic abnormalities were not specific, since these changes were also found in normal subjects and patients with benign diseases. Therefore, we concluded that mammography without physical examination at initial mass screening has a high risk of missing breast cancer. Mass screening for breast cancer should be performed by physical examination involving inspection and palpation at the first instance. If any suspicious findings are obtained, mammography, ultrasonography, and needle biopsy should be done. (author)

  16. Development of a Federally Funded Demonstration Colorectal Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    Janet Royalty, MS

    2008-04-01

    Full Text Available Colorectal cancer is the second leading cause of cancer-related mortality among U.S. adults. In 2004, treatment costs for colorectal cancer were $8.4 billion.There is substantial evidence that colorectal cancer incidence and mortality are reduced with regular screening. The natural history of this disease is also well described: most colorectal cancers develop slowly from preexisting polyps. This slow development provides an opportunity to intervene with screening tests, which can either prevent colorectal cancer through the removal of polyps or detect it at an early stage. However, much less is known about how best to implement an effective colorectal cancer screening program. Screening rates are low, and uninsured persons, low-income persons, and persons who have not visited a physician within a year are least likely to be screened.Although the Centers for Disease Control and Prevention (CDC has 15 years of experience supporting the National Breast and Cervical Cancer Early Detection Program for the underserved population, a similar national program for colorectal cancer is not in place. To explore the feasibility of implementing a national program for the underserved U.S. population and to learn which settings and which program models are most viable and cost-effective, CDC began a 3-year colorectal cancer screening demonstration program in 2005.This article describes briefly this demonstration program and the process CDC used to design it and to select program sites. The multiple-methods evaluation now under way to assess the program’s feasibility and describe key outcomes is also detailed. Evaluation results will be used to inform future activities related to organized screening for colorectal cancer.

  17. Breast cancer screening: cultural beliefs and diverse populations.

    Science.gov (United States)

    Simon, Cassandra E

    2006-02-01

    This article addresses the role of culture in breast cancer screening behavior among African American, American Indian/Alaskan Native, Asian American/Pacific Islander, and Hispanic/ Latina women. It reviews cultural beliefs, attitudes, and knowledge and their relative influence on women's decisions regarding health tests. The article explores how to build on these cultural values, simultaneously mediating their barrier effects. Building on cultural explanatory models of health behavior, suggestions for incorporating culture into early detection strategies for ethnically and racially diverse, underserved women are provided. In addition, the article offers four practice principles that can be used with all of the groups: inclusion and use of indigenous support; cross-application of approaches for diverse populations; honor and incorporation of culture; and attention to language, literacy, and cultural information.

  18. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    Directory of Open Access Journals (Sweden)

    Lu Mingshan

    2012-06-01

    Full Text Available Abstract Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear. 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective

  19. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women

    Science.gov (United States)

    2012-01-01

    Background The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women. Methods This study systematically reviewed studies published as of January 2010 to synthesize knowledge about effectiveness of cancer screening interventions targeting Asian women. Fifteen multidisciplinary peer-reviewed and grey literature databases were searched to identify relevant studies. Results The results of our systematic review were reported in accordance with the PRISMA Statement. Of 37 selected intervention studies, only 18 studies included valid outcome measures (i.e. self-reported or recorded receipt of mammograms or Pap smear). 11 of the 18 intervention studies with valid outcome measures used multiple intervention strategies to target individuals in a specific Asian ethnic group. This observed pattern of intervention design supports the hypothesis that employing a combination of multiple strategies is more likely to be successful than single interventions. The effectiveness of community-based or workplace-based group education programs increases when additional supports, such as assistance in scheduling/attending screening and mobile screening services are provided. Combining cultural awareness training for health care professionals with outreach workers who can help healthcare professionals overcome language and cultural barriers is likely to improve cancer screening uptake. Media campaigns and mailed culturally sensitive print materials alone may be ineffective in increasing screening

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

    International Nuclear Information System (INIS)

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

  1. Lung Cancer Screening: The Radiologist's Perspective

    NARCIS (Netherlands)

    Prokop, M.

    2014-01-01

    Lung cancer is the leading cause of cancer death worldwide and accounts for more deaths than breast, prostate, colon, and pancreatic cancers combined. A distinct minority (15\\%) of lung cancers are diagnosed at an early stage; 5-year survival (all lung cancers) approximates 15\\%. Randomized, control

  2. Breast Cancer Screening in Black and Hispanic Subpopulations

    Directory of Open Access Journals (Sweden)

    Sarah J. Miller

    2014-03-01

    Full Text Available Background: The primary objective was to examine and compare the breast cancer screening adherence rates between black (African American and Afro-Caribbean and Hispanic (foreign born Hispanic and US-born Hispanic subpopulations. Methods: Study data was collected in community settings in New York City between the years of 2011-2012. Participants (N=592 were black and Hispanic individuals who attended a breast cancer screening community outreach program. Breast cancer screening rates as well as demographic data were collected. Results: Results revealed that Afro-Caribbean and foreign-born Hispanics are at a greater risk for non-adherence in breast cancer screening compared with African Americans and US-born Hispanics. Conclusions: The majority of breast screening research and community outreach programs categorize people into broad racial and ethnic groups (e.g., black and Hispanic. The results revealed significant variability within these broader racial/ethnic categories with regard to breast cancer screening. Community outreach programs and future research efforts should target the subpopulations that are at particular risk for breast cancer screening non-adherence.

  3. Review of screening for pancreatic cancer in high risk individuals

    Institute of Scientific and Technical Information of China (English)

    Alina Stoita; Ian D Penman; David B Williams

    2011-01-01

    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.

  4. The many unanswered questions related to the German skin cancer screening programme.

    Science.gov (United States)

    Stang, Andreas; Garbe, Claus; Autier, Philippe; Jöckel, Karl-Heinz

    2016-09-01

    In 2008, the first nationwide skin cancer screening (SCS) programme in the world was established in Germany. The main reason to implement the SCS programme in Germany was the expected reduction of costs of care due to earlier detection of skin cancer. The aim of this commentary is to raise and discuss several unanswered questions related to the German SCS programme. The evidence of a temporary mortality decline of skin melanoma after SCS in Schleswig-Holstein is lower than previously assumed and the temporary decline may have been caused by other factors than screening (e.g. awareness effects, selection bias, data artifact, and random fluctuation). The evaluation of the nationwide effect of SCS on skin cancer mortality is hampered by birth cohort effects and low quality of the routine cause-of-death statistics. The nationwide skin melanoma mortality did not decrease from 2007 through 2014. The time interval between screenings after a screening without pathological findings is unclear. Appropriate research designs are needed that monitor and evaluate the effect of SCS not only on skin cancer mortality but also on other factors that may help to judge the potential benefits and harms of SCS including aggressiveness of therapy, costs of care, quality of life, and stage-specific incidence rates of skin cancer. Furthermore, SCS may profit from a high-risk strategy instead of population-wide screening and from newer technologies for early detection of skin cancer (e.g. dermoscopy). PMID:27371911

  5. Life expectancy of screen-detected invasive breast cancer patients compared with women invited to the Nijmegen Screening Program

    NARCIS (Netherlands)

    J.D.M. Otten; M.J.M. Broeders (Mireille); G.J. den Heeten (Gerard); R. Holland (Roland); J. Fracheboud (Jacques); H.J. de Koning (Harry); A.L.M. Verbeek (Andre)

    2010-01-01

    textabstractBACKGROUND: Screening can lead to earlier detection of breast cancer and thus to an improvement in survival. The authors studied the life expectancy of women with screen-detected invasive breast cancer (patients) compared with women invited to the breast cancer screening program in Nijme

  6. Enhancing citizen engagement in cancer screening through deliberative democracy.

    Science.gov (United States)

    Rychetnik, Lucie; Carter, Stacy M; Abelson, Julia; Thornton, Hazel; Barratt, Alexandra; Entwistle, Vikki A; Mackenzie, Geraldine; Salkeld, Glenn; Glasziou, Paul

    2013-03-20

    Cancer screening is widely practiced and participation is promoted by various social, technical, and commercial drivers, but there are growing concerns about the emerging harms, risks, and costs of cancer screening. Deliberative democracy methods engage citizens in dialogue on substantial and complex problems: especially when evidence and values are important and people need time to understand and consider the relevant issues. Information derived from such deliberations can provide important guidance to cancer screening policies: citizens' values are made explicit, revealing what really matters to people and why. Policy makers can see what informed, rather than uninformed, citizens would decide on the provision of services and information on cancer screening. Caveats can be elicited to guide changes to existing policies and practices. Policies that take account of citizens' opinions through a deliberative democracy process can be considered more legitimate, justifiable, and feasible than those that don't.

  7. Metoder til screening for kolorektal cancer kan forbedres

    DEFF Research Database (Denmark)

    Rasmussen, Louise; Jørgensen, Lars Nannestad; Madsen, Mogens Rørbæk;

    2014-01-01

    Screening programmes for colorectal cancer (CRC) are being implemented in various countries worldwide including Denmark. The majority of programmes rely on faecal occult blood testing with subsequent colonoscopy. This approach is challenged by limited compliance, which reduces the efficiency...

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

    Science.gov (United States)

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

  9. Low adherence to cervical cancer screening after subtotal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Mikael Alling; Gimbel, Helga Margrethe

    2015-01-01

    INTRODUCTION: A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications. METHODS: Data regarding adherence to screening.......7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found. CONCLUSIONS: Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients...... have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer. FUNDING: Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster...

  10. Reasons why patients fail screening in Indian breast cancer trials

    Directory of Open Access Journals (Sweden)

    P Mahajan

    2015-01-01

    Full Text Available Introduction: An increased number of screen failure patients in a clinical trial increases time and cost required for the recruitment. Assessment of reasons for screen failure can help reduce screen failure rates and improve recruitment. Materials and Methods: We collected retrospective data of human epidermal growth factor receptor (HER2 positive Indian breast cancer patients, who failed screening for phase 3 clinical trials and ascertained their reasons for screen failure from screening logs. Statistical comparison was done to ascertain if there are any differences between private and public sites. Results: Of 727 patients screened at 14 sites, 408 (56.1% failed screening. The data on the specific reasons for screen failures was not available at one of the public sites (38 screen failures out of 83 screened patients. Hence, after excluding that site, further analysis is based on 644 patients, of which 370 failed screening. Of these, 296 (80% screen failure patients did not meet selection criteria. The majority -266 were HER2 negative. Among logistical issues, 39 patients had inadequate breast tissue sample. Sixteen patients withdrew their consent at private sites as compared to six at public sites. The difference between private and public sites for the above three reasons was statistically significant. Conclusion: Use of prescreening logs to reduce the number of patients not meeting selection criteria and protocol logistics, and patient counseling to reduce consent withdrawals could be used to reduce screen failure rate.

  11. Screening for cervical cancer: new alternatives and research

    Directory of Open Access Journals (Sweden)

    Lörincz Attila T

    2003-01-01

    Full Text Available Evidence for the clinical utility of human papillomavirus (HPV DNA testing has increased over the years and has now become very convincing. Some specific uses of HPV detection are a triage of women with cytological determinations of atypical squamous cells of undetermined significance (ASC-US and related management strategies, b as a marker for test of cure post-treatment, and c most importantly, as an adjunct to cytology in routine cervical disease screening programs. There are many studies that support each of these applications and include 8 studies on ASC-US triage, 10 on test of cure and 13 on adjunctive or stand-alone HPV screening. The most notable investigation of ASC-US triage was ALTS, a randomized controlled trial of 3 488 women. With respect to routine HPV screening the combined studies included 77 000 women, providing as a histological endpoint more than 1 000 cases of high-grade cervical intraepithelial neoplasia (CIN or cancer. Testing methods were either the Hybrid Capture 2 (HC2 test or the polymerase chain reaction (PCR test. HPV testing of women with ASC-US cytology had on average a higher sensitivity (90% and specificity (70% than repeating the cytological test (sensitivity 75%, specificity 60% and was also more sensitive than colposcopy for follow-up. As an adjunct to the Papanicolaou (Pap cytology test in routine screening, HPV DNA testing was a more sensitive indicator for prevalent high-grade CIN than either conventional or liquid cytology. A combination of HPV DNA and Papanicolaou testing had almost 100% sensitivity and negative predictive value. The specificity of the combined tests was slightly lower than the specificity of the Papanicolaou test. One "double-negative" HPV DNA and Papanicolaou test indicated a higher prognostic assurance against risk of future CIN 3 than three subsequent negative conventional Papanicolaou tests and may safely allow three-year or longer screening intervals for such low- risk women. It

  12. The Quebec Association of Gastroenterology Position Paper on Colorectal Cancer Screening - 2003

    Directory of Open Access Journals (Sweden)

    AN Barkun

    2004-01-01

    Full Text Available Colorectal cancer is a leading cause of death and the third most common cancer in Canada. Evidence suggests that screening can reduce mortality rates and the cost effectiveness of a program compares favourably with initiatives for breast and cervical cancer. The objectives of the Association des gastro-entérologues du Québec Task Force were to determine the need for a policy on screening for colorectal cancer in Quebec, to evaluate the testing methods available and to propose one or more of these alternatives as part of a formal screening program, if indicated. Fecal occult blood testing (FOBT, endoscopy (including sigmoidoscopy and colonoscopy, barium enema and virtual colonoscopy were considered. Although most clinical efficacy data are available for FOBT and sigmoidoscopy, there are limitations to programs based on these strategies. FOBT has a high false positive rate and a low detection yield, and even a combination of these strategies will miss 24% of cancers. Colonoscopy is the best strategy to both detect and remove polyps and to diagnose colorectal cancer, with double contrast barium enema also being a sensitive detection method. The Task Force recommended the establishment, in Quebec, of a screening program with five- to 10-yearly double contrast barium enema or 10-yearly colonoscopy for individuals aged 50 years or older at low risk. The program should include outcome monitoring, public and professional education to increase awareness and promote compliance, and central coordination with other provincial programs. The program should be evaluated; specific billing codes for screening for colorectal cancer would help facilitate this. Formal feasibility, effectiveness and cost-effectiveness studies in Quebec are now warranted.

  13. How much colonoscopy screening should be recommended to individuals with various degrees of family history of colorectal cancer?

    NARCIS (Netherlands)

    J.A. Wilschut (Janneke); E.W. Steyerberg (Ewout); M.E. van Leerdam (Monique); I. Lansdorp-Vogelaar (Iris); J.D.F. Habbema (Dik); M. van Ballegooijen (Marjolein)

    2011-01-01

    textabstractBACKGROUND: Individuals with a family history of colorectal cancer (CRC) are at increased risk for CRC. Current screening recommendations for these individuals are based on expert opinion. The authors investigated optimal screening strategies for individuals with various degrees of famil

  14. Teaching Tools to Engage Anishinaabek First Nations Women in Cervical Cancer Screening: Report of an Educational Workshop

    Science.gov (United States)

    Zehbe, Ingeborg; Wood, Brianne; Wakewich, Pamela; Maar, Marion; Escott, Nicholas; Jumah, Naana; Little, Julian

    2016-01-01

    Objective: To explore educational strategies for engaging First Nations women in Canada to attend cervical cancer screening. Design: Within a participatory action research framework, semi-structured interviews with health-care providers in First Nations communities revealed that education about the value of screening is perceived as being a key…

  15. New Molecular Tools for Efficient Screening of Cervical Cancer

    OpenAIRE

    Magnus von Knebel Doeberitz

    2001-01-01

    Cytological screening using the Pap-smear led to a remarkable reduction of the mortality of cervical cancer. However, due to subjective test criteria it is hampered by poor inter- and intra-observer agreement. More reproducible assays are expected to improve the current screening and avoid unnecessary medical intervention and psychological distress for the affected women. Cervical cancer arises as consequence of persistent high risk papillomavirus (HR-HPV) infections. Expression of two viral ...

  16. Screening and cervical cancer cure: population based cohort study

    OpenAIRE

    Andrae, B.; Andersson, T. M.-L.; Lambert, P C; Kemetli, L.; Silfverdal, L.; Strander, B.; Ryd, W.; Dillner, J.; Tornberg, S.; Sparen, P.

    2012-01-01

    Objective To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death. Design Nationwide population based cohort study. Setting Sweden. Participants All 1230 women with cervical cancer diagnosed during 1999-2001 in Sweden prospectively followed up for an average of 8.5 years. Main outcome measures Cure proportions and five year relative survival ratios, stratified by screening history, mode of detection, age...

  17. Korean Guidelines for Colorectal Cancer Screening and Polyp Detection

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bo In [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Hong, Sung Pil [Yensei University College of Medicine, Seoul (Korea, Republic of); Kim, Seong Eun [Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2012-04-15

    Colorectal cancer is currently the second most common cancer among Korean males and the fourth most common among females. Since the majority of colorectal cancer case present following the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are vital methods in its prevention. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish national guidelines for colorectal cancer screening and polyp detection. The proposed guidelines have been developed by the Korean Multi-Society Task Force using evidence-based methods. Systematic reviews and meta-analyses have been used to form the statements contained in the guidelines. This paper discusses the epidemiology of colorectal cancers and adenomas in Korea as well as optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.

  18. Lung cancer screening: latest developments and unanswered questions.

    Science.gov (United States)

    van der Aalst, Carlijn M; Ten Haaf, Kevin; de Koning, Harry J

    2016-09-01

    The US National Lung Screening Trial showed that individuals randomly assigned to screening with low-dose CT scans had 20% lower lung cancer mortality than did those screened with conventional chest radiography. On the basis of a review of the literature and a modelling study, the US Preventive Services Task Force recommends annual screening for lung cancer for individuals aged 55-80 years who have a 30 pack-year smoking history and either currently smoke or quit smoking within the past 15 years. However, the balance between benefits and harms of lung cancer screening is still greatly debated. The large number of false-positive results and the potential for overdiagnosis are causes for concern. Some investigators suggest the ratio between benefits and harms could be improved through various means. Nevertheless, many questions remain with regard to the implementation of lung cancer screening. This paper highlights the latest developments in CT lung cancer screening and provides an overview of the main unanswered questions. PMID:27599248

  19. Secondary solid cancer screening following hematopoietic cell transplantation

    Science.gov (United States)

    Inamoto, Y; Shah, NN; Savani, BN; Shaw, BE; Abraham, AA; Ahmed, IA; Akpek, G; Atsuta, Y; Baker, KS; Basak, GW; Bitan, M; DeFilipp, Z; Gregory, TK; Greinix, HT; Hamadani, M; Hamilton, BK; Hayashi, RJ; Jacobsohn, DA; Kamble, RT; Kasow, KA; Khera, N; Lazarus, HM; Malone, AK; Lupo-Stanghellini, MT; Margossian, SP; Muffly, LS; Norkin, M; Ramanathan, M; Salooja, N; Schoemans, H; Wingard, JR; Wirk, B; Wood, WA; Yong, A; Duncan, CN; Flowers, MED; Majhail, NS

    2016-01-01

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

  20. Secondary solid cancer screening following hematopoietic cell transplantation.

    Science.gov (United States)

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

    2015-08-01

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

  1. Effects of Prostate Cancer Screening and Treatment

    NARCIS (Netherlands)

    E.M. Wever (Elisabeth)

    2012-01-01

    textabstractProstate cancer is the second most frequently diagnosed cancer of men worldwide. The number of new cases worldwide was estimated at 899,000 and accounted for 13.6% of all cancers in men in 2008. With an estimated 258,000 deaths in 2008, prostate cancer is the sixth leading cause of death

  2. Cost-effectiveness of colorectal cancer screening - An overview

    NARCIS (Netherlands)

    I. Lansdorp-Vogelaar (Iris); A.B. Knudsen (Amy); H. Brenner (Hermann)

    2010-01-01

    textabstractThere are several modalities available for a colorectal cancer (CRC) screening program. When determining which CRC screening program to implement, the costs of such programs should be considered in comparison to the health benefits they are expected to provide. Cost-effectiveness analysi

  3. Diagnostic and treatment procedures induced by cervical cancer screening

    NARCIS (Netherlands)

    M. van Ballegooijen (Marjolein); M.A. Koopmanschap (Marc); G.J. van Oortmarssen (Gerrit); J.D.F. Habbema (Dik); N. van der Lubbe (Nils); H.M.A. van Agt (H. M A)

    1990-01-01

    markdownabstractAbstract The amount of diagnostic and treatment procedures induced by cervical cancer screening has been assessed prospectively and related to mortality reduction. Assumptions are based on data from Dutch screening programmes and on a scenario for future developments. With 5 invita

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

    Science.gov (United States)

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

    2000-01-01

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

  5. Prospects for population screening and diagnosis of lung cancer

    DEFF Research Database (Denmark)

    Field, John K; Oudkerk, Matthijs; Pedersen, Jesper Holst;

    2013-01-01

    Deaths from lung cancer exceed those from any other type of malignancy, with 1·5 million deaths in 2010. Prevention and smoking cessation are still the main methods to reduce the death toll. The US National Lung Screening Trial, which compared CT screening with chest radiograph, yielded a mortality...

  6. European Randomized Lung Cancer Screening Trials : Post NLST

    NARCIS (Netherlands)

    Field, John K.; van Klaveren, Rob; Pedersen, Jesper H.; Pastorino, Ugo; Paci, Eugino; Becker, Nikolauss; Infante, Maurizo; Oudkerk, Matthijs; de Koning, Harry J.

    2013-01-01

    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 tri

  7. Value of audits in breast cancer screening quality assurance programmes

    NARCIS (Netherlands)

    Geertse, Tanya D.; Holland, Roland; Timmers, Janine M. H.; Paap, Ellen; Pijnappel, Ruud M.; Broeders, Mireille J. M.; den Heeten, Gerard J.

    2015-01-01

    Our aim was to retrospectively evaluate the results of all audits performed in the past and to assess their value in the quality assurance of the Dutch breast cancer screening programme. The audit team of the Dutch Reference Centre for Screening (LRCB) conducts triennial audits of all 17 reading uni

  8. Screening in breast cancer: a view from the front line

    International Nuclear Information System (INIS)

    Mammography screning presents the only real breakthrough in breast cancer in this century. Twenty-five percent of all cancer in women is breast cancer. About 50 percent of these women die from their disease. It has not been possible to reduce breast cancer mortality more than marginally by any mode of treatment. Single view mammography screening can do so, however, at the rate of 30 to 40 percent. Screening has many detractors, especially in the treatment camp. These detractors do not always act in the patients' best interests. Considering the vast resources used up until now in trying to improve on breast cancer treatment, and to little avail, it is time to divert some of these efforts to set up screening programmes wherever possible. Well handled, these are able to reduce suffering and health care costs and save lines

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

    Science.gov (United States)

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

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

    Science.gov (United States)

    Sharma, Divakar; Newman, Thomas G.

    2015-01-01

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

  11. Analysis of previous screening examinations for patients with breast cancer

    International Nuclear Information System (INIS)

    We wanted to improve the quality of subsequent screening by reviewing the previous screening of breast cancer patients. Twenty-four breast cancer patients who underwent previous screening were enrolled. All 24 took mammograms and 15 patients also took sonograms. We reviewed the screening retrospectively according to the BI-RADS criteria and we categorized the results into false negative, true negative, true positive and occult cancers. We also categorized the causes of false negative cancers into misperception, misinterpretation and technical factors and then we analyzed the attributing factors. Review of the previous screening revealed 66.7% (16/24) false negative, 25.0% (6/24) true negative, and 8.3% (2/24) true positive cancers. False negative cancers were caused by the mammogram in 56.3% (9/16) and by the sonogram in 43.7% (7/16). For the false negative cases, all of misperception were related with mammograms and this was attributed to dense breast, a lesion located at the edge of glandular tissue or the image, and findings seen on one view only. Almost all misinterpretations were related with sonograms and attributed to loose application of the final assessment. To improve the quality of breast screening, it is essential to overcome the main causes of false negative examinations, including misperception and misinterpretation. We need systematic education and strict application of final assessment categories of BI-RADS. For effective communication among physicians, it is also necessary to properly educate them about BI-RADS

  12. Imaging screening of breast cancer: primary results in 5307 cases

    International Nuclear Information System (INIS)

    Objective: To discuss the values of three screening methods for the detection of early breast cancer, and to analyze the features of the screening cancer. Methods: The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years. The three screening methods included physical examination with ultrasound and mammography, physical examination with mammography and mammography only. The rate of recall, biopsy, cancer detection of three methods were analyzed and the mammographic findings were reviewed. Chi-square test or Fisher's exact test were used for the statistics. Results: The recall rates were 4.90% (49/1001), 6.90% (166/2407) and 4. 48% (85/1899) in three methods respectively, the biopsy rates were 1.60% (16/1001), 1.04% (25/2407) and 0.63% (12/1899), the cancer detection rates were 0.50% (5/1001), 0.17% (4/2407) and 0 (0/1899). There were statistical differences among the three groups (χ2=12.99,6.264,8.764, P<0.05). Physical examination with ultrasound and mammography had the highest cancer detection rate, ten breast cancers were detected and 8 were early stage breast cancer. Of seven cancers detected by mammography, only two were found by ultrasound. A cluster of calcifications were found in 2 cases, linear calcifications in 2 cases. One case presented as a asymmetric density, one as a asymmetric density with calcifications, one as multiple nodules with a cluster of calcifications. Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review. Conclusion: Physical examination with ultrasound and mammography is the best method for breast cancer screening. The breast cancer can be detected by mammography earlier than other methods. (authors)

  13. Prevention strategies in prostate cancer

    OpenAIRE

    Trottier, Greg; Lawrentschuk, N.; Fleshner, N.E.

    2010-01-01

    Prostate cancer (pca) prevention has been an exciting and controversial topic since the results of the Prostate Cancer Prevention Trial (pcpt) were published. With the recently published results of the reduce (Reduction by Dutasteride of Prostate Cancer Events) trial, interest in this topic is at a peak. Primary pca prevention will be unlikely to affect mortality significantly, but the reduction in overtreatment and the effect on quality of life from the avoidance of a cancer diagnosis are im...

  14. Colorectal cancer screening among Latinos from U.S. cities along the Texas-Mexico border.

    Science.gov (United States)

    Fernandez, Maria E; Wippold, Rosario; Torres-Vigil, Isabel; Byrd, Theresa; Freeberg, Diamond; Bains, Yadvindera; Guajardo, Jessica; Coughlin, Steven S; Vernon, Sally W

    2008-03-01

    Colorectal cancer (CRC) screening rates are comparatively low for U.S. Hispanics. To learn more about the factors influencing CRC screening among Hispanics living along the U.S.-Mexico border, 12 focus groups were conducted with Hispanic men and women aged 50 years and older in three Texas counties; Cameron County (Brownsville), Webb County (Laredo), and El Paso County, (El Paso). The focus group guide contained questions about health care behavior, knowledge about CRC, experiences with cancer, and factors that influence CRC screening. A total of 92 individuals participated with the majority aged 50-69 (75%). Twenty percent were born in the United States and 51% had lived in the United States for more than 20 years. Participants had low levels of education, income, and insurance coverage. The analysis revealed several overarching and contextual themes relating to knowledge, attitudes, beliefs, and emotions about cancer and CRC screening. A prevalent theme that emerged from all groups was frustration and a lack of confidence in the U.S. healthcare system. Few participants had been advised by their providers to obtain CRC screening. Lack of patient knowledge about colorectal cancer and screening appeared to be a critical factor influencing screening. Themes about death and pain due to cancer were prevalent as were cultural factors such as machismo and embarrassment. System level barriers such as cost, medical insurance and transportation also impacted screening. These findings suggest that strategies are needed to educate Hispanic residents of border communities about CRC and to motivate them to undergo CRC screening.

  15. Pathways of cervical cancer screening among Chinese women

    Directory of Open Access Journals (Sweden)

    Ma GX

    2013-06-01

    Full Text Available Grace X Ma,1 Min Qi Wang,2 Xiang S Ma,3 Steven E Shive,4 Yin Tan,5 Jamil I Toubbeh51Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, 2Department of Public and Community Health, University of Maryland, College Park, MD, 3College of Health Professions and School of Medicine, Temple University, Philadelphia, PA, 4Center for Asian Health, Temple University, and Department of Health, East Stroudsburg University, East Stroudsburg, PA, 5Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, USABackground: The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancer screening among Chinese American women.Methods: A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancer screening.Results: Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancer screening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor.Conclusion: This model highlights the significance of sociocultural factors in relation to cervical cancer screening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical

  16. The benefits and harms of screening for cancer with a focus on breast screening

    DEFF Research Database (Denmark)

    Brodersen, John; Juhl Jørgensen, Karsten; Gøtzsche, Peter C.

    2010-01-01

    -positive result, or live more years as a patient with breast cancer. Systematic reviews of the randomized trials have shown that for every 2000 women invited for mammography screening throughout 10 years, only 1 will have her life prolonged. In addition, 10 healthy women will be overdiagnosed with breast cancer...

  17. Screening women at high risk of breast cancer on the basis of evidence

    International Nuclear Information System (INIS)

    Geneticists are able to identify the risk of breast cancer. Strategies on offer include prevention, early diagnosis by screening, and prophylactic surgery. This paper analyses the evidence for offering screening. The radiation dose of mammography has been measured, but the risk is not fully known. Mammography screening of women of 40-50 years in the normal population has known effect. Little evidence is available for women under 40 years or for women with genetic susceptibility to breast cancer. Dense parenchymal pattern is associated with high grade cancers, and is both a risk factor and a reason for impaired screening sensitivity. Whether this applies to younger women or women at high risk is speculative. The pathological features of the cancers in gene carriers show differences from those occurring in normal women. This work should be correlated with imaging features. There is no literature to support the use of newer imaging methods in these women. Ultrasound and MRI avoid radiation and may be useful in dense breasts. SestaMIBI and PET scanning are not yet mature enough for screening, and may never have such a role. Any newer modality must be subjected to a formal randomised trial before being offered to screen women at high risk

  18. Register-based studies of cancer screening effects

    DEFF Research Database (Denmark)

    Von Euler-Chelpin, My; Lynge, Elsebeth; Rebolj, Matejka

    2011-01-01

    INTRODUCTION: There are two organised cancer screening programmes in Denmark, against cervical and breast cancers. The aim with this study was to give an overview of the available register-based research regarding these two programmes, to demonstrate the usefulness of data from the national regis...

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

    Science.gov (United States)

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

  20. Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study

    Directory of Open Access Journals (Sweden)

    Ajibola Idowu

    2016-01-01

    Full Text Available Introduction. Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women. Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at p<0.05. Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%, p=0.001, respondents who were aware of the disease (100.0%, p=0.001, and those who were aware of cervical cancer screening (88.9%, p=0.001. Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.01–0.28. Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them.

  1. Cervical cancer screening: on the way to a shift from cytology to full molecular screening.

    Science.gov (United States)

    Dijkstra, M G; Snijders, P J F; Arbyn, M; Rijkaart, D C; Berkhof, J; Meijer, C J L M

    2014-05-01

    Cytology-based nation-wide cervical screening has led to a substantial reduction of the incidence of cervical cancer in western countries. However, the sensitivity of cytology for the detection of high-grade precursor lesions or cervical cancer is limited; therefore, repeated testing is necessary to achieve program effectiveness. Additionally, adenocarcinomas and its precursors are often missed by cytology. Consequently, there is a need for a better screening test. The insight that infection with high-risk human papillomavirus (hrHPV) is the causal agent of cervical cancer and its precursors has led to the development of molecular tests for the detection of hrHPV. Strong evidence now supports the use of hrHPV testing in the prevention of cervical cancer. In this review, we will discuss the arguments in favor of, and concerns on aspects of implementation of hrHPV testing in primary cervical cancer screening, such as the age to start hrHPV-based screening, ways to increase screening attendance, requirements for candidate hrHPV tests to be used, and triage algorithms for screen-positive women. PMID:24445150

  2. Older Korean American men's prostate cancer screening behavior: the prime role of culture.

    Science.gov (United States)

    Lee, Hee Yun; Jung, Yunkyung

    2013-12-01

    East and South Asian male immigrants show markedly low odds of prostate cancer screening as compared to U.S.-born men. However, knowledge about these immigrants' culture-based screening behavior and barriers to screening is extremely limited. This study investigates factors influencing receipt of prostate cancer screening among Korean American immigrant men, particularly investigating culture's impact on screening behaviors. Data were collected through a convenience and purposive sampling technique from 134 Korean American males aged 50 and older recruited in New York City. A structured questionnaire was used and cultural variables were measured by adopting items from Tang and colleagues' work. Approximately 60 % of the sample had received a prostate-specific antigen (PSA) test in their lifetime, and of these, about 66 % reported having done so in the previous 12 months. Logistic regression analysis revealed that a crisis-oriented intervention approach was associated with a substantially reduced likelihood of screening. A positive correlation was noted between the use of Eastern medicine and PSA test receipt. Further analysis revealed a significant interaction effect between use of Eastern medicine and age in predicting PSA test uptake. Culture-specific intervention strategies for increasing prostate cancer screening in this group are discussed, with particular attention to increasing pertinent health literacy. Health professionals should consider the cultural domain when working with Korean immigrant men in order to provide culturally competent care.

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

    Directory of Open Access Journals (Sweden)

    Farooqui Maryam

    2013-01-01

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

  4. Transillumination in breast cancer detection: screening failures and potential

    International Nuclear Information System (INIS)

    This prospective study of 1265 women referred to a multimodality breast diagnostic center compares the sensitivity for breast cancer detection of state-of-the-art transillumination light scanning and film-screen mammography. Of 33 biopsy-proven cancers, transillumination light scanning detected 58%, while mammography detected 97% of the cancers. Light scanning did detect 55% of the nonpalpable breast cancers, and 30% of those tumors smaller than 1 cm. Detection of breast cancer by light scanning was affected by breast size, but not architecture, and was directly related to tumor size. Although transillumination light scanning can detect some small curable breast cancers (smaller than 1 cm), it does not do so at a sensitivity adequate for screening

  5. Invited commentary: screening and the elusive etiology of prostate cancer.

    Science.gov (United States)

    Garcia-Closas, Montserrat; Berrington de Gonzalez, Amy

    2015-09-01

    The role of lifestyle risk factors in prostate cancer risk remains elusive despite a large number of epidemiologic studies. In a pooled analysis of data from South and East Asian countries published in this issue, Fowke et al. (Am J Epidemiol. 2015;182(5):381-389) found no evidence for an association between prostate cancer mortality and obesity, alcohol, or smoking. Prostate cancer screening is very uncommon in these countries, and previous evidence for associations with lifestyle factors comes primarily from studies carried out in North America, where screening is very common. Fowke et al. concluded that screening biases are likely to explain the differences in study results. In this commentary, we discuss the potential influence of population-based cancer screening programs in estimates of association from epidemiologic studies. This highlights the importance of carefully considering the impact of screening in the analysis and interpretation of results, in order to advance our understanding of the etiology of cancers that can be detected by screening.

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

    Science.gov (United States)

    Pivot, Xavier; Viguier, Jérôme; Touboul, Chantal; Morère, Jean-François; Blay, Jean-Yves; Coscas, Yvan; Lhomel, Christine; Eisinger, François

    2015-06-01

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

  7. Risks of Liver (Hepatocellular) Cancer Screening

    Science.gov (United States)

    ... cancer is present in the body. Alpha-fetoprotein (AFP) is the most widely used tumor marker for ... and other types of cancer, may also increase AFP levels. Specific tumor markers that may lead to ...

  8. December 2013 Phoenix pulmonary journal club: lung cancer screening

    Directory of Open Access Journals (Sweden)

    Manoj Mathew

    2013-12-01

    Full Text Available No abstract available. Article truncated at 150 words. During this month’s pulmonary journal club we reviewed several of the sentinel studies looking at lung cancer screening. Since the National Lung Screening Research Team (NLSRT (1 published the impressive results showing a 20% reduction in lung cancer mortality, the debate on when and if to initiate a national lung cancer screening program has been at the forefront of debate. The American Lung Association and American Cancer Society have issued statements that are not guidelines, but did offer insight on the price we pay for earlier lung cancer detection and reduction in mortality…which is the increased rates of false positives detected and increased rates of biopsies. The US Task Force on Lung Cancer Screening has yet to decide on a screening program and have yielded a statement that neither supports nor refutes the current level of evidence. Prior to the NLSRT study there were others that showed conflicting results on …

  9. Chemical genetics and drug screening in Drosophila cancer models

    Institute of Scientific and Technical Information of China (English)

    Mara Gladstone; Tin Tin Su

    2011-01-01

    Drug candidates often fail in preclinical and clinical testing because of reasons of efficacy and/or safety.It would be time- and cost-efficient to have screening models that reduce the rate of such false positive candidates that appear promising at first but fail later.In this regard,it would be particularly useful to have a rapid and inexpensive whole animal model that can pre-select hits from high-throughput screens but before testing in costly rodent assays.Drosophila melanogaster has emerged as a potential whole animal model for drug screening.Of particular interest have been drugs that must act in the context of multi-cellularity such as those for neurological disorders and cancer.A recent review provides a comprehensive summary of drug screening in Drosophila,but with an emphasis on neurodegenerative disorders.Here,we review Drosophila screens in the literature aimed at cancer therapeutics.

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Women's perspectives on illness in being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    Background In Greenland, the incidence of cervical cancer caused by human papillomavirus (HPV) is 25 per 100,000 women; 2.5 times the Danish rate. In Greenland, the disease is most frequent among women aged 30–40. Systematic screening can identify women with cervical cell changes, which...... if untreated may cause cervical cancer. In 2007, less than 40% of eligible women in Greenland participated in screening. Objective To examine Greenlandic women's perception of disease, their understanding of the connection between HPV and cervical cancer, and the knowledge that they deem necessary to decide...... whether to participate in cervical cancer screening. Study design The methods used to perform this research were 2 focus-group interviews with 5 Danish-speaking women and 2 individual interviews with Greenlandic-speaking women. The analysis involved a phenomenological-hermeneutic approach with 3 levels...

  12. An Unbiased Oncology Compound Screen to Identify Novel Combination Strategies.

    Science.gov (United States)

    O'Neil, Jennifer; Benita, Yair; Feldman, Igor; Chenard, Melissa; Roberts, Brian; Liu, Yaping; Li, Jing; Kral, Astrid; Lejnine, Serguei; Loboda, Andrey; Arthur, William; Cristescu, Razvan; Haines, Brian B; Winter, Christopher; Zhang, Theresa; Bloecher, Andrew; Shumway, Stuart D

    2016-06-01

    Combination drug therapy is a widely used paradigm for managing numerous human malignancies. In cancer treatment, additive and/or synergistic drug combinations can convert weakly efficacious monotherapies into regimens that produce robust antitumor activity. This can be explained in part through pathway interdependencies that are critical for cancer cell proliferation and survival. However, identification of the various interdependencies is difficult due to the complex molecular circuitry that underlies tumor development and progression. Here, we present a high-throughput platform that allows for an unbiased identification of synergistic and efficacious drug combinations. In a screen of 22,737 experiments of 583 doublet combinations in 39 diverse cancer cell lines using a 4 by 4 dosing regimen, both well-known and novel synergistic and efficacious combinations were identified. Here, we present an example of one such novel combination, a Wee1 inhibitor (AZD1775) and an mTOR inhibitor (ridaforolimus), and demonstrate that the combination potently and synergistically inhibits cancer cell growth in vitro and in vivo This approach has identified novel combinations that would be difficult to reliably predict based purely on our current understanding of cancer cell biology. Mol Cancer Ther; 15(6); 1155-62. ©2016 AACR. PMID:26983881

  13. Cervical cancer screening: knowledge, health perception and attendance rate among Hong Kong Chinese women

    Directory of Open Access Journals (Sweden)

    Sharron SK Leung

    2010-07-01

    Full Text Available Sharron SK Leung1, Ivy Leung21School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong; 2Quality Healthcare Medical Services, Hong KongPurpose: Cervical cancer screening has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. However, cervical screening attendance rates are still far from satisfactory in many countries. Strategies, health promotion and education programs need to be developed with clear evidence of the causes and factors relating to the low attendance rate. The study aims to assess the prediction of cervical screening attendance rate by Chinese women’s knowledge about cervical cancer and cervical screening as well as their perception of health.Patients and methods: A survey with self-reported questionnaires was conducted on 385 Chinese women recruited from a community clinic in Hong Kong. Participants were Chinese women, Hong Kong residents, aged 18–65 years, able to read Chinese or English, and were not pregnant.Results: Women aged 37 years or less, with at least tertiary education, who perceived having control over their own health and had better knowledge on risk factors, were more likely to attend cervical cancer screening. Many participants had adequate general knowledge but were unable to identify correct answers on the risk factors.Conclusion: Health promotion efforts need to focus on increasing women’s knowledge on risk factors and enhancing their perceived health control by providing more information on the link between screening and early detection with lower incidence rates and mortality from cervical cancer.Keywords: cervical screening attendance, cervical cancer, health perception and knowledge, perceived health control, Chinese

  14. Radiologic aspects of breast cancers detected through a breast cancer screening program

    International Nuclear Information System (INIS)

    Early detection in breast cancer and reduced mortality in women with this disease is today attributed to widespread use of mammography. High-quality performance is essential in all steps of breast cancer screening programs in order to avoid unnecessary anxiety and surgery in the women concerned. This report presents radiologic aspects of screening cancers. A total of 8370 asymptomatic women aged 50-69 years were screened with 2-view mammography, of which only 70 (0.84 percent) were selected for surgery after a thorough work-up. Cancers were verified histologically in 61 women and 9 showed non-malignant histology, giving a cancer detection rate of 7.3 cancers per thousand screened asymptomatic women. The benign/malignant ratio in the operated cases is thus approximately 1:7. The cancers detected showed all existing types of mammographic features where 77 percent (47 cases) showed rather typical findings, such as spiculated densities both with and without microcalcifications. The results indicate that surgery can be minimized without impairing the breast cancer detection rate. Radiologists in screening programs should be aware that a large proportion of non-palpable breast cancers present in rather unconventional forms. This point is important in order to maintain a high cancer detection rate and thereby justify the widespread use of mammography as a screening tool for breast cancer in asymptomatic women. (author). 20 refs.; 1 tab

  15. International Association for the Study of Lung Cancer Computed Tomography Screening Workshop 2011 report

    DEFF Research Database (Denmark)

    Field, John K; Smith, Robert A; Aberle, Denise R;

    2011-01-01

    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...... 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.......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 cancer screening from other organ sites.The IASLC CT Screening Workshop 2011 further developed these discussions...

  16. Detection of lung cancer through low-dose CT screening (NELSON) : a prespecifi ed analysis of screening test performance and interval cancers

    NARCIS (Netherlands)

    Horeweg, Nanda; Scholten, Ernst Th; de Jong, Pim A.; van der Aalst, Carlijn M.; Weenink, Carla; Lammers, Jan-Willem J.; Nackaerts, Kristiaan; Vliegenthart, Rozemarijn; ten Haaf, Kevin; Yousaf-Khan, Uraujh A.; Heuvelmans, Marjolein A.; Thunnissen, Erik; Oudkerk, Matthijs; Mali, Willem; de Koning, Harry J.

    2014-01-01

    Background Low-dose CT screening is recommended for individuals at high risk of developing lung cancer. However, CT screening does not detect all lung cancers: some might be missed at screening, and others can develop in the interval between screens. The NELSON trial is a randomised trial to assess

  17. Contributing Factors to Colorectal Cancer Screening among Chinese People: A Review of Quantitative Studies.

    Science.gov (United States)

    Leung, Doris Y P; Chow, Ka Ming; Lo, Sally W S; So, Winnie K W; Chan, Carmen W H

    2016-01-01

    Colorectal cancer (CRC) is a major health problem in Asia. It has been reported that the Chinese are more susceptible to CRC than many other ethnic groups. Screening for CRC is a cost-effective prevention and control strategy; however, the screening rates among the Chinese are sub-optimal. We conducted a review to identify the factors associated with CRC screening participation among Chinese people. Twenty-two studies that examined the factors related to CRC screening behaviors among the Chinese were identified through five databases. Seven factors were consistently reported to influence CRC screening behaviors in at least one of the studies: socio-demographic characteristics (educational level, health insurance, and knowledge about CRC and its screening); psychological factors (perceived severity of CRC, susceptibility of having CRC, and barriers to screening); and contact with medical provider (physician recommendation). The evidence base for many of these relationships is quite limited. Furthermore, the associations of many factors, including age, gender, income, cancer worry/fear, and self-efficacy with CRC screening behaviors, were mixed or inconsistent across these studies, thereby indicating that more studies are needed in this area. PMID:27196920

  18. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.

    Directory of Open Access Journals (Sweden)

    Waseem Khaliq

    Full Text Available Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women.A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography.Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89, current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67, and history of stroke (OR = 2.83, 95%CI; 1.21-6.60. By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34.Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

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

    Science.gov (United States)

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

  20. Intelligent Screening Systems for Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Yessi Jusman

    2014-01-01

    Full Text Available 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.

  1. Cancer literacy as a mediator for cancer screening behaviour in Korean adults.

    Science.gov (United States)

    Lee, Hee Yun; Rhee, Taeho Greg; Kim, Nam Keol

    2016-09-01

    This study investigates the cancer literacy level in Korean adults and examines whether cancer literacy plays a mediating role in the relationship between population characteristics and cancer screening behaviours. We collected data from 585 community-dwelling adults in Korea using self-administered surveys and face-to-face interviews from October to December in 2009. Guided by Andersen's behavioural model, we used a structural equation model to estimate the effect of cancer literacy as a mediator and found that cancer literacy mediated cancer screening behaviour. In the individual path analysis models, cancer literacy played a significant mediating role for the use of eastern medicine, fatalism, health status and the number of chronic diseases. When controlling for other relevant covariates, we found that in the optimal path model, cancer literacy played a mediating role in the relationship between the use of eastern medicine and self-rated health status as well as cancer screening behaviour. Thus, developing community-based cancer education programmes and training clinical practitioners in eastern medicine clinics about the importance of informing their patients about regular cancer screening may be an option to boost cancer literacy and screening behaviour in Korea. PMID:25975449

  2. Screening for cervical cancer in French Guiana: screening rates from 2006 to 2011.

    Science.gov (United States)

    Douine, M; Roué, T; Lelarge, C; Adenis, A; Thomas, N; Nacher, M

    2015-12-01

    In French Guiana, the age-standardized incidence rate of cervical cancer is four times higher than in France and the mortality rate 5.5 times higher. A survival study revealed that stage at diagnosis was the main factor influencing the prognosis, showing that early detection is crucial to increase cervical cancer survival. The present study aimed at evaluating the cervical cancer screening rate between 2006 and 2011 by age and for a 3-year period in French Guiana. All pap smears realised in French Guiana were analysed in two laboratories allowing exhaustive review of screening data. The screening rate was estimated at about 54% from 2006 to 2011, with a statistical difference between coastal and rural area (56.3% versus 18.7%). Although the methodological difference did not allow comparisons with metropolitan France, these results could be used to evaluate the impact of organised cervical cancer screening by the French Guiana Association for Organized Screening of Cancers which has been implemented in French Guiana since 2012.

  3. Risk-benefit analysis for mass screening of breast cancer utilizing mammography as a screening test

    International Nuclear Information System (INIS)

    Incidence of breast cancers in Japanese women is increasing steadily. Mass screening of breast cancer was started in Japan under auspices of Adult Health Promotion Act of the Japanese Government from 1987. As the first screening method, the palpation of breasts is employed at present, but it is expected to be replaced by the mammography. In this report, the risk-benefit analysis is presented between risk of breast carcinogenesis due to radiation and benefit of mass screening of breast cancer. The benefit of mass screening is taken as the net elongation of average life expectancy of women due to survival from breast cancers. The risk of mammography is taken as the net loss of average life expectancy of women due to breast carcinogenesis. In the latter, the latency time and plateau period of radiation carcinogenesis were taken into consideration in the calculation. The results show that the ages at which the benefit and risk become equal are between 30 and 35 years old when dose equivalent of mammography is between 10 and 20 mSv, that are conventionally used. However, the critical age will be reduced to 20 years old if the dose equivalent becomes 1 mSv. Therefore, it is strongly recommended that a low dose mammographic system should be developed in order to achieve 1 mSv for the mass screening of breast cancer of Japanese women. In author's opinion, this is quite feasible by employing a new digital radiography with imaging plate. (author)

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Race/Ethnicity, Gender, Weight Status, and Colorectal Cancer Screening

    Directory of Open Access Journals (Sweden)

    Heather Bittner Fagan

    2011-01-01

    The literature on colorectal cancer (CRC screening is contradictory regarding the impact of weight status on CRC screening. This study was intended to determine if CRC screening rates among 2005 National Health Interview Survey (NHIS respondent racial/ethnic and gender subgroups were influenced by weight status. Methods. Univariable and multivariable logistic regression analyses were performed to determine if CRC screening use differed significantly among obese, overweight, and normal-weight individuals in race/ethnic and gender subgroups. Results. Multivariable analyses showed that CRC screening rates did not differ significantly for individuals within these subgroups who were obese or overweight as compared to their normal-weight peers. Conclusion. Weight status does not contribute to disparities in CRC screening in race/ethnicity and gender subgroups.

  6. Therapeutic strategies targeting cancer stem cells.

    Science.gov (United States)

    Ning, Xiaoyan; Shu, Jianchang; Du, Yiqi; Ben, Qiwen; Li, Zhaoshen

    2013-04-01

    Increasing studies have demonstrated a small proportion of cancer stem cells (CSCs) exist in the cancer cell population. CSCs have powerful self-renewal capacity and tumor-initiating ability and are resistant to chemotherapy and radiation. Conventional anticancer therapies kill the rapidly proliferating bulk cancer cells but spare the relatively quiescent CSCs, which cause cancer recurrence. So it is necessary to develop therapeutic strategies acting specifically on CSCs. In recent years, studies have shown that therapeutic agents such as metformin, salinomycin, DECA-14, rapamycin, oncostatin M (OSM), some natural compounds, oncolytic viruses, microRNAs, cell signaling pathway inhibitors, TNF-related apoptosis inducing ligand (TRAIL), interferon (IFN), telomerase inhibitors, all-trans retinoic acid (ATRA) and monoclonal antibodies can suppress the self-renewal of CSCs in vitro and in vivo. A combination of these agents and conventional chemotherapy drugs can significantly inhibit tumor growth, metastasis and recurrence. These strategies targeting CSCs may bring new hopes to cancer therapy. PMID:23358473

  7. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  8. Cultural sensitivity and informed decision making about prostate cancer screening.

    Science.gov (United States)

    Chan, Evelyn C Y; Haynes, Michelle C; O'Donnell, Frederick T; Bachino, Carolyn; Vernon, Sally W

    2003-12-01

    Because informed consent for prostate cancer screening with prostate specific antigen (PSA) is recommended, we determined how African Americans, Hispanics, and Caucasians want information about screening with PSA and the digital rectal exam (DRE) presented in culturally sensitive brochures specific for each group. We analyzed focus group discussions using content analysis and compared themes across groups in a university outpatient internal medicine practice setting. The participants were twenty couples with men age 50 and older who participated in four focus groups. Main outcome measures were participants' views on the content and graphic design of culturally sensitive brochures promoting informed decision making about prostate cancer screening. There were content and graphic design differences in the way ethnic groups wanted information presented about the prostate, prostate cancer, risk, and screening. Caucasians likened the size of the prostate to a walnut; Hispanics, to a small lime. Hispanics emphasized how advanced prostate cancer can be symptomatic; Caucasians, how early prostate cancer can be asymptomatic. African Americans wanted risk information specific for them and the advantages and disadvantages of a PSA and DRE; Hispanics, did not. Caucasians and African Americans sought a more active role for men in informed decision making than Hispanics. Differences in the way African Americans, Hispanics, and Caucasians want information presented about prostate cancer screening suggest there may be cultural differences in the reasonable person standard of informed consent, in attitudes toward the physician-patient relationship, screening, and informed decision making. Physicians promoting informed decision making about controversial screening tests should take cultural sensitivity into account when designing educational interventions and using them. PMID:14620963

  9. Panel Reviews Benefits and Harms of CT Scans for Lung Cancer Screening | Division of Cancer Prevention

    Science.gov (United States)

    A panel of experts has reviewed the evidence regarding the benefits and harms of screening for lung cancer with low-dose computed tomography (CT) and concluded that the technology may benefit some individuals at high risk for lung cancer. But the panel cautioned that many questions remain about the potential harms of screening and how to translate screening into clinical practice. |

  10. Cervical cancer screening: A never-ending developing program.

    Science.gov (United States)

    Comparetto, Ciro; Borruto, Franco

    2015-07-16

    With the term "oncological screening", we define the overall performances made to detect early onset of tumors. These tests are conducted on a population that does not have any signs or symptoms related to a neoplasm. The whole population above a certain age, only one sex, only subjects with a high risk of developing cancer due to genetic, professional, discretionary reasons may be involved. Screening campaigns should be associated, when risk factors that can be avoided are known, with campaigns for the prevention of cancer by means of suitable behavior. The goal of cancer screening cannot however be limited to the diagnosis of a greater number of neoplasms. Screening will be useful only if it leads to a reduction in overall mortality or at least in mortality related to the tumor. Screening should then allow the diagnosis of the disease at a stage when there is a possibility of healing, possibility that is instead difficult when the disease is diagnosed at the appearance of signs or symptoms. This is the reason why not all campaigns of cancer screening have the same effectiveness. In Italy, every year there are about 150000 deaths due to cancer. Some of these tumors can be cured with a very high percentage of success if diagnosed in time. Cervical cancer can be diagnosed with non-invasive tests. The screening test used all over the world is Papanicolaou (Pap) test. This test may be carried out over the entire healthy population potentially exposed to the risk of contracting cancer. Public health has begun the screening campaigns in the hope of saving many of the approximately 270000 new cases of cancer reported each year. Screening is done following protocols that guarantee quality at the national level: these protocols are subject to change over time to reflect new realities or to correct any errors in the system. A simplified sketch of a possible route of cancer screening is as follows: (1) after selecting the target population, for example all women between 25

  11. How do people interpret information about colorectal cancer screening: observations from a think-aloud study

    OpenAIRE

    Smith, S. G.; Vart, G.; Wolf, M. S.; Obichere, A; Baker, H. J.; Raine, R; Wardle, J.; Von Wagner, C.

    2013-01-01

    The English NHS Bowel Cancer Screening Programme biennially invites individuals aged 60-74 to participate in screening. The booklet, 'Bowel Cancer Screening: The Facts' accompanies this invitation. Its primary aim is to inform potential participants about the aims, advantages and disadvantages of colorectal cancer screening.

  12. Five year colorectal cancer outcomes in a large negative CT colonography screening cohort

    Energy Technology Data Exchange (ETDEWEB)

    Kim, David H.; Pooler, B.D.; Pickhardt, Perry J. [University of Wisconsin School of Medicine and Public Health, Department of Radiology, Madison, WI (United States); Weiss, Jennifer M. [University of Wisconsin School of Medicine and Public Health, Section of Gastroenterology, Department of Internal Medicine, Madison, WI (United States)

    2012-07-15

    To assess the 5-year incidence of clinically presenting colorectal cancers following a negative CT colonography (CTC) screening examination, as few patient outcome data regarding a negative CTC screening result exist. Negative CTC screening patients (n = 1,050) in the University of Wisconsin Health system over a 14-month period were included. An electronic medical record (EMR) review was undertaken, encompassing provider, colonoscopy, imaging and histopathology reports. Incident colorectal cancers and other important GI tumours were recorded. Of the 1,050 cohort (mean [{+-}SD] age 56.9 {+-} 7.4 years), 39 (3.7%) patients were excluded owing to lack of follow-up within our system beyond the initial screening CTC. The remaining 1,011 patients were followed for an average of 4.73 {+-} 1.15 years. One incident colorectal adenocarcinoma represented a crude cancer incidence of 0.2 cancers per 1,000 patient years. EMR revealed 14 additional patients with clinically important GI tumours including: advanced adenomas (n = 11), appendiceal goblet cell carcinoid (n = 1), appendiceal mucinous adenoma (n = 1) and metastatic ileocolonic carcinoid (n = 1). All positive patients including the incident carcinoma are alive at the time of review. Clinically presenting colorectal adenocarcinoma is rare in the 5 years following negative screening CTC, suggesting that current strategies, including non-reporting of diminutive lesions, are appropriate. (orig.)

  13. Screening Technologies for Target Identification in Pancreatic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Michl, Patrick, E-mail: michlp@med.uni-marburg.de; Ripka, Stefanie; Gress, Thomas; Buchholz, Malte [Department of Gastroenterology and Endocrinology, University Hospital, Philipps-University Marburg, Baldinger Strasse, D-35043 Marburg (Germany)

    2010-12-29

    Pancreatic cancer exhibits an extraordinarily high level of resistance to almost any kind of systemic therapy evaluated in clinical trials so far. Therefore, the identification of novel therapeutic targets is urgently required. High-throughput screens have emerged as an important tool to identify putative targets for diagnosis and therapy in an unbiased manner. More than a decade ago, microarray technology was introduced to identify differentially expressed genes in pancreatic cancer as compared to normal pancreas, chronic pancreatitis and other cancer types located in close proximity to the pancreas. In addition, proteomic screens have facilitated the identification of differentially secreted proteins in body fluids of pancreatic cancer patients, serving as possible biomarkers. Recently, RNA interference-based loss-of-function screens have been used to identify functionally relevant genes, whose knock-down has impact on pancreatic cancer cell viability, thereby representing potential new targets for therapeutic intervention. This review summarizes recent results of transcriptional, proteomic and functional screens in pancreatic cancer and discusses potentials and limitations of the respective technologies as well as their impact on future therapeutic developments.

  14. Screening Technologies for Target Identification in Pancreatic Cancer

    International Nuclear Information System (INIS)

    Pancreatic cancer exhibits an extraordinarily high level of resistance to almost any kind of systemic therapy evaluated in clinical trials so far. Therefore, the identification of novel therapeutic targets is urgently required. High-throughput screens have emerged as an important tool to identify putative targets for diagnosis and therapy in an unbiased manner. More than a decade ago, microarray technology was introduced to identify differentially expressed genes in pancreatic cancer as compared to normal pancreas, chronic pancreatitis and other cancer types located in close proximity to the pancreas. In addition, proteomic screens have facilitated the identification of differentially secreted proteins in body fluids of pancreatic cancer patients, serving as possible biomarkers. Recently, RNA interference-based loss-of-function screens have been used to identify functionally relevant genes, whose knock-down has impact on pancreatic cancer cell viability, thereby representing potential new targets for therapeutic intervention. This review summarizes recent results of transcriptional, proteomic and functional screens in pancreatic cancer and discusses potentials and limitations of the respective technologies as well as their impact on future therapeutic developments

  15. Prevention strategies for prostate cancer.

    Science.gov (United States)

    Schmitz-Dräger, B J; Lümmen, G; Bismarck, E; Fischer, C

    2012-12-01

    Through the last decade consideration of the role of vitamins and minerals in primary prevention of genitourinary tumors has dramatically changed. Despite all efforts efficacy of a specific compound has not been proven, so far. In consequence, recommendations for a use of vitamins or other supplements with the intention of prostate cancer prevention should be avoided today. In contrast, there is some evidence that life style modification might be helpful: recent investigations suggest that smoking may be involved in prostate cancer carcinogenesis. In addition, there is evidence that moderate food consumption, reduction of dairy products and an Asian or Mediterranean diet might not only prevent prostate cancer but also harbors additional beneficial effects on general health. This move from single compounds to more complex diets can be considered as a change of paradigm in prostate cancer prevention and could be the starting point of future epidemiological research. Disappointing findings with regards to nutritional cancer prevention contrast with a solid evidence concerning the efficacy of chemoprevention using 5a-reductase inhibitors: Long-term use of Finasteride and Dutasteride significantly reduces prostate cancer detection. Further candidate drugs are under investigation. However, translation of these findings into urological practice remains a matter of controversial discussion. PMID:23288209

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Experience with breast cancer, pre-screening perceived susceptibility and the psychological impact of screening

    DEFF Research Database (Denmark)

    Absetz, Pilvikki; Aro, Arja R; Sutton, Stephen R

    2003-01-01

    This prospective study examined whether the psychological impact of organized mammography screening is influenced by women's pre-existing experience with breast cancer and perceived susceptibility (PS) to the disease. From a target population of 16,886, a random sample of women with a normal...... responded to the follow-ups. Psychological impact was measured as anxiety (STAI-S), depression (BDI), health-related concerns (IAS), and breast cancer-specific beliefs and concerns. Data was analyzed with repeated measures analyses of variance, with estimates of effect size based on Eta-squared. Women...... normal mammograms. Experience and PS did not influence responses to different screening findings. Of the finding groups, false positives experienced most adverse effects: their risk perception increased and they reported most post-screening breast cancer-specific concerns. Furthermore, they became more...

  18. Colorectal cancer screening of high-risk populations: A national survey of physicians

    Directory of Open Access Journals (Sweden)

    White Pascale M

    2012-01-01

    Full Text Available Abstract Background The incidence of colorectal cancer can be decreased by appropriate use of screening modalities. Patients with a family history of colon cancer and of African-American ethnicity are known to be at higher risk of developing colorectal cancer. We aimed to determine if there is a lack of physician knowledge for colorectal cancer screening guidelines based on family history and ethnicity. Between February and April 2009 an anonymous web-based survey was administered to a random sample selected from a national list of 25,000 internists, family physicians and gastroenterologists. A stratified sampling strategy was used to include practitioners from states with high as well as low CRC incidence. All data analyses were performed following data collection in 2009. Results The average knowledge score was 37 ± 18% among the 512 respondents. Gastroenterologists averaged higher scores compared to internists, and family physicians, p = 0.001. Only 28% of physicians correctly identified the screening initiation point for African-Americans while only 12% of physicians correctly identified the screening initiation point and interval for a patient with a family history of CRC. The most commonly cited barriers to referring high-risk patients for CRC screening were "patient refusal" and "lack of insurance reimbursement." Conclusions There is a lack of knowledge amongst physicians of the screening guidelines for high-risk populations, based on family history and ethnicity. Educational programs to improve physician knowledge and to reduce perceived barriers to CRC screening are warranted to address health disparities in colorectal cancer.

  19. Strategies for Sustainable Cancer Care.

    Science.gov (United States)

    Kerr, David J; Jani, Anant; Gray, Sir Muir

    2016-01-01

    There is an increasing focus on the relative cost-effectiveness and sustainability of delivering high-quality cancer care, with most emphasis, debatably, given to cost control of innovative treatments. It is difficult to calculate all the direct and indirect contributors to the total cost of cancer treatment, but it is estimated that cancer drugs constitute 10% to 30% of the total cost of cancer care. A 2007 study in France showed the contribution of drug costs was less than 20%, with approximately 70% of the total expenditure on cancer accounted for by health care resource use, such as hospitalization. The U.K. government established the National Institute for Health and Care Excellence (NICE)-the dominant function of which is technology appraisal-to assess the clinical and cost-effectiveness of new pharmaceutical and biopharmaceutical products. This is to ensure that all National Health Service (NHS) patients have equitable access to the most clinically effective and cost-effective treatments that are viable. NICE has developed a transparent, public process to judge incremental cost-effectiveness using the quality-adjusted life year (QALY), which allows comparisons of cost-effectiveness across medical specialties. NICE has been both lauded and criticized-especially when it passes judgment on marginally effective but expensive anticancer drugs-but it provides a route to "rational rationing" and, therefore, may contribute to sustainable cancer care by highlighting the issue of affordable medicine. This implies a challenge to the wider oncology community as to how we might cooperate to introduce the concept of value-driven cancer care. PMID:27249712

  20. Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices.

    Science.gov (United States)

    Catarino, Rosa; Petignat, Patrick; Dongui, Gabriel; Vassilakos, Pierre

    2015-12-10

    Cervical cancer (CC) represents the fourth most common malignancy affecting women all over the world and is the second most common in developing areas. In these areas, the burden from disease remains important because of the difficulty in implementing cytology-based screening programmes. The main obstacles inherent to these countries are poverty and a lack of healthcare infrastructures and trained practitioners. With the availability of new technologies, researchers have attempted to find new strategies that are adapted to low- and middle-income countries (LMIC) to promote early diagnosis of cervical pathology. Current evidence suggests that human papillomavirus (HPV) testing is more effective than cytology for CC screening. Therefore, highly sensitive tests have now been developed for primary screening. Rapid molecular methods for detecting HPV DNA have only recently been commercially available. This constitutes a milestone in CC screening in low-resource settings because it may help overcome the great majority of obstacles inherent to previous screening programmes. Despite several advantages, HPV-based screening has a low positive predictive value for CC, so that HPV-positive women need to be triaged with further testing to determine optimal management. Visual inspection tests, cytology and novel biomarkers are some options. In this review, we provide an overview of current and emerging screening approaches for CC. In particular, we discuss the challenge of implementing an efficient cervical screening adapted to LMIC and the opportunity to introduce primary HPV-based screening with the availability of point-of-care (POC) HPV testing. The most adapted screening strategy to LMIC is still a work in progress, but we have reasons to believe that POC HPV testing makes part of the future strategies in association with a triage test that still needs to be defined. PMID:26677441

  1. Women's perspectives on illness in being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    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 untrea......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...... 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...

  2. Building Successful Relationships in the PLCO Cancer Screening Trial.

    Science.gov (United States)

    Marcus, Pamela M; Broski, Karen G; Buys, Saundra S; Childs, Jeffery; Church, Timothy R; Gohagan, John K; Gren, Lisa H; Higgins, Darlene; Jaggi, Rachel; Jenkins, Victoria; Johnson, Christine C; Lappe, Karen; O'Brien, Barbara; Ogden, Sheryl L; Prorok, Philip C; Reding, Douglas; Shambaugh, Vicki; Yokochi, Lance A; Yurgalevitch, Susan

    2015-01-01

    Biomedical research cannot succeed without funding, knowledgeable staff, and appropriate infrastructure. There are however equally important but intangible factors that are rarely considered in planning large multidisciplinary endeavors or evaluating their success. The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial required extensive collaborations between individuals from many fields, including clinicians, clinical trialists, and administrators; it also addressed questions across the spectrum of cancer prevention and control. In this manuscript, we examine the experiences and opinions of trial staff regarding the building of successful relationships in PLCO. We summarize, in narrative form, data collected using open-ended questionnaires that were administered to the National Cancer Institute project officers, coordinating center staff, screening center principal investigators, and screening center coordinators in 2015, about 3 years after publication of the final primary trial manuscript. Trust, respect, listening to others, and in-person interaction were frequently mentioned as crucial to building successful relationships.

  3. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline

    Science.gov (United States)

    2011-01-01

    Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? Methods A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Results Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale) for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Conclusion Using established guideline development methodologies and the AGREE II as our methodological frameworks, we developed an

  4. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline

    Directory of Open Access Journals (Sweden)

    Brouwers Melissa C

    2011-09-01

    Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. Several high-quality systematic reviews and practice guidelines exist to inform the most effective screening options. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. We developed an implementation guideline to answer the question: What interventions have been shown to increase the uptake of cancer screening by individuals, specifically for breast, cervical, and colorectal cancers? Methods A guideline panel was established as part of Cancer Care Ontario's Program in Evidence-based Care, and a systematic review of the published literature was conducted. It yielded three foundational systematic reviews and an existing guidance document. We conducted updates of these reviews and searched the literature published between 2004 and 2010. A draft guideline was written that went through two rounds of review. Revisions were made resulting in a final set of guideline recommendations. Results Sixty-six new studies reflecting 74 comparisons met eligibility criteria. They were generally of poor to moderate quality. Using these and the foundational documents, the panel developed a draft guideline. The draft report was well received in the two rounds of review with mean quality scores above four (on a five-point scale for each of the items. For most of the interventions considered, there was insufficient evidence to support or refute their effectiveness. However, client reminders, reduction of structural barriers, and provision of provider assessment and feedback were recommended interventions to increase screening for at least two of three cancer sites studied. The final guidelines also provide advice on how the recommendations can be used and future areas for research. Conclusion Using established guideline development methodologies and the AGREE II as our methodological

  5. Preventive cancer screening practices in HIV-positive patients.

    Science.gov (United States)

    Momplaisir, Florence; Mounzer, Karam; Long, Judith A

    2014-01-01

    As patients with HIV age, they are at risk of developing non-AIDS defining malignancies. We performed a questionnaire study to evaluate colorectal and breast cancer screening among HIV-positive and HIV-negative patients seeking care from either an integrated (HIV/primary care), nonintegrated (specialized HIV), or general internal medicine clinic between August 2010 and July 2011. We performed a logistic regression to determine the odds of cancer screening. A total of 813 surveys were collected, and 762 were included in the analysis. As much as 401 were from HIV-positive patients. Patients with HIV were less likely to be current with their colorectal cancer screening (CRCS) (54.4% versus 65.0%, p=0.009); mammography rates were 24.3% versus 62.3% if done during the past year (pscreening in HIV-positive patients compared to negative controls was not statistically significant (OR 0.8; 95% CI 0.5-1.3); however, HIV-positive women remained significantly less likely to be current with breast cancer screening (BCS) whether their mammogram was completed within 1 year (OR 0.1, 95% CI 0.1-0.2) or within 5 years (OR 0.1, 95% CI 0.0-0.2). Integrated care was not associated with improved screening; however, having frequent visits to a primary care physician (PCP) increased the likelihood of getting screened. BCS was lower in HIV-positive compared to HIV-negative women. Frequent visits to a PCPs improved cancer screening.

  6. Telenovela: an innovative colorectal cancer screening health messaging tool

    Directory of Open Access Journals (Sweden)

    Melany Cueva

    2013-08-01

    Full Text Available Background. Alaska Native people have nearly twice the rate of colorectal cancer (CRC incidence and mortality as the US White population. Objective. Building upon storytelling as a culturally respectful way to share information among Alaska Native people, a 25-minute telenovela-style movie, What's the Big Deal?, was developed to increase CRC screening awareness and knowledge, role-model CRC conversations, and support wellness choices. Design. Alaska Native cultural values of family, community, storytelling, and humor were woven into seven, 3–4 minute movie vignettes. Written post-movie viewing evaluations completed by 71.3% of viewers (305/428 were collected at several venues, including the premiere of the movie in the urban city of Anchorage at a local movie theater, seven rural Alaska community movie nights, and five cancer education trainings with Community Health Workers. Paper and pencil evaluations included check box and open-ended questions to learn participants' response to a telenovela-style movie. Results. On written-post movie viewing evaluations, viewers reported an increase in CRC knowledge and comfort with talking about recommended CRC screening exams. Notably, 81.6% of respondents (249/305 wrote positive intent to change behavior. Multiple responses included: 65% talking with family and friends about colon screening (162, 24% talking with their provider about colon screening (59, 31% having a colon screening (76, and 44% increasing physical activity (110. Conclusions. Written evaluations revealed the telenovela genre to be an innovative way to communicate colorectal cancer health messages with Alaska Native, American Indian, and Caucasian people both in an urban and rural setting to empower conversations and action related to colorectal cancer screening. Telenovela is a promising health communication tool to shift community norms by generating enthusiasm and conversations about the importance of having recommended colorectal

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  8. Socioeconomic position and participation in colorectal cancer screening

    DEFF Research Database (Denmark)

    Frederiksen, B L; Jørgensen, Torben; Brasso, K;

    2010-01-01

    Colorectal cancer (CRC) screening with faecal occult blood test (FOBT) has the potential to reduce the incidence and mortality of CRC. Screening uptake is known to be inferior in people with low socioeconomic position (SEP) when compared with those with high position; however, the results of most...... information on education, employment, and income to encompass different but related aspects of socioeconomic stratification. Also, the impact of ethnicity and cohabiting status was analysed....

  9. Overcoming Barriers to Cervical Cancer Screening Among Asian American Women

    OpenAIRE

    Fang, Carolyn Y.; Ma, Grace X.; Tan, Yin

    2011-01-01

    Significant disparities in cervical cancer incidence and mortality exist among ethnic minority women, and in particular, among Asian American women. These disparities have been attributed primarily to differences in screening rates across ethnic/racial groups. Asian American women have one of the lowest rates of screening compared to other ethnic/racial groups. Yet Asian Americans, who comprise one of the fastest growing populations in the United States, have received the least attention in c...

  10. Mammography - importance, possibilities, current screening situation of the breast cancer and further expansion possibilities

    International Nuclear Information System (INIS)

    Breast cancer still remains the most frequent cancer in women population. Incidence of breast cancer is increasing, but mortality is decreasing. The most important for decreasing of breast cancer mortality is early diagnostic, especially screening. Screening is a form of secondary prevention. Although many screening studies have shown that mammography decreases of the breast cancer death, there are still many controversies. The published recommendations for the breast screening are sometimes very different. (author)

  11. Is prostate cancer screening responsible for the negative results of prostate cancer treatment trials?

    Science.gov (United States)

    Prasad, Vinay

    2016-08-01

    Clinical guidelines continue to move away from routine prostate specific antigen screening (PSA), once a widespread medical practice. A curious difference exists between early prostate cancer and early breast cancer. While randomized trials of therapy in early breast cancer continue to show overall survival benefit, this is not the case in prostate cancer, where prostatectomy was no better than observation in a recent trial, and where early androgen deprivation is no better than late androgen deprivation. Here, I make the case that prostate cancer screening contributes so greatly to over diagnosis that even treatment trials yield null results due to contamination with non-life threatening disease. PMID:27372859

  12. Screening for second primary lung cancer after treatment of laryngeal cancer

    NARCIS (Netherlands)

    Ritoe, Savitri C; Krabbe, Paul F M; Jansen, Margriet M G; Festen, Jan; Joosten, Frank B M; Kaanders, J Hans A M; van den Hoogen, Frank J A; Verbeek, André L M; Marres, Henri A M

    2002-01-01

    OBJECTIVES/HYPOTHESIS: As a result of smoking, patients who have received curative treatment for laryngeal cancer run a high risk of developing lung cancer. Therefore, these patients enter a screening program that aims to detect lung cancer at an asymptomatic stage. The study evaluated whether scree

  13. Prostate Cancer Screening : The effect on prostate cancer mortality and incidence

    NARCIS (Netherlands)

    P.J. van Leeuwen (Pim)

    2012-01-01

    textabstractAt first glance, deciding whether to get the PSA screening test for prostate cancer seems to be pretty straightforward and attractive. It’s a simple blood test that can pick up the prostate cancer long before your symptoms appear. After all, your prostate cancer is earlier treated result

  14. Decision aid for women considering breast cancer screening

    DEFF Research Database (Denmark)

    Pasternack, Iris; Saalasti-Koskinen, Ulla; Mäkelä, Marjukka

    2011-01-01

    OBJECTIVES: The aim of this study was to describe the process and challenges of developing a decision aid for the national public breast cancer screening program in Finland. METHODS: An expert team with stakeholder representation used European guidelines and other literature as basis for selecting...... information for women invited to breast cancer screening is demanding and requires careful planning. Professionals and service providers need to be engaged in the HTA process to ensure proper dissemination and implementation of the information. End user participation is essential in the formulation...

  15. Preferences and acceptance of colorectal cancer screening in Thailand.

    Science.gov (United States)

    Saengow, Udomsak; Chongsuwiwatvong, Virasakdi; Geater, Alan; Birch, Stephen

    2015-01-01

    Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authorities are planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as a primary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explore factors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before the program was implemented. Patients aged 50-69, visiting the primary care unit during the study period, were invited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-face interviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy. Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7% response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% of subjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceived susceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxious about diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasiveness compared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chose colonoscopy because of its accuracy; it was refused for the process and complications. If the screening program is implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT, between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRC in the first round of the program. PMID:25824749

  16. Equity and practice issues in colorectal cancer screening

    Science.gov (United States)

    Buchman, Sandy; Rozmovits, Linda; Glazier, Richard H.

    2016-01-01

    Abstract Objective To investigate overall colorectal cancer (CRC) screening rates, patterns in the use of types of CRC screening, and sociodemographic characteristics associated with CRC screening; and to gain insight into physicians’ perceptions about and use of fecal occult blood testing [FOBT] and colonoscopy for patients at average risk of CRC. Design Mixed-methods study using cross-sectional administrative data on patient sociodemographic characteristics and semistructured telephone interviews with physicians. Setting Toronto, Ont. Participants Patients aged 50 to 74 years and physicians in family health teams in the Toronto Central Local Health Integration Network. Main outcome measures Rates of CRC screening by type; sociodemographic characteristics associated with CRC screening; thematic analysis using constant comparative method for semistructured interviews. Main findings Ontario administrative data on CRC screening showed lower overall screening rates among those who were younger, male patients, those who had lower income, and recent immigrants. Colonoscopy rates were especially low among those with lower income and those who were recent immigrants. Semistructured interviews revealed that physician opinions about CRC screening for average-risk patients were divided: one group of physicians accepted the evidence and recommendations for FOBT and the other group of physicians strongly supported colonoscopy for these patients, believing that the FOBT was an inferior screening method. Physicians identified specialist recommendations and patient expectations as factors that influenced their decisions regarding CRC screening type. Conclusion There was considerable variation in CRC screening by sociodemographic characteristics. A key theme that emerged from the interviews was that physicians were divided in their preference for FOBT or colonoscopy; factors that influenced physician preference included the health care system, recommendations by other

  17. New Molecular Tools for Efficient Screening of Cervical Cancer

    Directory of Open Access Journals (Sweden)

    Magnus von Knebel Doeberitz

    2001-01-01

    Full Text Available Cytological screening using the Pap-smear led to a remarkable reduction of the mortality of cervical cancer. However, due to subjective test criteria it is hampered by poor inter- and intra-observer agreement. More reproducible assays are expected to improve the current screening and avoid unnecessary medical intervention and psychological distress for the affected women. Cervical cancer arises as consequence of persistent high risk papillomavirus (HR-HPV infections. Expression of two viral oncogenes, E6 and E7, in epithelial stem cells is required to initiate and maintain cervical carcinogenesis and results in significant overexpression of the cellular p16INK4a protein. Since this protein is not expressed in normal cervical squamous epithelia, screening for p16INK4a over-expressing cells allows to specifically identify dysplastic lesions, and significantly reduces the inter-observer disagreement of the conventional cytological or histological tests. Progression of preneoplastic lesions to invasive cancers is associated with extensive recombination of viral and cellular genomes which can be monitored by detection of papillomavirus oncogene transcripts (APOT assay derived from integrated viral genome copies. Detection of integrated type oncogene transcripts points to far advanced dysplasia or invasive cancers and thus represents a progression marker for cervical lesions. These new assays discussed here will help to improve current limitations in cervical cancer screening, diagnosis, and therapy control.

  18. ESR/ERS white paper on lung cancer screening.

    Science.gov (United States)

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

    2015-07-01

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

  19. ESR/ERS white paper on lung cancer screening

    Energy Technology Data Exchange (ETDEWEB)

    Kauczor, Hans-Ulrich; Stackelberg, Oyunbileg von [University Hospital Heidelberg, Dept of Diagnostic and Interventional Radiology, Heidelberg (Germany); Member of the German Lung Research Center, Translational Lung Research Center, Heidelberg (Germany); Bonomo, Lorenzo [A. Gemelli University Hospital, Institute of Radiology, Rome (Italy); Gaga, Mina [Athens Chest Hospital, 7th Resp. Med. Dept and Asthma Center, Athens (Greece); Nackaerts, Kristiaan [KU Leuven-University of Leuven, University Hospitals Leuven, Department of Respiratory Diseases/Respiratory Oncology Unit, Leuven (Belgium); Peled, Nir [Tel Aviv University, Davidoff Cancer Center, Rabin Medical Center, Tel Aviv (Israel); Prokop, Mathias [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Remy-Jardin, Martine [Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Universite de Lille, Lille (France); Sculier, Jean-Paul [Universite Libre de Bruxelles, Thoracic oncology, Institut Jules Bordet, Brussels (Belgium); Collaboration: on behalf of the European Society of Radiology (ESR) and the European Respiratory Society (ERS)

    2015-09-15

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

  20. Breast cancer screening; cost-effective in practice?

    International Nuclear Information System (INIS)

    The main aim of national breast screening is a reduction in breast cancer mortality. The data on the reduction in breast cancer mortality from three (of the five) Swedish trials in particular gave rise to the expectation that the Dutch programme of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. In all likelihood, many of the years of life gained as a result of screening are enjoyed in good health. According to its critics the actual benefit that can be achieved from the national breast cancer screening programmes is overstated. Considerable benefits have recently been demonstrated in England and Wales. However, the fall was so considerable in such a relatively short space of time that screening (started in 1987) was thought to only have played a small part. As far as the Dutch screening programme is concerned it is still too early to reach any conclusions about a possible reduction in mortality. The first short-term results of the screening are favourable and as good as (or better than) expectations. In Swedish regions where mammographic screening was introduced, a 19% reduction in breast cancer mortality can be estimated at population level, and recently a 20% reduction was presented in the UK. In countries where women are expected to make appointments for screening themselves, the attendance figures are significantly lower and the quality of the process as a whole is sometimes poorer. The benefits of breast cancer screening need to be carefully balanced against the burden to women and to the health care system. Mass breast screening requires many resources and will be a costly service. Cost-effectiveness of a breast cancer screening programme can be estimated using a computer model. Published cost-effectiveness ratios may differ tremendously, but are often the result of different types of calculation, time periods considered, including or excluding downstream cost. The approach of simulation and estimation is here

  1. Lung cancer screening: Computed tomography or chest radiographs?

    Institute of Scientific and Technical Information of China (English)

    Edwin; JR; van; Beek; Saeed; Mirsadraee; John; T; Murchison

    2015-01-01

    Worldwide, lung cancer is the leading cause of mortalitydue to malignancy. The vast majority of cases of lung cancer are smoking related and the most effective way of reducing lung cancer incidence and mortality is by smoking cessation. In the Western world, smoking cessation policies have met with limited success. The other major means of reducing lung cancer deaths is to diagnose cases at an earlier more treatable stage employing screening programmes using chest radiographs or low dose computed tomography. In many countries smoking is still on the increase, and the sheer scale of the problem limits the affordability of such screening programmes. This short review article will evaluate the current evidence and potential areas of research which may benefit policy making across the world.

  2. Strategies for advancing cancer nanomedicine

    Science.gov (United States)

    Chauhan, Vikash P.; Jain, Rakesh K.

    2013-11-01

    Cancer nanomedicines approved so far minimize toxicity, but their efficacy is often limited by physiological barriers posed by the tumour microenvironment. Here, we discuss how these barriers can be overcome through innovative nanomedicine design and through creative manipulation of the tumour microenvironment.

  3.   Personal invitations for population-based breast cancer screening

    DEFF Research Database (Denmark)

    Saalasti-Koskinen, Ulla; Mäkelä, Marjukka; Saarenmaa, Irma;

    2010-01-01

    , leaflets) the units sent to women was collected. Results from 2005 were sent as feedback to the units. Data were analyzed descriptively, and results from the 2 years were compared. RESULTS: Screening units sent personal invitation letters usually providing fixed appointment times. Most units informed about......RATIONALE AND OBJECTIVES: Women who are invited for breast cancer screening should get enough information about the benefits and harms of screening to make an informed decision on participation. Personal invitations are an important source of information, because all invited women receive them...

  4. Colorectal cancer screening:The role of CT colonography

    Institute of Scientific and Technical Information of China (English)

    Andrea; Laghi; Franco; Iafrate; Marco; Rengo; Cesare; Hassan

    2010-01-01

    Computed tomography colonography(CTC) in colorectal cancer(CRC) screening has two roles:one present and the other potential.The present role is,without any further discussion,the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy.The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test,sigmoidoscopy and colonoscopy.However,despite the fact that CTC has been officially endorsed for CRC scre...

  5. Participant recruitment and motivation for participation in optical technology for cervical cancer screening research trials.

    Science.gov (United States)

    Shuhatovich, Olga M; Sharman, Mathilde P; Mirabal, Yvette N; Earle, Nan R; Follen, Michele; Basen-Engquist, Karen

    2005-12-01

    In order to improve recruitment for cervical cancer screening trials, it is necessary to analyze the effectiveness of recruitment strategies used in current trials. A trial to test optical spectroscopy for the diagnosis of cervical neoplasia recruited 1000 women from the community; the trial evaluated the emerging technology against Pap smears and colposcopically directed biopsies for cervical dysplasia. We have examined women's reasons for participating as well as the effectiveness and efficiency for each recruitment strategy. Reasons for participation were identified and compared between trials. The recruitment method that resulted in the most contacts was newspaper reportorial coverage and advertising, followed by family and friends, then television news coverage. The most cost-effective method for finding eligible women who attend the research appointment is word of mouth from a family member or friend. Recommendations are given for maximizing the efficiency of recruitment for cervical cancer screening trials. PMID:16143374

  6. The evidence for low-dose CT screening of lung cancer.

    Science.gov (United States)

    Ruchalski, Kathleen; Gutierrez, Antonio; Genshaft, Scott; Abtin, Fereidoun; Suh, Robert

    2016-01-01

    Lung cancer remains the leading cause of cancer-related death in the United States. An effective screening tool for early lung cancer detection has long been sought. Early chest radiograph and low-dose computed tomography (LDCT) screening trials were promising and demonstrated increased cancer detection. However, these studies were not able to improve lung cancer mortality. The National Lung Screening Trial resulted in decreased lung cancer mortality with LDCT screening in a high-risk population. Similar trials are currently underway in Europe. With LDCT now being widely implemented, it is paramount for radiologists to understand the evidence for lung cancer screening.

  7. Risk of cancer radioinduced by mammographic screening

    International Nuclear Information System (INIS)

    This work aims to estimate the risk benefit of mammography, in terms of the number of lives saved/number of lives lost, in the female population of the State of Goias, Brazil, depending on the age range indicated for screening and the type of technology available

  8. Prostate Cancer: Current Treatment and Prevention Strategies

    OpenAIRE

    Chen, Fang-zhi; Zhao, Xiao-kun

    2013-01-01

    Abstract Prostate cancer is one of the life threatening disorders of male. Although, over the last two decades, a high rate of overdiagnosis, and overtreatment has lowered the incidence rate of prostate cancer, the treatment or prevention strategies are not enough to control the high rate of disease related mortality. Current medical treatment approaches include surgery, radiation therapy, chemotherapy, hormonal therapy, cryosurgery and other methods. These approaches are more or less effecti...

  9. Filipina American women's breast cancer knowledge, attitudes, and screening behaviors

    OpenAIRE

    Ryujin Lisa; Sadler Georgia; Ko Celine M; Dong Adam

    2003-01-01

    Abstract Background Filipino Americans are the fastest growing Asian minority group in the United States. There is limited knowledge about their breast cancer knowledge, screening practices and attitudes. Methods As part of the evaluation of the Asian Grocery Store-Based Cancer Education Program, 248 Filipino American women completed baseline and follow-up surveys, while an additional 58 took part in focus groups. Results Compliance with annual clinical breast exam guidelines among women 40 t...

  10. ACOG Recommendations and Guidelines for Cervical Cancer Screening and Management

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about ACOG's recommendations for cervical cancer screening and management.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  11. Current strategies for the prevention of breast cancer

    Directory of Open Access Journals (Sweden)

    Advani P

    2014-05-01

    Full Text Available Pooja Advani, Alvaro Moreno-AspitiaDepartment of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USAAbstract: Due to the high incidence of breast cancer in the United States, optimal strategies for its prevention are imperative. This entails identification of women who are at an increased risk for breast cancer and an integrative approach that includes effective screening methods as well as nutritional, pharmacologic, and surgical management. Several breast cancer risk-assessment tools, such as the Gail and Claus models, can help clinicians determine the quantitative risk of breast cancer. The role of selective estrogen receptor modulators, such as tamoxifen and raloxifene, for the prevention of breast cancer has been well established. Several other agents, such as aromatase inhibitors, are currently being investigated. The potential adverse effects of these chemopreventive agents, which include an impact on the quality of life, must be discussed with the patient before deciding on this approach. Additionally, breast cancer risk factors have been identified over the years; some of them are modifiable, but others are not. Although there is no conclusive evidence to suggest the protective role of specific dietary components, alcohol consumption and obesity are associated with an increased breast cancer risk; thus lifestyle changes can lead to a lower risk of developing breast cancer. Surgical approaches, including bilateral risk-reduction mastectomy and salpingo-oophorectomy, are usually limited to women with a hereditary predisposition to development of breast cancer. The objective of this review is to summarize the various approaches directed at reducing the incidence of breast cancer.Keywords: chemoprevention, tamoxifen, raloxifene, prophylactic surgery

  12. BREAST CANCER SCREENING KNOWLEDGE AND PRACTICE AMONG WOMEN IN SOUTHEAST OF IRAN

    OpenAIRE

    Z Heidari; H. R Mahmoudzadeh-Sagheb; N. Sakhavar

    2008-01-01

    "nBreast cancer is the most common cancer occurring among women. The mortality rate of breast cancer can be reduced by regular breast cancer screening program. This study was carried out to identify the knowledge and practice of women about breast cancer screening in Zahedan, southeast of Iran. In this cross- sectional study, 384 women were selected as an improbability sample of women referring to Qouds maternity hospital. Knowledge and practice of them about breast cancer screening were...

  13. [Cancer screening with whole-body FDG PET].

    Science.gov (United States)

    Yasuda, S; Ide, M; Takagi, S; Shohtsu, A

    1996-10-01

    We are using whole-body positron emission tomography (PET) for cancer screening. A total of 1,105 healthy subjects have undergone PET studies 1,138 times in fifteen months. Emission scans were performed from the pelvis to the maxilla 45 to 60 minutes after intravenous administration of 260 to 370 MBq 2-deoxy-2-[18F]fluoro-D-glucose (FDG). Malignant tumors were detected with PET in nine patients (0.81%): 2 lung cancers, 2 colonic cancers, 1 breast cancer, 1 thyroid cancer, 1 gastric cancer, 1 renal cancer, and 1 lymphoma. Eight of these patients underwent surgery (excepting the lymphoma patient). Lymph node metastasis was not observed in any of the eight cases and surgery was curative. PET scan results were negative in the cases of three prostatic cancers, one bladder cancer, and two colonic mucosal cancers. High FDG accumulations were noticed in benign lesions such as sarcoidosis, chronic thyroiditis, pulmonary tuberculoma, Warthin's tumor of the parotid gland, and chronic sinusitis. In some cases, image artifacts caused by intense myocardial FDG accumulations resulted in incomplete examinations of the lung. Occasionally, high FDG accumulations were observed in the bowel. Our study results suggest the possibility of using whole-body PET for detecting wide varieties of cancers in resectable stages.

  14. Screening strategies for active tuberculosis: focus on cost-effectiveness

    Science.gov (United States)

    Dobler, Claudia Caroline

    2016-01-01

    In recent years, there has been renewed interest in screening for active tuberculosis (TB), also called active case-finding (ACF), as a possible means to achieve control of the global TB epidemic. ACF aims to increase the detection of TB, in order to diagnose and treat patients with TB earlier than if they had been diagnosed and treated only at the time when they sought health care because of symptoms. This will reduce or avoid secondary transmission of TB to other people, with the long-term goal of reducing the incidence of TB. Here, the history of screening for active TB, current screening practices, and the role of TB-diagnostic tools are summarized and the literature on cost-effectiveness of screening for active TB reviewed. Cost-effectiveness analyses indicate that community-wide ACF can be cost-effective in settings with a high incidence of TB. ACF among close TB contacts is cost-effective in settings with a low as well as a high incidence of TB. The evidence for cost-effectiveness of screening among HIV-infected persons is not as strong as for TB contacts, but the reviewed studies suggest that the intervention can be cost-effective depending on the background prevalence of TB and test volume. None of the cost-effectiveness analyses were informed by data from randomized controlled trials. As the results of randomized controlled trials evaluating different ACF strategies will become available in future, we will hopefully gain a better understanding of the role that ACF can play in achieving global TB control. PMID:27418848

  15. The benefits and harms of screening for cancer with a focus on breast screening

    DEFF Research Database (Denmark)

    Brodersen, John; Juhl Jørgensen, Karsten; Gøtzsche, Peter C.

    2010-01-01

    . The effects of routine clinical breast examination are unknown, but considering the results of the breast self-examination trials, it is likely that it is harmful. The effects of screening for breast cancer with thermography, ultrasound or magnetic resonance imaging are unknown. It is not clear whether...

  16. Pathway-based screening strategy for multitarget inhibitors of diverse proteins in metabolic pathways.

    Directory of Open Access Journals (Sweden)

    Kai-Cheng Hsu

    Full Text Available Many virtual screening methods have been developed for identifying single-target inhibitors based on the strategy of "one-disease, one-target, one-drug". The hit rates of these methods are often low because they cannot capture the features that play key roles in the biological functions of the target protein. Furthermore, single-target inhibitors are often susceptible to drug resistance and are ineffective for complex diseases such as cancers. Therefore, a new strategy is required for enriching the hit rate and identifying multitarget inhibitors. To address these issues, we propose the pathway-based screening strategy (called PathSiMMap to derive binding mechanisms for increasing the hit rate and discovering multitarget inhibitors using site-moiety maps. This strategy simultaneously screens multiple target proteins in the same pathway; these proteins bind intermediates with common substructures. These proteins possess similar conserved binding environments (pathway anchors when the product of one protein is the substrate of the next protein in the pathway despite their low sequence identity and structure similarity. We successfully discovered two multitarget inhibitors with IC50 of <10 µM for shikimate dehydrogenase and shikimate kinase in the shikimate pathway of Helicobacter pylori. Furthermore, we found two selective inhibitors (IC50 of <10 µM for shikimate dehydrogenase using the specific anchors derived by our method. Our experimental results reveal that this strategy can enhance the hit rates and the pathway anchors are highly conserved and important for biological functions. We believe that our strategy provides a great value for elucidating protein binding mechanisms and discovering multitarget inhibitors.

  17. Breast Cancer Screening Interventions in Selected Counties Across US Regions

    Science.gov (United States)

    Austin, Shamly; Martin, Michelle Y; Levine, Robert S.; Pisu, Maria

    2010-01-01

    Objectives To determine the types of, and the populations targeted by interventions implemented to increase breast cancer screening 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 cancer screening. Conclusion In this selected group of counties, different types of interventions were used to increase breast cancer screening 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. PMID:20820899

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Van Kerrebroeck, Helena; Makar, Amin

    2016-03-01

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

  20. Communicating the balance sheet in breast cancer screening.

    NARCIS (Netherlands)

    Giordano, L.; Cogo, C.; Patnick, J.; Paci, E.; Broeders, M.J.M.

    2012-01-01

    OBJECTIVE: Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening. METHODS: In this paper we review the issues in communication of benefits and harms of medical interventions and discuss these in terms

  1. The effects and costs of breast cancer screening

    NARCIS (Netherlands)

    H.J. de Koning (Harry)

    1993-01-01

    textabstractIn 1986, the Dutch Ministry of Welfare, Health and Cultural Affairs asked a research group to investigate the expected effect of breast cancer screening on mortality and possibly morbidity, if implemented in the Netherlands. The research group consisted of members from 3 centres, the Dep

  2. Cervical cancer screening policies and coverage in Europe

    DEFF Research Database (Denmark)

    Anttila, Ahti; von Karsa, Lawrence; Aasmaa, Auni;

    2009-01-01

    The aim of the study was to compare current policy, organisation and coverage of cervical cancer screening programmes in the European Union (EU) member states with European and other international recommendations. According to the questionnaire-based survey, there are large variations in cervical...

  3. Women's perspectives on illness when being screened for cervical cancer

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Augustussen, Mikaela; Møller, Helle;

    2013-01-01

    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 untre...

  4. Breast Cancer Screening: Cultural Beliefs and Diverse Populations

    Science.gov (United States)

    Simon, Cassandra E.

    2006-01-01

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

  5. Message from Terrence Howard: Screening for Colorectal Cancer PSA (:20)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message from the actor/musician Terrence Howard about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  6. Message from Terrence Howard: Screening for Colorectal Cancer PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message from the actor/musician Terrence Howard about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  7. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    OpenAIRE

    Lopamudra Das; Soumen Das; Jyotirmoy Chatterjee

    2015-01-01

    Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cy...

  8. Screening for Bladder and Other Urothelial Cancers

    Science.gov (United States)

    ... Using tobacco , especially smoking cigarettes. Having a family history of bladder cancer. Having certain changes in the genes . Being exposed to paints, dyes, metals or petroleum products in the workplace. Past treatment with radiation therapy to the pelvis or with certain anticancer drugs, ...

  9. Perspectives of colorectal cancer screening in Germany 2009.

    Science.gov (United States)

    Sieg, Andreas; Friedrich, Kilian

    2009-10-15

    Adequate screening methods can decrease colorectal cancer (CRC) mortality. The guaiac test for fecal occult-blood (FOBT) is part of the German CRC Screening Program since 1970 and has evidence level Ia. In randomized multicenter-studies FOBT has an average sensitivity of 24% and decreases CRC mortality up to 30%. Immunological tests for human haemoglobin (iFOBT) show better performance characteristics than guaiac FOBT, with augmented sensitivity and specificity. However, the single tests show wide differences in diagnostic performance and iFOBT is not yet covered by insurance companies although it should replace the guaiac test for CRC screening. Visual colonoscopy, which was introduced to the German National Cancer Screening Program in 2002, is the gold standard for the diagnosis of colorectal neoplasia. From 2003 to 2007 more than 2.8 million examinations have been documented in Germany. The prevalence of adenomas is around 20% and of CRC about 0.7% to 1.0% of the screenings. Seventy percent of the carcinomas detected during screening are in an early stage (UICC I and II). Furthermore, screening colonoscopy is a cost saving procedure with a low complication rate (0.25% overall). Insurance companies save 216€ for each screening colonoscopy mainly by prevention of neoplasia due to polypectomy. In Germany, virtual colonography by computed tomography (CT) or magnetic resonance imaging still lacks standardization of the hard and software. In experienced centres the sensitivity for CRC and large polyps of CT colonography is comparable to colonoscopy but in meta-analyses the ranking is lower. New technologies like computer-aided colonoscopies with sheath or double balloon techniques are coming up as well as capsule colonoscopy, which sensitivity for large polyps is about 70%. Advised by his physician, the patient can choose his most acceptable examination method from this whole set of screening tools.

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

    Science.gov (United States)

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

  11. Effects of screening for psychological distress on patient outcomes in cancer : A systematic review

    NARCIS (Netherlands)

    Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

    2013-01-01

    Objective: Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identif

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

    Science.gov (United States)

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

  13. Screening for Breast Cancer: #BeBrave: A Life-Saving Test

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Screening For Breast Cancer #BeBrave: A Life-Saving Test ... cancer survivor, you may not have gotten your screening mammogram. What is your message to other women ...

  14. Two cytological methods for screening for cervical cancer

    DEFF Research Database (Denmark)

    Kirschner, B.; Simonsen, K.; Junge, J.

    2008-01-01

    INTRODUCTION: Denmark has had an organized screening programme for cervical cancer since the 1960s. In spite of this, almost 150 Danish women die from the disease each year. There are currently two different methods for preparation of cervical samples: conventional Papanicolaou smear and liquid......-based cytology. MATERIALS AND METHODS: In 2002, the Department of Pathology, Hvidovre Hospital changed over from the conventional Papanicolaou smear screening method to SurePath liquid-based cytology. This article is based on a retrospective comparison on data from the population screening programme for cervical...... cancer in the Municipality of Copenhagen. RESULTS: The number of tests with the diagnosis of "normal cells" decreased 1% after the conversion to liquid-based cytology, whilst the number of tests with "atypical cells" and "cells suspicious for malignancy" increased by 64.3% and 41.2% respectively...

  15. Colorectal cancer screening brochure for Latinos: focus group evaluation.

    Science.gov (United States)

    Cooperman, Julia L; Efuni, Elizaveta; Villagra, Cristina; DuHamel, Katherine; Jandorf, Lina

    2013-09-01

    Colorectal cancer (CRC) can be effectively prevented via screening colonoscopy, yet adherence rates remain low among Latinos. Interventions targeting individual and cultural barriers to screening are needed. We developed an educational brochure to target these barriers faced by a diverse Latino population. The objective was to evaluate the responses of the target population to the culturally and theoretically informed brochure through community member focus groups. Facilitators conducted six focus groups, stratified by gender, language, and prior colonoscopy experience. Topics included: brochure content and layout, cancer knowledge, and CRC screening determinants. Focus groups documented community members' responses to the brochure's overall message and its informational and visual components. Changes to wording, visual aids, and content were suggested to make the brochure culturally more acceptable. Results indicated relevance of the theoretically and culturally guided approach to the development of the brochure leading to refinement of its content and design.

  16. Ultrasound screening of contralateral breast after surgery for breast cancer

    International Nuclear Information System (INIS)

    Highlights: • The addition of supplemental US to mammography depicted additional 5.0 cancers per 1000 postoperative women. • Positive biopsy rate of mammography-detected lesions was 66.7% (4 of 6) and that of US-detected lesions was 40.0% (6 of 15). • US can be helpful to detect mammographically occult breast cancer in the contralateral breast in women with previous history of cancer and dense breast. - Abstract: Objective: To determine whether supplemental screening ultrasound (US) to mammography could improve cancer detection rate of the contralateral breast in patients with a personal history of breast cancer and dense breasts. Materials and methods: During a one-year study period, 1314 screening patients with a personal history of breast cancer and dense breasts simultaneously underwent mammography and breast US. BI-RADS categories were given for mammography or US-detected lesions in the contralateral breast. The reference standard was histology and/or 1-year imaging follow-up, and the cancer rate according to BI-RADS categories and cancer detection rate and positive biopsy rate according to detection modality were analyzed. Results: Of 1314 patients, 84 patients (6.4%) were categorized as category 3 with one interval cancer and one cancer which was upgraded to category 4A after 6-month follow-up US (2.5% cancer rate, 95% CIs 1.5–9.1%). Fifteen patients (1.1%) had category 4A or 4B lesions in the contralateral breast. Four lesions were detected on mammography (two lesions were also visible on US) and 11 lesions were detected on US and 5 cancers were confirmed (33.3%, 95% CIs 15.0–58.5%). Six patients (0.5%) had category 4C lesions, 2 detected on mammography and 4 on US and 4 cancers were confirmed (66.7%, 95% CIs 29.6–90.8%). No lesions were categorized as category 5 in the contralateral breast. Cancer detection rate by mammography was 3.3 per 1000 patients and that by US was 5.0 per 1000 patients, therefore overall cancer detection rate by

  17. Ultrasound screening of contralateral breast after surgery for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ja [Department of Radiology, Seoul Metropolitan Government Seoul National University, Boramae Medical Center (Korea, Republic of); Chung, Se-Yeong; Chang, Jung Min; Cho, Nariya [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Han, Wonshik [Department of Surgery, Seoul National University Hospital (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University Hospital (Korea, Republic of)

    2015-01-15

    Highlights: • The addition of supplemental US to mammography depicted additional 5.0 cancers per 1000 postoperative women. • Positive biopsy rate of mammography-detected lesions was 66.7% (4 of 6) and that of US-detected lesions was 40.0% (6 of 15). • US can be helpful to detect mammographically occult breast cancer in the contralateral breast in women with previous history of cancer and dense breast. - Abstract: Objective: To determine whether supplemental screening ultrasound (US) to mammography could improve cancer detection rate of the contralateral breast in patients with a personal history of breast cancer and dense breasts. Materials and methods: During a one-year study period, 1314 screening patients with a personal history of breast cancer and dense breasts simultaneously underwent mammography and breast US. BI-RADS categories were given for mammography or US-detected lesions in the contralateral breast. The reference standard was histology and/or 1-year imaging follow-up, and the cancer rate according to BI-RADS categories and cancer detection rate and positive biopsy rate according to detection modality were analyzed. Results: Of 1314 patients, 84 patients (6.4%) were categorized as category 3 with one interval cancer and one cancer which was upgraded to category 4A after 6-month follow-up US (2.5% cancer rate, 95% CIs 1.5–9.1%). Fifteen patients (1.1%) had category 4A or 4B lesions in the contralateral breast. Four lesions were detected on mammography (two lesions were also visible on US) and 11 lesions were detected on US and 5 cancers were confirmed (33.3%, 95% CIs 15.0–58.5%). Six patients (0.5%) had category 4C lesions, 2 detected on mammography and 4 on US and 4 cancers were confirmed (66.7%, 95% CIs 29.6–90.8%). No lesions were categorized as category 5 in the contralateral breast. Cancer detection rate by mammography was 3.3 per 1000 patients and that by US was 5.0 per 1000 patients, therefore overall cancer detection rate by

  18. Academic detailing to increase colorectal cancer screening by primary care practices in Appalachian Pennsylvania

    Directory of Open Access Journals (Sweden)

    Graybill Marie A

    2011-05-01

    Full Text Available Abstract Background In the United States, colorectal cancer (CRC is the third most frequently diagnosed cancer and second leading cause of cancer death. Screening is a primary method to prevent CRC, yet screening remains low in the U.S. and particularly in Appalachian Pennsylvania, a largely rural area with high rates of poverty, limited health care access, and increased CRC incidence and mortality rates. Receiving a physician recommendation for CRC screening is a primary predictor for patient adherence with screening guidelines. One strategy to disseminate practice-oriented interventions is academic detailing (AD, a method that transfers knowledge or methods to physicians, nurses or office staff through the visit(s of a trained educator. The objective of this study was to determine acceptability and feasibility of AD among primary care practices in rural Appalachian Pennsylvania to increase CRC screening. Methods A multi-site, practice-based, intervention study with pre- and 6-month post-intervention review of randomly selected medical records, pre- and post-intervention surveys, as well as a post-intervention key informant interview was conducted. The primary outcome was the proportion of patients current with CRC screening recommendations and having received a CRC screening within the past year. Four practices received three separate AD visits to review four different learning modules. Results We reviewed 323 records pre-intervention and 301 post-intervention. The prevalence of being current with screening recommendation was 56% in the pre-intervention, and 60% in the post-intervention (p = 0. 29, while the prevalence of having been screened in the past year increased from 17% to 35% (p Conclusions AD appears to be acceptable and feasible for primary care providers in rural Appalachia. A ceiling effect for CRC screening may have been a factor in no change in overall screening rates. While the study was not designed to test the efficacy of AD

  19. Population screening for breast cancer in the European Community

    International Nuclear Information System (INIS)

    Although our understanding of the causes of breast cancer is increasing, it is as yet not possible to recommend measures to decrease its occurrence. Therefore we have to resort to a substitute called secondary prevention which aims at preventing the occurrence of metastatic breast cancer and death by detecting the primary cancer in the breast at an earlier point in its natural history. The question whether this can be achieved can only be answered by scientific study. Such studies are being called: population-based screening programmes. Screening requires one or more tests by which one can partition a population in those who probably have a cancer and those who have not. Since an early breast cancer does not produce symptoms like pain the test has to be some sort of objective assessment. In the field of detecting breast cancer we have been greatly helped by the development of a radiologic technique called mammography. Mammography basically is not an easy technique since there is little contrast between structures in the breast compared with e.g. bone. The quality of mammograms, therefore, was not very high in the pioneering era during the nineteen-fifties and -sixties. This presentation discusses a move of a few doctors in New York city: a radiologist, a surgeon and epidemiologist, to design a scientific study which could answer the question whether mammography, added to a standard clinical examination of the breast would decrease mortality from breast cancer

  20. Aromatase inhibitor strategies in metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Heather L McArthur

    2009-07-01

    Full Text Available Heather L McArthur, Patrick G MorrisBreast Cancer Medicine Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USAAbstract: Despite ongoing therapeutic innovations, metastatic breast cancer (MBC remains a treatable but incurable disease. In the developed world, a diagnosis of MBC without a preceding diagnosis of early stage disease is a rare event. However, approximately one-third of women with early stage breast cancer ultimately experience a distant recurrence. Because the majority of breast cancers express estrogen and/or progesterone receptors and are accordingly considered hormone-sensitive, therapeutic strategies that interfere with hormone-mediated tumorigenesis have been a cornerstone of the breast cancer management paradigm for decades. Historically, the selective estrogen receptor modulator tamoxifen has been the most extensively studied and widely used hormone maneuver in breast cancer. However, a recent therapeutic innovation, namely the successful development of third-generation aromatase inhibitors (AIs, has had a dramatic impact on the treatment paradigm for women with hormone-sensitive MBC. Because of the demonstrated efficacy in postmenopausal breast cancer patients, the generally favorable side-effect profile, and the convenience of oral administration, AIs are now in widespread clinical use. Currently, there are three clinically available third-generation AIs: two reversible, nonsteroidal AIs, letrozole and anastrozole; and one irreversible, steroidal AI, exemestane. All three agents are at least as efficacious as tamoxifen as monotherapy for postmenopausal women with hormone-sensitive MBC. Current clinical research aims to improve upon existing strategies by evaluating AIs in combination with systemic chemotherapy regimens and/or novel targeted agents. It is hoped that these therapeutic innovations will lead to ongoing improvements in quality of life parameters and ideally survival for women

  1. Contrary to Evidence, Some Doctors Recommend Ovarian Cancer Screening | Division of Cancer Prevention

    Science.gov (United States)

    One in three doctors believes that screening for ovarian cancer is effective, according to a recently published survey of practicing physicians, even though substantial evidence to the contrary exists. |

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

    Science.gov (United States)

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

  3. Research Needs for Understanding the Biology of Overdiagnosis in Cancer Screening.

    Science.gov (United States)

    Srivastava, Sudhir; Reid, Brian J; Ghosh, Sharmistha; Kramer, Barnett S

    2016-09-01

    Many cancers offer an extended window of opportunity for early detection and therapeutic intervention that could lead to a reduction in cause-specific mortality. The pursuit of early detection in screening settings has resulted in decreased incidence and mortality for some cancers (e.g., colon and cervical cancers), and increased incidence with only modest or no effect on cause-specific mortality in others (e.g., breast and prostate). Whereas highly sensitive screening technologies are better at detecting a number of suspected "cancers" that are indolent and likely to remain clinically unimportant in the lifetime of a patient, defined as overdiagnosis, they often miss cancers that are aggressive and tend to present clinically between screenings, known as interval cancers. Unrecognized overdiagnosis leads to overtreatment with its attendant (often long-lasting) side effects, anxiety, and substantial financial harm. Existing methods often cannot differentiate indolent lesions from aggressive ones or understand the dynamics of neoplastic progression. To correctly identify the population that would benefit the most from screening and identify the lesions that would benefit most from treatment, the evolving genomic and molecular profiles of individual cancers during the clinical course of progression or indolence must be investigated, while taking into account an individual's genetic susceptibility, clinical and environmental risk factors, and the tumor microenvironment. Practical challenges lie not only in the lack of access to tissue specimens that are appropriate for the study of natural history, but also in the absence of targeted research strategies. This commentary summarizes the recommendations from a diverse group of scientists with expertise in basic biology, translational research, clinical research, statistics, and epidemiology and public health professionals convened to discuss research directions. J. Cell. Physiol. 231: 1870-1875, 2016. © 2015 Wiley

  4. Melanoma skin cancer screenings. A how-to approach.

    Science.gov (United States)

    Dobes, W L

    1995-01-15

    Development of a workshop on skin cancer screening should begin with physicians who are able to best diagnose and treat skin cancer, that is, dermatologists who are board certified or board eligible. Local societies should then be involved as well as organizations that can offer ancillary help such as screening, clinics' location and assisting with personnel financial aid, and exposure to the public, such as advertising. Support groups then become essential to a good screening. The help of the American Cancer Society, local churches, clubs, and others is beneficial. The organization should have a central organizing body that sets the dates and locations for the clinics and that helps get supplies, such as tables, screens for privacy, and literature. Volunteers can help with sign-in and sign-out sheets for the screening and can act as traffic directors and assist the physicians. Media exposure then becomes important. A TV or radio show can get the public's attention, for example, by releasing the latest data on skin cancer or by presenting a solar meter project showing the local risk of ultraviolet radiation. The workshop itself should begin on time. Additionally, a cutoff time is also needed. In the final stage, the forms should be processed and a follow-up evaluation should be done on the number of patients seen, precancerous and cancerous lesions found, and the potential for future functions. Popular ancillary aids are good literature on the subjects discussed, and samples of sunscreens (SPF 15 or better) that are donated by pharmaceutical companies. PMID:7804998

  5. Development and Validation of the Assessment of Health Literacy in Breast and Cervical Cancer Screening

    OpenAIRE

    Han, Hae-Ra; Huh, Boyun; Kim, Miyong T.; Kim, Jiyun; Nguyen, Tam

    2014-01-01

    For many people limited health literacy is a major barrier to effective preventive health behavior such as cancer screening, yet a comprehensive health literacy measure that is specific to breast and cervical cancer screening is not readily available. The purpose of this paper is to describe the development and testing of a new instrument to measure health literacy in the context of breast and cervical cancer screening, the Assessment of Health Literacy in Cancer Screening (AHL-C). The AHL-C ...

  6. Breast cancer mortality in organised mammography screening in Denmark: comparative study

    DEFF Research Database (Denmark)

    Juhl Jørgensen, Karsten; Zahl, Per-Henrik; Gøtzsche, Peter C

    2010-01-01

    To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up....

  7. Exploring Different Virtual Screening Strategies for Acetylcholinesterase Inhibitors

    Directory of Open Access Journals (Sweden)

    Nibha Mishra

    2013-01-01

    Full Text Available The virtual screening problems associated with acetylcholinesterase (AChE inhibitors were explored using multiple shape, and structure-based modeling strategies. The employed strategies include molecular docking, similarity search, and pharmacophore modeling. A subset from directory of useful decoys (DUD related to AChE inhibitors was considered, which consists of 105 known inhibitors and 3732 decoys. Statistical quality of the models was evaluated by enrichment factor (EF metrics and receiver operating curve (ROC analysis. The results revealed that electrostatic similarity search protocol using EON (ET_combo outperformed all other protocols with outstanding enrichment of >95% in top 1% and 2% of the dataset with an AUC of 0.958. Satisfactory performance was also observed for shape-based similarity search protocol using ROCS and PHASE. In contrast, the molecular docking protocol performed poorly with enrichment factors <30% in all cases. The shape- and electrostatic-based similarity search protocol emerged as a plausible solution for virtual screening of AChE inhibitors.

  8. Comorbidity-Adjusted life expectancy: A new tool to inform recommendations for optimal screening strategies

    NARCIS (Netherlands)

    H. Cho Dr. (Hyunsoon); C.N. Klabunde (Carrie); K.R. Yabroff Dr. (K. Robin); Z. Wang Dr. (Zhuoqiao); A. Meekins Dr. (Angela); I. Lansdorp-Vogelaar (Iris); A.B. Mariotto Dr. (Angela)

    2013-01-01

    textabstractBackground: Many guidelines recommend considering health status and life expectancy when making cancer screening decisions for elderly persons. Objective: To estimate life expectancy for elderly persons without a history of cancer, taking into account comorbid conditions. Design: Populat

  9. Cost Effectiveness of Breast Cancer Screening Using Mammography; a Systematic Review

    Directory of Open Access Journals (Sweden)

    Arash Rashidian

    2013-04-01

    Full Text Available Background: Breast cancer is the leading cause of malignancy among women. Screening using mammography is proposed as an effective intervention for reducing early deaths due to breast cancer. We conducted a systematic review to assess the cost-effectiveness of such screening programs. We searched Medline, Scopus and Google Scholar and complemented it by other searches using sensitive search terms from 1993-2010. We screened the titles and abstracts, assessed the full texts of the remaining studies, and extracted data to a pre-designed data extraction sheet. Studies were categorized according to the age groups of the target population. We used narrative synthesis approaches for analyzing the data. Twenty-eight articles met the minimum inclusion criteria, mostly from high income settings. All studies used secondary data, and a variety of modeling techniques, age groups, screening intervals and outcome measures. Cost per life year gained, ranging from $1,634 (once at the age of 50 in India to $65,000 (extending the lower age limit of screening to 40 Australian study, was the most commonly used outcome measure. Biennial screening test for those aged 50-70 years seems to be the most cost-effective option ($2685. Biennial screening for aged 50-70 years is the most cost-effective option among alternative scenarios. Screening those aged less than 50 is not recommended. Further studies in low-income and middle-income countries, and cost effectiveness studies along with randomized trials are required. To improve the comparability of the findings, future studies should include biennial screening in 50-70 age groups as an alternative strategy.

  10. Breast cancer mortality in organised mammography screening in Denmark: comparative study

    DEFF Research Database (Denmark)

    Juhl Jørgensen, Karsten; Zahl, Per-Henrik; Gøtzsche, Peter C

    2010-01-01

    To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up.......To determine whether the previously observed 25% reduction in breast cancer mortality in Copenhagen following the introduction of mammography screening was indeed due to screening, by using an additional screening region and five years additional follow-up....

  11. Population Based Screening for Prostate Cancer: assessment of diagnostic tools and cancers detected

    NARCIS (Netherlands)

    J.B.W. Rietbergen (John)

    1998-01-01

    textabstractOver the past decade, considerable debate has occurred over the question whether or not to screen asymptomatic men for prostate cancer. It is unknown whether early detection and treatment of the disease will decrease the disease specific mortality. On theoretical grounds screening may pr

  12. Barriers to colorectal cancer screening: A case-control study

    Institute of Scientific and Technical Information of China (English)

    Shan-Rong Cai; Su-Zhan Zhang; Shu Zheng; Hong-Hong Zhu

    2009-01-01

    AIM:To investigate barriers to colorectal cancer (CRC) screening in a community population. METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire. Cases were selected from those completing both a fecal occult blood test (FOBT) case and colonoscopy in a CRC screening program in 2004. Control groups were matched by gender, age group and community. Control 1 included those having a positive FOBT but refusing a colonoscopy. Control 2 included those who refused both an FOBT and colonoscopy. RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender. P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2. Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate. Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test. Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%,respectively, if it was self-paid. Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy. CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.

  13. Advances in breast cancer screening program%乳腺癌筛查研究进展

    Institute of Scientific and Technical Information of China (English)

    莫淼; 柳光宇; 吕力琅; 徐望红

    2012-01-01

    Breast cancer is the most common malignancy in women around the world. Breast cancer screening has been recognized as the primary approach to effectively improve the survival of female breast cancer. The most commonly used methods for breast cancer screening in China and other countries include mammography (MAM), ultrasonography (US), clinical breast examination (CBE) and magnetic resonance imaging (MRI). This paper summarizes the advantages and disadvantages of these screening techniques and reviewes the economic efficiency in health care of different screening techniques based on these examination approaches to provide some evidence for developing a breast cancer screening strategy with optimal cost-effectiveness for Chinese women.%乳腺癌是危害全世界女性健康最常见的恶性肿瘤.乳腺癌筛查是公认的能够有效提高女性乳腺癌生存率的主要方法.目前国内外常用的乳腺癌筛查手段包括乳房X线摄影术(钼靶X线摄影)、超声成像、临床乳腺检查和磁共振成像等.本文对这些筛查手段的优缺点进行了比较,并对基于这些手段建立的不同筛查方案在人群中的应用效果和卫生经济学评价进行综述,以期为建立符合中国国情的具有成本-效果的女性乳腺癌筛查策略提供参考和依据.

  14. Socio-economic inequalities in breast and cervical cancer screening practices in Europe: influence of the type of screening program

    NARCIS (Netherlands)

    L. Palència; A. Espelt; M. Rodríguez-Sanz; R. Puigpinós; M. Pons-Vigués; M.I. Pasarín; T. Spadea; A.E. Kunst; C. Borrell

    2010-01-01

    Methods A cross-sectional study was performed using individual-level data from the WHO World Health Survey (2002) and data regarding the implementation of cancer screening programmes. The study population consisted of women from 22 European countries, aged 25-69 years for cervical cancer screening (

  15. Recording of hormone therapy and breast density in breast screening programs: summary and recommendations of the International Cancer Screening Network.

    NARCIS (Netherlands)

    Cox, B.; Ballard-Barbash, R.; Broeders, M.J.M.; Dowling, E.; Malila, N.; Shumak, R.; Taplin, S.; Buist, D.; Miglioretti, D.

    2010-01-01

    Breast density and the use of hormone therapy (HT) for menopausal symptoms alter the risk of breast cancer and both factors influence screening mammography performance. The International Cancer Screening Network (ICSN) surveyed its 29 member countries and found that few programs record breast densit

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

    Directory of Open Access Journals (Sweden)

    Cibelli Navarro

    2015-01-01

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

  17. Effects of repeated mammographic screening on breast cancer stage distribution

    International Nuclear Information System (INIS)

    A randomised controlled trial of mass screening for breast cancer by single-view mammography was begun in Sweden in 1977. All women aged 40 and older and resident in the counties of Koppaberg and Oestergoetland were enrolled. The present report is confined to the Oestergoetland study, which started in 1978 and comprised 92934 women. After randomisation, which was done on the basis of communities rather than individuals, 47001 women were allocated to the study group and offered repeated mammographic screening; 45933 were allocated to the control group. As compliance among women over 74 years of age was poor these were excluded from the present report. The yearly incidence of stage II or more advanced breast cancers after the initial screening round up to and including the second was reduced by 40 per cent in the study group compared with the controls. This effect was less marked in the age group 40-49. After 5.5 years average from the date of entry the absolute number of women with stage II-IV disease in the control group exceeded that for the study group by 44, whereas there was a large excess of cancer in situ and stage I cancer in the study group. (orig.)

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

    Science.gov (United States)

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

    2016-03-01

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

  19. Implementing women's cancer screening programs in American Indian and Alaska Native populations.

    Science.gov (United States)

    Lantz, Paula M; Orians, Carlyn E; Liebow, Edward; Joe, Jennie R; Burhansstipanov, Linda; Erb, Julie; Kenyon, Kathryn

    2003-01-01

    The National Breast and Cervical Cancer Early Detection Program provides funding to tribes and tribal organizations to implement comprehensive cancer screening programs using a program model developed for state health departments. We conducted a multiple-site case study using a participatory research process to describe how 5 tribal programs implemented screening services, and to identify strategies used to address challenges in delivering services to American Indian and Alaska Native women. We analyzed data from semistructured interviews with 141 key informants, 16 focus groups with 132 program-eligible women, and program documents. Several challenges regarding the delivery of services were revealed, including implementing screening programs in busy acute-care environments, access to mammography, providing culturally sensitive care, and providing diagnostic/treatment services in rural and remote locations. Strategies perceived as successful in meeting program challenges included identifying a "champion" or main supporter of the program in each clinical setting, using mobile mammography, using female providers, and increasing the capacity to provide diagnostic services at screening sites. The results should be of interest to an international audience, including those who work with health-related programs targeting indigenous women or groups that are marginalized because of culture, geographic isolation, and/or socioeconomic position.

  20. COPING STRATEGIES IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    J. R. Gardanova

    2015-01-01

    Full Text Available Diagnostics of psycho-emotional disorders of patients with malignant diseases of the prostate is not doubt, because timely correction contributes to the shortening of rehabilitation period and restoration of the quality of life of patients after treatment. Detection and diagnosis of prostate cancer for many patients is stressful and causes changes in the affective sphere, and manifests itself in increased levels of anxiety and depression in men. To cope with stress is possible due to the used coping strategies.Purpose. Studying the coping mechanisms in prostate cancer patients.Materials and methods. 56 men treated in FGBU "LRTS" Russian Ministry of Health. The average age was 65.7 ± 6.1 years. The average duration of the disease prostate cancer is 3 ± 2 months. All men were subjected to the standard algorithm for the evaluation of hormonal status, the PSA, taking a history, inspection and physical examination, magnetic resonance imaging and scintigraphy of bones of a skeleton. All the patients underwent laparoscopic radical prostatectomy. Psychological testing with the use of the method of "Coping test" the scale of reactive and personal anxiety for the differentiated evaluation of anxiety. Results. The most common for prostate cancer revealed constructive coping strategies are "planning solve", "selfcontrol" and "search of social support". According to the scale Spielberg–Hanin a high level of situational anxiety was revealed.Conclusion. According to the results of the research, patients with prostate cancer are likely to use constructive coping strategies, that leads to stabilization of psycho-emotional state of men and promotes more effective adaptation in the terms of stress, that is caused by treatment of prostate cancer.

  1. Breast cancer screening results 5 years after introduction of digital mammography in a population-based screening program.

    NARCIS (Netherlands)

    Karssemeijer, N.; Bluekens, A.M.; Beijerinck, D.; Deurenberg, J.J.; Beekman, M.; Visser, R.; Engen, R. van; Bartels-Kortland, A.; Broeders, M.J.M.

    2009-01-01

    PURPOSE: To compare full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) with screen-film mammography (SFM) in a population-based breast cancer screening program for initial and subsequent screening examinations. MATERIALS AND METHODS: The study was approved by the regional med

  2. Association of eHealth literacy with cancer information seeking and prior experience with cancer screening.

    Science.gov (United States)

    Park, Hyejin; Moon, Mikyung; Baeg, Jung Hoon

    2014-09-01

    Cancer is a critical disease with a high mortality rate in the US. Although useful information exists on the Internet, many people experience difficulty finding information about cancer prevention because they have limited eHealth literacy. This study aimed to identify relationships between the level of eHealth literacy and cancer information seeking experience or prior experience with cancer screening tests. A total of 108 adults participated in this study through questionnaires. Data covering demographics, eHealth literacy, cancer information seeking experience, educational needs for cancer information searching, and previous cancer screening tests were obtained. Study findings show that the level of eHealth literacy influences cancer information seeking. Individuals with low eHealth literacy are likely to be less confident about finding cancer information. In addition, people who have a low level of eHealth literacy need more education about seeking information than do those with a higher level of eHealth literacy. However, there is no significant relationship between eHealth literacy and cancer screening tests. More people today are using the Internet for access to information to maintain good health. It is therefore critical to educate those with low eHealth literacy so they can better self-manage their health.

  3. A practical approach to radiological evaluation of CT lung cancer screening examinations

    NARCIS (Netherlands)

    Xie, Xueqian; Heuvelmans, Marjolein A.; van Ooijen, Peter M. A.; Oudkerk, Matthijs; Vliegenthart, Rozemarijn

    2013-01-01

    Lung cancer is the most common cause of cancer-related death in the world. The Dutch-Belgian Randomized Lung Cancer Screening 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

  4. Sniffer dogs as part of a bimodal bionic research approach to develop a lung cancer screening.

    Science.gov (United States)

    Boedeker, Enole; Friedel, Godehard; Walles, Thorsten

    2012-05-01

    Lung cancer (LC) continues to represent a heavy burden for health care systems worldwide. Epidemiological studies predict that its role will increase in the near future. While patient prognosis is strongly associated with tumour stage and early detection of disease, no screening test exists so far. It has been suggested that electronic sensor devices, commonly referred to as 'electronic noses', may be applicable to identify cancer-specific volatile organic compounds in the breath of patients and therefore may represent promising screening technologies. However, three decades of research did not bring forward a clinically applicable device. Here, we propose a new research approach by involving specially trained sniffer dogs into research strategies by making use of their ability to identify LC in the breath sample of patients.

  5. A Review of Different Behavior Modification Strategies Designed to Reduce Sedentary Screen Behaviors in Children

    OpenAIRE

    Jeremy A. Steeves; Thompson, Dixie L; Bassett, David R.; Eugene C. Fitzhugh; Raynor, Hollie A.

    2011-01-01

    Previous research suggests that reducing sedentary screen behaviors may be a strategy for preventing and treating obesity in children. This systematic review describes strategies used in interventions designed to either solely target sedentary screen behaviors or multiple health behaviors, including sedentary screen behaviors. Eighteen studies were included in this paper; eight targeting sedentary screen behaviors only, and ten targeting multiple health behaviors. All studies used behavior mo...

  6. Are U.S. cancer screening test patterns consistent with guideline recommendations with respect to the age of screening initiation?

    Directory of Open Access Journals (Sweden)

    Kadiyala Srikanth

    2009-10-01

    Full Text Available Abstract Background U.S. cancer screening guidelines communicate important information regarding the ages for which screening tests are appropriate. Little attention has been given to whether breast, colorectal and prostate cancer screening 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 cancer screening 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 cancer screening 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 cancer screening 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 cancer screening. Since information regarding the age of cancer screening

  7. 42 CFR 410.37 - Colorectal cancer screening tests: Conditions for and limitations on coverage.

    Science.gov (United States)

    2010-10-01

    ... purpose of early detection of colorectal cancer: (i) Screening fecal-occult blood tests. (ii) Screening... determines appropriate, in consultation with appropriate organizations (2) Screening fecal-occult blood test... for coverage of screening fecal-occult blood tests. Medicare Part B pays for a screening...

  8. [Cost-effectiveness of an organized breast cancer screening program in Southern Brazil].

    Science.gov (United States)

    Ribeiro, Rodrigo Antonini; Caleffi, Maira; Polanczyk, Carisi Anne

    2013-11-01

    The aim of this study was to evaluate the cost-effectiveness of an organized breast cancer mammographic screening program implemented in Porto Alegre (Núcleo Mama Porto Alegre - NMPOA), Rio Grande do Sul State, Brazil. A Markov model was constructed to estimate the incremental cost-effectiveness ratio of NMPOA compared to current BC diagnosis and care in the Brazilian public health system, in a hypothetical cohort of women aged 40-69 years at risk of developing breast cancer. Model parameters were collected from NMPOA and the national literature. In the NMPOA strategy, effectiveness was modeled taking into account the actual observed screening adherence. Effectiveness was measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio in the base case was R$ 13,426 per QALY. This result was not sensitive to variation in the main model parameters in sensitivity analyses. Considering the threshold usually suggested as highly attractive in Brazil, breast cancer screening as performed in NMPOA is cost-effective in cities with high incidence of breast cancer.

  9. [Cost-effectiveness of an organized breast cancer screening program in Southern Brazil].

    Science.gov (United States)

    Ribeiro, Rodrigo Antonini; Caleffi, Maira; Polanczyk, Carisi Anne

    2013-11-01

    The aim of this study was to evaluate the cost-effectiveness of an organized breast cancer mammographic screening program implemented in Porto Alegre (Núcleo Mama Porto Alegre - NMPOA), Rio Grande do Sul State, Brazil. A Markov model was constructed to estimate the incremental cost-effectiveness ratio of NMPOA compared to current BC diagnosis and care in the Brazilian public health system, in a hypothetical cohort of women aged 40-69 years at risk of developing breast cancer. Model parameters were collected from NMPOA and the national literature. In the NMPOA strategy, effectiveness was modeled taking into account the actual observed screening adherence. Effectiveness was measured in quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio in the base case was R$ 13,426 per QALY. This result was not sensitive to variation in the main model parameters in sensitivity analyses. Considering the threshold usually suggested as highly attractive in Brazil, breast cancer screening as performed in NMPOA is cost-effective in cities with high incidence of breast cancer. PMID:25402242

  10. Task Force Reaffirms Recommendation against Ovarian Cancer Screening | Division of Cancer Prevention

    Science.gov (United States)

    Women at average risk of ovarian cancer should not be screened for the disease, the U.S. Preventive Services Task Force (USPSTF) has reaffirmed. Published in the Annals of Internal Medicine on September 11, the latest USPSTF clinical guideline does not apply to women who have symptoms of ovarian cancer or who have genetic mutations that increase their risk of ovarian cancer. |

  11. Screening of human bocavirus in surgically excised cancer specimens.

    Science.gov (United States)

    Abdel-Moneim, Ahmed S; El-Fol, Hosam A; Kamel, Mahmoud M; Soliman, Ahmed S A; Mahdi, Emad A; El-Gammal, Ahmed S; Mahran, Taha Z M

    2016-08-01

    Human bocavirus (HBoV) is a prevalent virus worldwide and is mainly associated with respiratory disorders. Recently, it was detected in several disease conditions, including cancers. Colorectal cancer (CRC) is the third main cause of cancers worldwide. Risk factors that initiate cell transformation include nutritional, hereditary and infectious causes. The aim of the current study was to screen for the presence of HBoV in solid tumors of colorectal cancer and to determine the genotypes of the detected strains. Surgically excised and paraffin-embedded colorectal cancer tissue specimens from 101 male and female patients with and without metastasis were collected over the last four years. Pathological analysis and tumor stages were determined. The presence of HBoV was screened by polymerase chain reaction, and the genotype of the detected HBoV was determined by direct gene sequencing. Most of the examined specimens were adenocarcinoma with mucinous activity in many of them. Twenty-four out of 101 (23.8 %) CRC tissue specimens were found to contain HBoV-1. Low sequence diversity was recorded in the detected strains. The virus was detected in both male and female patients with an age range of 30-75 years. It is proposed that HBoV-1 could play a potential role in the induction of CRC. PMID:27155943

  12. Factors associated with breast and cervical cancer screening behavior among African immigrant women in Minnesota.

    Science.gov (United States)

    Harcourt, Nonyelum; Ghebre, Rahel G; Whembolua, Guy-Lucien; Zhang, Yan; Warfa Osman, S; Okuyemi, Kolawole S

    2014-06-01

    Immigrant populations in the United States (US) have lower cancer screening rates compared to none immigrant populations. The purpose of this study was to assess the rates of cancer screening and examine factors associated with cancer screening 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. Cancer screening 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 cancer screening. 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.

  13. Cervical cancer screening in primary health care setting in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Aro, Arja R.; Rasch, Vibeke;

    2012-01-01

    of this study showed that VIA has higher sensitivity and lower specificity compared to Pap smear, but a combination of both tests has greater sensitivity and specificity than each test independently. It indicates that VIA is useful for screening of cervical cancer in the primary health care setting in Sudan......OBJECTIVE: To determine the feasibility of visual inspection with the use of acetic acid (VIA) as a screening method for cervical cancer, an alternative to the Pap smear used in primary health care setting in Sudan, and to compare sensitivity, specificity, positive and negative predictive values......, and histological diagnosis of positive cases of both tests. METHODS: A cross-sectional study of 934 asymptomatic women living in Khartoum, Sudan, was conducted during 2009-2010. A semi-structured questionnaire containing socio-economic and reproductive variables was used to collect data from each participant...

  14. Perspectives of colorectal cancer risk and screening among Dominicans and Puerto Ricans: stigma and misperceptions.

    Science.gov (United States)

    Goldman, Roberta E; Diaz, Joseph A; Kim, Ivone

    2009-11-01

    Colorectal cancer is the second most common cancer among Latinos, but a lower percentage of Latinos are screened than Whites and Blacks. Along with recognized economic barriers, differences in knowledge and perceptions might impede colorectal screening among Latinos. We conducted 147 individual, qualitative interviews with Dominicans and Puerto Ricans in the northeastern United States to explore their explanatory models for colorectal cancer and screening barriers. Many participants had not previously heard of colorectal cancer. The most commonly mentioned cause of colorectal cancer was anal sex. Also considered risks were "bad food," digestion leading to constipation, and strained bowel movements. Screening barriers included stigma, misperceptions, embarrassment, and machismo. Progress toward increasing colorectal cancer screening requires normalization of this screening among Latinos. Higher patient familiarity, along with improved physician counseling and referral, might contribute to reducing stigma and other barriers, and to enhancing knowledge and Latino community support of colorectal cancer screening.

  15. Advanced strategies in liposomal cancer therapy

    DEFF Research Database (Denmark)

    Andresen, Thomas Lars; Jensen, Simon Skøde; Jørgensen, Kent

    2005-01-01

    Tumor specific drug delivery has become increasingly interesting in cancer therapy, as the use of chemotherapeutics is often limited due to severe side effects. Conventional drug delivery systems have shown low efficiency and a continuous search for more advanced drug delivery principles...... of this paper, we review our own work, exploiting secretory phospholipase A(2) as a site-specific trigger and prodrug activator in cancer therapy. We present novel prodrug lipids together with biophysical investigations of liposome systems, constituted by these new lipids and demonstrate their degradability...... is therefore of great importance. In the first part of this review, we present current strategies in the drug delivery field, focusing on site-specific triggered drug release from liposomes in cancerous tissue. Currently marketed drug delivery systems lack the ability to actively release the carried drug...

  16. Results of lung cancer screening in atomic bomb survivors

    International Nuclear Information System (INIS)

    Risk of lung cancer in A-bomb survivors is reportedly increased. The screening in the title has been conducted since 1988 and this report summarizes its results of the latest 6-year term (2004-2009). The total number of subjects who visited authors' facility for the screening in the period was 39,147 men (average age 70.6 y) and 45,351 women (71.8 y), of the age range of 60-89 y. The screening results of the cancer were examined concerning with sex, age and exposure situation. As well, the relationship between the found cancer incidence and exposure in never, formerly and currently smoking subjects were also examined. Exposure situation was divided in 3 groups of the exposure by entrance in the city/by other reasons, within 2 km close (Close, C) to, and out of 2.1 km afar (Distant, D) from, the city. Statistic analysis was performed by Chi-squire and/or Fisher's exact test. The index of positive finding in the screening of the lung cancer per 1,000 subjects was the highest in C men of ages 70s, 2.88 subjects, which was statistically significant from 0.85 in D men of the same generation. In current smokers, the index 5.40 in C men of ages 70s was significantly higher than 0.90 in D men of the same generation. Overall, positive results tended to be high in survivors of C regardless to sex and smoking, and was significantly high in current smokers of C as above, both implying the particular necessity of promotion to stop smoking in survivors. (T.T.)

  17. Behavioral Theory in the Context of Applied Cancer Screening Research

    OpenAIRE

    Zapka, Jane; Cranos, Caroline

    2009-01-01

    The U.S. health care system is indeed challenged to provide effective, equitable, and efficient care for its citizens (Aday, Begley, Lairson, & Balkrishnan, 2004). The past decades have witnessed profound concern about the quality of care Americans receive, the equality of care across racial ethnic communities, and the escalating costs of private and public coverage. These concerns apply to the cancer care continuum, including screening. This commentary reflects on the methods, findings, and ...

  18. CT screening for lung cancer: Is the evidence strong enough?

    Science.gov (United States)

    Field, J K; Devaraj, A; Duffy, S W; Baldwin, D R

    2016-01-01

    The prevailing questions at this time in both the public mind and the clinical establishment is, do we have sufficient evidence to implement lung cancer Computed Tomography (CT) screening in Europe? If not, what is outstanding? This review addresses the twelve major areas, which are critical to any decision to implement CT screening and where we need to assess whether we have sufficient evidence to proceed to a recommendation for implementation in Europe. The readiness level of these twelve categories in 2015 have been with colour coded, where green indicates we have sufficient evidence, amber is borderline evidence and red requires further evidence. Recruitment from the 'Hard to Reach' community still remains at red, while mortality data, cost effectiveness and screening interval are all categorised as amber. The integration of smoking cessation into CT screening programmes is still considered to be category amber. The US Preventive Services Task Force have recommended that CT screening is implemented in the USA utilising the NLST criteria, apart from continuing screening to 80 years of age. The cost effectiveness of the NLST was calculated to be $81,000/QALY, however, its well recognised that the costs of medical care in the USA, is far higher than that of Europe. Medicare have agreed to cover the cost of screening but have stipulated a number of stringent requirements for inclusion. To date we do not have good CT screening mortality data available in Europe and eagerly await the publication of the NELSON trial data in 2016 and then the pooled UKLS and NELSON data thereafter. However in the meantime we should start planning for implementation in Europe, especially in the areas of the radiological service provision and accreditation, as well as identifying novel mechanisms to recruit from the hardest to reach communities. PMID:26711931

  19. Squamous Cell Cancer of Unknown Primary and Primary Breast Cancer in an HIV-Infected Woman: The Importance of Cancer Screening for People Living with HIV/AIDS.

    Science.gov (United States)

    Gulvin, Joshua; Aboulafia, David M

    2016-05-01

    People living with HIV/AIDS (PLWHA) are surviving longer, with an increased risk of cancer. Cancer screening strategies in PLWHA are lacking. We describe the case of a woman with a history of AIDS, who had a nondetectable viral load on treatment. She is an activist, promoting HIV care, but had not undergone routine screening for breast, cervical, or colonic neoplasia. She presented with a left groin mass, which on biopsy proved to be a p16 immuno-histochemical positive squamous cell carcinoma. Anal and cervicovaginal examinations did not show invasive cancer, although high-resolution anoscopy identified high-grade anal dysplasia. A mammogram followed by magnetic resonance imaging showed invasive ductal carcinoma. Her breast cancer was treated with lumpectomy, adjuvant brachytherapy and chemotherapy. The left groin tumor was treated with chemo-radiation. Herein, we also review medical literature concerning anal, cervical, breast, colorectal, and lung cancer screening for PLWHA, which is important for our aging population of PLWHA. PMID:26864079

  20. Knowledge of colorectal cancer screening among young Malaysians.

    Science.gov (United States)

    Al-Naggar, Redhwan Ahmed; Bobryshev, Yuri V

    2013-01-01

    The objective of this study was to determine the knowledge and associated factors regarding colorectal cancer screening among university students in Malaysia. The questionnaire consisted of three parts: socio-demographic characteristics, lifestyle practice and knowledge of colorectal screening. A cross-sectional study was conducted among 300 students (21.3±1.4 years old). The majority of the participants were Malay with a monthly family income of less than 5,000 Ringgit Malaysia (equal to 1,700 USD) (67.0% and 76.0%, respectively). Regarding their lifestyle practices, the majority were non-smokers and had never consumed alcohol (83.7%, and 88.0%, respectively). The majority of the participants had no knowledge of digital rectal examination, colonoscopy, barium enema and fecal occult blood screening (63.3%, 60.7%, 74.0% and 62.3%, respectively). Univariate and multivariate analysis revealed that their age and the discipline which the students were studying significantly influenced their level of knowledge about colorectal screening. The present study results indicate that education campaigns about colorectal cancer should be promoted. PMID:23679301

  1. Start-Up of the Colorectal Cancer Screening Demonstration Program

    Directory of Open Access Journals (Sweden)

    Amy DeGroff, MPH

    2008-04-01

    Full Text Available IntroductionIn 2005, the Centers for Disease Control and Prevention funded five sites to implement the Colorectal Cancer Screening Demonstration Program (CRCSDP. An evaluation is being conducted that includes a multiple case study. Case study results for the start-up period, the time between initial funding and screening initiation, provide details about the program models and start-up process and reveal important lessons learned.MethodsThe multiple case study includes all five CRCSDP sites, each representing a unique case. Data were collected from August 2005 through September 2006 from documents, observations, and more than 70 interviews with program staff and stakeholders.ResultsSites differed by geographic service area, screening modality selected, and service delivery structure. Program models were influenced by two factors: preexisting infrastructure and the need to adapt programs to fit local service delivery structures. Several sites modeled program components after their National Breast and Cervical Cancer Early Detection Program. Medical advisory boards convened by all sites provided clinical support for developing program policies and quality assurance plans. Partnerships with comprehensive cancer control programs facilitated access to financial and in-kind resources.ConclusionThe program models developed by the CRCSDP sites offer a range of prototypes. Case study results suggest benefits in employing a multidisciplinary staff team, assembling a medical advisory board, collaborating with local partners, using preexisting resources, designing programs that are easily incorporated into existing service delivery systems, and planning for adequate start-up time.

  2. Problems in screening colorectal cancer in the elderly

    Institute of Scientific and Technical Information of China (English)

    Davidovic M. Mladen; Milosevic P. Dragoslav; Zdravkovic Sanja; Bojic Bozidar; Djurica Snezana

    2003-01-01

    AIM: To explore the problems in the screening of colorectal carcinoma in the elderly.METHODS: Three models of colorectal cancer prevention were examined: standard screening, active check-up of suspected cases and summons to have endoscopic checkup for previously diagnosed colorectal polyps. The study was performed among three groups of elderly individuals:Group 1 (167 cases), hospitalized asymptomatic individuals without symptoms in large intestines. Group 2 (612 cases):old individuals at home for the aged, out of which 32 showed symptoms of colon disorders; Group 3 (44 cases): elderly people with diagnosed polyps. As a result of 1788rectosigmoidoscopies, we identified 61 individuals with polyps, out of which 44 patients were over 65 years old.However, only 9 of these 44 individuals agreed to have the endoscopy performed again.RESULTS: One cancer and 13 polyps were detected in Group 1, and two polyps in Group 2. However, it should be noted that only eleven individuals from Group 2 agreed to have the endoscopy. In Group 3, there were no relapses of the polyps among the nine individuals who came back for the endoscopy.CONCLUSION: Poor understanding of the screening procedures is one of the greatest problems in early detection of the cancer in the aged. Paradoxically, the cooperation is better with hospitalized patients, than with "successfully old"persons.

  3. Adherence to cervical cancer screening in an Italian SLE cohort

    Directory of Open Access Journals (Sweden)

    R. Talarico

    2011-06-01

    Full Text Available Objective: Papanicolau (Pap smear abnormalities are more frequently observed in systemic lupus erythematosus (SLE respect to the general population. The primary objective of the present study was to evaluate the adherence to cervical cancer (CC screening in an Italian cohort of SLE patients and, secondly, to evaluate the disease-related factors possibly influencing the patients’ behavior. Methods: Consecutive 25 to 64 year old SLE patients and aged- matched healthy women were enrolled for the study. All patients were interviewed during ambulatory visits, at admission to the clinic or by a telephone contact; disease related variables were also collected from the clinical charts. Results: 140 SLE patients (mean age 48.3±12 years and 70 controls matched for demographic and sociocultural characteristics were enrolled. Ninety-three SLE patients (66.4% declared to perform the Pap test at least every three years (23.6% yearly and 42.8% when asked by the screening programs while 47 (33.6% did not perform regular CC screening (16.4% never did the test and 17.1% only occasionally. No significant differences were observed between patients and controls in cancer screening adherence. No significant associations were observed between the screening program behaviours and disease-related variables. Conclusions: Despite the growing evidence of an increased risk of CC in SLE, and regardless of the broad availability of screening programs and official recommendations, our results show insufficient CC surveillance among SLE patients and emphasize to rheumatologists and/or general practitioners the importance to discuss with patients this aspect during routine evaluations in order to encourage compliance to the recommended preventive measures.

  4. Assessment of Breast Cancer Risk and Belief in Breast Cancer Screening Among the Primary Healthcare Nurses.

    Science.gov (United States)

    İz, Fatma Başalan; Tümer, Adile

    2016-09-01

    Breast cancer is the most frequently diagnosed cancer in women. Early detection of breast cancer is known to increase survival rates significantly after diagnosis. This research was carried out to determine the level of breast cancer risk among primary healthcare nurses and their belief in breast cancer screening. In this descriptive research, the data were collected in face-to-face interviews with the participants. The researchers contacted all primary healthcare nurses currently working in the province. The data collection tools included a questionnaire form on sociodemographic characteristics, breast cancer risk assessment form, and Champion's Health Belief Model Scale (CHBMS) for breast cancer screening. In data analysis, descriptive statistics, t test, and analysis of variance (ANOVA) were used. The mean age of nurses was 35 ± 3.6. The mean score for the breast cancer risk assessment form was calculated as 82.9 ± 18.7. The subscale scores for the CHBMS for breast cancer screening were as follows: susceptibility 7.3 ± 1.8, seriousness 19.5 ± 4.1, benefits of breast self-exam 15.5 ± 2.6, barriers to breast self-exam 15.1 ± 2.8, self-efficacy 40.3 ± 7.0, and motivation 19.5 ± 4.1. The risk of breast cancer was found to be low in the study group. The analysis of the subscale scores for the CHBMS for breast cancer screening revealed that nurses had a below-average susceptibility perception, a somewhat lower perception of seriousness, an above-average mean score for perceived benefits, a moderate barrier perception, a relatively high perceived self-efficacy, and motivation above average. PMID:26758047

  5. Assessment of Breast Cancer Risk and Belief in Breast Cancer Screening Among the Primary Healthcare Nurses.

    Science.gov (United States)

    İz, Fatma Başalan; Tümer, Adile

    2016-09-01

    Breast cancer is the most frequently diagnosed cancer in women. Early detection of breast cancer is known to increase survival rates significantly after diagnosis. This research was carried out to determine the level of breast cancer risk among primary healthcare nurses and their belief in breast cancer screening. In this descriptive research, the data were collected in face-to-face interviews with the participants. The researchers contacted all primary healthcare nurses currently working in the province. The data collection tools included a questionnaire form on sociodemographic characteristics, breast cancer risk assessment form, and Champion's Health Belief Model Scale (CHBMS) for breast cancer screening. In data analysis, descriptive statistics, t test, and analysis of variance (ANOVA) were used. The mean age of nurses was 35 ± 3.6. The mean score for the breast cancer risk assessment form was calculated as 82.9 ± 18.7. The subscale scores for the CHBMS for breast cancer screening were as follows: susceptibility 7.3 ± 1.8, seriousness 19.5 ± 4.1, benefits of breast self-exam 15.5 ± 2.6, barriers to breast self-exam 15.1 ± 2.8, self-efficacy 40.3 ± 7.0, and motivation 19.5 ± 4.1. The risk of breast cancer was found to be low in the study group. The analysis of the subscale scores for the CHBMS for breast cancer screening revealed that nurses had a below-average susceptibility perception, a somewhat lower perception of seriousness, an above-average mean score for perceived benefits, a moderate barrier perception, a relatively high perceived self-efficacy, and motivation above average.

  6. [When research and clinical recommendations are (temporarily) in contradiction: the evaluation of lung cancer screening for high-risk subjects in Europe and in the USA].

    Science.gov (United States)

    Paci, Eugenio

    2016-01-01

    Lung cancer is the first cancer mortality cause in Italy. In last decades, incidence rates have been falling down, but the annual number of deaths is stable because of population ageing. Survival rates for population-based lung cancer cases were at maximum 17% in the last decades. In 2011, the National Lung Screening Trial (NLST) has published the results of the evaluation of efficacy of low-dose CT scan screening compared with chest X-ray showing a 20%cause-specific mortality reduction, based on the randomization, screening, and follow-up of about 53,000 subjects in USA. In Europe, 7 randomized studies are ongoing: the Nelson study, with about 16,000 people enrolled, is the largest one and its results are expected to be published soon. The US Preventive Service Task Force recommended screening for lung cancer. CT Scan screening will be made available within Medicare to high-risk subjects until 74 years or 80 years of age. In Europe, recommendations continue to discourage screening for lung cancer in all member Countries. The implementation of organised screening in Europe is conditioned by an health technology assessment aimed to the identification of the risk profile, performance of screening (false positive rates), and overdiagnosis harm. All the potential harms of screening must be balanced with expected benefits and evaluated in a formal cost-benefits analysis. Better strategies aimed to selective lung cancer screening of high risk subjects, including asbestos workers, must be evaluated in prospective studies.

  7. [When research and clinical recommendations are (temporarily) in contradiction: the evaluation of lung cancer screening for high-risk subjects in Europe and in the USA].

    Science.gov (United States)

    Paci, Eugenio

    2016-01-01

    Lung cancer is the first cancer mortality cause in Italy. In last decades, incidence rates have been falling down, but the annual number of deaths is stable because of population ageing. Survival rates for population-based lung cancer cases were at maximum 17% in the last decades. In 2011, the National Lung Screening Trial (NLST) has published the results of the evaluation of efficacy of low-dose CT scan screening compared with chest X-ray showing a 20%cause-specific mortality reduction, based on the randomization, screening, and follow-up of about 53,000 subjects in USA. In Europe, 7 randomized studies are ongoing: the Nelson study, with about 16,000 people enrolled, is the largest one and its results are expected to be published soon. The US Preventive Service Task Force recommended screening for lung cancer. CT Scan screening will be made available within Medicare to high-risk subjects until 74 years or 80 years of age. In Europe, recommendations continue to discourage screening for lung cancer in all member Countries. The implementation of organised screening in Europe is conditioned by an health technology assessment aimed to the identification of the risk profile, performance of screening (false positive rates), and overdiagnosis harm. All the potential harms of screening must be balanced with expected benefits and evaluated in a formal cost-benefits analysis. Better strategies aimed to selective lung cancer screening of high risk subjects, including asbestos workers, must be evaluated in prospective studies. PMID:26951731

  8. 子宫颈癌筛查及早诊早治方案的绩效和卫生经济学评价%Effectiveness and health economic analysis of strategies on cervical cancer screening and early diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    赵方辉; 徐小玲; 胡尚英; 宁岩; 石菊芳; 乔友林; 陈俊峰; 高晓虹; 高丽敏; 刘启贵; 刘植华; 徐赫; 马俊飞; 马莉

    2012-01-01

    Objective To explore the appropriate strategies which are suitable for the areas with diverse bealth and economic resource settings in China by estimating the life outcomes and cost-effectiveness of several cervical cancer screening strategies.Methods Markov model was used to calculate the long-term effectiveness,utility,benefit and cost among screened and unscreened cohorts in rural and urban areas,and then analyses of cost-effectiveness,cost-utility and cost-benefit were performed.The assessed screening strategies were acetic acid of visual inspection combined with Lugol's iodine staining (VIA/VILI),conventional Pap smear and simple HPV DNA testing (careHPV) in rural areas,and conventional Pap smear,simple HPV DNA testing (careHPV),HPV DNA testing (HC2) and liquid-based cytology (LBC) alone or combined with HPV DNA testing ( LBC + HC2) in urban areas.We estimated the life outcomes and cost-effectiveness of the above screening strategies at one-year,3-year and 5-year intervals.Results All of the screening strategies were effective to decrease cervical cancer mortality and to increase life years,with a trend of shorter screening interval having better effectiveness.However,no matter in urban or rural areas,compared with careHPV testing at 5-year interval,the costs of other screening strategies were 1.28-13.86 folds,1.31-14.14 folds,and 1.27-12.80 folds higher to avoid one death,to save a year of life,and a QALY,and the benefit per cost of other screening strategies was 9.9%-90.2%.Conclusions careHPV testing at 5-year interval has the best cost-effectiveness performance and the highest benefit-cost ratio with the moderate life outcomes.It is the optimal cervical cancer screening strategy to be generalized in our country.careHPV testing at 3 years interval can be considered in more developed areas to achieve better effectiveness.%目的 通过评价多种子宫颈癌筛查方案的生物学和卫生经济学效果,探索适合在我国不同卫生和经济水平

  9. Improved detection of breast cancer on FDG-PET cancer screening using breast positioning device

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the detection rate of breast cancer by positron emission tomography cancer screening using a breast positioning device. Between January 2004 and January 2006, 1,498 healthy asymptomatic individuals underwent cancer screening by fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) at our institution; 660 of 1498 asymptomatic healthy women underwent breast PET imaging in the prone position using the breast positioning device to examine the mammary glands in addition to whole-body PET imaging. All subjects that showed abnormal 18F-FDG uptake in the mammary glands were referred for further examination or surgery at our institution or a local hospital. Our data were compared with the histopathological findings or findings of other imaging modalities in our institution and replies from the doctors at another hospital. Of the 660 participants, 7 (1.06%) were found to have breast cancers at a curable stage. All the seven cancers were detected by breast PET imaging, but only five of these were detected by whole-body PET imaging; the other two were detected by breast PET imaging using the breast positioning device. In cancer screening, prone breast imaging using a positioning device may help to improve the detection rate of breast cancer. However, overall cancer including mammography and ultrasonography screening should be performed to investigate the false-negative cases and reduce false-positive cases. The effectiveness of prone breast PET imaging in cancer screening should be investigated using a much larger number of cases in the near future. (author)

  10. Sociodemographic Characteristics, Distance to the Clinic, and Breast Cancer Screening Results

    OpenAIRE

    Kim, Seijeoung; Chukwudozie, Beverly; Calhoun, Elizabeth

    2013-01-01

    Timely detection and follow-up of abnormal cellular changes can aid in early diagnosis of breast cancer, thus leading to better treatment outcomes. However, despite substantial breast cancer screening initiatives, the proportion of female breast cancer cases diagnosed at late stages remains high. Distance to screening clinics may affect access to care, particularly for women living in impoverished areas with limited means of reliable transportation. Utilizing breast cancer screening data coll...

  11. Cancer and fertility: strategies to preserve fertility.

    Science.gov (United States)

    Diedrich, K; Fauser, B C J M; Devroey, P

    2011-03-01

    Fertility preservation is a key component of cancer management in young people. The Fourth Evian Annual Reproduction Workshop Meeting was held in April 2009 to discuss cancer and fertility in young adults. Specialists in oncology, assisted reproduction, embryology and clinical genetics presented published data and ongoing research on cancer and fertility, with particular focus on strategies to preserve fertility. This report is based on the expert presentations and group discussions, supplemented with publications from literature searches and the authors' knowledge. Fertility preservation should be considered for all young people undergoing potentially gonadotoxic cancer treatment. A variety of options are required to facilitate safe and effective fertility preservation for individual patients. Sperm banking is a simple and low-cost intervention. Embryo cryopreservation is the only established method of female fertility preservation. Oocyte cryopreservation offers a useful option for women without a male partner. Emergency ovarian stimulation and cryopreservation of ovarian tissue (followed by tissue transplantation or in-vitro maturation of oocytes) are experimental techniques for women who require urgent cancer treatment. Further prospective studies are required to validate cryopreservation of oocytes and ovarian tissue, in-vitro maturation of oocytes and new vitrification techniques and to identify any long-term sequelae of slow freezing of embryos.

  12. Electrical Bioimpedance Analysis: A New Method in Cervical Cancer Screening

    Directory of Open Access Journals (Sweden)

    Lopamudra Das

    2015-01-01

    Full Text Available Cervical cancer is the second most common female cancer worldwide and a disease of concern due to its high rate of incidence of about 500,000 women annually and is responsible for about 280,000 deaths in a year. The mortality and morbidity of cervical cancer are reduced through mass screening via Pap smear, but this technique suffers from very high false negativity of around 30% to 40% and hence the sensitivity of this technique is not more than 60%. Electrical bioimpedance study employing cytosensors over a frequency range offers instantaneous and quantitative means to monitor cellular events and is an upcoming technique in real time to classify cells as normal and abnormal ones. This technology is exploited for label-free detection of diseases by identifying and measuring nonbiological parameters of the cell which may carry the disease signature.

  13. Mass Spectrometric Screening of Ovarian Cancer with Serum Glycans

    Directory of Open Access Journals (Sweden)

    Jae-Han Kim

    2014-01-01

    Full Text Available 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.

  14. Screening for cancer: when to stop?: A practical guide and review of the evidence.

    Science.gov (United States)

    Soung, Michael C

    2015-03-01

    Deciding when to stop cancer screening in older adults is a complex challenge that involves multiple factors: individual health status and life expectancy; risks and benefits of screening, which vary with age and comorbidity; and individual preferences and values. This article examines current cancer screening practices and reviews the risks and benefits of cancer screening for colorectal, breast, lung, prostate, and cervical cancer, particularly in older individuals and those with multiple comorbidities. Tools for estimating life expectancy are reviewed, and a practical framework is presented to guide discussions on when the harms of screening likely outweigh the benefits.

  15. Systematic review of 3D mammography for breast cancer screening.

    Science.gov (United States)

    Hodgson, Robert; Heywang-Köbrunner, Sylvia H; Harvey, Susan C; Edwards, Mary; Shaikh, Javed; Arber, Mick; Glanville, Julie

    2016-06-01

    This review investigated the relative performance of digital breast tomosynthesis (DBT) (alone or with full field digital mammography (FFDM) or synthetic digital mammography) compared with FFDM alone for detecting breast cancer lesions in asymptomatic women. A systematic review was carried out according to systematic reviewing principles provided in the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. A protocol was developed a priori. The review was registered with PROSPERO (number CRD42014013949). Searches were undertaken in October 2014. Following selection, five studies were eligible. Higher cancer detection rates were observed when comparing DBT + FFDM with FFDM in two European studies: the summary difference per 1000 screens was 2.43 (95% CI: 1.8 to 3.1). Both European studies found lower false positive rates for individual readers. One found a lower recall rate based on conditional recall. The second study was not designed to compare post-arbitration recall rates between FFDM and DBT + FFDM. One European study presented data on interval cancer rates; sensitivity and specificity for DBT + FFDM were both higher compared to FFDM. One large multicentre US study showed a higher cancer detection rate for DBT + FFDM, while two smaller US studies did not find statistically significant differences. Reductions in recall and false positive rates were observed in the US studies in favour of DBT + FFDM. In comparison to FFDM, DBT, as an adjunct to FFDM, has a higher cancer detection rate, increasing the effectiveness of breast cancer screening. Additional benefits of DBT may also include reduced recalls and, consequently, reduced costs and distress caused to women who would have been recalled. PMID:27212700

  16. Measuring the burden of interval cancers in long-standing screening mammography programmes

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini;

    2015-01-01

    OBJECTIVES: Mammography screening programme sensitivity is evaluated by comparing the interval cancer rate (ICR) with the expected breast cancer incidence without screening, ie. the proportional interval cancer rate (PICR). The PICR is usually found by extrapolating pre-screening incidence rates......, whereas ICR is calculated from data available in the screening programmes. As there is no consensus regarding estimation of background incidence, we seek to validate the ICR measure against the PICR. METHODS: Screening data from the three mammography screening programmes of Stockholm, Copenhagen, and...

  17. Is mammography screening history a predictor of future breast cancer risk?

    DEFF Research Database (Denmark)

    Andersen, Sune Bangsbøll; Törnberg, Sven; Kilpeläinen, Sini;

    2015-01-01

    was not a predictor of a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Sweden, Copenhagen and Funen, Denmark. The history of previous negative screens is therefore not suitable for personalisation of mammography screening.......Inspired by the model by Walter and Day for risk of cervical cancer following negative screens, one might hypothesize that women in a mammography screening programme with a certain number of negative screens had a lower remaining breast cancer risk than that of women in general. We studied whether...... number of negative screens was a predictor for a low remaining breast cancer risk in women participating in the mammography screening programmes in Stockholm, Copenhagen and Funen. Data were collected from the mammography screening programmes in Stockholm, Sweden (1989-2012), Copenhagen, Denmark (1991...

  18. Volumetric computed tomography screening for lung cancer : three rounds of the NELSON trial

    NARCIS (Netherlands)

    Horeweg, Nanda; van der Aalst, Carlijn M.; Vliegenthart, Rozemarijn; Zhao, Yingru; Xie, Xueqian; Scholten, Ernst Th; Mali, Willem; Thunnissen, Erik; Weenink, Carla; Groen, Harry J. M.; Lammers, Jan-Willem J.; Nackaerts, Kristiaan; van Rosmalen, Joost; Oudkerk, Matthijs; de Koning, Harry J.

    2013-01-01

    Several medical associations recommended lung cancer screening by low-dose computed tomography scanning for high-risk groups. Counselling of the candidates on the potential harms and benefits and their lung cancer risk is a prerequisite for screening. In the NELSON trial, screenings are considered p

  19. Natural history of breast cancers detected in the Swedish mammography screening programme: a cohort study

    DEFF Research Database (Denmark)

    Zahl, Per-Henrik; Gøtzsche, Peter C; Mæhlen, Jan

    2011-01-01

    The natural history of screen-detected breast cancers is not well understood. A previous analysis of the incidence change during the introduction of the Norwegian screening programme in the late 1990s suggested that the natural history of many screen-detected invasive breast cancers is to regress...

  20. Seventeen-years overview of breast cancer inside and outside screening in Denmark

    DEFF Research Database (Denmark)

    Domingo, Laia; Jacobsen, Katja Kemp; von Euler-Chelpin, My Catarina;

    2013-01-01

    Background. Long-term data on breast cancer detection in mammography screening programs are warranted to better understand the mechanisms by which screening changes the breast cancer pattern in the population. We aimed to analyze 17 years of breast cancer detection rates inside and outside...... to women aged 50-69 years. We identified targeted, eligible, invited and participating women. We calculated screening detection and interval cancer rates for participants, and breast cancer incidence in non-screened women (= targeted women excluding participants) by biennial invitation rounds. Tumor...... characteristics were tabulated for each of the three groups of cancers. Results. Start of screening resulted in a prevalence peak in participants, followed by a decrease to a fairly stable detection rate in subsequent invitation rounds. A similar pattern was found for breast cancer incidence in non-screened women...

  1. Breast and cervical cancer screening in Great Britain: Dynamic interrelated processes.

    Science.gov (United States)

    Labeit, Alexander; Peinemann, Frank

    2015-12-01

    No previous analysis has investigated the determinants of screening uptake for breast and cervical cancer screening for possible spillover effects from one type of screening examination to the other type of screening examination with a dynamic bivariate panel probit model. For our analysis, we used a dynamic random effects bivariate panel probit model with initial conditions (Wooldridge-type estimator) and dependent variables were the participation of breast and cervical cancer screening in the recent year. The balanced panel sample consisted of 844 women from the British Household Panel Survey (BHPS) from the time period 1992 to 2008. Our analysis showed the high relevance of past screening behaviour and the importance of state dependency for the same and the other type of cancer screening examinations even after controlling for covariates and unobserved heterogeneity. The uptake for breast and cervical cancer screening was higher when the same screening examination was done one or three years earlier. This result is in accordance with the medical screening programmes in Great Britain. With regard to breast and cervical cancer screening positive spillover effects existed between screening examinations in the third order lags. Women with a previous visit to a general practitioner and individuals in the recommended age groups had a higher uptake for breast and cervical cancer screening. Other socioeconomic and health related variables had non-uniform results in both screening examinations. Promoting the uptake of one female prevention activity could also enhance the uptake of the other prevention activity. PMID:26487452

  2. Therapeutic strategies for targeting cancer stem cells

    Institute of Scientific and Technical Information of China (English)

    Yu Jeong Kim; Elizabeth L Siegler; Natnaree Siriwon; Pin Wang

    2016-01-01

    The therapeutic limitations of conventional chemotherapeutic drugs present a challenge for cancer therapy; these shortcomings are largely attributed to the ability of cancer cells to repopulate and metastasize after initial therapies. Compelling evidence suggests that cancer stem cells (CSCs) have a crucial impact in current shortcomings of cancer therapy because they are largely responsible for tumor initiation, relapse, metastasis, and chemo-resistance. Thus, a better understanding of the properties and mechanisms underlying CSC resistance to treatments is necessary to improve patient outcomes and survival rates. In this review, the authors characterize and compare different CSC-speciifc biomarkers that are present in various types of tumors. We further discuss multiple targeting approaches currently in preclinical or clinical testing that show great potential for targeting CSCs. This review discusses numerous strategies to eliminate CSCs by targeting surface biomarkers, regulating CSC-associated oncogenes and signaling pathways, inhibiting drug-eflfux pumps involved in drug resistance, modulating the tumor microenvironment and immune system, and applying drug combination therapy using nanomedicine.

  3. Network-based reading system for lung cancer screening CT

    Science.gov (United States)

    Fujino, Yuichi; Fujimura, Kaori; Nomura, Shin-ichiro; Kawashima, Harumi; Tsuchikawa, Megumu; Matsumoto, Toru; Nagao, Kei-ichi; Uruma, Takahiro; Yamamoto, Shinji; Takizawa, Hotaka; Kuroda, Chikazumi; Nakayama, Tomio

    2006-03-01

    This research aims to support chest computed tomography (CT) medical checkups to decrease the death rate by lung cancer. We have developed a remote cooperative reading system for lung cancer screening over the Internet, a secure transmission function, and a cooperative reading environment. It is called the Network-based Reading System. A telemedicine system involves many issues, such as network costs and data security if we use it over the Internet, which is an open network. In Japan, broadband access is widespread and its cost is the lowest in the world. We developed our system considering human machine interface and security. It consists of data entry terminals, a database server, a computer aided diagnosis (CAD) system, and some reading terminals. It uses a secure Digital Imaging and Communication in Medicine (DICOM) encrypting method and Public Key Infrastructure (PKI) based secure DICOM image data distribution. We carried out an experimental trial over the Japan Gigabit Network (JGN), which is the testbed for the Japanese next-generation network, and conducted verification experiments of secure screening image distribution, some kinds of data addition, and remote cooperative reading. We found that network bandwidth of about 1.5 Mbps enabled distribution of screening images and cooperative reading and that the encryption and image distribution methods we proposed were applicable to the encryption and distribution of general DICOM images via the Internet.

  4. Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system

    Directory of Open Access Journals (Sweden)

    Jorge Salmerón-Castro

    1998-01-01

    Full Text Available The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionaling CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1 improving coverage; 2 implementing smear-taking quality control; 3 improving quality in interpretation of Pap test; 4 guaranteeing treatment for women for whom abnormalities are detected; 5 improving follow-up; 6 development of quality control measures and 7 development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.

  5. Community-based intervention to promote breast cancer awareness and screening: The Korean experience

    Directory of Open Access Journals (Sweden)

    Kim Myung-hyun

    2011-06-01

    Full Text Available Abstract Background There are many differences in culture, community identity, community participation, and ownership between communities in Western and Asian countries; thus, it is difficult to adopt the results of community intervention studies from Western countries. In this study, we conducted a multicity, multicomponent community intervention trial to correct breast cancer myths and promote screening mammography for women living in an urban community in Korea. Methods A 6-month, 2-city community intervention trial was conducted. In the intervention city, 480 women were surveyed at baseline and 7 months later to evaluate the effects of the intervention program. Strategies implemented in the intervention city included community outreach and clinic and pharmacy-based in-reach strategies. Results This study showed a 20.4-percentage-point decrease in myths about the link between cancer and breast size, a 19.2-percentage-point decrease in myths concerning mammography costs, and a 14.1-percentage-point increase in intention to undergo screening mammography. We also saw a 23.4-percentage-point increase in the proportion of women at the action stage of the transtheoretical model in the intervention city. In the comparison city, smaller decreases and increases were observed. Conclusions Our study showed the value of an intervention study aimed at reducing belief in breast cancer myths in an urban community in Korea. The invention also made women more likely to undergo mammography in future.

  6. The comparison of the performance of two screening strategies identifying newly-diagnosed HIV during pregnancy

    NARCIS (Netherlands)

    K. Boer; C. Smit; M. van der Flier; F. de Wolf

    2011-01-01

    In the Netherlands, a non-selective opt-out instead of a selective opt-in antenatal HIV screening strategy was implemented in 2004. In case of infection, screening was followed by prevention of mother-to-child-transmission (PMTCT). We compared the performance of the two strategies in terms of detect

  7. The comparison of the performance of two screening strategies identifying newly-diagnosed HIV during pregnancy

    NARCIS (Netherlands)

    Boer, Kees; Smit, Colette; van der Flier, Michiel; de Wolf, Frank; Borleffs, Jan

    2011-01-01

    BACKGROUND: In the Netherlands, a non-selective opt-out instead of a selective opt-in antenatal HIV screening strategy was implemented in 2004. In case of infection, screening was followed by prevention of mother-to-child-transmission (PMTCT). We compared the performance of the two strategies in ter

  8. International Association for the Study of Lung Cancer Computed Tomography Screening Workshop 2011 Report

    NARCIS (Netherlands)

    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.

    2012-01-01

    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 de

  9. Overdiagnosis by mammographic screening for breast cancer studied in birth cohorts in The Netherlands

    NARCIS (Netherlands)

    Ripping, T.M.; Verbeek, A.L.; Fracheboud, J.; Koning, H.J. de; Ravesteyn, N.T. van; Broeders, M.J.

    2015-01-01

    A drawback of early detection of breast cancer through mammographic screening is the diagnosis of breast cancers that would never have become clinically detected. This phenomenon, called overdiagnosis, is ideally quantified from the breast cancer incidence of screened and unscreened cohorts of women

  10. Healthcare costs in the Danish randomised controlled lung cancer CT-screening trial

    DEFF Research Database (Denmark)

    Rasmussen, J.F.; Siersma, V.; Pedersen, Jesper H.;

    2014-01-01

    OBJECTIVES: Low dose computerised tomography (CT) screening for lung cancer can reduce lung-cancer-specific mortality. The objective of this study was to analyse healthcare costs and healthcare utilisation of participants in the Danish lung cancer CT-screening trial (DLCST). MATERIALS AND METHODS...

  11. Influence of Spirituality and Modesty on Acceptance of Self-Sampling for Cervical Cancer Screening.

    Directory of Open Access Journals (Sweden)

    Eileen O Dareng

    Full Text Available Whereas systematic screening programs have reduced the incidence of cervical cancer in developed countries, the incidence remains high in developing countries. Among several barriers to uptake of cervical cancer screening, the roles of religious and cultural factors such as modesty have been poorly studied. Knowledge about these factors is important because of the potential to overcome them using strategies such as self-collection of cervico-vaginal samples. In this study we evaluate the influence of spirituality and modesty on the acceptance of self-sampling for cervical cancer screening.We enrolled 600 participants in Nigeria between August and October 2014 and collected information on spirituality and modesty using two scales. We used principal component analysis to extract scores for spirituality and modesty and logistic regression models to evaluate the association between spirituality, modesty and preference for self-sampling. All analyses were performed using STATA 12 (Stata Corporation, College Station, Texas, USA.Some 581 (97% women had complete data for analysis. Most (69% were married, 50% were Christian and 44% were from the south western part of Nigeria. Overall, 19% (110/581 of the women preferred self-sampling to being sampled by a health care provider. Adjusting for age and socioeconomic status, spirituality, religious affiliation and geographic location were significantly associated with preference for self-sampling, while modesty was not significantly associated. The multivariable OR (95% CI, p-value for association with self-sampling were 0.88 (0.78-0.99, 0.03 for spirituality, 1.69 (1.09-2.64, 0.02 for religious affiliation and 0.96 (0.86-1.08, 0.51 for modesty.Our results show the importance of taking cultural and religious beliefs and practices into consideration in planning health interventions like cervical cancer screening. To succeed, public health interventions and the education to promote it must be related to the

  12. Helicobacter pylori Antibody Titer and Gastric Cancer Screening

    Directory of Open Access Journals (Sweden)

    Hiroshi Kishikawa

    2015-01-01

    Full Text Available The “ABC method” is a serum gastric cancer screening method, and the subjects were divided based on H. pylori serology and atrophic gastritis as detected by serum pepsinogen (PG: Group A [H. pylori (− PG (−], Group B [H. pylori (+ PG (−], Group C [H. pylori (+ PG (+], and Group D [H. pylori (− PG (+]. The risk of gastric cancer is highest in Group D, followed by Groups C, B, and A. Groups B, C, and D are advised to undergo endoscopy, and the recommended surveillance is every three years, every two years, and annually, respectively. In this report, the reported results with respect to further risk stratification by anti-H. pylori antibody titer in each subgroup are reviewed: (1 high-negative antibody titer subjects in Group A, representing posteradicated individuals with high risk for intestinal-type cancer; (2 high-positive antibody titer subjects in Group B, representing active inflammation with high risk for diffuse-type cancer; and (3 low-positive antibody titer subjects in Group C, representing advanced atrophy with increased risk for intestinal-type cancer. In these subjects, careful follow-up with intervals of surveillance of every three years in (1, every two years in (2, and annually in (3 should be considered.

  13. Filipina American women's breast cancer knowledge, attitudes, and screening behaviors

    Directory of Open Access Journals (Sweden)

    Ryujin Lisa

    2003-08-01

    Full Text Available Abstract Background Filipino Americans are the fastest growing Asian minority group in the United States. There is limited knowledge about their breast cancer knowledge, screening practices and attitudes. Methods As part of the evaluation of the Asian Grocery Store-Based Cancer Education Program, 248 Filipino American women completed baseline and follow-up surveys, while an additional 58 took part in focus groups. Results Compliance with annual clinical breast exam guidelines among women 40 to 49 years old was 43%, and annual mammography use among women 50 and over was 56%. The Asian Grocery Store-Based Cancer Education Program and complementary focus group study identified multiple barriers that hindered women from attending education programs, with time as the most frequently reported barrier. Conclusion The Asian Grocery Store-Based Cancer Education Program was reported to be a culturally acceptable and effective way of disseminating breast cancer information and one that addressed the women's most frequently reported barrier, lack of time.

  14. Effect of adding screening ultrasonography to screening mammography on patient recall and cancer detection rates: A retrospective study in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Tohno, Eriko, E-mail: tohno@tmch.or.jp [Total Health Evaluation Center Tsukuba, 1-2, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Umemoto, Takeshi, E-mail: umemoto@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Sasaki, Kyoko, E-mail: kdon@za.cyberhome.ne.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Morishima, Isamu, E-mail: morishima@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Ueno, Ei, E-mail: e-ueno@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan)

    2013-08-15

    Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening.

  15. Effect of adding screening ultrasonography to screening mammography on patient recall and cancer detection rates: A retrospective study in Japan

    International Nuclear Information System (INIS)

    Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening

  16. Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

    OpenAIRE

    Samantha Garbers; Karen Schmitt; Anne Marie Rappa; Mary Ann Chiasson

    2010-01-01

    Samantha Garbers1, Karen Schmitt2, Anne Marie Rappa2, Mary Ann Chiasson11Public Health Solutions, New York, NY, USA; 2Columbia University Breast Cancer Screening Program, New York, NY, USABackground: This analysis examines the association between functional health literacy and follow-up after mammography among women receiving breast cancer screening at a National Breast and Cervical Cancer Early Detection Program site in New York City that provides universal bilingual case management.Methods:...

  17. Stage and survival in breast cancer patients in screened and non-screened Danish and Swedish populations

    DEFF Research Database (Denmark)

    Jensen, Anni R; Garne, Jens P; Storm, Hans H;

    2003-01-01

    Comparisons between the Danish and Swedish Cancer Registry revealed a 9% difference in 5-year survival for breast cancer patients diagnosed between 1983 and 1989. The purpose of this study was to determine whether previous differences in survival and stage still exist or whether the Danish figures...... approach those of the Swedish registry. Complete population-based cohorts of patients with breast cancer in the years 1996-1997 from well-defined areas in Denmark and Sweden were compared. The study regions were a Danish (Funen) and a Swedish (Malmö) county with mammography screening and two Danish...... counties without screening. No difference in extent of disease or survival was observed between screening areas regardless of country. However, there were significant differences in stage distribution and survival between screening populations and Danish non-screening populations, to the benefit of...

  18. Long-term cost-effectiveness of screening strategies for hearing loss

    OpenAIRE

    Chuan-Fen Liu, PhD, MPH; Margaret P. Collins, PhD, CCC-A; Pamela E. Souza, PhD, CCC-A; Bevan Yueh, MD, MPH

    2011-01-01

    Routine hearing screening can identify patients who are motivated to seek out and adhere to treatment, but little information exists on the cost-effectiveness of hearing screening in a general population of older veterans. We compared the cost-effectiveness of three screening strategies (tone-emitting otoscope, hearing handicap questionnaire, and both together) against no screening (control group) in 2,251 older veterans. The effectiveness measure for each group was the proportion of hearing ...

  19. Simulation of reduced breast cancer mortality in breast cancer screening programs

    International Nuclear Information System (INIS)

    The breast cancer screening programs are an essential tool in the fight against breast cancer. Currently, many questions concerning the setup of these programs are open, namely: age range of women who undergo the same, frequency of mammography, ... The effectiveness of a program should be evaluated in terms of mortality reduction is its systematic implementation in the population. In this sense, we performed Monte Carlo simulations to assess that these reductions.

  20. [Assessment of screening in women cancers and in 75 years older in Loire department].

    Science.gov (United States)

    Swalduz, Aurélie; Guibert, Cyril; Trone, Jane-Chloé; Guichard, Jean-Baptiste; Rivoirard, Romain; Pacaut, Cécile; Méry, Benoîte; Guy, Jean-Baptiste; Eddekkaoui, Houda; Fournel, Pierre; de Laroche, Guy; Merrouche, Yacine; Magné, Nicolas

    2014-09-01

    In France, there is an important interregional disparity concerning participation to cancer screening programs. The aim of this study was to assess oncologic screening practices in Loire, a French rural department, in women and in the elderly (over age 74 years). For this, two surveys were conducted. The first one was regarding screening for breast, cervical and colorectal cancer in women over age 18 years living in Loire. The second survey was regarding onco-geriatric screening through two questionnaires : one for the elderly and the other for general practitioner (GP) of the department, evaluating screening for breast, colorectal, prostate, cervical and lung cancer. One hundred sixty six women were included in the first investigation mean age of 47.6 years. Ninety three point six per cent were screening for breast cancer, 19% received Human Papilloma virus vaccine, 83.1% were screening by Papanicolau smear for cervical cancer and finally, 51.7% were screening for colorectal cancer, among the one entering screening program criteria. In the second survey, 44 patients and 28 GP were included. Thirty-eight point six per cent of patients over 74 years continue screening. Only 11.4% were reluctant to screening and in 80% because of anxiety du to the results. Among GP, 50 % continued screening on two major criteria : life expectancy and performans status. The present study shows heterogeneity of screening in this department both rural and working class and gives us a societo-medical photography.

  1. Psychological research and the prostate-cancer screening controversy.

    Science.gov (United States)

    Arkes, Hal R; Gaissmaier, Wolfgang

    2012-06-01

    In October of 2011, the U.S. Preventive Services Task Force released a draft report in which they recommended against using the prostate-specific antigen (PSA) test to screen for prostate cancer. We attempt to show that four factors documented by psychological research can help explain the furor that followed the release of the task force's report. These factors are the persuasive power of anecdotal (as opposed to statistical) evidence, the influence of personal experience, the improper evaluation of data, and the influence of low base rates on the efficacy of screening tests. We suggest that augmenting statistics with facts boxes or pictographs might help such committees communicate more effectively with the public and with the U.S. Congress. PMID:22555966

  2. Psychological barriers and facilitators of colorectal cancer screening: a French qualitative study

    Directory of Open Access Journals (Sweden)

    Morgiane Bridou

    2013-06-01

    Full Text Available The aim of this qualitative study was to explore the psychological barriers to and facilitators of undergoing the Hemoccult-II® colorectal cancer screening test in France. Sixty-nine French people aged 50 to 74 years were divided into seven qualitative focus groups. Three issues were discussed with participants: knowledge and beliefs about colorectal cancer screening; facilitators of colorectal cancer screening by Hemoccult-II®; barriers to colorectal cancer screening by Hemoccult-II®. All the discussions were led by two psychologists and were recorded, transcribed verbatim and analyzed using qualitative data analysis software. Correspondence factor analyses identified three dimensions for each topic. The main psychological facilitators of colorectal cancer screening were: information about colorectal cancer screening, perceived simplicity of using Hemoccult-II®, and perception of risk. Uncertainty about the reliability of Hemoccult-II®, health anxiety, and embarrassment emerged as the main barriers to colorectal cancer screening. Cross-sectional analyses identified the differences between the views expressed by women and men. Women appeared more embarrassed about Hemoccult-II® and men seemed to be more worried about colorectal cancer. This preliminary study suggests that psychological factors play an important role in colorectal cancer screening by Hemoccult-II®. This finding may help health organizations to conceive better awareness campaigns to promote colorectal cancer screening in order to reduce the related mortality rate by taking into account psychological determinants.

  3. Attitudes towards Lung Cancer Screening in an Australian High-Risk Population

    Directory of Open Access Journals (Sweden)

    Alexandra E. Flynn

    2013-01-01

    Full Text Available Objectives. To determine whether persons at high risk of lung cancer would participate in lung cancer screening test if available in Australia and to elicit general attitudes towards cancer screening and factors that might affect participation in a screening program. Methods. We developed a 20-item written questionnaire, based on two published telephone interview scripts, addressing attitudes towards cancer screening, perceived risk of lung cancer, and willingness to be screened for lung cancer and to undertake surgery if lung cancer were detected. The questionnaire was given to 102 current and former smokers attending the respiratory clinic and pulmonary rehabilitation programmes. Results. We gained 90 eligible responses (M:F, 69:21. Mean [SD] age was 63 [11] and smoking history was 32 [21] pack years. 95% of subjects would participate in a lung cancer screening test, and 91% of these would consider surgery if lung cancer was detected. 44% of subjects considered that they were at risk of lung cancer. This was lower in ex-smokers than in current smokers. Conclusions. There is high willingness for lung cancer screening and surgical treatment. There is underrecognition of risk among ex-smokers. This misperception could be a barrier to a successful screening or case-finding programme in Australia.

  4. Characteristics of colorectal cancer diagnosed with screening abdominal ultrasonography

    OpenAIRE

    TOMIZAWA, MINORU; Shinozaki, Fuminobu; HASEGAWA, RUMIKO; Fugo, Kazunori; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; YAMAMOTO, SHIGENORI; Kishimoto, Takashi; ISHIGE, NAOKI

    2016-01-01

    Patient records were retrospectively analyzed to elucidate the characteristics of patients with colorectal cancer (CRC) diagnosed with screening abdominal ultrasound (US). Patients diagnosed with CRC using abdominal US [localized irregular wall thickening (W) or a hypoechoic mass with a hyperechoic mass (M)] were enrolled. The patients were subjected to colonoscopy and treated surgically between March, 2010 and January, 2015. A total of 5 men (aged 74.0±0.8 years) and 10 women (aged 73.0±12.0...

  5. Persistent demographic differences in colorectal cancer screening utilization despite Medicare reimbursement

    OpenAIRE

    Kreuter William; Ko Cynthia W; Baldwin Laura-Mae

    2005-01-01

    Abstract Background Colorectal cancer screening is widely recommended, but often under-utilized. In addition, significant demographic differences in screening utilization exist. Insurance coverage may be one factor influencing utilization of colorectal cancer screening tests. Methods We conducted a retrospective analysis of claims for outpatient services for Washington state Medicare beneficiaries in calendar year 2000. We determined the proportion of beneficiaries utilizing screening fecal o...

  6. The impact of mammographic screening on breast cancer mortality in Europe

    DEFF Research Database (Denmark)

    Moss, S M; Nyström, L; Jonsson, H.;

    2012-01-01

    Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value.......Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value....

  7. Attitudes to colorectal cancer screening among ethnic minority groups in the UK

    OpenAIRE

    Atkin Wendy; Power Emily; Solarin Ijeoma; Robb Kathryn A; Wardle Jane

    2008-01-01

    Abstract Background Colorectal screening by Flexible Sigmoidoscopy (FS) is under evaluation in the UK. Evidence from existing cancer screening programmes indicates lower participation among minority ethnic groups than the white-British population. To ensure equality of access, it is important to understand attitudes towards screening in all ethnic groups so that barriers to screening acceptance can be addressed. Methods Open- and closed-ended questions on knowledge about colorectal cancer and...

  8. Efficacy of an educational material on second primary cancer screening practice for cancer survivors: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Dong Wook Shin

    Full Text Available BACKGROUND: Cancer surivors have limited knowledge about second primary cancer (SPC screening and suboptimal rates of completion of screening practices for SPC. Our objective was to test the efficacy of an educational material on the knowledge, attitudes, and screening practices for SPC among cancer survivors. METHODS: Randomized, controlled trial among 326 cancer survivors from 6 oncology care outpatient clinics in Korea. Patients were randomized to an intervention or an attention control group. The intervention was a photo-novel, culturally tailored to increase knowledge about SPC screening. Knowledge and attitudes regarding SPC screening were assessed two weeks after the intervention, and screening practices were assessed after one year. RESULTS: At two weeks post-intervention, the average knowledge score was significantly higher in the intervention compared to the control group (0.81 vs. 0.75, P<0.01, with no significant difference in their attitude scores (2.64 vs. 2.57, P = 0.18. After 1 year of follow-up, the completion rate of all appropriate cancer screening was 47.2% in both intervention and control groups. CONCLUSION: While the educational material was effective for increasing knowledge of SPC screening, it did not promote cancer screening practice among cancer survivors. More effective interventions are needed to increase SPC screening rates in this population. TRIAL REGISTRATION: ClinicalTrial.gov NCT00948337.

  9. Stage distribution of breast cancer diagnosed before and after implementation of population-based mammographic screening

    International Nuclear Information System (INIS)

    Purpose: The German mammographic screening program is very similar to the Norwegian Breast Cancer Screening Program (NBCSP), which started about 10 years earlier. This study analyzes the stage distribution of invasive breast cancers diagnosed in the pre-screening and screening period, and evaluates the overall mortality in women aged 55 - 74 in the pilot and non-pilot counties of the NBCSP. Materials and Methods: The NBCSP invites women aged 50 - 69 to participate in two-view mammography biennially. Chi-square statistics were used to compare percentages of the stage and treatment of invasive breast cancers diagnosed in women residing in the four pilot counties in the pre-screening (1984 - 1995) and screening (1996 - 2007) period. An ecological approach was used to analyze the age-specific mortality in the pilot and non-pilot counties for the period 1970 - 2007. Results: 50 % of the breast cancers diagnosed in the pre-screening period, 70 % of the cases detected with screening, 43 % of the interval cancers, and 52 % of the cancers diagnosed outside the NBCSP were stage I. Stage III + was present in 11 % of the cancers in the pre-screening period, and in 1 % of the cancers detected with screening. In the screening period, the breast cancer mortality rate decreased substantially more in the pilot counties than in the non-pilot counties. Conclusion: The stage distribution of breast cancer diagnosed in the NBCSP is prognostically favorable compared to cancers diagnosed outside the screening program. The reduction in the breast cancer mortality rate was more pronounced in the four pilot counties compared to the non-pilot counties. It is necessary to evaluate the program based on individual data. (orig.)

  10. Screen-detected vs symptomatic breast cancer: is improved survival due to stage migration alone?

    OpenAIRE

    Wishart, G. C.; Greenberg, D. C.; Britton, P D; Chou, P; Brown, C.H.; Purushotham, A. D.; Duffy, S W

    2008-01-01

    This paper examines whether screen-detected breast cancer confers additional prognostic benefit to the patient, over and above that expected by any shift in stage at presentation. In all, 5604 women (aged 50–70 years) diagnosed with invasive breast cancer between 1998 and 2003 were identified by the Eastern Cancer Registration and Information Centre (ECRIC) and mammographic screening status was determined. Using proportional hazards regression, we estimated the effect of screen detection comp...

  11. Who and when should we screen for prostate cancer? Interviews with key opinion leaders

    OpenAIRE

    Carlsson, Sigrid; Leapman, Michael; Carroll, Peter; Schröder, Fritz; Albertsen, Peter; Ilic, Dragan; Barry, Michael; Frosch, Dominick L.; Vickers, Andrew

    2015-01-01

    textabstractProstate cancer screening using prostate-specific antigen (PSA) is highly controversial. In this Q & A, Guest Editors for BMC Medicine's 'Spotlight on Prostate Cancer' article collection, Sigrid Carlsson and Andrew Vickers, invite some of the world's key opinion leaders to discuss who, and when, to screen for prostate cancer. In response to the points of view from the invited experts, the Guest Editors summarize the experts' views and give their own personal opinions on PSA screen...

  12. Effective screening for early diagnosis of pancreatic cancer.

    Science.gov (United States)

    Hanada, Keiji; Okazaki, Akihito; Hirano, Naomichi; Izumi, Yoshihiro; Minami, Tomoyuki; Ikemoto, Juri; Kanemitsu, Kozue; Hino, Fumiaki

    2015-12-01

    Diagnosis of pancreatic cancer (PC) at an early stage with curative surgery should improve long-term patient outcome. At present, improving survival should lie in identifying those cases with high-risk factors or precursor lesions through an effective screening including ultrasonography, some biological markers, or national familial pancreatic cancer registration. Recently, cases with PC detection was higher on endoscopic ultrasonography (EUS) than on CT or other modalities, and EUS-guided fine needle aspiration was helpful in confirming the histologic diagnosis. Additionally, for the diagnosis of cases with PC in situ, EUS and magnetic resonance cholangiopancreatography (MRCP) may play important roles in detecting the local irregular stenosis of the pancreatic duct. Cytodiagnosis of pancreatic juice using endoscopic nasopancreatic drainage multiple times may be useful in the final diagnosis. PMID:26651254

  13. Age appropriate screening for cancer: Evidence-based practice in the United States of America

    Directory of Open Access Journals (Sweden)

    T S Pandey

    2014-01-01

    Full Text Available Cancer screening is a well established and integral part of routine care in the Western world including United States. Men and women are recommended to get age-specific screening for common cancers like breast, cervical, prostate, and colon. The goal of screening is primary and secondary prevention. Cancer prevention and early detection of cancers has been shown to improve survival rates and decrease mortality by prompt appropriate treatment. This article serves to outline the current guidelines in the United States for cancer screening and the evidence for them as well as discusses the possibility of a similar model of care in India as well as barriers to such a screening program for cancer. The evidence was mostly obtained from systematic reviews done by the United States Preventive Services Task Force guidelines and other peer institutions like American Cancer Society and Agency for Healthcare Research and Quality.

  14. What we have learned from randomized trials of prostate cancer screening

    Institute of Scientific and Technical Information of China (English)

    Richard M Hoffman; Anthony Y Smith

    2011-01-01

    The introduction of prostate-specific antigen (PSA) for prostate cancer screening in the late 1980s led to an epidemic of prostate cancer, particularly in developed countries. However, the first valid reports from randomized controlled trials on the efficacy of screening were not published until 2009. Men in the screening group in the European Randomized Study of Screening for Prostate Cancer were 20% less likely than those in the control group to die from prostate cancer. The absolute difference was only 0.7/1000, implying that over 1400 men needed to be screened to prevent one prostate cancer death. Screening was also associated with a 70% increased risk for being diagnosed with prostate cancer. The American Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial found no survival benefit for screening. Results were not conclusive because a substantial proportion of study subjects had previously undergone PSA testing, over half of the control group had PSA testing, follow-up was relatively short, and fewer than 100 subjects died from prostate cancer. Balancing the potential survival benefit from screening is the risk of overdiagnosis-finding cancers that would not otherwise cause clinical problems-and the risk of treatment complications, including urinary, sexual and bowel dysfunction. Prostate cancer screening efforts would benefit from improved biomarkers, which more readily identify clinically important cancers. Cancer control efforts might also need to include chemoprevention, though currently available agents are controversial. In the meantime, patients need to be supported in achieving informed decisions on whether to be screened for prostate cancer.

  15. Digital breast tomosynthesis (3D-mammography) screening: A pictorial review of screen-detected cancers and false recalls attributed to tomosynthesis in prospective screening trials.

    Science.gov (United States)

    Houssami, Nehmat; Lång, Kristina; Bernardi, Daniela; Tagliafico, Alberto; Zackrisson, Sophia; Skaane, Per

    2016-04-01

    This pictorial review highlights cancers detected only at tomosynthesis screening and screens falsely recalled in the course of breast tomosynthesis screening, illustrating both true-positive (TP) and false-positive (FP) detection attributed to tomosynthesis. Images and descriptive data were used to characterise cases of screen-detection with tomosynthesis, sourced from prospective screening trials that performed standard (2D) digital mammography (DM) and tomosynthesis (3D-mammography) in the same screening participants. Exemplar cases from four trials highlight common themes of relevance to screening practice including: the type of lesions frequently made more conspicuous or perceptible by tomosynthesis (spiculated masses, and architectural distortions); the histologic findings (both TP and FP) of tomosynthesis-only detection; and the need to extend breast work-up protocols (additional imaging including ultrasound and MRI, and tomosynthesis-guided biopsy) if tomosynthesis is adopted for primary screening. PMID:27017251

  16. Perceived Neighborhood Quality and Cancer Screening Behavior: Evidence from the Survey of the Health of Wisconsin.

    Science.gov (United States)

    Beyer, Kirsten M M; Malecki, Kristen M; Hoormann, Kelly A; Szabo, Aniko; Nattinger, Ann B

    2016-02-01

    Socioeconomic disparities in colorectal and breast cancer screening persist, partially accounting for disparities in cancer outcomes. Some neighborhood characteristics--particularly area level socioeconomic factors--have been linked to cancer screening behavior, but few studies have examined the relationship between perceived neighborhood quality and screening behavior, which may provide more insight into the ways in which neighborhood environments shape cancer related behaviors. This study examines the relationship between several aspects of the perceived neighborhood environment and breast and colorectal cancer screening behavior among a population-based sample of Wisconsin residents. A sub-goal was to compare the relevance of different perceived neighborhood factors for different screening tests. This is a cross-sectional study of 2008-2012 data from the Survey of the Health of Wisconsin, a population-based annual survey of Wisconsin residents. An average risk sample of Black, Hispanic and White women age 50 and older (n = 1265) were selected. Survey regression analyses examined predictors of screening, as well as adherence to screening guidelines. Models controlled for individual socio-demographic information and insurance status. Perceptions of social and physical disorder, including fear of crime and visible garbage, were associated with screening rates. Findings emphasize the particular importance of these factors for colorectal cancer screening, indicating the necessity of improving screening rates in areas characterized by social disorganization, crime, and physical disorder. Additional work should be done to further investigate the pathways that explain the linkage between neighborhood conditions, perceived neighborhood risks and cancer screening behavior. PMID:26275881

  17. A comparative study of breast cancer mass screening using ultrasonography and mammography at a single institution

    International Nuclear Information System (INIS)

    In order to evaluate the effectiveness of ultrasonic screening for breast cancer (US group) in comparison with mammographic screening (MMG group), we analyzed 78,214 breast screening examinees presenting between 2007 and 2008 at our institution. The cancer detection rate in the US group was lower than that in the MMG group. However, the average age in the US group was significantly younger than that in the MMG group, and the rate of annual screening was significantly higher in the former than in the latter. In the US subgroup who underwent annual screening, the recall rate and the cancer detection rate were significantly lower, and the rate of detection of early breast cancers was significantly higher than that in the subgroup who underwent screening biennially or at longer intervals, and there was no significant inter-group difference in the cancer detection rate between women in their 40s and those aged 50 or above who underwent annual screening. The proportion of early breast cancers detected was almost the same in the both groups. In summary, US screening as well as MMG screening seems to be useful for detection of early breast cancer. Although a high recall rate for US screening has been reported previously, annual screening and sufficient quality control based on the guidelines proposed by the Japan Association of Breast and Thyroid Sonology (JABTS) are considered to reduce the recall rate. (author)

  18. Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling

    DEFF Research Database (Denmark)

    M. W. Wille, Mathilde; Dirksen, Asger; Ashraf, Haseem;

    2016-01-01

    RATIONALE: As of April 2015, participants in the Danish Lung Cancer Screening Trial had been followed for at least 5 years since their last screening. OBJECTIVES: Mortality, causes of death, and lung cancer findings are reported to explore the effect of computed tomography (CT) screening. METHODS...... fewer deaths in the screening group. CONCLUSIONS: No statistically significant effects of CT screening on lung cancer mortality were found, but the results of post hoc high-risk subgroup analyses showed nonsignificant trends that seem to be in good agreement with the results of the National Lung...

  19. Psychosocial consequences of cancer screening - development and validation of a questionnaire

    DEFF Research Database (Denmark)

    Brodersen, John; Thorsen, H; Kreiner, Svend

    2010-01-01

    of the COS were tested on participants in a lung cancer screening program. The results were thematically analyzed to identify the key consequences of abnormal and false-positive screening results. Item Response Theory and Classical Test Theory were used to analyze data. Dimensionality, objectivity......, the reliability and the dimensionality of a condition-specific measure with high content validity for persons having abnormal or false-positive lung cancer screening results have been demonstrated. This new questionnaire called Consequences of Screening in Lung Cancer (COS-LC) covers in two parts the psychosocial.......” Keywords: lung cancer, psychometrics, public health, questionnaire development, secondary prevention....

  20. The community pharmacist’s role in cancer screening and prevention

    Science.gov (United States)

    Havlicek, Anthony James; Mansell, Holly

    2016-01-01

    As the Canadian population continues to age, the incidence of cancer is on the rise. To help alleviate the burden malignancy imposes on our health care system, a shift toward early cancer detection is necessary. Pharmacists are well positioned and willing to assume a more active role in cancer surveillance. Patients are receptive to pharmacist involvement and seem to prefer a convenient community pharmacy–based location for screening programs. The community pharmacist’s current and potential role in cancer screening and prevention is summarized in this article. A review of screening recommendations and a discussion of opportunities will hopefully inspire pharmacists to consider incorporating malignancy screening initiatives into their practice.

  1. Determinants of successful implementation of population-based cancer screening programmes

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Törnberg, Sven; von Karsa, Lawrence;

    2012-01-01

    consider when planning, implementing and running population based cancer screening programmes. The list is general and is applicable to breast, cervical and colorectal cancer screening. It is based on evidence presented in the three European Union guidelines on quality assurance in cancer screening......) piloting or trial implementation, (5) scaling up from pilot to service, (6) running of full-scale programme, and (7) sustainability. For each phase, a substantial number of specified conditions have to be met. Successful implementation of a cancer screening programme requires societal acceptance and local...

  2. US Primary Care Physicians’ Prostate Cancer Screening Practices

    Directory of Open Access Journals (Sweden)

    Sun Hee Rim

    2014-12-01

    Full Text Available Background: Limited information exists on primary care physicians’ (PCPs use of the prostate-specific antigen (PSA test by patient risk category. We describe PCP responses to hypothetical patient scenario (PS involving PSA testing among high-risk asymptomatic men. Methods: Data were from the 2007 to 2008 National Survey of Primary Care Physicians’ Practices Regarding Prostate Cancer Screening. PS#1: healthy 55-year-old white male with no family history of prostate cancer; PS#2: healthy 45-year-old African American male with no family history of prostate cancer; and PS#3: healthy 50-year-old male with a family history of prostate cancer. Data were analyzed in SAS/SUDAAN. Results: Most PCPs indicated that they generally discuss the possible benefits/risks of PSA testing with the patient and then recommend the test (PS#1-PS#3 range, 53.4%-68.7%; P < .001; only about 1% reported discussing and then recommending against the test. For PS#3, compared to PS#1 and #2, PCPs were more likely to discuss and recommend the test or attempt to persuade the patient who initially declines the test. For PS#3, all clinicians generally would order/discuss the PSA test and not rely on the patient to ask. Conclusion: Clinicians treat family history as an important reason to recommend, persuade, and initiate PSA testing.

  3. Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi

    Directory of Open Access Journals (Sweden)

    Melanie Y. Hami

    2014-10-01

    Full Text Available Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services. Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi. Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003 and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041 at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages. Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women

  4. Primary care physicians' reported use of pre-screening discussions for prostate cancer screening: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Cooper Crystale P

    2009-03-01

    Full Text Available Abstract Background Professional medical organizations recommend individualized patient decision making about prostate cancer screening. Little is known about primary care physicians' use of pre-screening discussions to promote informed decision making for prostate cancer screening. The aim of this study is to explore physicians' use of pre-screening discussions and reasons why physicians would or would not try to persuade patients to be screened if they initially refuse testing. Methods Primary care physicians completed a self-administered survey about prostate cancer screening practices for informed decision making. Results Sixty-six physicians (75.9% completed the survey, and 63 were used in the analysis. Thirteen physicians (20.6% reported not using prescreening discussions, 45 (71.4% reported the use of prescreening discussions, and 3 (4.8% reported neither ordering the PSA test nor discussing it with patients. Sixty-nine percent of physicians who reported not having discussions indicated they were more likely to screen African American patients for prostate cancer, compared to 50% of physicians who reported the use of discussions (Chi-square(1 = 1.62, p = .20. Similarly, 91% of physicians who reported not having discussions indicated they are more likely to screen patients with a family history of prostate cancer, compared to 46% of those who reported the use of discussion (Chi-square(1 = 13.27, p Conclusion Although guidelines recommend discussing the risks and benefits of prostate cancer screening, physicians report varying practice styles. Future research needs to consider the nature of discussions and the degree to which informed decision making is being achieved in clinical practice.

  5. Strategies for early detection of resectable pancreatic cancer

    OpenAIRE

    Okano, Keiichi; Suzuki, Yasuyuki

    2014-01-01

    Pancreatic cancer is difficult to diagnose at an early stage and generally has a poor prognosis. Surgical resection is the only potentially curative treatment for pancreatic carcinoma. To improve the prognosis of this disease, it is essential to detect tumors at early stages, when they are resectable. The optimal approach to screening for early pancreatic neoplasia has not been established. The International Cancer of the Pancreas Screening Consortium has recently finalized several recommenda...

  6. Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme.

    Directory of Open Access Journals (Sweden)

    Margarita Posso

    Full Text Available The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme.Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1 double reading; 2 double reading for women in their first participation and single reading for women in their subsequent participations; and 3 single reading. We calculated the incremental cost-effectiveness ratio (ICER, which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER.The detection rate of double reading (5.17‰ was similar to that of single reading (4.78‰; P = .768. The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance.From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs.

  7. Cost-Effectiveness of Double Reading versus Single Reading of Mammograms in a Breast Cancer Screening Programme

    Science.gov (United States)

    Posso, Margarita; Carles, Misericòrdia; Rué, Montserrat; Puig, Teresa; Bonfill, Xavier

    2016-01-01

    Objectives The usual practice in breast cancer screening programmes for mammogram interpretation is to perform double reading. However, little is known about its cost-effectiveness in the context of digital mammography. Our purpose was to evaluate the cost-effectiveness of double reading versus single reading of digital mammograms in a population-based breast cancer screening programme. Methods Data from 28,636 screened women was used to establish a decision-tree model and to compare three strategies: 1) double reading; 2) double reading for women in their first participation and single reading for women in their subsequent participations; and 3) single reading. We calculated the incremental cost-effectiveness ratio (ICER), which was defined as the expected cost per one additionally detected cancer. We performed a deterministic sensitivity analysis to test the robustness of the ICER. Results The detection rate of double reading (5.17‰) was similar to that of single reading (4.78‰; P = .768). The mean cost of each detected cancer was €8,912 for double reading and €8,287 for single reading. The ICER of double reading versus single reading was €16,684. The sensitivity analysis showed variations in the ICER according to the sensitivity of reading strategies. The strategy that combines double reading in first participation with single reading in subsequent participations was ruled out due to extended dominance. Conclusions From our results, double reading appears not to be a cost-effective strategy in the context of digital mammography. Double reading would eventually be challenged in screening programmes, as single reading might entail important net savings without significantly changing the cancer detection rate. These results are not conclusive and should be confirmed in prospective studies that investigate long-term outcomes like quality adjusted life years (QALYs). PMID:27459663

  8. African American Men and Prostate Cancer: Be Your Own Advocate and Understand Screening

    Science.gov (United States)

    AFRICAN AMERICAN MEN AND PROSTATE CANCER: BE YOUR OWN ADVOCATE AND UNDERSTAND SCREENING By the National Cancer ... American men. For reasons that are still unknown, African American men are more likely to get prostate ...

  9. Inadequate cervical cancer screening among mid-aged Australian women who have experienced partner violence

    NARCIS (Netherlands)

    Loxton, Deborah; Powers, Jennifer; Schofield, Margot; Hussain, Rafat; Hosking, Stacey

    2009-01-01

    Objectives. Partner violence is linked to cervical cancer and other gynaecological conditions. However, results of current research into associations between partner violence and cervical cancer screening have been inconclusive. Therefore, the current research investigates the association between pa

  10. Progress of breast cancer screening technology%乳腺癌筛查技术的进展

    Institute of Scientific and Technical Information of China (English)

    蔡卓君

    2016-01-01

    As a main threat to female health, breast cancer has shown increasing morbidity rate in recent years, and it has become an critical public health issue in society. Breast cancer screening is helpful for detecting and preventing breast cancer, and the main screening technology in China include clinical breast check, breast X-ray, breast ultrasounography, breast magnetic resonance imaging, and breast blood oxygen functional imaging. This paper made a comparison of advantages and disadvantages of breast cancer screening technology, so as to provide reference and basis for female breast cancer screening strategy.%乳腺癌是威胁女性健康的主要疾病,近年其发病率呈上升趋势,成为当前社会重大公共卫生问题。乳腺癌筛查有助于发现和预防乳腺癌,国内外目前主要筛查技术有临床乳腺检查、乳腺X 线、乳腺超声、乳腺磁共振成像、乳腺血氧功能成像等,本文对乳腺癌筛查技术的优缺点进行比较,为女性乳腺癌筛查策略提供参考和依据。

  11. Predictors of colorectal cancer screening in diverse primary care practices

    Directory of Open Access Journals (Sweden)

    Tabbarah Melissa

    2006-09-01

    Full Text Available Abstract Background To explain why rates of colorectal cancer (CRC screening including fecal occult blood testing (FOBT, flexible sigmoidoscopy (FS, colonoscopy (CS, and barium enema (BE, are low, this study assessed determinants of CRC screening from medical records. Methods Data were abstracted from patients aged ≥64 years selected from each clinician from 30 diverse primary care practices (n = 981. Measurements included the rates of annual FOBT, ever receiving FOBT, ever receiving FS/CS/BE under a combination variable, endoscopy/barium enema (EBE. Results Over five years, 8% had received annual FOBT, 53% had ever received FOBT and 22% had ever received EBE. Annual FOBT was negatively associated with female gender, odds ratio (OR = .23; 95% confidence interval = .12–.44 and positively associated with routinely receiving influenza vaccine, OR = 2.55 (1.45–4.47; and more office visits: 3 to Conclusion Overall CRC screening rates were low, but were related to the number of primary care office visits. FOBT was related to immunization status, suggesting the possible benefit of linking these preventive services.

  12. The `Ohana Day Project: A Community Approach to Increasing Cancer Screening

    OpenAIRE

    Gellert, Kapuaola; Braun, Kathryn L.; Morris, Robert; Starkey, Valerie

    2006-01-01

    Background Native Hawaiians have higher cancer mortality rates and lower cancer screening rates compared with non-Hawaiians in Hawaii. People living in rural areas have particularly limited options for cancer services, especially for services that are culturally attractive and convenient. Context `Ohana Day, offered in a small, rural, and predominantly Hawaiian community, was designed to attract underserved Hawaiians to cancer screening. Methods The year-long project involved a 1-day ho`olaul...

  13. An ongoing case–control study to evaluate the NHS Bowel Cancer Screening Programme

    OpenAIRE

    Massat, Nathalie J; Sasieni, Peter D; Parmar, Dharmishta; Duffy, Stephen W

    2014-01-01

    Background Colorectal cancer is the third most common cause of cancer death in both males and females in England. A national bowel cancer screening programme was rolled out in England between 2006 and 2010. In the post-randomised controlled trials epoch, assessment of the impact of the programme using observational studies is needed. This study protocol was set up at the request of the UK Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis to evaluate the effect of the cur...

  14. Influences on uptake of cancer screening in mental health service users: a qualitative study

    OpenAIRE

    Clifton, Abigail; Burgess, Caroline; Clement, Sarah; Ohlsen, Ruth; Ramluggun, Pras; Sturt, Jackie; Walters, Paul; Barley, Elizabeth A.

    2016-01-01

    Background Cancers are a leading cause of death worldwide. People with mental illness are 30 % more likely to die from cancer than the general population. One reason for this may be low uptake of nationally offered cancer screening tests by people with mental illness. We aimed to identify barriers and facilitators for breast, cervical and bowel cancer screening uptake by people with mental illness in order to inform interventions to promote equal access. Methods The interview study was conduc...

  15. The first national public breast cancer screening program in Saudi Arabia

    OpenAIRE

    Abulkhair, Omalkhair A.; Al Tahan, Fatina M.; Young, Susan E.; Musaad, Salma MA.; Jazieh, Abdul-Rahman M.

    2010-01-01

    BACKGROUND AND OBJECTIVES: Despite its relatively low incidence in Saudi Arabia, breast cancer has been the most common cancer among Saudi females for the past 12 consecutive years. The objective of this study was to report the results of the first national public breast cancer screening program in Saudi Arabia. METHODS: Women 40 years of age or older underwent breast cancer screening. Mammograms were scored using the Breast Imaging-Reporting and Data System (BI-RADS). Correlations between im...

  16. Advances in Tumor Screening, Imaging, and Avatar Technologies for High-Grade Serous Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Anders eOhman

    2014-11-01

    Full Text Available The majority of high-grade serous ovarian carcinoma cases are detected in advanced stages when treatment options are limited. Surgery is less effective at eradicating the disease when it is widespread, resulting in high rates of disease relapse and chemoresistance. Current screening techniques are ineffective for early tumor detection and consequently, BRCA mutations carriers, with an increased risk for developing high-grade serous ovarian cancer, elect to undergo risk-reducing surgery. While prophylactic surgery is associated with a significant reduction in the risk of cancer development, it also results in surgical menopause and significant adverse side effects. The development of efficient early-stage screening protocols and imaging technologies is critical to improving the outcome and quality of life for current patients and women at increased risk. In addition, more accurate animal models are necessary in order to provide relevant in vivo testing systems and advance our understanding of the disease origin and progression. Moreover, both genetically engineered and tumor xenograft animal models enable the preclinical testing of novel imaging techniques and molecularly targeted therapies as they become available. Recent advances in xenograft technologies have made possible the creation of avatar mice, personalized tumorgrafts, which can be used as therapy testing surrogates for individual patients prior to or during treatment. High-grade serous ovarian cancer may be an ideal candidate for use with avatar models based on key characteristics of the tumorgraft platform. This review explores multiple strategies, including novel imaging and screening technologies in both patients and animal models, aimed at detecting cancer in the early stages and improving the disease prognosis.

  17. Yield of claims data and surveys for determining colon cancer screening among health plan members.

    Science.gov (United States)

    Pignone, Michael; Scott, Tracy L; Schild, Laura A; Lewis, Carmen; Vázquez, Raquel; Glanz, Karen

    2009-03-01

    Screening can reduce incidence and mortality from colorectal cancer but has been underutilized. Efforts to increase screening depend on accurate data about screening status. We sought to evaluate the independent and combined yield of claims and direct survey for identifying colorectal cancer screening among average-risk health plan beneficiaries. Participants were Aetna members ages between 52 and 80 years from 32 primary care practices in Florida and Georgia participating in the Communicating Health Options through Information and Cancer Education study. Main outcomes were the proportion of average-risk patients who were up-to-date with colorectal cancer screening based on claims data and the estimated additional yield of survey data for patients with no evidence of screening in their claims history. Of 4,020 average-risk members identified, claims data indicated that 1,066 (27%) had recent colorectal cancer screening. Among the 1,269 average-risk members with no evidence of screening by claims data who returned surveys, 498 (39%) reported being up-to-date with screening. Combining claims data and survey data and accounting for survey nonresponse, we estimate that 47% to 59% of member patients were actually up-to-date with screening, an additional yield of 20 to 32 percentage points. We conclude that, among health plan members, the combination of claims data and survey information had substantially higher yield than claims data alone for identifying colorectal cancer screening. PMID:19273480

  18. A history of breast cancer screening and future problems in Japan

    International Nuclear Information System (INIS)

    In Europe and the United States, mortality due to breast cancer is decreasing. There are various reasons for this trend, including an increase in the detection of early-stage breast cancers due to the increased use of mammographic screening, and the establishment of standardized systemic treatments derived from evidence-based medicine (EBM). On the other hand, in Japanese women, both morbidity and mortality due to breast cancer are increasing. This paper describes the process of breast cancer screening in the past, its current status, and the quality control system for mammographic screening in Japan, as well as the status of breast cancer screening in Europe and the United States. Furthermore, problems of breast cancer screening in Japan discussed, together with the need for practical measures such as implementation of quality control systems aimed at improving the cancer screening rate (with a target of 50%), financial support, and population-based screening (organized screening), based on the Cancer Control Act. Current measures for screening of dense breast tissue in women in their 40s in Japan are also described. (author)

  19. Lung cancer screening: did we really need a randomized controlled trial?

    Science.gov (United States)

    Al-Ayoubi, Adnan M; Flores, Raja M

    2016-07-01

    Lung cancer is the leading cause of cancer mortality in the USA. Within the past decade, two large trials (the National Lung Screening Trial Research and the International Early Lung Cancer Action Program) confirmed a significant role for low-dose CT (LDCT) screening in identifying early stages of cancer leading to reduced mortality in high-risk patients. Given the evidence, the US Preventive Services Task Force issued a recommendation in favour of LDCT screening for high-risk individuals. Despite the strong support for LDCT among physicians who treat lung cancer and cumulative data demonstrating a survival benefit for screening and early detection, it took more than a decade for lung cancer screening to be embraced at the policy level. With many lives lost in the interim, did we really need a randomized controlled trial to make this decision?

  20. Breast Cancer Screening in Women with Learning Disabilities: Current Knowledge and Considerations

    Science.gov (United States)

    Willis, Diane S.; Kennedy, Catriona M.; Kilbride, Lynn

    2008-01-01

    As people with learning disabilities now live longer, they will experience the same age-related illnesses as the general population and cancer is a prime example of this. In women, cancer screening is used to detect early on-set of cancer of the breast and abnormalities of the cervix which might, if left untreated, develop into cancer.…

  1. 76 FR 22108 - Proposed Collection; Comment Request; Prostate, Lung, Colorectal and Ovarian Cancer Screening...

    Science.gov (United States)

    2011-04-20

    ... to determine if screening for prostate, lung, colorectal and ovarian cancer can reduce mortality from these cancers which currently cause an estimated 254,570 deaths annually in the U.S. The design is a two... of the trial is cancer specific mortality for each of the four cancer sites (prostate,...

  2. Adherence to cancer screening guidelines across Canadian provinces: an observational study

    Directory of Open Access Journals (Sweden)

    Chai Zhijin

    2010-06-01

    Full Text Available Abstract Background Cancer screening guidelines reflect the costs and benefits of population-based screening based on evidence from clinical trials. While most of the existing literature on compliance with cancer screening guidelines only measures raw screening rates in the target age groups, we used a novel approach to estimate degree of guideline compliance across Canadian provinces for breast, colorectal and prostate cancer screening. Measuring compliance as the change in age-specific screening rates at the guideline-recommended initiation age (50, we generally found screening patterns across Canadian provinces that were not consistent with guideline compliance. Methods We calculated age-cancer-specific screening rates for ages 40-60 using the Canadian Community Health Survey (2003 and 2005, a cross-sectional, nationally representative survey of health status, health care utilization and health determinants in the Canadian population. We estimated the degree of compliance using logistic regression to measure the change in adjusted screening rates at the guideline-recommended initiation age for each province in the sample. Results For breast cancer, after adjusting for age trends and other covariates, being above age 50 in Quebec increased the probability of being screened by 19 percentage points, from an average screening rate of 24% among 40-49 year olds. None of the other regions exhibited a statistically significant change in screening rates at age 50. Additional analyses indicated that these patterns reflect asymptomatic screening and that Quebec's breast cancer screening program enhanced the degree of guideline compliance in that province. Colorectal cancer screening practice was consistent with guidelines only in Saskatchewan, as screening rates increased at age 50 by 12 percentage points, from an average rate of 6% among 40-49 year olds. For prostate cancer, the regions examined here are not compliant with Canadian guidelines since

  3. Radial scars detected mammographically in a breast cancer screening programme

    International Nuclear Information System (INIS)

    Radial scars are getting more and more common since implementation of mammography as diagnostic tool in screening women for breast cancer. At Karolinska Hospital, 18987 asymptomatic women, aged 50-69, were screened for breast cancer through mammography during August 1989-May 1991. A total of 735 (3.87%) were recalled for additional views after initial mammograms and 463 (2.44%) were assessed with help of cytology. In all 175 women (0.92%) were selected for surgery and 146 (0.77%) had histologically verified cancers. The remaining 29 (0.15%) had non- malignant lesions of which 11 (0.06%) were radial scars. All radial scars were diagnosed on mammograms and later confirmed with histology. The radiologic characteristics were found to be a) rather thick and long radiating structures accompanied by radiolucent linear structures parallel to some of the spicules, b) absence of calcifications, c) radiolucent areas in the body of the lesion, d) an average mean size of 6 mm and e) changing image in different views. Most of the lesions, 73% (8/11), were in moderately dense breasts and there was no specific relation to the right or left breast. A majority of radial scars, 64% (7/11), were found in the upper outer quadrants, 3/11 in the lower outer quadrants and 1/11 in the lower inner quadrant. Literature shows that histology uses many synonyms for radial scars and therefore team work between radiologists and pathologists is suggested for better conformity of the diagnosis. (author). 32 refs.; 1 fig

  4. Differences between men with screening-detected versus clinically diagnosed prostate cancers in the USA

    Directory of Open Access Journals (Sweden)

    Stone S Noell

    2005-03-01

    Full Text Available Abstract Background The advent of prostate specific antigen (PSA testing in the United States of America (USA has led to a dramatic increase in the incidence of prostate cancer in the United States as well as the number of men undergoing aggressive treatment with radical prostatectomy and radiation therapy. We compared patient characteristics and treatment selection between American men with screening-detected versus clinically diagnosed prostate cancers. Methods We evaluated 3,173 men with prostate cancer in the USA. Surveys and medical records provided information on demographics, socioeconomic status, comorbidities, symptoms, tumor characteristics, and treatment. We classified men presenting with symptoms of advanced cancer – bone pain, weight loss, or hematuria – as "clinically diagnosed"; asymptomatic men and those with only lower urinary tract symptoms were considered "screening-detected." We used multivariate analyses to determine whether screening predicted receiving aggressive treatment for a clinically localized cancer. Results We classified 11% of cancers as being clinically diagnosed. Men with screening-detected cancers were more often non-Hispanic white (77% vs. 65%, P Conclusion Most cancers were detected by screening in this American cohort. Appropriately, younger, healthier men were more likely to be diagnosed by screening. Minority status and lower socio-economic status appeared to be screening barriers. Screening detected earlier-stage cancers and was associated with receiving aggressive treatment.

  5. New product strategy and the screening of new products: A competency trap?

    DEFF Research Database (Denmark)

    Jespersen, Kristina Risom

    2005-01-01

    The article analyses the correlation between NPD strategy and the value of the information to the screening of new product ideas. Though this is common reasoning in NPD literature, it is by falsification of these hypotheses that the article will identify the existence of a potential NPD competency...... trap. Data were collected with a selfadministered questionnaire. Results reveal that a prospector strategy increases the value of secondary rather than primary information, and screen new products similar to a defender strategy. This phenomenon depicts a potential competency trap regarding...... the information used within the NPD process for the screening of new product ideas....

  6. Radiation-Induced Breast Cancer Incidence and Mortality from Digital Mammography Screening: A Modeling Study

    Science.gov (United States)

    Miglioretti, Diana L.; Lange, Jane; van den Broek, Jeroen J.; Lee, Christoph I.; van Ravesteyn, Nicolien T.; Ritley, Dominique; Kerlikowske, Karla; Fenton, Joshua J.; Melnikow, Joy; de Koning, Harry J.; Hubbard, Rebecca A.

    2016-01-01

    Background Estimates of radiation-induced breast cancer risk from mammography screening have not previously considered dose exposure variation or diagnostic work-up after abnormal screening. Objective To estimate distributions of radiation-induced breast cancer incidence and mortality from digital mammography screening, considering exposure from screening and diagnostic mammography and dose variation across women. Design Two simulation-modeling approaches using common data on screening mammography from the Breast Cancer Surveillance Consortium and radiation dose from mammography from the Digital Mammographic Imaging Screening Trial. Setting U.S. population. Patients Women aged 40–74 years. Interventions Annual or biennial digital mammography screening from age 40, 45, or 50 until 74. Measurements Lifetime breast cancer deaths averted (benefits) and radiation-induced breast cancer incidence and mortality per 100,000 women screened (harms). Results On average, annual screening of 100,000 women aged 40 to 74 years was projected to induce 125 breast cancers (95% confidence interval [CI]=88–178) leading to 16 deaths (95% CI=11–23) relative to 968 breast cancer deaths averted by early detection from screening. Women exposed at the 95th percentile were projected to develop 246 radiation-induced breast cancers leading to 32 deaths per 100,000 women. Women with large breasts requiring extra views for complete breast examination (8% of population) were projected to have higher radiation-induced breast cancer incidence and mortality (266 cancers, 35 deaths per 100,000 women), compared to women with small or average breasts (113 cancers, 15 deaths per 100,000 women). Biennial screening starting at age 50 reduced risk of radiation-induced cancers 5-fold. Limitations We were unable to estimate years of life lost from radiation-induced breast cancer. Conclusions Radiation-induced breast cancer incidence and mortality from digital mammography screening are impacted by dose

  7. Chlamydia screening strategies and outcomes in educational settings: a systematic review.

    Science.gov (United States)

    Jamil, Muhammad Shahid; Bauer, Heidi M; Hocking, Jane S; Ali, Hammad; Wand, Handan; Walker, Jennifer; Douglas, Laura; Donovan, Basil; Kaldor, John M; Guy, Rebecca J

    2014-03-01

    Chlamydia trachomatis (CT) screening programs have been established in educational settings in many countries during the past 2 decades. However, recent evidence suggests that high uptake of screening and management (treatment, partner notification, and retesting for reinfection) improves program effectiveness. We conducted a systematic review to understand the screening strategies, the extent of screening conducted, and uptake of management strategies in educational settings. Screening studies in educational settings were identified through a systematic search of published literature from 2005 to 2011. We identified 27 studies describing 30 screening programs in the United States/Canada (n = 10), Europe (n = 8), Australia/New Zealand (n = 5), and Asia (n = 4). Most studies targeted both male and female students (74%). Classroom-based strategies resulted in 21,117 testes overall (4 programs), followed by opportunistic screening during routine health examination (n = 13,470; 5 programs) and opportunistic screening at school-based health centers (n = 13,006; 5 programs). The overall median CT positivity was 4.7% (range, 1.3%-18.1%). Only 5 programs reported treatment rates (median, 100%; range, 86%-100%), 1 partner notification rate (71%), 1 retesting rate within a year of an initial CT diagnosis (47%), and 2 reported repeat positivity rates (21.1% and 26.3%). In conclusion, this systematic review shows that a variety of strategies have been used to screen large numbers of students in educational settings; however, only a few studies have reported CT management outcomes. PMID:24521724

  8. Characteristics and prognosis of interval cancers after biennial screen-film or full-field digital screening mammography.

    Science.gov (United States)

    Weber, Roy J P; van Bommel, Rob M G; Louwman, Marieke W; Nederend, Joost; Voogd, Adri C; Jansen, Frits H; Tjan-Heijnen, Vivianne C G; Duijm, Lucien E M

    2016-08-01

    We determined the characteristics and prognosis of interval breast cancers (IC) at screen-film (SFM) and full-field digital (FFDM) screening mammography. The study population consisted of 417,746 consecutive screening mammograms (302,699 SFM screens and 115,047 FFDM screens), obtained between 2000 and 2011. During 2-year follow-up, we collected breast imaging reports, surgical reports, and pathology results. A total of 800 ICs had been diagnosed in the screened population, of which 288 detected in the first year (early ICs) and 512 in the second year (late ICs) after a negative screen. 31.3 % of early IC's and 19.1 % of late IC's, respectively, were visible in retrospect on the latest previous screens, but had been missed during screening (P < 0.001). Missed invasive ICs were larger (28.5 mm vs. 23.9 mm, P = 0.003) and showed a higher fraction of T3+cancers (16.9 vs. 8.5 %, P = 0.02) than true ICs (i.e., not visible at the latest screen). A higher portion of missed than true ICs underwent mastectomy (44.7 vs. 30.8 %, P = 0.002). We found no differences in mammographic and tumor characteristics for early ICs, detected either after SFM or FFDM. Late ICs following FFDM were more often true ICs than missed ICs (69.0 vs. 57.6 %, P = 0.03) and more often receptor triple negative (P = 0.02), compared to late ICs at SFM. Interval cancer subgroups showed comparable overall survival. Interval cancer subgroups show distinctive mammographic and tumor characteristics but a comparable overall survival. PMID:27393617

  9. Cancer Biomarker Discovery: Lectin-Based Strategies Targeting Glycoproteins

    Directory of Open Access Journals (Sweden)

    David Clark

    2012-01-01

    Full Text Available Biomarker discovery can identify molecular markers in various cancers that can be used for detection, screening, diagnosis, and monitoring of disease progression. Lectin-affinity is a technique that can be used for the enrichment of glycoproteins from a complex sample, facilitating the discovery of novel cancer biomarkers associated with a disease state.

  10. Identification of novel pro-migratory, cancer-associated genes using quantitative, microscopy-based screening.

    Directory of Open Access Journals (Sweden)

    Suha Naffar-Abu-Amara

    Full Text Available BACKGROUND: Cell migration is a highly complex process, regulated by multiple genes, signaling pathways and external stimuli. To discover genes or pharmacological agents that can modulate the migratory activity of cells, screening strategies that enable the monitoring of diverse migratory parameters in a large number of samples are necessary. METHODOLOGY: In the present study, we describe the development of a quantitative, high-throughput cell migration assay, based on a modified phagokinetic tracks (PKT procedure, and apply it for identifying novel pro-migratory genes in a cancer-related gene library. In brief, cells are seeded on fibronectin-coated 96-well plates, covered with a monolayer of carboxylated latex beads. Motile cells clear the beads, located along their migratory paths, forming tracks that are visualized using an automated, transmitted-light screening microscope. The tracks are then segmented and characterized by multi-parametric, morphometric analysis, resolving a variety of morphological and kinetic features. CONCLUSIONS: In this screen we identified 4 novel genes derived from breast carcinoma related cDNA library, whose over-expression induces major alteration in the migration of the stationary MCF7 cells. This approach can serve for high throughput screening for novel ways to modulate cellular migration in pathological states such as tumor metastasis and invasion.

  11. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

    LENUS (Irish Health Repository)

    Duffy, Michael J

    2012-02-01

    Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.

  12. The utility of cancer-related cultural constructs to understand colorectal cancer screening among African Americans

    Directory of Open Access Journals (Sweden)

    Vetta L. Sanders Thompson

    2013-09-01

    Full Text Available Background. Data suggest that colorectal cancer could be cut by approximately 60% if all people aged 50 years or older received regular screening. Studies have identified socio-cultural attitudes that might inform cancer education and screening promotion campaigns. This article applies item response theory (IRT to a set of survey items selected to assess sociocultural attitudes in order to determine how current measures may affect what we know about how these attitudes affect colorectal cancer screening (CRCS.Design and Methods. A survey of colorectal cancer screening, screening attitudes and cultural beliefs was administered to 1021 African Americans – 683 women and 338 men, ages 50 to 75. Eligibility crite ria for participation included being born in the United States, self-identified African American male or female, age 50 to 75 years. The IRT analysis was performed on 655 individuals with complete data for the 43 observed variables. Results. Twenty-nine items comprise the Multi-construct African American Cultural Survey (MAACS that addresses seven cultural con- structs: mistrust/distrust, privacy, ethnic identity, collectivism, empowerment, and male gender roles. The items provide adequate information about the attitudes of the population across most levels of the constructs assessed. Among the sociocultural variables considered, empowerment (OR=1.078; 95% CI: 1.008, 1.151 had the strongest association with CRCS adherence and privacy showed promise. Conclusions. The MAACS provides a fixed length questionnaire to assess African American CRCS attitudes, two new constructs that might assist in CRCS promotion, and a suggested focus for identification of additional constructs of interest.

  13. Reviewing risks and benefits of low-dose computed tomography screening for lung cancer.

    Science.gov (United States)

    Chopra, Ishveen; Chopra, Avijeet; Bias, Thomas K

    2016-01-01

    Lung cancer is the third most common cancer among men and women and is one of the leading causes of cancer-related mortality. Diagnosis at an early stage has been suggested crucial for improving survival in individuals at high-risk of lung cancer. One potential facilitator to early diagnosis is low-dose computed tomography (LDCT). The United States Preventive Services Task Force guidelines call for annual LDCT screening for individuals at high-risk of lung cancer. This recommendation was based on the effectiveness of LDCT in early diagnosis of lung cancer, as indicated by the findings from the National Lung Screening Trial conducted in 2011. Although lung cancer accounts for more than a quarter of all cancer deaths in the United States and LDCT screening shows promising results regarding early lung cancer diagnosis, screening for lung cancer remains controversial. There is uncertainty about risks, cost-effectiveness, adequacy of evidence, and application of screening in a clinical setting. This narrative review provides an overview of risks and benefits of LDCT screening for lung cancer. Further, this review discusses the potential for implementation of LDCT in clinical setting. PMID:26680693

  14. Cervical Cancer Knowledge, Perceptions and Screening Behaviour Among Female University Students in Ghana.

    Science.gov (United States)

    Binka, Charity; Nyarko, Samuel H; Doku, David T

    2016-06-01

    Cervical cancer is becoming a leading cause of death among women in developing countries. Nevertheless, little is known regarding knowledge and perception of cervical cancer and screening behaviour particularly among female tertiary students in Ghana. This study sought to examine the knowledge and perceptions of cervical cancer and screening behaviour among female students in the University of Cape Coast and Ghana Institute of Management and Public Administration in Ghana. A cross-sectional survey design was adopted for the study. Systematic and stratified random sampling techniques were used to select 410 participants for the study. The study found that the participants lacked knowledge on specific risk factors and symptoms of cervical cancer. Also, even though the participants had a fair perception of cervical cancer, they had a poor cervical cancer screening behaviour. Awareness of cervical cancer was significantly influenced by religious affiliation while cervical cancer screening was significantly determined by the working status of the participants. Specific knowledge on cervical cancer and its risk factors as well as regular screening behaviour is paramount to the prevention of cervical cancer. Consequently, the University Health Services should focus on promoting regular cervical cancer awareness campaigns and screening among the students particularly, females. PMID:25957285

  15. Differences in Patient Outcomes of Prevalence, Interval, and Screen-Detected Lung Cancers in the CT Arm of the National Lung Screening Trial

    Science.gov (United States)

    Massion, Pierre P.; Thompson, Zachary J.; Eschrich, Steven A.; Balagurunathan, Yoganand; Goldof, Dmitry; Aberle, Denise R.; Gillies, Robert J.

    2016-01-01

    Lung cancer screening identifies cancers with heterogeneous behaviors. Some lung cancers will be identified among patients who had prior negative CT screens and upon follow-up scans develop a de novo nodule that was determined to be cancerous. Other lung cancers will be identified among patients who had one or more prior stable positive scans that were not determined to be lung cancer (indeterminate pulmonary nodules), but in follow-up scans was diagnosed with an incidence lung cancer. Using data from the CT arm of the National Lung Screening Trial, this analysis investigated differences in patient characteristics and survival endpoints between prevalence-, interval-, and screen-detected lung cancers, characterized based on sequence of screening results. Lung cancers immediately following a positive baseline (T0), and prior to the T1 screen, formed the prevalence cohort. Interval cancers were diagnosed following a negative screen at any time point prior to the next screening round. Two cohorts of screen-detected lung cancers (SDLC) were identified that had a baseline positive screen that was that was not determined to be lung cancer (i.e., an indeterminate pulmonary nodule), but in follow-up scans was diagnosed with an incidence lung cancer 12 (SDLC1) or 24 (SDLC2) months later. Two other incidence cohorts had screen-detected lung cancers that had baseline negative screen and upon follow-up scans developed a de novo nodule determined to be cancerous at 12 (SDLC3) or 24 (SDLC4) months later. Differences in patient characteristics, progression-free survival (PFS), and overall survival (OS) were assessed. The lung cancer-specific death rate was higher for SDLC3/SDLC4 compared to SDLC1/SDLC2 lung cancers (136.6/1,000 person-years vs. 71.3/1,000 person-years, P lung cancers (HR = 1.00). Lung cancer patients who develop a de novo nodule that determined to be cancerous (i.e., at least one negative CT screen prior to cancer diagnosis) had poorer survival outcomes compared

  16. Recommendations for cervical cancer screening programs in developing countries: the need for equity and technological development

    Directory of Open Access Journals (Sweden)

    Lazcano-Ponce Eduardo

    2003-01-01

    Full Text Available The cervical cancer screening programs (CCSP have not been very efficient in the developing countries. This explains the need to foster changes on policies, standards, quality control mechanisms, evaluation and integration of new screening alternatives considered as low and high cost, as well as to regulate colposcopy practices and the foundation of HPV laboratories. Cervical cancer (CC is a disease most frequently found in poverty-stricken communities and reflecting a problem of equity at both levels gender and regional, and this, is not only due to social and economic development inequalities, but to the infrastructure and human resources necessary for primary care. For this reason, the CCSP program must be restructured, a to primarily address unprivileged rural and urban areas; b to foster actions aimed at ensuring extensive coverage as well as a similar quality of that coverage in every region; c to use screening strategies in keeping with the availability of health care services. In countries with a great regional heterogeneity, a variety of screening procedures must be regulated and standardized, including a combination of assisted visual inspection, cervical cytology and HPV detection; d regional community intervention must be set up to assess the effectiveness of using HPV detection as an strategy in addition to cervical cytology (pap smear; e the practice of colposcopy must be regulated to prevent the use of it in healthy women at a population level, thus preventing unnecessary diagnosis and treatment which not only are expensive but also causes unnecessary anxiety to women at risk; f the operation of those clinical laboratories using HPV as a detection strategy must likewise be accredited and regulated and g the CCSP program for assuring health care quality should meet the expectations of its beneficiaries, and increase the knowledge in cervical cancer related matters. Finally, though a variety of clinical tests on prophylactic and

  17. Economics of blood screening: in search of an optimal blood screening strategy.

    Science.gov (United States)

    Chinkhumba, Jobiba

    2006-01-01

    The objectives of this retrospective study were to assess the economic impact that the practice of 'family replacement donor system' has on the operational costs of a rural blood bank and to rationalize efficient blood screening protocols with a view to minimizing blood screening costs without compromising blood safety. Prevalence of transfusion-transmissible infections such as HIV, hepatitis B and syphilis were ascertained from records of 870 potential donors screened over a period of 6 months. Costs of screening tests were approximated by summing up costs of materials used per test. Overhead and labour costs were not factored in. Average and marginal costs of a fully-screened blood unit were calculated using different blood screening protocols. The average and marginal costs of a fully-screened blood unit vary greatly depending on the order in which screening tests are conducted. Although the variation in average costs per blood unit among different protocols is narrow, US 29.44 dollars to US 33 dollars, the variation in marginal costs is significantly wider ranging from US 22.79 dollars to US 51.85 dollars. Overall, 78 (9%) of the potential donors had HIV infection while 25 (3.2%) had hepatitis B infections and nine (1.2%) donors had syphilis. Co-infection rate was very low at 1.4%. The study shows that it is possible to prioritize blood screening tests for the selection of safe blood donors simply and cost-effectively in a developing country hospital. In the face of rapid rises in health-care spending, it is very important that essential health services such as blood screening are safely delivered with as little expenditure of financial resources as possible. To make sound economic decisions, average cost is not what matters but marginal cost, the cost of one more test. PMID:16483429

  18. Cervical cancer risk factors and feasibility of visual inspection with acetic acid screening in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero;

    2011-01-01

    To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan.......To assess the risk factors of cervical cancer and the feasibility and acceptability of a visual inspection with acetic acid (VIA) screening method in a primary health center in Khartoum, Sudan....

  19. Screening for Breast Cancer : US Preventive Services Task Force Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen J.; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne M.; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Update of the 2002 U. S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population. Methods: The USPSTF examined the evidence on the efficacy of 5 screening modalities in reducing mortality from breast cancer: film mammogra

  20. Colorectal Cancer Screening at the Nexus of HIV, Minority Statuses, and Cultural Safety

    Science.gov (United States)

    Ka'opua, Lana Sue I.; Diaz, Tressa P.; Park, Soon H.; Bowen, Talita; Patrick, Kevin; Tamang, Suresh; Braun, Kathryn L.

    2014-01-01

    Background: The incidence of non-AIDS-defining cancers has increased significantly among persons living with HIV (PLHIV). Screening education is recommended. Purpose: Social learning, minority stress, and cultural safety theories informed this pilot to assess the feasibility of a colorectal cancer screening intervention targeted to PLHIV, with…