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Yu Y, Qiao L, Han J, Wang W, Kang W, Zhang Y, Shang S, Meng R, Zhuo L, Zhan S, Xi Y, Wang S. Integrated database-based Screening Cohort for Asian Nomadic descendants in China (Scan-China): Insights on prospective ethnicity-focused cancer screening. Epidemiol Health 2023; 45:e2023048. [PMID: 37080725 PMCID: PMC10593583 DOI: 10.4178/epih.e2023048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/29/2023] [Indexed: 04/22/2023] Open
Abstract
Established in 2017, the Screening Cohort for Asian Nomadic descendants in China (Scan-China) has benefited over 180,000 members of a multi-ethnic population, particularly individuals of Mongolian descent compared with the general population (Han ethnicity), in the Inner Mongolia Autonomous Region, China. This cohort study aims to evaluate the effectiveness of cancer screening and serve as a real-world data platform for cancer studies. The 6 most prevalent cancers in China are considered-namely, breast, lung, colorectal, gastric, liver and esophageal cancer. After baseline cancer risk assessments and screening tests, both active and passive follow-up (based on the healthcare insurance database, cancer registry, the front page of hospital medical records, and death certificates) will be conducted to trace participants' onset and progression of cancers and other prevalent chronic diseases. Scan-China has preliminarily found a disproportionately lower screening participation rate and higher incidence/mortality rates of esophageal and breast cancer among the Mongolian population than among their Han counterparts. Further research will explore the cancer burden, natural history, treatment patterns, and risk factors of the target cancers.
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Affiliation(s)
- Yuelin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Liying Qiao
- Center for Disease Control and Prevention in Inner Mongolia, Hohhot, China
| | - Jing Han
- Center for Disease Control and Prevention in Inner Mongolia, Hohhot, China
| | - Weiwei Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Weiwei Kang
- Center for Disease Control and Prevention in Inner Mongolia, Hohhot, China
| | - Yunjing Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shu Shang
- Center for Disease Control and Prevention in Inner Mongolia, Hohhot, China
| | - Ruogu Meng
- National Institute of Health Data Science, Peking University, Beijing, China
| | - Lin Zhuo
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yunfeng Xi
- Center for Disease Control and Prevention in Inner Mongolia, Hohhot, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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52
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Chong RIH, Leow JJ, Choo ZW, Salada R, Yong DZP, Chong YL. Testicular self-examination for early detection of testicular cancer. World J Urol 2023; 41:941-951. [PMID: 37036497 DOI: 10.1007/s00345-023-04381-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/14/2023] [Indexed: 04/11/2023] Open
Abstract
Testicular cancer (TCa) commonly presents as a painless scrotal mass. It has been suggested that testicular self-examination (TSE) can help in early detection and thus potentially improve treatment outcomes and prognosis. While TSE is more well established in guideline recommendations for patients with a known history of TCa, its role in healthy young men is less established and controversial. In this paper, we review contemporary data to provide an updated recommendation.
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Affiliation(s)
- Ryan I H Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jeffrey J Leow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Urology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | - Zhen Wei Choo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Urology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rolando Salada
- Department of Urology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Daniel Z P Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Urology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yew-Lam Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Urology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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53
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Canfell K, Liu B, Banks E. Reflections on the life and career of Professor Dame Valerie Beral AC DBE FRS FRCOG FMedSci (1943-2022). Med J Aust 2023; 218:352-353. [PMID: 37015378 DOI: 10.5694/mja2.51914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
- Karen Canfell
- Daffodil Centre, University of Sydney, a Joint Venture with Cancer Council NSW the University of Sydney, Sydney, NSW
| | - Bette Liu
- University of New South Wales, Sydney, NSW
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, NSW
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
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54
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Kim HJ, Jeong S, Oh YH, Park SJ, Cho Y, Park SM. Changes in high-density lipoprotein cholesterol with risk of Cardiovascular Disease among initially high-density lipoprotein-high participants. Cardiovasc Diabetol 2023; 22:71. [PMID: 36978181 PMCID: PMC10053475 DOI: 10.1186/s12933-023-01805-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND High-density lipoprotein cholesterol's (HDL-C) long-held status as a cardiovascular disease (CVD) preventative has been called into question. Most of the evidence, however, focused on either the risk of death from CVD, or on single time point level of HDL-C. This study aimed to determine the association between changes in HDL-C levels and incident CVD in individuals with high baseline HDL-C levels (≥ 60 mg/dL). METHODS 77,134 people from the Korea National Health Insurance Service-Health Screening Cohort were followed for 517,515 person-years. Cox proportional hazards regression was used to evaluate the association between change in HDL-C levels and the risk of incident CVD. All participants were followed up until 31 December 2019, CVD, or death. RESULTS Participants with the greatest increase in their HDL-C levels had higher risks of CVD (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.05-1.25) and CHD (aHR 1.27, CI 1.11-1.46) after adjusting for age, sex, household income, body mass index, hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol consumption, moderate-to-vigorous physical activity, Charlson comorbidity index, and total cholesterol than those with the lowest increase in HDL-C levels. Such association remained significant even among participants with decreased low-density lipoprotein cholesterol (LDL-C) levels for CHD (aHR 1.26, CI 1.03-1.53). CONCLUSIONS In people with already high HDL-C levels, additional increases in HDL-C levels may be associated with an increased risk of CVD. This finding held true irrespective of the change in their LDL-C levels. Increasing HDL-C levels may lead to unintentionally elevated risk of CVD.
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Affiliation(s)
- Hye Jun Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam, South Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Sun Jae Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - Yoosun Cho
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.
- Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea.
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55
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Koch HW, Larsen M, Bartsch H, Kurz KD, Hofvind S. Artificial intelligence in BreastScreen Norway: a retrospective analysis of a cancer-enriched sample including 1254 breast cancer cases. Eur Radiol 2023; 33:3735-3743. [PMID: 36917260 PMCID: PMC10121532 DOI: 10.1007/s00330-023-09461-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 12/13/2022] [Accepted: 01/24/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To compare results of selected performance measures in mammographic screening for an artificial intelligence (AI) system versus independent double reading by radiologists. METHODS In this retrospective study, we analyzed data from 949 screen-detected breast cancers, 305 interval cancers, and 13,646 negative examinations performed in BreastScreen Norway during the period from 2010 to 2018. An AI system scored the examinations from 1 to 10, based on the risk of malignancy. Results from the AI system were compared to screening results after independent double reading. AI score 10 was set as the threshold. The results were stratified by mammographic density. RESULTS A total of 92.7% of the screen-detected and 40.0% of the interval cancers had an AI score of 10. Among women with a negative screening outcome, 9.1% had an AI score of 10. For women with the highest breast density, the AI system scored 100% of the screen-detected cancers and 48.6% of the interval cancers with an AI score of 10, which resulted in a sensitivity of 80.9% for women with the highest breast density for the AI system, compared to 62.8% for independent double reading. For women with screen-detected cancers who had prior mammograms available, 41.9% had an AI score of 10 at the prior screening round. CONCLUSIONS The high proportion of cancers with an AI score of 10 indicates a promising performance of the AI system, particularly for women with dense breasts. Results on prior mammograms with AI score 10 illustrate the potential for earlier detection of breast cancers by using AI in screen-reading. KEY POINTS • The AI system scored 93% of the screen-detected cancers and 40% of the interval cancers with AI score 10. • The AI system scored all screen-detected cancers and almost 50% of interval cancers among women with the highest breast density with AI score 10. • About 40% of the screen-detected cancers had an AI score of 10 on the prior mammograms, indicating a potential for earlier detection by using AI in screen-reading.
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Affiliation(s)
- Henrik Wethe Koch
- Department of Radiology, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marthe Larsen
- Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Hauke Bartsch
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Kathinka Dæhli Kurz
- Department of Radiology, Stavanger University Hospital, Stavanger, Norway
- Department of Electrical Engineering and Computer Science, Faculty of Science and Technology, The University of Stavanger, Stavanger, Norway
| | - Solveig Hofvind
- Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
- Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
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56
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Schultz R. Modern paradigms for prostate cancer detection and management. Med J Aust 2023; 218:331. [PMID: 36914369 DOI: 10.5694/mja2.51886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 03/14/2023]
Affiliation(s)
- Rosalie Schultz
- Centre for Remote Health, Flinders University, Alice Springs, NT
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57
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Oliveira MC, Scharan KO, Thomés BI, Bernardelli RS, Reese FB, Kozesinski-Nakatani AC, Martins CC, Lobo SMA, Réa-Neto Á. Diagnostic accuracy of a set of clinical and radiological criteria for screening of COVID-19 using RT-PCR as the reference standard. BMC Pulm Med 2023; 23:81. [PMID: 36894945 PMCID: PMC9997428 DOI: 10.1186/s12890-023-02369-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The gold-standard method for establishing a microbiological diagnosis of COVID-19 is reverse-transcriptase polymerase chain reaction (RT-PCR). This study aimed to evaluate the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a set of clinical-radiological criteria for COVID-19 screening in patients with severe acute respiratory failure (SARF) admitted to intensive care units (ICUs), using reverse-transcriptase polymerase chain reaction (RT-PCR) as the reference standard. METHODS Diagnostic accuracy study including a historical cohort of 1009 patients consecutively admitted to ICUs across six hospitals in Curitiba (Brazil) from March to September, 2020. The sample was stratified into groups by the strength of suspicion for COVID-19 (strong versus weak) using parameters based on three clinical and radiological (chest computed tomography) criteria. The diagnosis of COVID-19 was confirmed by RT-PCR (referent). RESULTS With respect to RT-PCR, the proposed criteria had 98.5% (95% confidence interval [95% CI] 97.5-99.5%) sensitivity, 70% (95% CI 65.8-74.2%) specificity, 85.5% (95% CI 83.4-87.7%) accuracy, PPV of 79.7% (95% CI 76.6-82.7%) and NPV of 97.6% (95% CI 95.9-99.2%). Similar performance was observed when evaluated in the subgroups of patients admitted with mild/moderate respiratory disfunction, and severe respiratory disfunction. CONCLUSION The proposed set of clinical-radiological criteria were accurate in identifying patients with strong versus weak suspicion for COVID-19 and had high sensitivity and considerable specificity with respect to RT-PCR. These criteria may be useful for screening COVID-19 in patients presenting with SARF.
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Affiliation(s)
- Mirella Cristine Oliveira
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Complexo Hospitalar do Trabalhador (CHT), República Argentina Street, 4406, Curitiba, Paraná, 81050-000, Brazil
| | - Karoleen Oswald Scharan
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil
| | - Bruna Isadora Thomés
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil
| | - Rafaella Stradiotto Bernardelli
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,School of Medicine and Life Sciences, Pontifical Catholic University of Paraná, Imaculada Conceição Street, 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Fernanda Baeumle Reese
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Complexo Hospitalar do Trabalhador (CHT), República Argentina Street, 4406, Curitiba, Paraná, 81050-000, Brazil
| | - Amanda Christina Kozesinski-Nakatani
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Hospital Santa Casa de Curitiba, Praça Rui Barbosa, 694, Curitiba, Paraná, 80010-030, Brazil
| | - Cintia Cristina Martins
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Complexo Hospitalar do Trabalhador (CHT), República Argentina Street, 4406, Curitiba, Paraná, 81050-000, Brazil
| | - Suzana Margareth Ajeje Lobo
- Departament of Medicine, São José do Rio Preto Medical School, Brigadeiro Faria Lima avenue, 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil
| | - Álvaro Réa-Neto
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil. .,Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.
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58
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Tran L, Cowie BC. Universal testing for hepatitis B must be accompanied by better linkage with care. Med J Aust 2023; 218:165-166. [PMID: 36739107 DOI: 10.5694/mja2.51848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 02/06/2023]
Affiliation(s)
- Lien Tran
- WHO Collaborating Centre for Viral Hepatitis, the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC
| | - Benjamin C Cowie
- WHO Collaborating Centre for Viral Hepatitis, the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC.,Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, VIC
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Xiao Y, Hellard ME, Thompson AJ, Seaman C, Howell J, Scott N. The cost-effectiveness of universal hepatitis B screening for reaching WHO diagnosis targets in Australia by 2030. Med J Aust 2023; 218:168-173. [PMID: 36596568 DOI: 10.5694/mja2.51825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess the impact on diagnosis targets, cost, and cost-effectiveness of universal hepatitis B screening in Australia. DESIGN Markov model simulation of disease and care cascade progression for people with chronic hepatitis B in Australia. SETTING Three scenarios were compared: 1. no change to current hepatitis B virus (HBV) testing practice; 2. universal screening strategy, with the aim of achieving the WHO diagnosis target by 2030 (90% of people with chronic hepatitis B diagnosed), based on opportunistic (general practitioner-initiated) screening for HBsAg; 3. universal screening strategy, and also ensuring that 50% of people with chronic hepatitis B are receiving appropriate clinical management by 2030. MAIN OUTCOME MEASURES Projected care cascade for people with chronic hepatitis B, cumulative number of HBV-related deaths, intervention costs, and health utility (quality-adjusted life-years [QALYs] gained during 2020-2030). An incremental cost-effectiveness ratio (ICER) threshold (v scenario 1) of $50 000 per QALY gained was applied. RESULTS Compared with scenario 1, 80 HBV-related deaths (interquartile range [IQR], 41-127 deaths) were averted during 2020-2030 in scenario 2, 315 HBV-related deaths (IQR, 211-454 deaths) in scenario 3. Scenario 2 cost $84 million (IQR, $41-106 million) more than scenario 1 during 2020-2030 (+8%), yielding an ICER of $104 921 (IQR, $49 587-107 952) per QALY gained. Scenario 3 cost $263 million (IQR, $214-316 million) more than scenario 1 during 2020-2030 (+24%), yielding an ICER of $47 341 (IQR, $32 643-58 200) per QALY gained. Scenario 3 remained cost-effective if the test positivity rate was higher than 0.35% or the additional costs per person tested did not exceed $4.02. CONCLUSIONS Universal screening for hepatitis B will be cost-effective only if the cost of testing is kept low and people receive appropriate clinical management.
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Affiliation(s)
| | - Margaret E Hellard
- The Burnet Institute, Melbourne, VIC.,The Alfred Hospital, Melbourne, VIC
| | - Alexander J Thompson
- St Vincent's Hospital, Melbourne, VIC.,The University of Melbourne, Melbourne, VIC
| | | | - Jess Howell
- The Burnet Institute, Melbourne, VIC.,St Vincent's Hospital, Melbourne, VIC
| | - Nick Scott
- The Burnet Institute, Melbourne, VIC.,Monash University, Melbourne, VIC
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Cobb S, Ekwegh T, Adinkrah E, Ameli H, Dillard A, Kibe LW, Bazargan M. Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans. Health Promot Perspect 2023; 12:399-409. [PMID: 36852204 PMCID: PMC9958235 DOI: 10.34172/hpp.2022.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 02/22/2023] Open
Abstract
Background: The purpose of this study is to determine whether underserved middle-aged and older African Americans are receiving a colorectal cancer (CRC) screening test (sigmoidoscopy or colonoscopy) and if recommended by their provider. Additionally, we examined correlates of both provider recommendation and uptake of CRC screening. Methods: Seven hundred forty African American individuals, aged 55 and older, participated in this local community cross-sectional survey. We used a multivariate technique of logistic regression. Results: One out of three participants reported that they never received a sigmoidoscopy or colonoscopy for CRC screening. More than 31% indicted that their providers never suggested CRC testing. However, participants who indicated that their providers recommended sigmoidoscopy/colonoscopy were almost 49 times (odds ratio [OR]: 48.9, 95% confidence interval [CI]: 29.5-81.2) more likely to obtain it compared to their counterparts who were not advised to have these procedures. Our data suggest that African American men were significantly less likely than women to receive recommendations from their providers (OR: 0.70, 95% CI: 0.50-0.91). Furthermore, controlling for other variables, the following factors: 1) living arrangement (OR: 1.44, 95% CI: 1.02-2.04), 2) health maintenance organization (HMO) membership (OR: 1.84, 95% CI: 1.28-2.67), 3) number of providers (OR: 1.15, 95% CI: 1.01-1.32), 4) satisfaction with access to and quality of care (OR: 1.24, 95% CI: 1.03-1.51), 5) depressive symptoms (OR: 0.92, 95% CI: 0.86-0.98), and 6) gastrointestinal conditions (OR: 1.73, 95% CI: 1.16-2.58) were associated with obtaining a sigmoidoscopy or colonoscopy test. Conclusion: Our findings suggest that the absence of a provider recommendation is the primary barrier preventing underserved older African Americans from obtaining CRC screening. In addition, our data revealed significant association between obtaining CRC screening and some of the predisposing characteristics of participants, satisfaction with access to and quality of care, and physical and mental health. These findings are consistent with this notion that disparities in health care for African Americans can be traced back to four primary factors: patients, healthcare providers, the healthcare system, and society as a whole, and emphasize the need for establishing theory-driven, culturally-sensitive, and cost-effective CRC screening interventions that recognize and address the constraints to cancer screening experienced by this segment of population.
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Affiliation(s)
- Sharon Cobb
- Mervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science (CDU), CA, USA
| | - Tavonia Ekwegh
- Mervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science (CDU), CA, USA
| | - Edward Adinkrah
- Department of Public Health, College of Science & Health, CDU, CA, USA
| | | | - Attallah Dillard
- Mervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science (CDU), CA, USA
| | - Lucy W Kibe
- Physician Assistant Program, College of Science & Health, CDU, CA, USA
| | - Mohsen Bazargan
- Department of Family Medicine, College of Medicine, CDU, CA, USA.,Department of Family Medicine, David Geffen School of Medicine at UCLA, CA, USA
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Menéndez Rodríguez M, García-Morales N, Seoane Pillado T, Garau Ramírez J, Traver Salvador A, Hervás Jiménez Y, Pin Vieito N, Menéndez Rodríguez L, Cubiella J. Perceived barriers and benefits in the participation in faecal occult blood test colorectal cancer screening programme. Gastroenterol Hepatol 2023; 46:185-194. [PMID: 35605825 DOI: 10.1016/j.gastrohep.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/11/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Colorectal cancer is the second cancer-related cause of death in the world. Tumour stage at diagnosis is the principal prognosis factor of survival. However, the participation in the programme is around 50%. The aim of the study was to identify the benefits and barriers perceived by the population when participating in a colorectal cancer screening programme with faecal occult blood test. METHODS We carried out a cases-controls study with 408 participants. We analyzed epidemiological and social variables associated with lifestyle and behavioural factors based in the Health Belief Model. We conducted a descriptive analysis, and identified variables associated to adherence by a logistic regression. RESULTS Variables independently associated with the participation in a colorectal cancer screening programme were age (OR 1.06; 95% CI: 1.01-1.11), having a stable partner (OR 1.96; 95% CI: 1.20-3.18), the level of education (OR 1.59; 95% CI: 1.02-2.47) and two of the barriers to participate in the faecal occult blood test screening: "you don't know how to do one" (OR=0.46; 95% CI: 0.23-0.93) and "it is not that important right now" (OR=0.43; 95% CI: 0.24-0.78). CONCLUSION The existing barriers for screening with faecal occult blood test are the best factor predicting. This is relevant when designing the intervention programmes, as they should focus on reducing perceived barriers to increase the participation in colorectal cancer screening, thereby reducing colorectal cancer mortality.
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Affiliation(s)
- Martín Menéndez Rodríguez
- Primary Health Center Salceda de Caselas, Gerencia de Gestión Integrada de Vigo, SERGAS, Vigo, Spain; Area of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Natalia García-Morales
- Digestive Service, Complexo Hospitalario Universitario de Vigo Sergas, Vigo, Spain; South Galicia Health Research Institute, Vigo, Spain
| | - Teresa Seoane Pillado
- Unit of Preventive Medicine and Public Health, Department of Health Sciences, University of A Coruña-INIBIC, A Coruña, Spain
| | - Jorge Garau Ramírez
- Primary Health Center Chile, Área Hospital Clínic-Malvarrosa, Valencia, Spain
| | | | | | - Noel Pin Vieito
- South Galicia Health Research Institute, Vigo, Spain; Digestive Service, Hospital Universitario de Ourense, Ourense, Spain
| | | | - Joaquín Cubiella
- South Galicia Health Research Institute, Vigo, Spain; Digestive Service, Hospital Universitario de Ourense, Ourense, Spain; Center for Biomedical Research Network for Liver and Digestive Diseases, Ourense, Spain
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Jones M, Subramanian S, Jose R. Cancer screening behaviors and preferences among women in southern India. J Cancer Policy 2023; 35:100401. [PMID: 36632974 DOI: 10.1016/j.jcpo.2023.100401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/26/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION In 2020, India's cancer cases were estimated at 1.32 million (International Agency for Research on Cancer et al., 2020) and were predicted to double by 2040 (Smith and Mallath, 2019). METHODS Starting in March 2019, we recruited 211 adult women in the Trivandrum area of India who had an outpatient office visit within the past 6 months to participate in a structured survey. We identified the study population from the Gokulam Medical College and four peripheral centers. Two trained interviewers collected survey information from the participants, including information on breast, oral, and cervical cancer screening eligibility, history, recommendations, and screening initiation. For analysis, we stratified the sample into two groups by age: a priority screening group, aged 30-65 (n = 132), and an overall group, containing the entire sample, aged 19-85 (n = 211). RESULTS 14.22% of respondents in the overall group and 14.39% in the priority screening group reported receiving a prior cancer screening. Among women who had not received cancer screening, the most common reasons were "no provider recommendation" (42.18%) and not knowing they needed to be screened (40.76%). Most women estimated their risk of developing cancer to be "very low" (64.93%), although the vast majority also believed early detection could improve cancer outcomes (84.83%). Among those who had not been screened for cancer, 61.61% overall and 65.15% in the priority screening group responded that they would undergo all eligible cancer screenings if recommended by their provider. The figure jumps to 79.62% in the overall group and 77.27% in the priority screening group if additional respondent-identified barriers to screening were addressed. CONCLUSION Provider recommendations can be used to mitigate the suboptimal screening uptake and late-stage diagnosis that exacerbate the mortality and economic burden due to cancer in India. POLICY SUMMARY This study finds that provider recommendations can shape the trajectory of outcomes by increasing cancer screening among women.
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Affiliation(s)
- Madeleine Jones
- RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA
| | - Sujha Subramanian
- RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA.
| | - Regi Jose
- Sree Gokulam Medical College, Aalamthara-Bhoothamadakki Rd, Venjarammoodu, Kerala 695607, India
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Pautrat M, Renard C, Riffault V, Ciolfi D, Edeline A, Breton H, Brunault P, Lebeau JP. Cross-analyzing addiction specialist and patient opinions and experiences about addictive disorder screening in primary care to identify interaction-related obstacles: a qualitative study. Subst Abuse Treat Prev Policy 2023; 18:12. [PMID: 36803797 PMCID: PMC9938560 DOI: 10.1186/s13011-023-00522-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/04/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Promptly identifying individuals with addictive disorders reduces mortality and morbidity and improves quality of life. Although screening in primary care with the Screening, Brief Intervention and Referral Treatment strategy has been recommended since 2008, it remains underutilized. This may be due to barriers including lack of time, patient reluctance or perhaps the timing and approach for discussing addiction with their patients. OBJECTIVE This study aims to explore and cross-analyze patient and addiction specialist experiences and opinions about early addictive disorder screening in primary care to identify interaction-related screening obstacles. DESIGN AND PARTICIPANTS Qualitative study with purposive maximum variation sampling among nine addiction specialists and eight individuals with addiction disorders conducted between April 2017 and November 2019 in Val-de-Loire, France. MAIN MEASURES Using a grounded theory approach, verbatim data was collected from face-to-face interviews with addiction specialists and individuals with addiction disorders. These interviews explored their opinions and experiences with addiction screening in primary care. Initially, two independent investigators analyzed the coded verbatim according to the data triangulation principle. Secondly, convergences and divergences between addiction specialist and addict verbatim categories were identified, analyzed, and conceptualized. KEY RESULTS Four main interaction-related obstacles to early addictive disorder screening in primary care were identified and conceptualized: the new concepts of shared self-censorship and the patient's personal red line, issues not addressed during consultations, and opposition between how physicians and patients would like to approach addictive disorder screening. CONCLUSIONS To continue analysis of addictive disorder screening dynamics, further studies to examine the perspectives of all those involved in primary care are required. The information revealed from these studies will provide ideas to help patients and caregivers start discussing addiction and to help implement a collaborative team-based care approach. TRIAL REGISTRATION This study is registered with the Commission Nationale de l'Informatique et des Libertés (CNIL) under No. 2017-093.
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Affiliation(s)
- Maxime Pautrat
- Faculty of Medicine, University of Tours, 10 Boulevard Tonnellé, 37000, Tours, France.
- Department of General Practice, Tours Regional University Hospital, Tours, France.
| | - Caroline Renard
- Department of General Practice, Tours Regional University Hospital, Tours, France
| | - Vincent Riffault
- Department of General Practice, Tours Regional University Hospital, Tours, France
| | - David Ciolfi
- Department of General Practice, Tours Regional University Hospital, Tours, France
| | - Agathe Edeline
- Department of General Practice, Tours Regional University Hospital, Tours, France
| | - Hervé Breton
- Faculty of Medicine, University of Tours, 10 Boulevard Tonnellé, 37000, Tours, France
- Department of General Practice, Tours Regional University Hospital, Tours, France
| | - Paul Brunault
- Department of General Practice, Tours Regional University Hospital, Tours, France
- UMR 1253, iBrain, University of Tours, Inserm, Tours, France
- Qualipsy EE 1901, University of Tours, Tours, France
- Équipe de Liaison et de Soins en Addictologie, CHRU de Tours, Service d'Addictologie Universitaire, Tours, France
| | - Jean Pierre Lebeau
- Faculty of Medicine, University of Tours, 10 Boulevard Tonnellé, 37000, Tours, France
- Department of General Practice, Tours Regional University Hospital, Tours, France
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Bülow Therkildsen S, Larsen PT, Njor S. Subsequent participation in organized FIT based screening following screen-derived colonoscopy - A Danish nationwide cohort study. Prev Med Rep 2023; 32:102125. [PMID: 36816764 PMCID: PMC9929440 DOI: 10.1016/j.pmedr.2023.102125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction In the Danish National Colorectal Cancer (CRC) screening program, participants with screen-detected low-risk adenomas are invited to a new faecal immunochemical test (FIT) screening after two years. However, participation rate in next FIT screening is unknown. We aimed to investigate this subsequent participation rate within the Danish CRC screening program. Methods This nationwide register-based study included participants aged 50-72 years registered with FIT screening in the Danish CRC screening program between January 1, 2016, and June 30, 2017. Participants were included if their index FIT was negative or if it was positive and the subsequent colonoscopy detected low-risk adenomas. Invitees were categorized as subsequent participants if they returned a FIT within 135 days following the invitation to screening. We estimated the relative risk for participation depending on screening outcome, age, and sex. Result 415,107 with a negative result and 5,550 with low-risk adenomas were included. 86.0% (85.9;86.1) of the invitees with a negative result participated in the subsequent screening, while 71.8% (70.6;73.0) of the invitees with low-risk adenomas participated subsequently. The risk of participation in the subsequent screening was significantly lower among all age groups of men and women with low-risk adenomas compared to similar groups with negative results. Conclusion Invitees with low-risk adenomas detected at their initial colonoscopy are less likely to participate in the subsequent screening than invitees with negative results. This association was found in all age groups and for both sexes. Further studies are necessary to assess whether non-attendance is more pronounced in specific subgroups.
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Key Words
- Adenomas
- Adherence
- CI, Confidence Interval
- CRC, Colorectal cancer
- CRN, Civil register number
- Colonoscopy
- Colorectal cancer screening
- Colorectal neoplasm
- DCCG, The Danish Colorectal Cancer register
- DCCSD, Database for Colorectal cancer screening
- DCR, The Danish Cancer Registry
- DNPR, The National Patient Register
- FAP, Familial adenomatous polyposis
- FIT, Fecal Immunochemical Test
- IBD, Inflammatory bowel database
- ICD, International Classification of Diseases
- Mass screening
- Participation
- RR, Relative risk
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Affiliation(s)
- Signe Bülow Therkildsen
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NØ, Denmark,Corresponding authors.
| | - Pernille Thordal Larsen
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NØ, Denmark,Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen Boulevard 82, 8200 Aarhus N, Denmark,Corresponding authors.
| | - Sisse Njor
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Skovlyvej 15, 8930 Randers NØ, Denmark,Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen Boulevard 82, 8200 Aarhus N, Denmark
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De Troeyer K, Silversmit G, Rosskamp M, Truyen I, Van Herck K, Goossens MM, Martens P, Kellen E, Hendrickx E, Rummens E, De Smet F, Broeders M, Verdoodt F, De Schutter H. The effect of the Flemish breast cancer screening program on breast cancer-specific mortality: A case-referent study. Cancer Epidemiol 2023; 82:102320. [PMID: 36608495 DOI: 10.1016/j.canep.2022.102320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/21/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Breast cancer screening programs were introduced in many countries worldwide following randomized controlled trials in the 1980s showing a reduction in breast cancer-specific mortality. However, their effectiveness remains debated and estimates vary. A breast cancer screening program was introduced in 2001 in Flanders, Belgium where high levels of opportunistic screening practices are observed. The effectiveness of this program was estimated by measuring its effect on breast cancer-specific mortality. METHODS We performed a case-referent study to investigate the effect of participation in the Flemish population-based mammography screening program (PMSP) on breast cancer-specific mortality from 2005 to 2017. A multiple logistic regression model assessed the association between breast cancer-specific death and screening program participation status in the four years prior to (pseudo)diagnosis (yes/no), with adjustment for potential confounders (individual socio-economic position and calendar year of diagnosis) and stratified for age. In addition, we performed different sensitivity analyses. RESULTS We identified 1571 cases and randomly selected 6284 referents. After adjustment, women who participated in PMSP had a 51 % lower risk of breast cancer-specific mortality compared to those who did not (adjusted odds ratio [aOR] =0.49, 95 % CI: 0.44-0.55). Sensitivity analyses did not markedly change the estimated associations. Correction for self-selection bias reduced the effect size, but the estimate remained significant. CONCLUSION Our results indicate that in a context of high opportunistic screening rates, participation in breast cancer screening program substantially reduces breast cancer-specific mortality. For policy, these results should be balanced against the potential harms of screening, including overdiagnosis and overtreatment.
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Affiliation(s)
- Katrien De Troeyer
- Belgian Cancer Registry, 1210 Brussels, Belgium; Family Medicine and Population Health, Department of Epidemiology and Social Medicine, University of Antwerp, 2000 Antwerp, Belgium
| | | | | | - Inge Truyen
- Belgian Cancer Registry, 1210 Brussels, Belgium
| | | | - Mathijs Michiel Goossens
- Centre for Cancer Detection, 8000 Bruges, Belgium; Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | | | - Eliane Kellen
- Centre for Cancer Detection, 8000 Bruges, Belgium; University Hospital Leuven, Campus Sint Rafael, 3000 Leuven, Belgium
| | - Erik Hendrickx
- Agency for Care and Health, Flemish Government, 1030 Brussels, Belgium
| | - Elise Rummens
- Christian Health Insurance Fund, 1031 Brussels, Belgium
| | - Frank De Smet
- Christian Health Insurance Fund, 1031 Brussels, Belgium; Department of Public Health and Primary Care, Environment and Health, KU Leuven, 3000 Leuven, Belgium
| | - Mireille Broeders
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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Moon S, Lee EK, Choi H, Park SK, Park YJ. Survival Comparison of Incidentally Found versus Clinically Detected Thyroid Cancers: An Analysis of a Nationwide Cohort Study. Endocrinol Metab (Seoul) 2023; 38:81-92. [PMID: 36891655 PMCID: PMC10008651 DOI: 10.3803/enm.2023.1668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGRUOUND The true benefit of thyroid cancer screening is incompletely understood. This study investigated the impact of ultrasound screening on thyroid cancer outcomes through a comparison with symptomatic thyroid cancer using data from a nationwide cohort study in Korea. METHODS Cox regression analysis was performed to assess the hazard ratios (HRs) for all-cause and thyroid cancer-specific mortality. Considering the possible bias arising from age, sex, year of thyroid cancer registration, and confounding factors for mortality (including smoking/drinking status, diabetes, and hypertension), all analyses were conducted with stabilized inverse probability of treatment weighting (IPTW) according to the route of detection. RESULTS Of 5,796 patients with thyroid cancer, 4,145 were included and 1,651 were excluded due to insufficient data. In comparison with the screening group, the clinical suspicion group was associated with large tumors (17.2±14.6 mm vs. 10.4±7.9 mm), advanced T stage (3-4) (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.09 to 1.41), extrathyroidal extension (OR, 1.16; 95% CI, 1.02 to 1.32), and advanced stage (III-IV) (OR, 1.16; 95% CI, 1.00 to 1.35). In IPTW-adjusted Cox regression analysis, the clinical suspicion group had significantly higher risks of all-cause mortality (HR, 1.43; 95% CI, 1.14 to 1.80) and thyroid cancer-specific mortality (HR, 3.07; 95% CI, 1.77 to 5.29). Mediation analysis showed that the presence of thyroid-specific symptoms was directly associated with a higher risk of cancer-specific mortality. Thyroid-specific symptoms also indirectly affected thyroid cancer-specific mortality, mediated by tumor size and advanced clinicopathologic status. CONCLUSION Our findings provide important evidence for the survival benefit of early detection of thyroid cancer compared to symptomatic thyroid cancer.
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Affiliation(s)
- Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Eun Kyung Lee
- Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea
- Eun Kyung Lee Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea Tel: +82-31-920-1743, Fax: +82-31-920-2798, E-mail:
| | - Hoonsung Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
- Corresponding authors: Young Joo Park Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-4183, Fax: +82-2-764-2199, E-mail:
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Moon S, Song YS, Jung KY, Lee EK, Park YJ. Lower Thyroid Cancer Mortality in Patients Detected by Screening: A Meta-Analysis. Endocrinol Metab (Seoul) 2023; 38:93-103. [PMID: 36891656 PMCID: PMC10008652 DOI: 10.3803/enm.2023.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGRUOUND Thyroid cancer screening has contributed to the skyrocketing prevalence of thyroid cancer. However, the true benefit of thyroid cancer screening is not fully understood. This study aimed to evaluate the impact of screening on the clinical outcomes of thyroid cancer by comparing incidental thyroid cancer (ITC) with non-incidental thyroid cancer (NITC) through a meta-analysis. METHODS PubMed and Embase were searched from inception to September 2022. We estimated and compared the prevalence of high-risk features (aggressive histology of thyroid cancer, extrathyroidal extension, metastasis to regional lymph nodes or distant organs, and advanced tumor-node-metastasis [TNM] stage), thyroid cancer-specific death, and recurrence in the ITC and NITC groups. We also calculated pooled risks and 95% confidence intervals (CIs) of the outcomes derived from these two groups. RESULTS From 1,078 studies screened, 14 were included. In comparison to NITC, the ITC group had a lower incidence of aggressive histology (odds ratio [OR], 0.46; 95% CI, 0.31 to 0.7), smaller tumors (mean difference, -7.9 mm; 95% CI, -10.2 to -5.6), lymph node metastasis (OR, 0.64; 95% CI, 0.48 to 0.86), and distant metastasis (OR, 0.42; 95% CI, 0.23 to 0.77). The risks of recurrence and thyroid cancer-specific mortality were also lower in the ITC group (OR, 0.42; 95% CI, 0.25 to 0.71 and OR, 0.46; 95% CI, 0.28 to 0.74) than in the NITC group. CONCLUSION Our findings provide important evidence of a survival benefit from the early detection of thyroid cancer compared to symptomatic thyroid cancer.
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Affiliation(s)
- Shinje Moon
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Young Shin Song
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Kyong Yeun Jung
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
- Kyong Yeun Jung Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, 68 Hangeulbiseong-ro, Nowon-gu, Seoul 01830, Korea Tel: +82-2-970-8816, Fax: +82-2-970-8865, E-mail:
| | - Eun Kyung Lee
- Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea
- Corresponding authors: Eun Kyung Lee Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea Tel: +82-31-920-1743, Fax: +82-31-920-2798, E-mail:
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
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Zanker J, Sim M, Anderson K, Balogun S, Brennan-Olsen SL, Dent E, Duque G, Girgis CM, Grossmann M, Hayes A, Henwood T, Hirani V, Inderjeeth C, Iuliano S, Keogh J, Lewis JR, Lynch GS, Pasco JA, Phu S, Reijnierse EM, Russell N, Vlietstra L, Visvanathan R, Walker T, Waters DL, Yu S, Maier AB, Daly RM, Scott D. Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. J Cachexia Sarcopenia Muscle 2023; 14:142-156. [PMID: 36349684 PMCID: PMC9891980 DOI: 10.1002/jcsm.13115] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/18/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Sarcopenia is an age-associated skeletal muscle condition characterized by low muscle mass, strength, and physical performance. There is no international consensus on a sarcopenia definition and no contemporaneous clinical and research guidelines specific to Australia and New Zealand. The Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Sarcopenia Diagnosis and Management Task Force aimed to develop consensus guidelines for sarcopenia prevention, assessment, management and research, informed by evidence, consumer opinion, and expert consensus, for use by health professionals and researchers in Australia and New Zealand. METHODS A four-phase modified Delphi process involving topic experts and informed by consumers, was undertaken between July 2020 and August 2021. Phase 1 involved a structured meeting of 29 Task Force members and a systematic literature search from which the Phase 2 online survey was developed (Qualtrics). Topic experts responded to 18 statements, using 11-point Likert scales with agreement threshold set a priori at >80%, and five multiple-choice questions. Statements with moderate agreement (70%-80%) were revised and re-introduced in Phase 3, and statements with low agreement (<70%) were rejected. In Phase 3, topic experts responded to six revised statements and three additional questions, incorporating results from a parallel Consumer Expert Delphi study. Phase 4 involved finalization of consensus statements. RESULTS Topic experts from Australia (n = 62, 92.5%) and New Zealand (n = 5, 7.5%) with a mean ± SD age of 45.7 ± 11.8 years participated in Phase 2; 38 (56.7%) were women, 38 (56.7%) were health professionals and 27 (40.3%) were researchers/academics. In Phase 2, 15 of 18 (83.3%) statements on sarcopenia prevention, screening, assessment, management and future research were accepted with strong agreement. The strongest agreement related to encouraging a healthy lifestyle (100%) and offering tailored resistance training to people with sarcopenia (92.5%). Forty-seven experts participated in Phase 3; 5/6 (83.3%) revised statements on prevention, assessment and management were accepted with strong agreement. A majority of experts (87.9%) preferred the revised European Working Group for Sarcopenia in Older Persons (EWGSOP2) definition. Seventeen statements with strong agreement (>80%) were confirmed by the Task Force in Phase 4. CONCLUSIONS The ANZSSFR Task Force present 17 sarcopenia management and research recommendations for use by health professionals and researchers which includes the recommendation to adopt the EWGSOP2 sarcopenia definition in Australia and New Zealand. This rigorous Delphi process that combined evidence, consumer expert opinion and topic expert consensus can inform similar initiatives in countries/regions lacking consensus on sarcopenia.
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Affiliation(s)
- Jesse Zanker
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Kate Anderson
- Institute for Health Transformation - Determinants of Health, Faculty of Health, Deakin University, Burwood, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Saliu Balogun
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Sharon L Brennan-Olsen
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Elsa Dent
- Torrens University Australia, Adelaide, South Australia, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Christian M Girgis
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Mathis Grossmann
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alan Hayes
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Institute for Health and Sport (IHeS), Victoria University, Footscray, Victoria, Australia
| | - Tim Henwood
- Human Movement and Nutritional Science, University of Queensland, Brisbane, Queensland, Australia
| | - Vasant Hirani
- Nutrition and Dietetics Group, School of Life and Environmental Sciences Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia
| | - Charles Inderjeeth
- North Metropolitan Health Service & University of Western Australia, Perth, Western Australia, Australia
| | - Sandra Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia.,Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia.,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Gordon S Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Julie A Pasco
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,IMPACT-Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Steven Phu
- Department of Medicine - Western Health, The University of Melbourne, St. Albans, Victoria, Australia.,Falls, Balance, and Injury Research Centre, Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
| | - Nicholas Russell
- Department of Medicine - Austin Health, Department of Endocrinology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lara Vlietstra
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Troy Walker
- Institute for Health Transformation, Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - Debra L Waters
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Solomon Yu
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Aged & Extended Care Services, Acute and Urgent Care, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.,Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.,Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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Njor SH, Søborg B, Tranberg M, Rebolj M. Concurrent participation in breast, cervical, and colorectal cancer screening programmes in Denmark: A nationwide registry-based study. Prev Med 2023; 167:107405. [PMID: 36581010 PMCID: PMC10265133 DOI: 10.1016/j.ypmed.2022.107405] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 12/14/2022] [Accepted: 12/24/2022] [Indexed: 12/28/2022]
Abstract
Women in Denmark are invited to breast, cervical, and colorectal cancer screening in their fifties and sixties. We determined the patterns of concurrent participation in the three programmes. Participation in organised cancer screening was determined using the highly complete Danish population and health care registers for all women aged 53-65 years on 31 March 2018 who continuously resided in Denmark since 1 April 2012. Data were linked using unique personal identification numbers. We studied overall and cancer-specific proportions of women undergoing screening for all three, two, one, and none of the cancers. Among all 468,507 women, 406,306 (87%) participated in breast, 345,768 (74%) in cervical, and 316,496 (68%) in colorectal cancer screening. Despite high participation, only 255,698 (55%) women were screened for all three cancers, while 123,469 (26%) were screened for two, 54,538 (12%) for one, and 34,802 (7%) were not screened for any cancer. Cancer-specific patterns were highly heterogeneous across the population but changed little after accounting for women's medical history. A significant proportion of women who are screened for a specific cancer remain unscreened for other cancers. The consistency of these data at the international level requires a reconsideration of invitational practices for organised screening.
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Affiliation(s)
- Sisse Helle Njor
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Bo Søborg
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark
| | - Mette Tranberg
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark
| | - Matejka Rebolj
- Cancer Prevention Group, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
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Volta U, Bai JC, De Giorgio R. The role of serology in the diagnosis of coeliac disease. Gastroenterol Hepatol Bed Bench 2023; 16:118-128. [PMID: 37554756 PMCID: PMC10404833 DOI: 10.22037/ghfbb.v16i2.2713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/17/2023] [Indexed: 08/10/2023]
Abstract
Serology has significantly revolutionized the knowledge of celiac disease (CD), leading to the identification of unsuspected patients in at-risk CD groups, thereby increasing the number of CD diagnoses compared to the pre-screening era. Several markers for CD with a progressive diagnostic accuracy have been identified over the years, but only three of them, i.e. anti-tissue transglutaminase (anti-tTG), anti-endomysial (EmA) and anti-deamidated gliadin antibodies (DGP) are currently assessed in the daily clinical practice. A thorough review of the literature identified 44 original studies published between 1998 to 2022 for a total of 5098 pediatric and adult CD patients (without selective IgA deficiency) and 11930 disease controls. The results highlighted that anti-tTG IgA exhibited a higher sensitivity for CD (93.4%) than EmA IgA (92.8%), DGP IgG (81.8%) and DGP IgA (83.8%). The specificity of EmA IgA (99%) resulted to be higher than those of anti-tTG IgA (95.8%), DGP IgG (96.4%) and DGP IgA (92.1%). In patients with selective IgA deficiency, a condition closely related to CD, serological screening should include one of the three antibodies of IgG class, since anti-tTG, DGP and EmA have a very similar diagnostic accuracy in this clinical setting. According to age, there are two main diagnostic strategies for CD detection. In children, the revised ESPGHAN 2020 guidelines established that CD could be diagnosed in both symptomatic and asymptomatic children by high anti-tTG IgA titers (>10 times the cut-off) and EmA positivity with no need to obtain duodenal biopsy and HLA typing. In adult patients, although high tTG IgA titers (confirmed by EmA IgA positivity) correlate with villous atrophy, an intestinal biopsy is still considered mandatory for confirming CD diagnosis. Currently, a case finding approach in at-risk groups is preferred to mass screening for CD detection.
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Affiliation(s)
- Umberto Volta
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Julio Cesar Bai
- Institute of Investigations, University of Salvador, Gastroenterology Consultant, Hospital Dr. C. Bonorino Udaondo, Buenos Aires, Argentina
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Poelhekken K, Greuter MJW, de Munck L, Siesling S, Brokken FB, de Bock GH. Long-term effects of the interruption of the Dutch breast cancer screening program due to COVID-19: A modelling study. Prev Med 2023; 166:107376. [PMID: 36493865 DOI: 10.1016/j.ypmed.2022.107376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Due to COVID-19, the Dutch breast cancer screening program was interrupted for three months with uncertain long-term effects. The aim of this study was to estimate the long-term impact of this interruption on delay in detection, tumour size of screen-detected breast cancers, and interval cancer rate. After validation, the micro-simulation model SiMRiSc was used to calculate the effects of interruption of the breast cancer screening program for three months and for hypothetical interruptions of six and twelve months. A scenario without interruption was used as reference. Outcomes considered were tumour size of screen-detected breast cancers and interval cancer rate. Women of 55-59 and 60-64 years old at time of interruption were considered. Uncertainties were estimated using a sensitivity analysis. The three-month interruption had no clinically relevant long-term effect on the tumour size of screen-detected breast cancers. A 19% increase in interval cancer rate was found between last screening before and first screening after interruption compared to no interruption. Hypothetical interruptions of six and twelve months resulted in larger increases in interval cancer rate of 38% and 78% between last screening before and first screening after interruption, respectively, and an increase in middle-sized tumours in first screening after interruption of 26% and 47%, respectively. In conclusion, the interruption of the Dutch screening program is not expected to result in a long-term delay in detection or clinically relevant change in tumour size of screen-detected cancers, but only affects the interval cancer rate between last screening before and first screening after interruption.
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Santos EFDS, Monteiro CN, Vale DB, Louvison M, Goldbaum M, Cesar CLG, Barros MBDA. Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil. Clinics (Sao Paulo) 2023; 78:100160. [PMID: 36681068 PMCID: PMC9868844 DOI: 10.1016/j.clinsp.2022.100160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level. METHOD This is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. RESULTS The proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003‒2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003‒2015. CONCLUSIONS The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.
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Affiliation(s)
| | | | | | - Marília Louvison
- Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Song SY, Lee YY, Shin HY, Park B, Suh M, Choi KS, Jun JK. Trends in breast cancer screening rates among Korean women: results from the Korean National Cancer Screening Survey, 2005-2020. Epidemiol Health 2022; 44:e2022111. [PMID: 36470263 PMCID: PMC10396513 DOI: 10.4178/epih.e2022111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/24/2022] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES Since 2002, the Korean government has provided breast cancer screening as part of the National Cancer Screening Program. This study reported trends in the screening rate among Korean women from 2005 to 2020, including organized and opportunistic screening for breast cancer. METHODS Data from the Korean National Cancer Screening Survey, an annual cross-sectional nationwide survey, were collected using a structured questionnaire between 2005 and 2020. The study population included 23,702 women aged 40-74 years with no history of cancer. We estimated the screening rate based on the current recommendation of biennial mammographic screening for breast cancer. In addition, a joinpoint trend analysis was performed for breast cancer screening rates among various subgroups. RESULTS In 2020, the breast cancer screening rate was 63.5%, reflecting an annual increase of 7.72% (95% confidence interval 5.53 to 9.95) between 2005 and 2012, followed by non-significant trends thereafter. In particular, a significant decrease in the breast cancer screening rate was observed in the subgroups aged 50-59 years old, with 12-15 years of education, and living in rural areas. CONCLUSIONS Although there has been substantial improvement in breast cancer screening rates in Korean women, the trend has flattened in recent years. Therefore, continual efforts are required to identify subgroups with unmet needs and solve barriers to the uptake of breast cancer screening.
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Affiliation(s)
- Soo Yeon Song
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yun Yeong Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | | | - Bomi Park
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Kui Son Choi
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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Larsen MB, Hedelund M, Flander L, Andersen B. The impact of pre-notifications and reminders on participation in colorectal cancer screening - A randomised controlled trial. Prev Med 2022; 164:107229. [PMID: 36057390 DOI: 10.1016/j.ypmed.2022.107229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/28/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to test whether participation in colorectal cancer (CRC) screening can be increased by combining the standard invitation procedure with a pre-notification and/or an extra reminder. In a non-blinded randomised controlled trial nested in a population-based CRC screening programme employing the faecal immunochemical test, Group I received a three-staged invitation procedure (pre-notification, invitation and one reminder), Group II received a three-staged invitation procedure (invitation and two reminders) and Group III received a four-staged invitation procedure (pre-notification, invitation and two reminders). The control group received the invitation and one reminder (usual procedure). A total of 59,041 participants were included in the analyses. Overall participation rates increased from 66.9% in the control group to 69.8% in the four-staged invitation procedure corresponding to an increase in overall participation rate of 2.9% (95% CI: 1.8 to 4.0). In the age group 50-59 years, the four-staged invitation procedure increased the participation rate by 4.0% (95% CI: 2.4 to 5.6). An extra reminder increased participation with 2.7% (95% CI: 1.1; 4.2) for males compared to 1.1% (95% CI: -0.3; 2.5) for females. In conclusion, the four-staged invitation procedure was the most effective invitation procedure indicating that multiple invitation procedures are most effective, especially in the youngest age group. If a three-staged invitation procedure is applied, a second reminder should be preferred over a pre-notification. Trial registration The project was registered at ClinicalTrials.gov on 26 February 2020 and patient enrolment began in August 2020. ClinicalTrials.gov Identifier: NCT04292366.
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Affiliation(s)
- Mette Bach Larsen
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Skovlyvej 15, DK-8930 Randers, NO, Denmark.
| | - Mette Hedelund
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Skovlyvej 15, DK-8930 Randers, NO, Denmark
| | - Louisa Flander
- University of Melbourne, School of Population and Global Health, The University of Melbourne, Victoria 3010, Australia
| | - Berit Andersen
- University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Skovlyvej 15, DK-8930 Randers, NO, Denmark; Department of Clinical Medicine, Aarhus University, Incuba Skejby, Building 2, Palle Juul-Jensens Boulevard 82, DK-8200 Aarhus N, Denmark
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75
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Abstract
We analyze the group testing strategy that maximizes the efficiency of the SARS-CoV-2 screening test while ensuring its effectiveness, where the effectiveness of group testing guarantees that negative results from pooled samples can be considered presumptive negative. Two aspects of test efficiency are considered, one concerning the maximization of the welfare throughput and the other concerning the maximization of the identification rate (namely, identifying as many infected individuals as possible). We show that compared with individual testing, group testing leads to a higher probability of false negative results but a lower probability of false positive results. To ensure the test effectiveness, both the group size and the prevalence of SARS-CoV-2 must be below certain respective thresholds. To achieve test efficiency that concerns either the welfare throughput maximization or the identification rate maximization, the optimal group size is jointly determined by the test accuracy parameters, the infection prevalence rate, and the relative importance of identifying infected subjects. We also show that the optimal group size that maximizes the welfare throughput is weakly smaller than the one that maximizes the identification rate.
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Affiliation(s)
- Fengfeng Huang
- School of Management and Economics, University of Electronic Science and Technology of China, China
| | - Pengfei Guo
- College of Business, City University of Hong Kong, Kowloon, Hong Kong
| | - Yulan Wang
- Faculty of Business, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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76
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Sung SY, Choi HH, Kim S, Park BR, Kim YK, Kim HK, Cho YS, Kim SW, Kim SS, Chae HS. Colonoscopy decreases mortality in colorectal cancer patients compared with fecal immunochemical test. J Gastroenterol Hepatol 2022; 37:1991-1997. [PMID: 35738218 DOI: 10.1111/jgh.15924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/03/2022] [Accepted: 06/18/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM Colonoscopy and fecal immunochemical test (FIT) are commonly used screening methods for the detection of colorectal cancer (CRC), but their effects on survival have not been compared. We compared survival outcomes in patients with CRC according to the exposure history to colonoscopy or FIT before diagnosis of CRC. METHODS We performed a nationwide population-based retrospective cohort study using Korean national-insurance claims data. In total, 24 875 patients with CRC diagnosed in 2012 were included. The patients were divided into three groups in terms of examinations performed during the 10 years prior to CRC diagnosis: the colonoscopy group, the FIT group, and the never-screened group. Survival outcomes were compared among the three groups. The colonoscopy group and FIT group were matched using propensity score-matching method. RESULTS The cohort consisted of 9619 patients in the colonoscopy group, 6936 patients in the FIT group, and 8320 patients in the never-screened group. The 5-year overall survival rates were 74.1% in the colonoscopy group, 65.9% in the FIT group, and 59.6% in the never-screened group (P < 0.001). The adjusted hazard ratios for death were 0.56 (95% confidence interval [CI], 0.53-0.59) in the colonoscopy group and 0.78 (95% CI, 0.74-0.82) in the FIT group compared with the never-screened group. In the matched cohort, the adjusted hazard ratios for death was 0.76 (95% CI, 0.72-0.81) in the colonoscopy group compared with the FIT group. CONCLUSION Colonoscopy is a more effective method for reducing mortality in patients with CRC compared with FIT.
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Affiliation(s)
- Soo-Yoon Sung
- Department of Radiation Oncology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Ho Choi
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sukil Kim
- Department of Preventive Medicine and Public Health, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo Ram Park
- Big Data Department, National Health Insurance Service
| | - Young Ki Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyung-Keun Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Seok Cho
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Woo Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hiun-Suk Chae
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Hall H, Ruparel M, Quaife SL, Dickson JL, Horst C, Tisi S, Batty J, Woznitza N, Ahmed A, Burke S, Shaw P, Soo MJ, Taylor M, Navani N, Bhowmik A, Baldwin DR, Duffy SW, Devaraj A, Nair A, Janes SM. The role of computer-assisted radiographer reporting in lung cancer screening programmes. Eur Radiol 2022; 32:6891-6899. [PMID: 35567604 PMCID: PMC9474336 DOI: 10.1007/s00330-022-08824-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/11/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Successful lung cancer screening delivery requires sensitive, timely reporting of low-dose computed tomography (LDCT) scans, placing a demand on radiology resources. Trained non-radiologist readers and computer-assisted detection (CADe) software may offer strategies to optimise the use of radiology resources without loss of sensitivity. This report examines the accuracy of trained reporting radiographers using CADe support to report LDCT scans performed as part of the Lung Screen Uptake Trial (LSUT). METHODS In this observational cohort study, two radiographers independently read all LDCT performed within LSUT and reported on the presence of clinically significant nodules and common incidental findings (IFs), including recommendations for management. Reports were compared against a 'reference standard' (RS) derived from nodules identified by study radiologists without CADe, plus consensus radiologist review of any additional nodules identified by the radiographers. RESULTS A total of 716 scans were included, 158 of which had one or more clinically significant pulmonary nodules as per our RS. Radiographer sensitivity against the RS was 68-73.7%, with specificity of 92.1-92.7%. Sensitivity for detection of proven cancers diagnosed from the baseline scan was 83.3-100%. The spectrum of IFs exceeded what could reasonably be covered in radiographer training. CONCLUSION Our findings highlight the complexity of LDCT reporting requirements, including the limitations of CADe and the breadth of IFs. We are unable to recommend CADe-supported radiographers as a sole reader of LDCT scans, but propose potential avenues for further research including initial triage of abnormal LDCT or reporting of follow-up surveillance scans. KEY POINTS • Successful roll-out of mass screening programmes for lung cancer depends on timely, accurate CT scan reporting, placing a demand on existing radiology resources. • This observational cohort study examines the accuracy of trained radiographers using computer-assisted detection (CADe) software to report lung cancer screening CT scans, as a potential means of supporting reporting workflows in LCS programmes. • CADe-supported radiographers were less sensitive than radiologists at identifying clinically significant pulmonary nodules, but had a low false-positive rate and good sensitivity for detection of confirmed cancers.
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Affiliation(s)
- Helen Hall
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Mamta Ruparel
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Samantha L Quaife
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jennifer L Dickson
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Carolyn Horst
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Sophie Tisi
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - James Batty
- Department of Radiology, University College London Hospital, London, UK
| | | | - Asia Ahmed
- Department of Radiology, University College London Hospital, London, UK
| | - Stephen Burke
- Department of Radiology, Homerton University Hospital, London, UK
| | - Penny Shaw
- Department of Radiology, University College London Hospital, London, UK
| | - May Jan Soo
- Department of Radiology, Homerton University Hospital, London, UK
| | - Magali Taylor
- Department of Radiology, University College London Hospital, London, UK
| | - Neal Navani
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
- Department of Thoracic Medicine, University College London Hospital, London, UK
| | - Angshu Bhowmik
- Department of Thoracic Medicine, Homerton University Hospital, London, UK
| | - David R Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals, Nottingham, UK
| | - Stephen W Duffy
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anand Devaraj
- Department of Radiology, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Arjun Nair
- Department of Radiology, University College London Hospital, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK.
- Department of Thoracic Medicine, University College London Hospital, London, UK.
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Kregting LM, Olthof EMG, Breekveldt ECH, Aitken CA, Heijnsdijk EAM, Toes-Zoutendijk E, de Koning HJ, van Ravesteyn NT. Concurrent participation in breast, cervical, and colorectal cancer screening in the Netherlands. Eur J Cancer 2022; 175:180-186. [PMID: 36126478 DOI: 10.1016/j.ejca.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Many European countries offer organised population-based breast, cervical, and colorectal cancer screening programmes. Around age 55 and 60, Dutch women are invited to all three screening programmes. We examined the extent to which participation concurs and identified factors influencing concurrent participation. MATERIALS AND METHODS Individual level data from breast, cervical, and colorectal cancer screening invitations between 2017 and 2019 were extracted from the Dutch screening registry. The percentages of women participating in all three, two, one, or none of the programmes around age 55 and 60, and before subsequent round invitation were determined. Multivariate ordinal regression analyses were performed to estimate whether population density, socio-economic status (SES) per postal code area, and time between the three invitations (<3, 3-6, >6 months) were associated with concurrent participation. RESULTS Data from 332,484 women were analysed. At age 55, 53.7% participated in all three programmes, 22.1% in two, 11.7% in one, and 12.6% did not participate at all. At age 60, a similar participation pattern was observed. Women living in areas with higher population density were less likely (odds ratios 0.75-0.94) and women in higher SES groups were more likely (odds ratios 1.12-1.60) to participate in more screening programmes, although this positive association was smaller for the highest SES group. No substantial association was found between concurrent participation and timing of invitations. CONCLUSIONS More than half of Dutch women participated in all three screening programmes and around 12% did not participate in any. Concurrent participation was lower in cities and lower SES groups.
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Affiliation(s)
- Lindy M Kregting
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - Ellen M G Olthof
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Emilie C H Breekveldt
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Gastroenterology and Hepatology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Clare A Aitken
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Eveline A M Heijnsdijk
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Esther Toes-Zoutendijk
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Harry J de Koning
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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Kong Y, Zhuo L, Dong D, Zhuo L, Lou P, Cai T, Chen S, Pan J, Gao Y, Lu H, Ma Y, Dong Z, Luo X, Zhao H. Validation of the Asia-Pacific colorectal screening score and its modified versions in predicting colorectal advanced neoplasia in Chinese population. BMC Cancer 2022; 22:961. [PMID: 36071414 PMCID: PMC9450334 DOI: 10.1186/s12885-022-10047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/30/2022] [Indexed: 12/09/2022] Open
Abstract
Background Colorectal cancer is one of the most common cancers in the world. Several studies suggest using the Asia-Pacific colorectal screening (APCS) score and its modified versions to select high-risk populations for early colonoscopy, but external validation remains rare, and which score should be selected for CRC screening in China is unclear. Validation of multiple scores in the same population might help to choose the best performing score. Methods We conducted a cross-sectional study under the framework of Cancer Screening Program in Urban China, data from asymptomatic colorectal cancer screening in Xuzhou was used to validate the APCS score, the colorectal neoplasia predict (CNP) score, the Korean colorectal screening (KCS) score, the Modified APCS score and the 8-point risk score in predicting colorectal advanced neoplasia (CAN). Results 1804 subjects were included in the analysis and 112 CAN (6.21%) was detected. In each score, the detection rate of CAN was higher in the high-risk group than in the non-high-risk group (P < 0.05), and the RR (95%C.I.) ranged 2.20 (1.50–3.22) [8-point risk] to 4.00 (2.41–6.65) [Modified APCS]. The c-statistics (95%C.I.) of the scoring systems ranged from 0.58 (0.53–0.62) [8-point risk] to 0.65 (0.61–0.69) [KCS]. The sensitivity (95%C.I.) of these systems ranged from 31.25 (22.83–40.70) [8-point risk] to 84.82 (76.81–90.90) [Modified APCS], while the specificity (95%C.I.) ranged from 43.50 (41.12–45.90) [Modified APCS] to 83.81 (81.96–85.53) [8-point risk]. Using the APCS scoring system as a comparator, the net reclassification improvement (NRI) of each modified version ranged from − 10.34% (95%C.I.: − 22.63 to 1.95%) [8-point risk] to 4.79% (95%C.I.: − 1.50% to 11.08) [KCS]. The colonoscopy resource load (95%C.I.) ranged from 9 [1–3] [8-point risk] to 11 [3–5] [APCS and Modified APCS]. Conclusions The APCS score and its modified versions have certain ability to predict the risk of advanced neoplasia and reduce the resource load. The modified APCS score and the KCS score seemed the preferable systems to classify high risk subjects based on its high RR, sensitivity and predictive ability in the selected population. Future research could focus on adding risk factors or combining with laboratory test results to improve the predictive power of the scoring system.
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Affiliation(s)
- Yunxin Kong
- Cancer Prevention office, Xuzhou Cancer Hospital, Huancheng Road 131, Gulou District, Xuzhou, 221000, Jiangsu, China
| | - Lin Zhuo
- Endocrinology and metabolism, Tianjin Medical University General Hospital, Tianjin, 300000, China
| | - Dong Dong
- Cancer Prevention office, Xuzhou Cancer Hospital, Huancheng Road 131, Gulou District, Xuzhou, 221000, Jiangsu, China.
| | - Lang Zhuo
- School of Public Health, Xuzhou Medical University, Tong Shan Road 209, Yunlong District, Xuzhou, 221004, Jiangsu, China.
| | - Peian Lou
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, 221004, China
| | - Ting Cai
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004, China
| | - Siting Chen
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004, China
| | - Jianqiang Pan
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004, China
| | - Yihuan Gao
- School of Public Health, Xuzhou Medical University, Tong Shan Road 209, Yunlong District, Xuzhou, 221004, Jiangsu, China
| | - Hang Lu
- School of Management, Xuzhou Medical University, Xuzhou, Jiangsu Province, 221004, China
| | - Yue Ma
- Cancer Prevention office, Xuzhou Cancer Hospital, Huancheng Road 131, Gulou District, Xuzhou, 221000, Jiangsu, China
| | - Zongmei Dong
- Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, 221004, China
| | - Xiaohu Luo
- Toxicology Lab, Xuzhou Cancer Hospital, Xuzhou, 221000, China
| | - Hongying Zhao
- Department of Medical Oncology, Xuzhou Cancer Hospital, Xuzhou, 221000, China
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80
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Luu XQ, Lee K, Jun JK, Suh M, Jung KW, Lim MC, Choi KS. Effect of Pap smears on the long-term survival of cervical cancer patients: a nationwide population-based cohort study in Korea. Epidemiol Health 2022; 44:e2022072. [PMID: 36108672 PMCID: PMC9943631 DOI: 10.4178/epih.e2022072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/07/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the effect of cervical cancer screening by Papanicolaou (Pap) smears on the long-term survival of cervical cancer patients. METHODS We constructed a retrospective cohort of 14,903 women diagnosed with invasive cancer or carcinoma in situ in 2008 and 2009 and followed up until December 31, 2019, by using individual-level data from 3 national databases of the Korean National Cancer Screening Program, the Korean Central Cancer Registry, and death certificates. Cox proportional-hazards regression was used to investigate the effect of cervical cancer screening on mortality. RESULTS In total, 12,987 out of 14,867 patients (87.4%) were alive at the end of the follow-up period (median: 10.5 years). Screened patients had a 38% lower risk of cervical cancer death than never-screened patients (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.54 to 0.70). Screening was associated with 59% and 35% lower risks of death, respectively, in screened patients with localized and regional stages. Furthermore, lower HRs among women who received screening were observed in all age groups, especially women aged 50-59 years (HR, 0.54; 95% CI, 0.42 to 0.69). The lowest HR for cervical cancer death was reported among patients screened within the past 2 years (HR, 0.54; 95% CI, 0.47 to 0.63), and the HRs increased with increasing time intervals. CONCLUSIONS Pap smear screening significantly reduced the risk of cervical cancer-specific death in Korean women across all cancer stages.
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Affiliation(s)
- Xuan Quy Luu
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Kyeongmin Lee
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - kyu-won Jung
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Myong Cheol Lim
- Division of Tumor Immunology, Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea,Correspondence: Kui Son Choi Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea E-mail:
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Samoyeau T, Provost C, Roux A, Legrand L, Dezamis E, Plu-Bureau G, Pallud J, Oppenheim C, Benzakoun J. Meningioma in patients exposed to progestin drugs: results from a real-life screening program. J Neurooncol 2022; 160:127-136. [PMID: 36066786 DOI: 10.1007/s11060-022-04124-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/26/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To report the results of systematic meningioma screening program implemented by French authorities in patients exposed to progestin therapies (cyproterone (CPA), nomegestrol (NA), and chlormadinone (CMA) acetate). METHODS We conducted a prospective monocentric study on patients who, between September 2018 and April 2021, underwent standardized MRI (injection of gadolinium, then a T2 axial FLAIR and a 3D-T1 gradient-echo sequence) for meningioma screening. RESULTS Of the 210 included patients, 15 (7.1%) had at least one meningioma; seven (7/15, 47%) had multiple meningiomas. Meningiomas were more frequent in older patients and after exposure to CPA (13/103, 13%) compared to NA (1/22, 4%) or CMA (1/85, 1%; P = 0.005). After CPA exposure, meningiomas were associated with longer treatment duration (median = 20 vs 7 years, P = 0.001) and higher cumulative dose (median = 91 g vs. 62 g, P = 0.014). Similarly, their multiplicity was associated with higher dose of CPA (median = 244 g vs 61 g, P = 0.027). Most meningiomas were ≤ 1 cm3 (44/58, 76%) and were convexity meningiomas (36/58, 62%). At diagnosis, patients were non-symptomatic, and all were managed conservatively. Among 14 patients with meningioma who stopped progestin exposure, meningioma burden decreased in 11 (79%) cases with no case of progression during MR follow-up. CONCLUSION Systematic MR screening in progestin-exposed patients uncovers small and multiple meningiomas, which can be managed conservatively, decreasing in size after progestin discontinuation. The high rate of meningiomas after CPA exposure reinforces the need for systematic screening. For NA and CMA, further studies are needed to identify patients most likely to benefit from screening.
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Affiliation(s)
- Thomas Samoyeau
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France.,Université Paris Cité, Paris, France.,Service de Neuroradiologie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Corentin Provost
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France.,Université Paris Cité, Paris, France.,Service de Neuroradiologie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Alexandre Roux
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France.,Université Paris Cité, Paris, France.,Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Laurence Legrand
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France.,Université Paris Cité, Paris, France.,Service de Neuroradiologie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Edouard Dezamis
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France.,Université Paris Cité, Paris, France.,Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Geneviève Plu-Bureau
- Université Paris Cité, Paris, France.,Unité de gynécologie endocrinienne, Hôpital Cochin-Port-Royal, 123 Boulevard Port-Royal, Paris, France.,Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM U1153, Paris, France
| | - Johan Pallud
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France.,Université Paris Cité, Paris, France.,Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Catherine Oppenheim
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France.,Université Paris Cité, Paris, France.,Service de Neuroradiologie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Joseph Benzakoun
- Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U 1266, IMA-BRAIN, Paris, France. .,Service de Neuroradiologie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France.
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Hanibuchi M, Saijo A, Mitsuhashi A, Kajimoto T, Kitagawa T, Nishioka Y. The efficacy of mass screening for chronic obstructive pulmonary disease using screening questionnaires in a medical health check-up population. Respir Investig 2022; 60:815-821. [PMID: 36057534 DOI: 10.1016/j.resinv.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease, highlighting the need for efficient screening strategies to identify patients with COPD. However, there is little evidence regarding the efficacy of mass screening for COPD, and no epidemiological studies on COPD have been conducted in the Shikoku region of Japan. METHODS In this cross-sectional study, we originally investigated the efficacy of mass screening for COPD among community residents in the aforementioned region using two COPD screening questionnaires. RESULTS From July 2018 through January 2019, 688 participants were enrolled. COPD was diagnosed using the Global Initiative for the Chronic Obstructive Lung Disease criteria. Twenty-one patients were newly diagnosed with COPD and 19 (90.5%) had early stages COPD. The prevalence of COPD in this study was 3.1%. The COPD Population Screener (COPD-PS) questionnaire and the International Primary Care Airways Guidelines (IPAG) questionnaire had extremely high negative predictive values in discriminating participants with COPD from those without. The scores of both questionnaires were correlated with spirometric tests and with each other. The COPD-PS questionnaire had significantly better specificity and area under the receiver operating characteristic curve value than the IPAG questionnaire. Moreover, only the COPD-PS questionnaire was identified as an independent factor for predicting COPD diagnosis in the multivariate analysis. CONCLUSIONS Mass screening for COPD using screening questionnaires, particularly the COPD-PS questionnaire, might be useful to identify the early stages of COPD in a medical health check-up population.
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Affiliation(s)
- Masaki Hanibuchi
- Department of Respiratory Medicine, Shikoku Central Hospital of the Mutual aid Association of Public School teachers, 2233 Kawanoe-cho, Shikoku-Chuo, 799-0193, Japan; Department of Community Medicine for Respirology, Hematology, and Metabolism, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
| | - Atsuro Saijo
- Department of Respiratory Medicine, Shikoku Central Hospital of the Mutual aid Association of Public School teachers, 2233 Kawanoe-cho, Shikoku-Chuo, 799-0193, Japan
| | - Atsushi Mitsuhashi
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan
| | - Tatsuya Kajimoto
- Department of Respiratory Medicine, Shikoku Central Hospital of the Mutual aid Association of Public School teachers, 2233 Kawanoe-cho, Shikoku-Chuo, 799-0193, Japan
| | - Tetsuya Kitagawa
- Department of Cardiovascular Surgery, Shikoku Central Hospital of the Mutual Aid Association of Public School teachers, 2233 Kawanoe-cho, Shikoku-Chuo, 799-0193, Japan
| | - Yasuhiko Nishioka
- Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan
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Srivastava AK, Gupta A, Chauhan D, Meena RC, Sugadev R, Eslavath MR, Gupta H, Karuna, Singh S, Singh Y, Tiwari RP, Kohli V, Varshney R, Ganju L. Development of robust, indigenous ELISA for detection of IgG antibodies against CoV-2 N and S proteins: mass screening. Appl Microbiol Biotechnol 2022; 106:6225-6238. [PMID: 35976427 PMCID: PMC9382608 DOI: 10.1007/s00253-022-12113-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
Abstract The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has adversely affected humankind and caused millions of deaths globally since January 2020. Robust and quick serological tests such as antibody detection assays for SARS-CoV-2 provide relevant information and aid in the process of vaccine development and diagnostics, as well as in sero-epidemiological monitoring of antibody response to the virus. The receptor-binding domain (RBD) of spike and nucleocapsid protein are specific targets for detecting SARS-CoV-2 antibodies. Here, we present the development of a stable spike (S) and nucleocapsid (N) protein-based ELISA antibody detection test “CoroSuchak,” with 99% sensitivity, 98% specificity, cost-effective, and detection in a minimum time for serodiagnosis and mass screening of the population for antibodies against SARS-CoV-2. Blood samples were analyzed from 374 SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) positive, 772 negative and asymptomatic, and 874 random groups of subjects. We found that the antibody titer was significantly higher (p < 0.0001) in infected and vaccinated group compared to the only vaccinated and only infected group. Using enzyme-linked immunosorbent assay (ELISA), we detected SARS-CoV-2 immunoglobulin G (IgG) antibodies in 118/123 (96%) infected individuals, 570/653 (87%) non-infected but vaccinated individuals, 231/237 (97%) individuals who were both infected and vaccinated, and 499/874 (57%) from randomly selected individuals from the first and second waves of the pandemic. Similarly in the third wave, 14/14 (100%) infected and 16/20 (80%) RT-PCR-negative but symptomatic subjects were detected. Thus, the highly sensitive and specific in-house developed ELISA antibody detection kit “CoroSuchak” is extremely useful to determine the seroprevalence of SARS-CoV-2 antibodies in the coronavirus-exposed population. Key points •Indigenous kit using a combination of spike and nucleocapsid proteins and peptide sequences. •High sensitivity and specificity to detect variants. •Highly sensitive for mass screening. Supplementary Information The online version contains supplementary material available at 10.1007/s00253-022-12113-8.
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Affiliation(s)
- Ashish Kumar Srivastava
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Avinash Gupta
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Deepika Chauhan
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Ramesh Chand Meena
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Ragumani Sugadev
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Malleswara Rao Eslavath
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Harshita Gupta
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Karuna
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Sayar Singh
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Yamini Singh
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - R P Tiwari
- Vanguard Diagnostics Private Limited, Okhla Industrial Area, New Delhi, 110020, India
| | - Veena Kohli
- Vanguard Diagnostics Private Limited, Okhla Industrial Area, New Delhi, 110020, India
| | - Rajeev Varshney
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India
| | - Lilly Ganju
- Defence Institute of Physiology and Allied Sciences (DIPAS), Ministry of Defence, DRDO, Govt. of India, Lucknow Road, Timarpur, Delhi, 110054, India.
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Muniz PR, Simão J, Nunes RB, Campos HLM, Santos NQ, Ninke A, Lemos JT. Temperature thresholds and screening of febrile people by non-contact measurement of the face using infrared thermography - A methodology proposal. Sens Biosensing Res 2022; 37:100513. [PMID: 35958188 PMCID: PMC9356631 DOI: 10.1016/j.sbsr.2022.100513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/28/2022] Open
Abstract
Recent outbreaks of infectious diseases such as Covid-19 that have fever as one of the symptoms drive the search for systems to track people with fever quickly and non-contact, also known as sanitary barriers. The use of non-contact infrared-based instruments, especially the infrared thermal imager, has widely spread. However, the screening process has presented low performance. This article addresses the choice of regions of interest on the human face for the analysis of the individual's fever, deals with the temperature thresholds used for this analysis, as well as the way to issue the recommendation to screen the person or not. The data collection and statistical analysis of temperatures of 198 volunteers allowed us to study and define the most appropriate face regions as targets for these barriers, as well as the temperature thresholds to be used for screening for each of these regions. Besides, the paper presents a probabilistic method based on the metrological quality of the sanitary barrier to the emission of recommendation for screening potentially febrile people. The developed method was tested in feverish and non-febrile volunteers, showing complete assertiveness in the tested cases.
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Affiliation(s)
- Pablo Rodrigues Muniz
- Post Graduate Program in Sustainable Technologies, Campus Vitória, Federal Institute of Espírito Santo, 1729 Vitória Ave., Vitória 29040-780, ES, Brazil
| | - Josemar Simão
- Electrotechnical Coordination, Campus Vitória, Federal Institute of Espírito Santo, 1729 Vitória Ave., Vitória 29040-780, ES, Brazil
| | - Reginaldo Barbosa Nunes
- Post Graduate Program in Sustainable Technologies, Campus Vitória, Federal Institute of Espírito Santo, 1729 Vitória Ave., Vitória 29040-780, ES, Brazil
| | - Hércules Lázaro Morais Campos
- Institute of Health and Biotechnology, Federal University of Amazonas, 305 Estrada do Aeroporto, Coari 69460-000, AM, Brazil
| | - Natália Queirós Santos
- Espírito Santo Research and Innovation Support Foundation, 1080 Fernando Ferrari Ave., Vitória 29066-380, ES, Brazil
| | - Andriele Ninke
- Electrical Engineerging Undergraduate Coordination, Campus Vitória, Federal Institute of Espírito Santo, 1729 Vitória Ave., Vitória 29040-780, ES, Brazil
| | - João Thomaz Lemos
- Post Graduate Program in Sustainable Technologies, Campus Vitória, Federal Institute of Espírito Santo, 1729 Vitória Ave., Vitória 29040-780, ES, Brazil
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Innes S, Goncalves G, Leboeuf-Yde C. Who are the chiropractic students favouring a limitless scope of practice? Exploring the relationship with personality, magical thinking, and academic achievement. Chiropr Man Therap 2022; 30:30. [PMID: 35879769 PMCID: PMC9310675 DOI: 10.1186/s12998-022-00440-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/28/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Some chiropractors seem to have an inflated belief in the powers of spinal manipulation (SMT), for example aiming at preventing future spinal degeneration and health problems, activities that are without supporting evidence. Non-evidenced health beliefs have been shown to be associated with a tendency toward magical thinking. Holding such beliefs about SMT is associated with a limitless scope of practice (LLSoP). Recent studies have shown that “chiropractic conservatism” (ChiroCon) is also associated with such approaches. We wanted to understand ChiroCon and these attitudes toward SMT by exploring three different factors: intolerance to uncertainty, academic achievement, and tendency toward magical thinking and how they relate to ChiroCon and LLSoP.
Method A cross-sectional survey of 243 chiropractic students from an Australian chiropractic program was conducted in May 2020. Students answered a questionnaire involving a patient case-scenario for LLSoP, levels of ChiroCon, validated questionnaires on (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. LLSoP was defined as wanting to treat with SMT a 5-year-old asymptomatic child for future (i) Musculoskeletal (MSK) problems and/or (ii) Non-musculoskeletal diseases. Logistic regression models were used to confirm if there was an association between ChiroCon and LLSoP and to explore associations between LLSoP and (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. We repeated the same analyses using ChiroCon as the outcome variable. Results We confirmed that chiropractic students in the more extreme ChiroCon group were more likely to want to prevent future spinal disorders in an asymptomatic 5-year-old child as compared to those with lower levels (OR = 3.9, (95%CI 1.97–7.72). This was also the case for the prevention of future diseases in the same child (OR = 6.9, (95%CI 3.11–15.06). Of the three predictor variables, magical belief was positively associated with both ChiroCon and LLSoP. Conclusion Not surprisingly, ChiroCon is closely related to LLSoP and both were linked to magical thinking. Therefore, the questionnaire ‘Magical Health Beliefs’ could be a useful instrument to screen future chiropractic students to prevent a mismatch between student and institution. Depending on the outlook of the school, some schools would welcome these students, whereas other institutions would want to avoid them in their education program. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00440-6.
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Affiliation(s)
- Stanley Innes
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia. .,Faculty of Allied Health & Wellbeing, University of Central Lancashire (UClan), Preston, UK.
| | - Guillaume Goncalves
- Institut Franco Européen de Chiropraxie, 24 Boulevard Paul Vaillant Couturier, 94200, Ivry-Sur-Seine, France.,Faculty of Allied Health & Wellbeing, University of Central Lancashire (UClan), Preston, UK
| | - Charlotte Leboeuf-Yde
- Department of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 5000, Odense, Denmark
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Huo B, Manos D, Xu Z, Matheson K, Chun S, Fris J, Wallace AMR, French DG. Screening Criteria Evaluation for Expansion in Pulmonary Neoplasias (SCREEN). Semin Thorac Cardiovasc Surg 2022; 35:769-780. [PMID: 35878739 DOI: 10.1053/j.semtcvs.2022.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 06/06/2022] [Indexed: 12/14/2022]
Abstract
The SCREEN study investigated screening eligibility and survival outcomes between heavy smokers and light-or-never-smokers with lung cancer to determine whether expanded risk factor analysis is needed to refine screening criteria. SCREEN is a retrospective study of 917 lung cancer patients diagnosed between 2005 and 2018 in Nova Scotia, Canada. Screening eligibility was determined using the National Lung Screening Trial (NSLT) criteria. Mortality risk between heavy smokers and light-or-never-smokers was compared using proportional-hazards models. The median follow-up was 2.9 years. The cohort was comprised of 179 (46.1%) female heavy smokers and 306 (57.8%) female light-or-never-smokers. Light-or-never-smokers were more likely to have a diagnosis of adenocarcinoma [n=378 (71.6%)] compared to heavy smokers [n=234 (60.5%); P< 0.001]. Heavy smokers were more frequently diagnosed with squamous cell carcinoma [n=111 (28.7%)] compared to light-or-never-smokers, [n=100 (18.9%); P< 0.001]. Overall, 36.9% (338) of patients met NLST screening criteria. There was no difference in 5-year survival between light-or-never-smokers and heavy smokers [55.2% (338) vs 58.5% (529); P = 0.408; HR 1.06, 95% CI 0.80-1.40; P = 0.704]. Multivariate analysis showed that males had an increased mortality risk [HR 2.00 (95% CI 1.57-2.54); P< 0.001]. Half of lung cancer patients were missed with the conventional screening criteria. There were more curable, stage 1 tumors among light-or-never-smokers. Smoking status and age alone may be insufficient predictors of lung cancer risk and prognosis. Expanded risk factor analysis is needed to refine lung cancer screening criteria.
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Affiliation(s)
- Bright Huo
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Daria Manos
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Zhaolin Xu
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Kara Matheson
- Research Methods Unit, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Samuel Chun
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - John Fris
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Alison M R Wallace
- Department of Pathology, Dalhousie University, Halifax, NS, Canada; Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Daniel G French
- Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
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87
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Ding L, Poelhekken K, Greuter MJW, Truyen I, De Schutter H, Goossens M, Houssami N, Van Hal G, de Bock GH. Overdiagnosis of invasive breast cancer in population-based breast cancer screening: A short- and long-term perspective. Eur J Cancer 2022; 173:1-9. [PMID: 35839596 DOI: 10.1016/j.ejca.2022.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/30/2022] [Accepted: 06/12/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Overdiagnosis of invasive breast cancer (BC) is a contentious issue. OBJECTIVE The aim of this paper is to estimate the overdiagnosis rate of invasive BC in an organised BC screening program and to evaluate the impact of age and follow-up time. METHODS The micro-simulation model SiMRiSc was calibrated and validated for BC screening in Flanders, where women are screened biennially from age 50 to 69. Overdiagnosis rate was defined as the number of invasive BC that would not have been diagnosed in the absence of screening per 100,000 screened women during the screening period plus follow-up time (which was set at 5 years and varied from 2 to 15 years). Overdiagnosis rate was calculated overall and stratified by age. RESULTS The overall overdiagnosis rate for women screened biennially from 50 to 69 was 20.1 (95%CI: 16.9-23.2) per 100,000 women screened at 5-year follow-up from stopping screening. Overdiagnosis at 5-year follow-up time was 12.9 (95%CI: 4.6-21.1) and 74.2 (95%CI: 50.9-97.5) per 100,000 women screened for women who started screening at age 50 and 68, respectively. At 2- and 15-year follow-up time, overdiagnosis rate was 98.5 (95%CI: 75.8-121.3) and 13.4 (95%CI: 4.9-21.9), respectively, for women starting at age 50, and 297.0 (95%CI: 264.5-329.4) and 34.2 (95%CI: 17.5-50.8), respectively, for those starting at age 68. CONCLUSIONS Sufficient follow-up time (≥10 years) after screening stops is key to obtaining unbiased estimates of overdiagnosis. Overdiagnosis of invasive BC is a larger problem in older compared to younger women.
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88
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Luu XQ, Lee K, Jun JK, Suh M, Jung KW, Choi KS. Effect of gastric cancer screening on long-term survival of gastric cancer patients: results of Korean national cancer screening program. J Gastroenterol 2022; 57:464-475. [PMID: 35568752 DOI: 10.1007/s00535-022-01878-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Gastric cancer (GC) is the most common cancer type in Korea. Korean National Cancer Screening Program (KNCSP) offer either upper gastrointestinal series (UGIS) or upper endoscopy biennially for adults aged ≥ 40. This study aimed to investigate the effect of cancer screening program on the long-term survival among GC patients. METHODS A nationwide population-based cohort was constructed based on three national databases. Overall, 46,701 GC patients diagnosed in 2008 and 2009 were included in our final analysis, and they were followed-up until the end of 2019. Survival curves were estimated using the Kaplan-Meier analysis with the log-rank test. Cox proportional-hazards regression analysis was used to report the hazard ratios (HRs) with 95% confidence intervals. RESULTS A total of 18,614/46,701 (39.9%) patients died during the median follow-up time of 10.5 years. The survival rate was higher among screened patients (65.8%) than never-screened patients (49.1%). Screened patients had 53% (HR, 0.47; 95% CI 0.45-0.48) lower risk of death from GC. The HRs of GC-specific mortality was lower in upper endoscopy group (HR = 0.36; 95% CI = 0.34-0.37) compared with UGIS (HR = 0.69; 95% CI = 0.67-0.73). Screened patients within 2 years prior to cancer diagnosis had a 35% reduction in risk of GC death. The figure decline to approximately 19% among patients with interval time since last screening of > 3 years. CONCLUSIONS Our findings emphasized the positive effects of GC screening on long-term GC patient survival. Also, patients screened by upper endoscopy or within 2 years before diagnosis had the best survival outcomes.
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Affiliation(s)
- Xuan Quy Luu
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, Korea
| | - Kyeongmin Lee
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, Korea
| | - Kyu-Won Jung
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, Korea
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, 10408, Korea.
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89
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Jang HN, Moon MK, Koo BK. Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study. Diabetes Metab J 2022; 46:620-629. [PMID: 35193173 PMCID: PMC9353559 DOI: 10.4093/dmj.2021.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 09/29/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We investigated the prevalence of diabetic retinopathy (DR) in patients with undiagnosed diabetes through a nationwide survey, compared to those with known diabetes. METHODS Among the participants of the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2017 to 2018, individuals aged ≥40 years with diabetes and fundus exam results were enrolled. Sampling weights were applied to represent the entire Korean population. Newly detected diabetes patients through KNHANES were classified under "undiagnosed diabetes." RESULTS Among a total of 9,108 participants aged ≥40 years, 951 were selected for analysis. Of them, 31.3% (standard error, ±2.0%) were classified under "undiagnosed diabetes." The prevalence of DR in patients with known and undiagnosed diabetes was 24.5%±2.0% and 10.7%±2.2%, respectively (P<0.001). The DR prevalence increased with rising glycosylated hemoglobin (HbA1c) levels in patients with known and undiagnosed diabetes (P for trend=0.001 in both). Among those with undiagnosed diabetes, the prevalence of DR was 6.9%±2.1%, 8.0%±3.4%, 5.6%±5.7%, 16.7%±9.4%, and 42.6%±14.8% for HbA1c levels of <7.0%, 7.0%-7.9%, 8.0%-8.9%, 9.0%-9.9%, and ≥10.0% respectively. There was no difference in the prevalence of hypertension, dyslipidemia, hypertriglyceridemia, or obesity according to the presence or absence of DR. CONCLUSION About one-third of patients with diabetes were unaware of their diabetes, and 10% of them have already developed DR. Considering increasing the prevalence of DR according to HbA1c level was found in patients with undiagnosed diabetes like those with known diabetes, screening and early detection of diabetes and DR are important.
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Affiliation(s)
- Han Na Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
- Corresponding author: Bo Kyung Koo https://orcid.org/0000-0002-6489-2656 Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea E-mail:
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90
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Ambagtsheer RC, Casey MG, Lawless M, Archibald MM, Yu S, Kitson A, Beilby JJ. Practitioner perceptions of the feasibility of common frailty screening instruments within general practice settings: a mixed methods study. BMC Prim Care 2022; 23:160. [PMID: 35754037 PMCID: PMC9235102 DOI: 10.1186/s12875-022-01778-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Frailty is a highly prevalent clinical syndrome increasing older people's vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions. Consequently, the purpose of this study was to explore the attitudes and perceptions of a convenience and volunteer sample of Australian general practitioners (GPs) and practice nurses (PNs) towards common frailty screening instruments. METHODS The feasibility of several frailty screening instruments (PRISMA-7 [P7], Edmonton Frail Scale [EFS], FRAIL Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC] and Timed Up and Go [TUG]) to 43 Australian GPs and PNs was assessed. The study adopted a concurrent embedded mixed-methods design incorporating quantitative (ranking exercise) and qualitative (content analysis) data collection integrated during the analysis phase. RESULTS Practitioners assessed multi-dimensional instruments (EFS, GFI, KC) as having relatively higher clinical utility, better integration into existing assessment processes and stronger links to intervention over uni-dimensional (GST, TUG) and simple (FQ, P7) instruments. CONCLUSIONS While existing frailty screening instruments show promise as an initial step in supporting better care for older people, all the included instruments were associated with perceived advantages and disadvantages. Ultimately, clinicians will need to weigh several factors in their selection of the optimal screening instrument. Further translational research, with a focus on contextual fit, is needed to support clinical decision-making on the selection of instruments for frailty screening.
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Affiliation(s)
- Rachel C Ambagtsheer
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, GPO Box 2025, Adelaide, SA, 5000, Australia.
- Torrens University Australia, Adelaide, Australia.
| | - Mavourneen G Casey
- Institute of Health and Wellbeing, Federation University Australia, Ballarat, Victoria, Australia
| | - Michael Lawless
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, GPO Box 2025, Adelaide, SA, 5000, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Mandy M Archibald
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, GPO Box 2025, Adelaide, SA, 5000, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Solomon Yu
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, GPO Box 2025, Adelaide, SA, 5000, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Alison Kitson
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, GPO Box 2025, Adelaide, SA, 5000, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Justin J Beilby
- National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, GPO Box 2025, Adelaide, SA, 5000, Australia
- Torrens University Australia, Adelaide, Australia
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91
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Park H, Seo SH, Park JH, Yoo SH, Keam B, Shin A. The impact of COVID-19 on screening for colorectal, gastric, breast, and cervical cancer in Korea. Epidemiol Health 2022; 44:e2022053. [PMID: 35760396 PMCID: PMC9754922 DOI: 10.4178/epih.e2022053] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/21/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has affected the utilization of healthcare services, including participation in cancer screening programs. We compared cancer screening participation rates for colorectal, gastric, breast, and cervical cancers among participants in the National Cancer Screening Program (NCSP) in 2019 and 2020 to address the potential distraction effect of COVID-19 on cancer screening. METHODS Data from the NCSP for 4 cancer types (stomach, colorectal, breast, and cervical) in 2019 and 2020 were used to calculate cancer screening participation rates by calendar month, gender, age group, and geographical region. Monthly participation rates were analyzed per 1,000 eligible individuals. RESULTS The screening participation rate decreased in 2020 compared to 2019 for all 4 cancers: colorectal (40.5 vs. 35.3%), gastric (61.9 vs. 54.6%), breast (63.8 vs. 55.8%), and cervical (57.8 vs. 52.2%) cancers. Following 2 major COVID-19 waves in March and December 2020, the participation rates in the 4 types of cancer screening dropped compared with those in 2019. The highest decline was observed in the elderly population aged 80 years and older (percentage change: -21% for colorectal cancer; -20% for gastric cancer; -26% for breast cancer; -20% for cervical cancer). CONCLUSIONS After the 2 major COVID-19 waves, the screening participation rate for 4 types of cancer declined compared with 2019. Further studies are needed to identify the indirect effects of the COVID-19 pandemic on cancer patients, such as delayed diagnoses of cancer or excess cancer deaths.
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Affiliation(s)
- Hyeree Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea,Cancer Research Institute, Seoul National University, Seoul, Korea,Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hee Seo
- Cancer Research Institute, Seoul National University, Seoul, Korea,Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea,Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| | - Jong Heon Park
- Big Data Steering Department, National Health Insurance Service, Wonju, Korea
| | - Shin Hye Yoo
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea
| | - Bhumsuk Keam
- Cancer Research Institute, Seoul National University, Seoul, Korea,Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea,Cancer Research Institute, Seoul National University, Seoul, Korea,Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul, Korea,Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea,Correspondence: Aesun Shin Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea E-mail:
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92
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Larsen M, Aglen CF, Hoff SR, Lund-Hanssen H, Hofvind S. Possible strategies for use of artificial intelligence in screen-reading of mammograms, based on retrospective data from 122,969 screening examinations. Eur Radiol 2022; 32:8238-8246. [PMID: 35704111 DOI: 10.1007/s00330-022-08909-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 12/09/2022]
Abstract
OBJECTIVES Artificial intelligence (AI) has shown promising results when used on retrospective data from mammographic screening. However, few studies have explored the possible consequences of different strategies for combining AI and radiologists in screen-reading. METHODS A total of 122,969 digital screening examinations performed between 2009 and 2018 in BreastScreen Norway were retrospectively processed by an AI system, which scored the examinations from 1 to 10; 1 indicated low suspicion of malignancy and 10 high suspicion. Results were merged with information about screening outcome and used to explore consensus, recall, and cancer detection for 11 different scenarios of combining AI and radiologists. RESULTS Recall was 3.2%, screen-detected cancer 0.61% and interval cancer 0.17% after independent double reading and served as reference values. In a scenario where examinations with AI scores 1-5 were considered negative and 6-10 resulted in standard independent double reading, the estimated recall was 2.6% and screen-detected cancer 0.60%. When scores 1-9 were considered negative and score 10 double read, recall was 1.2% and screen-detected cancer 0.53%. In these two scenarios, potential rates of screen-detected cancer could be up to 0.63% and 0.56%, if the interval cancers selected for consensus were detected at screening. In the former scenario, screen-reading volume would be reduced by 50%, while the latter would reduce the volume by 90%. CONCLUSION Several theoretical scenarios with AI and radiologists have the potential to reduce the volume in screen-reading without affecting cancer detection substantially. Possible influence on recall and interval cancers must be evaluated in prospective studies. KEY POINTS • Different scenarios using artificial intelligence in combination with radiologists could reduce the screen-reading volume by 50% and result in a rate of screen-detected cancer ranging from 0.59% to 0.60%, compared to 0.61% after standard independent double reading • The use of artificial intelligence in combination with radiologists has the potential to identify negative screening examinations with high precision in mammographic screening and to reduce the rate of interval cancer.
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Affiliation(s)
- Marthe Larsen
- Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Camilla F Aglen
- Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Solveig R Hoff
- Department of Radiology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Håkon Lund-Hanssen
- Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Solveig Hofvind
- Section for Breast Cancer Screening, Cancer Registry of Norway, Oslo, Norway. .,Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
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93
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Yang S, Li P, Yu L, Liu N, Wang J, Guo P, Zhang X, Zhang W. Breast Cancer Awareness Based on Health Information Literacy and Influential Factors among Female Nursing Students in China. J Cancer Educ 2022; 37:546-554. [PMID: 32876864 DOI: 10.1007/s13187-020-01844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This investigation aimed to study breast cancer awareness based on health information literacy and influential factors of breast cancer awareness among female nursing students in Changchun city in China. A four-part self-report questionnaire including the participants' general demographic characteristics, the participants' specialized characteristics concerning breast cancer screening, the Chinese version of the Breast Cancer Awareness Measurement (C-BCAM), and the Chinese version of the Health Information Literacy Self-rating Scale (HILSS) was designed to investigate breast cancer awareness and health information literacy and influential factors of breast cancer awareness among 205 female nursing students in Year 1-Year 3 using convenience sampling. The data were analyzed with SPSS 26.0 using descriptive statistics, nonparametric tests, and multiple regression analysis. The nursing students had an average level of HIL (median = 101.00, (93.00, 107.00)) and a good level of breast cancer awareness (median = 82.00, (76.00, 88.00)). A significant positive correlation was found between the HILSS and total C-BCAM score (r = 0.439, P < 0.01). Multivariate logistic regression analysis demonstrated that grades (P < 0.001), training in BSE (P = 0.025), and intention of undergoing breast cancer screening (P = 0.028) were three predictive factors for breast cancer awareness among female nursing students. The female nursing students' HIL was at an average level, and breast cancer awareness was at a good level. Health information literacy and breast cancer awareness among female nursing students in Changchun were significantly positively correlation, as demonstrated by this survey. Therefore, nursing education has the responsibility to improve female nursing students' awareness of breast cancer at different grades and to cultivate health information literacy. More training in BSE is needed. Greater efforts may be needed to develop targeted nursing education to strengthen female nursing students' awareness of breast cancer and HIL.
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Affiliation(s)
- Shu Yang
- School of Nursing, Jilin University, Changchun, Jilin Province, 130021, China
| | - Ping Li
- The Second Hospital of Jilin University, Changchun, Jilin Province, 130041, China
| | - Lin Yu
- School of Nursing, Jilin University, Changchun, Jilin Province, 130021, China
| | - Na Liu
- School of Nursing, Jilin University, Changchun, Jilin Province, 130021, China
| | - Jie Wang
- School of Nursing, Jilin University, Changchun, Jilin Province, 130021, China
| | - Pingping Guo
- School of Nursing, Jilin University, Changchun, Jilin Province, 130021, China
| | - Xuehui Zhang
- School of Nursing, Jilin University, Changchun, Jilin Province, 130021, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, Jilin Province, 130021, China.
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94
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Park SH. Which of the Cornell Scale for Depression in Dementia or the Geriatric Depression Scale is more useful to screen for depression in older adults? Asian J Psychiatr 2022; 72:103147. [PMID: 35533539 DOI: 10.1016/j.ajp.2022.103147] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression in older adults is a major disorder that can be triggering, exacerbating, or co-occurring with dementia symptoms. AIM This study compared the diagnostic accuracy of the Cornell Scale for Depression in Dementia (CSDD) and the Geriatric Depression Scale (GDS), a depression screening tool developed for older adults. METHODS Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO databases using the following keywords: dementia, depression, and CSDD. RESULTS The pooled sensitivity of the CSDD and the GDS was 0.89 and 0.82, the pooled specificity was 0.88 and 0.85, and the summary receiver operating characteristic (SROC) curve was 0.94 and 0.91, respectively. In the subgroup analysis, the CSDD had the highest accuracy in the pooled sensitivity of 0.91, the pooled specificity of 0.87, and the sROC curve of 0.95 in the dementia group, and the GDS was the best in the non-dementia group at 0.88, 0.82, and 0.93, respectively. CONCLUSIONS The CSDD showed high diagnostic accuracy in older adults with dementia, and the GDS in older adults without dementia.
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Affiliation(s)
- Seong-Hi Park
- School of Nursing, Soonchunhyang University, 22 Soonchunhyang-ro, Sinchang-myen, Asan-si, Chungcheongnam-do 31538, Republic of Korea.
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95
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Trinh TTK, Lee YY, Suh M, Jun JK, Choi KS. Changes in cancer screening before and during COVID-19: findings from the Korean National Cancer Screening Survey 2019 and 2020. Epidemiol Health 2022; 44:e2022051. [PMID: 35638224 PMCID: PMC9754916 DOI: 10.4178/epih.e2022051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/30/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has negatively affected every aspect of medical care. However, information regarding the impact of the pandemic on cancer screening is lacking. This study aimed to explore cancer screening changes by geographic region before and during the pandemic in Korea. METHODS Korean National Cancer Screening Survey data for 2019 and 2020 were used. Changes in the screening rate before and during the COVID-19 pandemic were calculated by subtracting the rate in 2020 from the rate in 2019. Multivariate logistic regression analyses examined the differences in screening rates at the national and 16 provincial levels before and after the COVID-19 outbreak. RESULTS The 1-year screening rates for the four types of cancer decreased during the pandemic (stomach cancer: -5.1, colorectal cancer: -3.8, breast cancer: -2.5, cervical cancer: -1.5%p). In metropolitan areas, the odds of undergoing screening tests during the pandemic were significantly lower than before the pandemic for stomach (adjusted odds ratio [aOR], 0.66; 95% confidence interval [CI], 0.56 to 0.76), colorectal (aOR, 0.63; 95% CI, 0.50 to 0.79), and breast cancers (aOR, 0.75; 95% CI, 0.60 to 0.94). Furthermore, the likelihood of undergoing stomach cancer screening during the pandemic was significantly lower than before the pandemic in non-metropolitan urban areas (aOR, 0.81; 95% CI, 0.70 to 0.94), while it was higher in rural areas (aOR, 1.54; 95% CI, 1.10 to 2.16). CONCLUSIONS Since the COVID-19 pandemic, the cancer screening rate has decreased significantly, especially in large cities. Public health efforts are required to improve cancer screening rates.
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Affiliation(s)
- Thao Thi Kim Trinh
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yun Yeong Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea,National Cancer Control Institute, National Cancer Center, Goyang, Korea,Correspondence: Kui Son Choi Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea E-mail:
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Park MC, Yoon JH, Park S, Kim SC, Park S, Moon KH, Cheon SH, Kwon T. Effects of metabolic syndrome on renal stone progression. World J Urol 2022; 40:1845-1851. [PMID: 35622116 DOI: 10.1007/s00345-022-04047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE Studies on howmetabolic syndrome affects renal stone progression in untreated asymptomatic patients are lacking. Therefore, we investigated the effect of metabolic syndrome on changes in renal stone size. MATERIALS AND METHODS We retrospectively analyzed 820 patients with renal stones incidentally detected on CT during regular health examinations and who underwent follow-up CT evaluations for > 1 year. The patients were divided into two groups according to the presence of metabolic syndrome. Changes in stone size during the follow-up were assessed, and differences were compared according to various factors. Predictors of stone size change on CT were assessed using linear regression analysis. RESULTS Overall, 820 asymptomatic patients without a history of stone treatments and with a mean follow-up of 52.4 months were included. Of these, 104 (12.7%) had metabolic syndrome and 335 (40.9%) showed stone size increase during the follow-up. The stone size at diagnosis was not significantly different between patients with and without metabolic syndrome (225.3 ± 332.6 vs. 183.9 ± 310.2 mm3, p = 0.159); however, a significant difference was observed in the change in stone size at follow-up (148.5 ± 352.0 vs. 81.5 ± 222.4 mm3, p = 0.001). Multivariable analysis showed that age (β = - 0.11; - 5.92 to -0.69; p = 0.013), fasting glucose level ≥ 100 mg/dl (β = 0.11; 9.78-99.73; p = 0.017), and metabolic syndrome (β = 0.10; 9.78-99.73; p = 0.017) were factors predictive of stone size changes. CONCLUSION Metabolic syndrome, fasting glucose level ≥ 100 mg/dl and young age are positively related to renal stone size changes. Therefore, periodic follow-up and metabolic syndrome management are required in asymptomatic patients with renal stones, especially in young age.
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Affiliation(s)
- Myeong Chan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Ji Hyung Yoon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Sejun Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Seong Cheol Kim
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Sungchan Park
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Kyung Hyun Moon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Sang Hyeon Cheon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea
| | - Taekmin Kwon
- Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunwando-ro, Dong-gu, Ulsan, 44033, Korea.
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97
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Jing X, Wielema M, Cornelissen LJ, van Gent M, Iwema WM, Zheng S, Sijens PE, Oudkerk M, Dorrius MD, van Ooijen PMA. Using deep learning to safely exclude lesions with only ultrafast breast MRI to shorten acquisition and reading time. Eur Radiol 2022; 32:8706-8715. [PMID: 35614363 DOI: 10.1007/s00330-022-08863-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the feasibility of automatically identifying normal scans in ultrafast breast MRI with artificial intelligence (AI) to increase efficiency and reduce workload. METHODS In this retrospective analysis, 837 breast MRI examinations performed on 438 women from April 2016 to October 2019 were included. The left and right breasts in each examination were labelled normal (without suspicious lesions) or abnormal (with suspicious lesions) based on final interpretation. Maximum intensity projection (MIP) images of each breast were then used to train a deep learning model. A high sensitivity threshold was calculated based on the detection trade - off (DET) curve on the validation set. The performance of the model was evaluated by receiver operating characteristic analysis of the independent test set. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with the high sensitivity threshold were calculated. RESULTS The independent test set consisted of 178 examinations of 149 patients (mean age, 44 years ± 14 [standard deviation]). The trained model achieved an AUC of 0.81 (95% CI: 0.75-0.88) on the independent test set. Applying a threshold of 0.25 yielded a sensitivity of 98% (95% CI: 90%; 100%), an NPV of 98% (95% CI: 89%; 100%), a workload reduction of 15.7%, and a scan time reduction of 16.6%. CONCLUSION This deep learning model has a high potential to help identify normal scans in ultrafast breast MRI and thereby reduce radiologists' workload and scan time. KEY POINTS • Deep learning in TWIST may eliminate the necessity of additional sequences for identifying normal breasts during MRI screening. • Workload and scanning time reductions of 15.7% and 16.6%, respectively, could be achieved with the cost of 1 (1 of 55) false negative prediction.
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Affiliation(s)
- Xueping Jing
- Department of Radiation Oncology, and Data Science Center in Health (DASH), Machine Learning Lab, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands.
| | - Mirjam Wielema
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Ludo J Cornelissen
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Margo van Gent
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Willie M Iwema
- Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713, AV, Groningen, The Netherlands
| | - Sunyi Zheng
- Department of Radiation Oncology, and Data Science Center in Health (DASH), Machine Learning Lab, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Paul E Sijens
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Matthijs Oudkerk
- Faculty of Medical Sciences, University of Groningen and Institute of Diagnostic Accuracy, Wiersmastraat 5, 9713, GH, Groningen, The Netherlands
| | - Monique D Dorrius
- Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
| | - Peter M A van Ooijen
- Department of Radiation Oncology, and Data Science Center in Health (DASH), Machine Learning Lab, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands
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98
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Ritchie D, Van Hal G, Van den Broucke S. Factors affecting intention to screen after being informed of benefits and harms of breast cancer screening: a study in 5 European countries in 2021. Arch Public Health 2022; 80:143. [PMID: 35599312 PMCID: PMC9125943 DOI: 10.1186/s13690-022-00902-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participation in mammography screening comes with harms alongside benefits. Information about screening provided to women should convey this information yet concerns persist about its effect on participation. This study addressed factors that may influence the intention to screen once a woman has been informed about benefits and harms of participation. METHODS A cross-sectional survey of women from five countries (Belgium, France, Italy, Spain, and the United Kingdom) was performed in January 2021. The survey contained a statement regarding the benefits and harms of mammography screening along with items to measure cognitive variables from the theory of planned behaviour and health belief model and the 6-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q6). Logistic regression and mediation analysis were performed to investigate the effect of cognitive and sociodemographic variables. RESULTS A total of 1180 participants responded to the survey. 19.5% of participants (n = 230) were able to correctly identify that mammography screening carries both benefits and harms. 56.9% of participants (n = 672) responded that they would be more likely to participate in screening in the future after being informed about the benefits and harms of mammography screening. Perceived behavioural control and social norms demonstrated were significant in predicting intention, whereas, the effect of health literacy was limited. CONCLUSIONS Informing women about the presence of benefits and harms of in mammography screening participation did not negatively impact upon intention to be screened. Information should also address perception on implementation factors alongside messages on benefits and harms. Overall, screening programme managers should not be discouraged by the assumption of decreased participation through increasing efforts to address the lack of knowledge on benefits and harms.
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Affiliation(s)
- David Ritchie
- Faculty of Medicine and Health Sciences, Campus Drie Eiken, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - Guido Van Hal
- Faculty of Medicine and Health Sciences, Campus Drie Eiken, Universiteitsplein 1, 2610, Wilrijk, Belgium
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Rubery PT, Ramirez G, D'Agostino CR, Vasalos K, Thirukumaran C. A workplace wellness program at an academic health center influences employee health, satisfaction, productivity and the rate of workplace injury. Int Arch Occup Environ Health 2022; 95:1603-1632. [PMID: 35501508 DOI: 10.1007/s00420-022-01865-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/07/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Workplace wellness (WP) programs are an employer strategy to improve employee health and satisfaction. Their impact on productivity and benefit expense remains unclear. This study examines the association of a voluntary WP at an academic health center with both employee metrics and employer costs. METHODS We retrospectively reviewed prospectively collected data from January 2016 to April 2018 for employees who voluntarily underwent screening for a WP at an academic medical center. We used their demographic, social, work, and clinical data to address the central research question. The primary outcomes included wellness measures from the Patient-Reported Outcomes Measurement Information System (PROMIS), secondary wellness outcomes such as body mass index, job-related outcomes such as job satisfaction, and workers' compensation metrics such as the claim amount. The key independent variables were whether an observation was from before or after the WP. For workers' compensation metrics, additional key independent variables were intervention/control group, and an interaction between the before/after and intervention/control variables. We conducted univariate and bivariate/unadjusted analyses, and estimated multivariable linear, logistic, and gamma regression models that also controlled for confounders. RESULTS The study included 370 employees. Participation in the program was associated with significant improvements in the PROMIS pain interference, fatigue and sleep quality domains. Hip circumference diminished, and functional movement outcomes were improved. Job satisfaction improved by 4.4 percentage points (95% Confidence Interval [CI]: 0.3-8.5, p = 0.04) and self-reported productivity by 14.5 percentage points (95% Confidence Interval [CI]: 9.5-19.5, p < 0.001). The likelihood of a new compensation claim during the 12-month follow-up period fell by 10.1% (95% Confidence Interval [CI]: - 15.5 to - 4.7, p < 0.001). However, the value of a new claim was unchanged. CONCLUSION Employees who completed a WP at an academic medical center demonstrated improvements in several recognized patient-reported outcome measures, in job satisfaction and self-reported productivity, a decrease in hip circumference, an improvement in functional motion and a decreased rate of compensable injury.
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Affiliation(s)
- Paul T Rubery
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA.
| | - Gabriel Ramirez
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
| | - Charles R D'Agostino
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
| | - Kostantinos Vasalos
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
| | - Caroline Thirukumaran
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
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Behr CM, Koffijberg H, Degeling K, Vliegenthart R, IJzerman MJ. Can we increase efficiency of CT lung cancer screening by combining with CVD and COPD screening? Results of an early economic evaluation. Eur Radiol 2022; 32:3067-3075. [PMID: 34973103 PMCID: PMC9038824 DOI: 10.1007/s00330-021-08422-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/19/2022]
Abstract
Objectives Estimating the maximum acceptable cost (MAC) per screened individual for low-dose computed tomography (LDCT) lung cancer (LC) screening, and determining the effect of additionally screening for chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD), or both on the MAC. Methods A model-based early health technology assessment (HTA) was conducted to estimate whether a new intervention could be cost-effective by calculating the MAC at a willingness-to-pay (WTP) of €20k/quality-adjusted life-year (QALY) and €80k/QALY, for a population of current and former smokers, aged 50–75 years in The Netherlands. The MAC was estimated based on incremental QALYs gained from a stage shift assuming screened individuals are detected in earlier disease stages. Data were obtained from literature and publicly available statistics and validated with experts. Results The MAC per individual for implementing LC screening at a WTP of €20k/QALY was €113. If COPD, CVD, or both were included in screening, the MAC increased to €230, €895, or €971 respectively. Scenario analyses assessed whether screening-specific disease high-risk populations would improve cost-effectiveness, showing that high-risk CVD populations were more likely to improve economic viability compared to COPD. Conclusions The economic viability of combined screening is substantially larger than for LC screening alone, primarily due to benefits from CVD screening, and is dependent on the target screening population, which is key to optimise the screening program. The total cost of breast and cervical cancer screening is lower (€420) than the MAC of Big-3, indicating that Big-3 screening may be acceptable from a health economic perspective. Key Points • Once-off combined low-dose CT screening for lung cancer, COPD, and CVD in individuals aged 50–75 years is potentially cost-effective if screening would cost less than €971 per screened individual. • Multi-disease screening requires detailed insight into the co-occurrence of these diseases to identify the optimal target screening population. • With the same target screening population and WTP, lung cancer-only screening should cost less than €113 per screened individual to be cost-effective. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08422-7.
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Affiliation(s)
- Carina M Behr
- Health Technology and Services Research, Faculty of Behavioural and Management Science, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
| | - Hendrik Koffijberg
- Health Technology and Services Research, Faculty of Behavioural and Management Science, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
| | - Koen Degeling
- Cancer Health Services Research, University of Melbourne Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Melbourne, VIC 3010, Australia.,Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Melbourne, VIC 3010, Australia
| | - Rozemarijn Vliegenthart
- Dept of Radiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Maarten J IJzerman
- Health Technology and Services Research, Faculty of Behavioural and Management Science, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands. .,Cancer Health Services Research, University of Melbourne Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Melbourne, VIC 3010, Australia. .,Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Melbourne, VIC 3010, Australia.
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