SEARCH · PubMed Health

Results for “Cancer screening”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources

PubMed1995

Do general practitioners influence the uptake of breast cancer screening?

OBJECTIVES: To investigate the relative importance of patient and general practice characteristics in explaining variations between practices in the uptake of breast cancer screening. DESIGN: Ecological study examining variations in breast cancer screening rates among 131 general practices using routine data. SETTING: Merton, Sutton, and Wandsworth Family Health Services Authority, which covers parts of inner and outer London. MAIN OUTCOME MEASURE: Percentage of eligible women aged 50-64 who attended for mammography during the first round of screening for breast cancer (1991-1994). RESULTS: Of the 43,063 women eligible for breast cancer screening, 25,826 (60%) attended for a mammogram. Breast cancer screening rates in individual practices varied from 12.5% to 84.5%. The estimated percentage list inflation for the practices was the variable most highly correlated with screening rates (r = -0.69). There were also strong negative correlations between screening rates and variables associated with social deprivation, such as the estimated percentage of the practice population living in households without a car (r = -0.61), and with variables that measured the ethnic make-up of practice populations, such as the estimated percentage of people in non-white ethnic groups (r = -0.60). Screening rates were significantly higher in practices with a computer than in those without (59.5% v 53.9%, difference 5.6%, 95% confidence interval 1.1 to 10.2%). There was no significant difference in screening rates between practices with and without a female partner; with and without a practice nurse; and with and without a practice manager. In a forward stepwise multiple regression model that explained 58% of the variation in breast cancer screening rates, four factors were significant independent predictors (at P = 0.05) of screening rates: list inflation and people living in households without a car were both negative predictors of screening rates, and chronic illness and the number of partners in a practice were both positive predictors of screening rates. The practice with the highest screening rate (84.5%) contacted all women invited for screening to encourage them to attend for their mammogram and achieved a rate 38% higher than predicted from the regression model. Breast cancer screening rates were on average lower than cervical cancer screening rates (mean difference 14.5%, standard deviation 12.0%) and were less strongly associated with practice characteristics. CONCLUSIONS: The strong negative correlation between breast cancer screening rates and list inflation shows the importance of accurate age-sex registers in achieving high breast cancer screening rates. Breast cancer screening units, family health services authorities, and general practitioners need to collaborate to improve the accuracy of the age-sex registers used to generate invitations for breast cancer screening. The success of the practice with the highest screening rate suggests that practices can influence the uptake of breast cancer screening among their patients. Giving general practitioners a greater role in breast cancer screening, either by offering them financial incentives or by giving them clerical support to check prior notification lists and contact nonattenders, may also help to increase breast cancer screening rates.

Breast Neoplasms↗

PubMed2006

Relationship of communication and information measures to colorectal cancer screening utilization: results from HINTS.

Utilization of colorectal cancer screening tests is suboptimal. Knowledge of colorectal cancer screening has been associated with completion of screening. Thus, increasing awareness of colorectal cancer screening may lead to significant improvements in screening rates. We assessed for the association among provider-patient interaction, information-seeking patterns, sources of information, trust in cancer information, and Internet usage on colorectal cancer screening behavior using data obtained by the Health Information National Trends Survey (HINTS). From a cohort of 2,670 respondents greater than 50 years of age, we found that they (1) desired cancer information from personalized reading materials, meeting in person with a health care professional, and published materials; and (2) had great trust of information from their provider. Having trust in cancer information from the doctor or other health care professional was most predictive (OR 2.08, 95% CI 1.49-2.94) of being up to date. Other predictive factors include having a desire for cancer information from personalized reading materials (OR 1.56, 95% CI 1.24-1.95) and using the Internet from home (OR 1.32, 95% CI 1.04-1.67). We conclude that personalized communications from a health care provider are desired and trusted. Another promising information delivery approach is the Internet. Dedicated efforts using these approaches for information exchange may be most beneficial toward increasing utilization of colorectal cancer screening.

Aged↗

PubMed1999

Colorectal cancer screening.

Colorectal cancer is the second most lethal cancer in the United States. The lifetime risk of developing colorectal cancer in the United States is 5%. Early detection decreases mortality, and involves stratifying individuals by risk factors. Clinicians can use several methods for detection and surveillance of colorectal cancer including the digital rectal exam (DRE), fecal occult-blood test (FOBT), flexible sigmoidoscopy, colonoscopy, and double contrast barium enema. Several groups offer guidelines recommending specific screening techniques and intervals. In general, a combination of an annual FOBT and a flexible sigmoidoscopy every 5 years is recommended for average-risk individuals. Colonoscopy is the gold standard for visualizing the entire colon, and is reserved for abnormal findings on FOBT or flexible sigmoidoscopy or for individuals of greater-than-average risk for colorectal cancer.

Barium Sulfate↗

PubMed2006

Gastroenterologists utilize the referral for EGD to enhance colon cancer screening more effectively than primary care physicians.

BACKGROUND: Colorectal cancer screening rates among patients with upper gastrointestinal symptoms undergoing oesophagogastroduodenoscopy have not been previously established. We hypothesize that gastroenterologists seize this opportunity more frequently than primary care providers. AIMS: To assess colorectal cancer screening rates at the time of direct access oesophagogastroduodenoscopy and gastrointestinal clinic evaluation for upper gastrointestinal symptoms. To compare rates in the 6 months following the oesophagogastroduodenoscopy in both cohorts of patients. METHODS: Retrospective review. primary care physician group: direct access oesophagogastroduodenoscopy (n = 247) vs. gastrointestinal group (n = 278). Multivariable regression analysis utilized to assess predictors of screening outcome. RESULTS: Colorectal cancer screening at the time of referral was 54%. Among the 243 unscreened patients, an additional 29% in the primary care physician group vs. 59% in the gastrointestinal group completed colorectal cancer screening in 6 months of follow-up. Nearly 60% patients evaluated in gastrointestinal clinic for upper symptoms had documented discussion, and 99% of those patients underwent colonoscopy (P < 0.001). Gastrointestinal consultation increased the probability of colorectal cancer screening completion eightfold (95% CI 3.69-18.96). CONCLUSIONS: At the time of evaluation for upper symptoms, half of patients were not current with colorectal cancer screening recommendations. Referrals for the direct access oesophagogastroduodenoscopy and, more importantly, the gastroenterology consult represent key opportunities for colorectal cancer screening education and improved compliance.

Age Factors↗

PubMed2001

Promoting informed decision making about prostate cancer screening.

Because prostate cancer screening with prostate specific antigen is controversial, informed consent is recommended. Physicians are encouraged to discuss facts about prostate specific antigen with patients and to supplement such discussions with informational brochures or videotapes.

Biomarkers↗

PubMed1993

Do chart reviews and interviews provide the same information about breast and cervical cancer screening?

The National Cancer Institute of the United States has set a goal for the year 2000 that 80-90% of eligible women should have a Pap smear every 3 years and that 80% of women aged 50-70 should receive an annual breast examination and mammogram. Very few studies have examined how we might best measure our progress towards this goal. Specifically, should we employ interview data or data derived from medical records? To respond to this question, data were gathered at two different public health clinics in poor areas of Chicago using both techniques. The interviews estimated significantly higher proportions of women receiving Pap smears, breast examinations, and mammograms in the previous 12-month interval than were estimated from randomly selected medical records. A review of the literature suggests the same pattern exists when other studies using these two data gathering processes are compared. We are thus left with a serious problem, one that must be resolved before we will be able to fully assess our progress in increasing breast and cervical cancer screening.

Aged↗

PubMedDate not supplied

Virtual colonoscopy and colorectal cancer screening.

Colorectal cancer (CRC) is the leading cause of cancer related death in the United States. Virtual colonoscopy is a new method for imaging the colon and has produced promising early results for polyp and cancer detection. The challenge remains to reproduce these favorable results in clinical practice and to evaluate the use of virtual colonoscopy in a purely screening population. Virtual colonoscopy may dramatically improve population participation in screening programs and play a major role in minimizing the impact of CRC.

Colonic Polyps↗

PubMed2004

The economic impact of false-positive cancer screens.

OBJECTIVE: Despite the promotion and widespread use of routine cancer screening, little is known about the economic consequences of false-positive screening results. We evaluated the medical and nonmedical costs associated with false-positive prostate, lung, colorectal, and ovarian cancer screens. METHOD: We identified 1,087 Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial participants enrolled in a large managed care organization. Medical care use and costs were compiled from automated sources and trial data. Nonmedical care costs to patients with a false-positive lung cancer screen were obtained by telephone interview (n = 98). RESULTS: Forty-three percent of the study sample incurred at least one false-positive cancer screen. The majority of these patients (83%) received follow-up care. Prior to and after controlling for participant characteristics, significantly higher medical care expenditures in the year following screening were found among those with a false-positive screen. The adjusted mean difference was $1,024 for women and $1,171 for men. Among lung cancer screening patients, few nonmedical care costs were identified beyond the time (mean, 1.5 hours) spent receiving care. CONCLUSION: The results here indicate that false-positive results among some available cancer screening tests are relatively common, that patients incurring a false-positive screen tend to receive follow-up testing, and that such follow-up is not without associated medical costs. Along with trials evaluating the health benefits of available cancer screening modalities, investigations into potential undesirable consequences of cancer screening are also warranted.

Aged↗

PubMed1995

An overview cost-utility analysis of prostate cancer screening.

The value of prostate cancer screening remains controversial because of the high prevalence of the disease and the fact that many tumors detected through screening are not destined to lead to morbidity or mortality, rendering treatment unnecessary. An ongoing NCI-sponsored screening trial may eventually put an end to the controversy. However, in the meantime, cost-utility estimates suggest that the cost per crude and quality-adjusted life year gained from prostate cancer screening and treatment ranges from $8,400 to $23,100 (with an estimated 1 to 2.68 QALYs gained from screening and treatment), and that these estimates are actually lower than, or well within the range of, the costs of many commonly accepted medical interventions, including screening mammography in women under age 50 ($232,000) and treatment of hypertension with captopril ($82,600) or hydrochlorothiazide ($23,500). Thus, we conclude that prostate cancer screening may indeed be cost effective and should be offered to men in the at-risk age range.

Costs and Cost Analysis↗

PubMed2001

Body weight and cancer screening among women.

Obesity increases cancer risk, yet small-scale surveys indicate that obese women delay or avoid cancer screening even more so than do nonobese women. We sought to estimate the association between body mass index (BMI) (kg/m(2)) and delayed cancer screening among adult women in a population-based survey. Subjects were women classified by BMI as underweight (<18.5), desirable weight (18.5-24.9), overweight (25-29.9), obese class I (30-34.9), obese class II (35-39.9), and obese class III (> or =40). Outcome measures were intervals (0 for < or =2 years versus 1 for >2 years) since most recent screening for Papanicolaou (Pap) smear, mammography, and clinical breast examination (CBE). Adjusting for age, race, smoking, and health insurance, we observed J-shaped associations between BMI and screening. Compared with desirable weight women, underweight women (odds ratios [OR] = 1.21, 95% confidence interval [95% CI] 1.09-1.34), overweight women (OR = 1.13, 95% CI 1.07-1.18), and obese women (OR range 1.22-1.69) were significantly more likely to delay Pap smear testing for >2 years. Underweight (OR = 1.32, 95% CI 1.13-1.54), obesity class I (OR = 1.12, 95% CI 1.02-1.23), and obesity class III women (OR = 1.32, 95% CI 1.10-1.54) were more likely to delay mammography, and overweight (OR = 1.10, 95% CI 1.01-1.19), obesity class I (OR = 1.18, 95% CI 1.08-1.30), and obesity class III women (OR = 1.47, 95% CI 1.23-1.75) were more likely to delay CBE. White women were more likely to delay CBE as a function of BMI than were non-white women. Weight may be an important correlate of cancer screening behavior, particularly for white women.

Adult↗

PubMed1995

A likelihood ratio test for cancer screening trials.

In randomized cancer screening trials, mortality rates for the screened group relative to those of the control group are not likely to be constant as a function of years from randomization due to the inherent lag between initiation of screening and any putative effects of screening on mortality. In this situation, a log rank test for differences in mortality between the randomization groups will not be optimal. Although optimality could potentially be recovered by use of a weighted log rank statistic, the optimal weights are difficult to specify a priori and the potential loss of power by use of poorly specified weights is great. We describe a likelihood ratio test with two degrees of freedom for use in this situation which is based on a fit of a weakly structured full model. Computation of an approximate significance level for this test is described and a large sample justification for this approximation is given. Size and power properties of the proposed statistic are compared to that of several other statistics in a small simulation study and the statistic is applied to data from the HIP Breast Cancer Screening Trial.

Biometry↗

PubMed1993

Increasing cervical cancer screening among minority elderly. Education and on-site services increase screening.

Older women participate in cervical cancer screening less regularly than do younger women. As a consequence, more lesions are found in more advanced and less curable stages in older women. Elderly black and Hispanic women have had lower rates of participation in cervical cancer screening than white women. There is a marked, inverse relationship between the stage of cervical cancer at diagnosis and the 5-year survival rate. The rate of cervical cancer screening among older women can be increased by offering education about Pap tests and onsite cervical cancer screening in housing for the elderly.

Adult↗

PubMed2001

African American women's experiences with breast cancer screening.

PURPOSE: To describe the experience and meaning of breast cancer screening for African American women. Breast cancer screening offers the greatest hope of reducing breast cancer mortality and improving breast cancer outcomes. Despite the proliferation of initiatives targeting African American women, they continue to be first diagnosed only when they have late-stage disease. DESIGN AND METHODS: Using hermeneutic phenomenological research methods, 23 low- and middle-income African American women were interviewed to gain an understanding of their experiences with breast cancer screening. FINDINGS: Participants varied in their experiences with breast cancer screening. Women spoke of a desire for a holistic approach to health that did not separate the breast from the rest of the body. This desire is indicated in the theme of minding the body, self, and spirit, along with themes of relationships and spreading the word about breast health issues. CONCLUSIONS: Interventions for African American women should include a focus on minding the body, self, and spirit to promote breast cancer screening, and should indicate the importance of relationships and spreading the word about breast cancer screening.

Adult↗

PubMedDate not supplied

Colorectal cancer screening.

Colorectal cancer (CRC) is the third most common cancer in the world, and mortality has remained the same for the past 50 years, despite advances in diagnosis and treatment. Because significant numbers of patients present with advanced or incurable stages, patients with pre-malignant lesions (adenomatous polyps) that occur as result of genetic inheritance or age should be screened, and patients with long-standing inflammatory bowel disease should undergo surveillance. There are different risk groups for CRC, as well as different screening strategies. It remains to be determined which screening protocol is the most cost-effective for each risk catagory. The objective of screening is to reduce morbidity and mortality in a target population. The purpose of this review is to analyze the results of the published CRC screening studies, with regard to the measured reduction of morbidity and mortality, due to CRC in the studied populations, following various screening procedures. The main screening techniques, used in combination or alone, include fecal occult blood tests, flexible sigmoidoscopy, and colonoscopy. Evidence from the published literature on screening methods for specific risk groups is scanty and frequently does not arise from controlled studies. Nevertheless, data from these studies, combined with recent advances in molecular genetics, certainly lead the way to greater efficacy and lower cost of CRC screening.

Colonoscopy↗

PubMed2000

ATM heterozygosity and breast cancer: screening of 37 breast cancer patients for ATM mutations using a non-isotopic RNase cleavage-based assay.

Based upon the results of several epidemiologic studies, it has been suggested that women who are carriers for a mutation in the ataxia telangiectasia-mutated (ATM) gene are susceptible for the development of breast cancer. Therefore, 37 consecutive breast cancer patients were screened for the presence of a germline ATM mutation using a non-isotopic RNase cleavage-based assay (NIRCA). This paper reports the first use of NIRCA for detection of ATM mutations in breast cancer patients. Using this assay, no ATM mutations were found in our patient population. This result is similar to the findings of other studies that have employed approaches complementary to NIRCA.

Adult↗

PubMed2005

Confounding by dietary factors in case-control studies on the efficacy of cancer screening in Japan.

Evaluation of cancer screening using case-control studies is less valid in comparison to randomized controlled trails, due to the intrusion of a possible self-selection bias in the former. The randomized controlled trial approach, however, may be difficult in developed countries where mass cancer screening programs are already being performed nationally. Accordingly, case-control studies are often performed instead of randomized controlled trials. In case-control studies, no reports could be found in the literature using dietary habit, an important influencing factor in carcinogenesis, as an adjusting item. We surveyed nutrition and food intake status through a nutrition survey using the weighing method, and smoking prevalence and alcohol consumption with questionnaires in the general population in northern Japan, in subjects over 30 years of age. We then compared these results among non-participants and participants in cancer screening programs, and evaluated how any differences between the two groups might affect the results of case-control studies. Non-participants had a significantly lower intake of vegetables, carotene, vitamin C, and dietary fiber, which are thought to be beneficial factors in the prevention of carcinogenesis. Non-participants had a significantly higher cigarette smoking prevalence than participants. In relation to the intake of vegetables, a difference between participants and non-participants was evident, as proper adjustment for vegetable intake led to an odds ratio closer to the null value. The value of the odds ratio will probably not decrease, but it might increase when other dietary factors or smoking are taken into consideration.

Case-Control Studies↗

PubMed2002

Rising incidence of breast cancer after completion of the first prevalent round of the breast cancer screening programme.

OBJECTIVES: After completion of the prevalent screening round of the breast cancer screening programme in Limburg, The Netherlands, incidences started rising once again. This increase was contrary to expectations, which had predicted a slightly higher, but stable, incidence after the first screening round. The trends in incidence were studied to find explanations for the observed rise in incidence. SETTING: Breast cancer screening programme in mid-Limburg and southern Limburg, the Netherlands. METHODS: The data files of the breast cancer screening programme and the Maastricht cancer registry were linked to evaluate the effect of breast cancer screening. Only the first primary breast tumour was included in the evaluation. RESULTS: The second peak of incidence after the prevalent screening round was 45% higher than the incidences before the start of the screening. Also, the decrease in incidence of large and node positive tumours was interrupted. Compared with national detection rates, the number of screen detected cancers was lower before 1995 and higher after that year. After 1997, incidence decreased again of all breast cancers, but also of large and node positive tumours. The incidence of node positive tumours showed large fluctuations, probably due to the introduction of the sentinel node procedure and immunohistochemistry. In 1999, incidence of large tumours and node positive tumours was 18% and 28%, respectively, lower than before the start of the screening. CONCLUSIONS: An increase in the background incidences and improved detection in the screening programme most likely explain this trend. The improved detection after 1995, and the lower than desirable decrease in large tumours, indicate that the screening performance was not optimal before 1996. The incidence of node positive tumours cannot be used any more as an indicator of the success of the screening programme because of detection bias.

Aged↗

PubMed2006

The 'Ohana Day Project: a community approach to increasing cancer screening.

BACKGROUND: Native Hawaiians have higher cancer mortality rates and lower cancer screening rates compared with non-Hawaiians in Hawaii. People living in rural areas have particularly limited options for cancer services, especially for services that are culturally attractive and convenient. CONTEXT: 'Ohana Day, offered in a small, rural, and predominantly Hawaiian community, was designed to attract underserved Hawaiians to cancer screening. METHODS: The year-long project involved a 1-day ho'olaule'a (community celebration) for families that featured 30-minute visits with a same-sex Hawaiian physician (for adults), culturally relevant cancer education and brochures, Hawaiian music, and games for children. Recruitment and follow-up for screening and treatment were offered. Principles of community-based participatory research, Hawaiian values, and Kreuter's strategies guided the design of the event. CONSEQUENCES: Of the 73 participants, 10 had abnormal screening results, and all received follow-up screening, treatment, or both within 3 months. Six months after the event, the number of men current with prostate cancer and colorectal cancer screening and the number of women current with clinical breast examination and colorectal cancer screening increased significantly. In addition, the number of participants affiliated with the community's Native Hawaiian health care system and the number with health insurance increased significantly. Participant evaluations showed high overall satisfaction with the 'Ohana Day program. INTERPRETATION: Previous studies have noted the barriers to increasing cancer screening among underserved minorities. Culture- and community-based strategies appear to be successful at overcoming these barriers.

Adult↗