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PubMed2000

Clinicopathologic study of mass-screened neuroblastoma with special emphasis on untreated observed cases: a possible histologic clue to tumor regression.

Spontaneous regression and maturation of neuroblastoma (NB) are well documented and occur frequently in infants, including those detected by mass screening. To seek histologic clues for regression/maturation in mass-screened NB, clinicopathologic features of 12 tumors that were resected after 2 to 18 months of untreated observation were reviewed. Unobserved screened and age-matched unscreened patients were also studied. To evaluate the possible important role of apoptosis, apoptotic cells were detected by in situ deoxyribonucleic acid (DNA) nick end labeling and immunohistochemical stain for activated caspase-3. Nests with a varying degree of reduced cellularity ("less cellular" and "hypocellular" nests) were common in patients younger than 18 months of age, and were rare in older patients. Two characteristic cells, which have not been focused previously, were frequent, especially in the hypocellular nests. One showed amorphic eosinophilic cytoplasm with pyknotic nuclei and the other contained plump cytoplasm with well-maintained nuclei. These cells were also observed in 89% of the unobserved screened NBs and 79% of the age-matched unscreened patients with good outcome, whereas they could not be confirmed in any of the age-matched unscreened NBs with poor outcome. The amorphic and plump cells were negative for activated caspase-3 and in situ DNA nick end labeling. From these results, the authors hypothesize that these cells most likely represent a degenerative process, in either a state before the activation of caspase-3 or a caspase-independent form of cell death. The presence of less cellular and hypocellular nests with amorphic/plump cells may serve as one of the important clues in predicting tumor prognosis.

Age Factors↗
PubMed1984

[Mass screening for colorectal cancer--issues and future prospects].

The incidence of colorectal cancer has been gradually going up among the Japanese in the past decade, but a ratio of early cancer is only ten per cent of total lesions. To improve this problem, mass screening in asymptomatic populations will be needed urgently. In order to establish a mass program, it is important to match various factors regarding a disease and method, which makes the screening valuable and acceptable. Fecal occult blood test is the method which will be most acceptable with regard to the cost, time and number to be examined. Since 1979 the author and his colleagues have been evaluating mass screening for colorectal cancer with fecal occult blood testing in combination with gastric mass screening already established in Japan and would like to stress that this combination method is useful and widely acceptable from the viewpoints of cost-benefit and early detection of colorectal cancers. Finally, the author expects that "Gastrointestinal mass screening" with this combination method will be spread throughout the country in the near future.

Aged↗
PubMed2005

Mortality from colorectal cancer in Andalusia: findings in favor of mass screening.

OBJECTIVE: To describe mortality from colorectal cancer (CRC) in Andalusia from 1975 to 2001 in order to facilitate decision-making on mass screening. DESIGN: A population-based descriptive study. Considering mortality data from CRC and the resident population of Andalusia during the studied period, the main indicators of mortality by age and sex groups were calculated, and trends were estimated. RESULTS: There have been annual increases in mortality of 1.99% in men and 0.15% in women during the study period. In men, this is mainly due to increased mortality in those older than 65 years, and in women in those in the 35- to 64-year-old age group. In the younger age groups of both sexes, there has been a decline in mortality. The trend of mortality from colon cancer was positive in both men and women, but from rectal cancer was negative in women and slightly positive in men. CONCLUSIONS: Increased mortality from CRC in Andalusia may justify mass screening measures to potentially change mortality evolution, as has occurred in other countries.

Adult↗
PubMed1983

[Evaluation of mass screening for cervical cancer in Shiga Prefecture].

During 1969 and 1979 cervical cancer was found in 269 women out of a population of 166,202 who were attending mass screening for cervical cancer in Shiga Prefecture, Japan. The overall 0.162% detection rate for this disease in the mass screening was within the range reported from other prefectures in Japan. The peak prevalence of carcinoma in situ was found at ages 40 to 44 years, while invasive cancer was found evenly distributed between ages 35 and 54 years. Among 269 women with cervical cancer, 68.8% were found to have suspicious or positive smears at the time of the initial screening, and 94% were detected by the time of the third screening. Ten women with carcinoma in situ had received the screenings almost annually more than three times and were found to have suspicious or positive smears at the time of the fourth or fifth screening. Re-evaluation of previous smears in these patients revealed that 55.6% should have been diagnosed as positive smears. Also eight women with cervical cancer in stage Ia or Ib were initially found to have positive smears at the time of the second screening, and re-evaluation of their previous smears showed that 50% had been suspicious or positive smears at the initial screening. These findings indicate that annual repeat screenings for at least three years are necessary for the early detection of cervical cancer. It is also emphasized that laboratory quality and/or accuracy should be properly controlled to avoid false negative results.

Adult↗
PubMed1989

Mass screening for colorectal cancer.

A voluntary community colorectal cancer screening project to detect occult blood in the stool of asymptomatic individuals was undertaken; 49,353 Hemoccult II kits were distributed. A total of 23,674 completed kits were returned to a central repository and processed (compliance rate, 48 percent); 851 participants had positive results (3.6 percent). Of the 640 who underwent further medical evaluation, 299 participants (46.7 percent) who had adequate follow-up had no evidence of disease. Diverse disease entities were detected in 341 participants, which was 1.4 percent of those enrolled. Forty-one patients (0.17 percent) showed significant findings that included 29 cancers (0.12 percent) and 12 (0.05 percent) noninvasive malignant polyps. Of the cancers, there were 27 colorectal, one non-Hodgkin's lymphoma, and one carcinoma of the vocal cord. In addition, 107 patients (0.45 percent) had benign polyps and 193 patients (0.82 percent) had various diseases of the gastrointestinal tract and other medical conditions. The cost of the program was modest and the results conformed to those found in previous screening surveys. The heightened public awareness of testing for colorectal disease and the detection of early lesions justifies the guaiac test screening program for mass survey.

Adult↗
PubMed2001

Newborn mass screening versus selective investigation: benefits and costs.

Cost-benefit analysis of newborn screening has an unimpressive record and yet it is still regarded as an important decision tool. This workshop surveyed ongoing research into the costs and benefits of systematic whole-population screening, as opposed to selective investigation of symptomatic patients, for inherited metabolic disease. Much current interest is focused on newborn screening by tandem mass spectrometry, which can replace current methods for detecting phenylketonuria and cover a much wider range of diseases. Two observational studies are comparing cost-effectiveness of tandem mass spectrometry screening versus symptomatic diagnosis in either concurrent or historical control populations. A number of other studies are assessing screening performance against predetermined criteria but without any formal control group. Medium-chain acyl-CoA dehydrogenase deficiency is the most common of the additional diseases being detected and it seems that octanoylcarnitine in blood is a particularly sensitive indicator: some of the cases detected by screening have genotypes suggesting a relatively low risk of serious metabolic decompensation. Ongoing studies should provide further quantitative and qualitative data but will not in themselves define the optimum balance between screening sensitivity and specificity.

Cost-Benefit Analysis↗
PubMed1988

Mass screening of primary hepatocellular carcinoma by alpha-fetoprotein in a rural area of Taiwan--a dried blood spot method.

A prospective survey of primary hepatocellular carcinoma (PHC) was conducted in a rural area of Taiwan using a two-site enzyme immunoassay for alpha-fetoprotein (AFP) in dried blood samples collected on filter paper. Of 1894 men over 40 years of age who were tested, 20 (1%) had AFP levels of greater than 20 ng/ml of blood on screening. Nineteen of these men received ultrasound examinations, and small PHCs were detected in 4 (21%). The remaining 15 cases had other types of hepatobiliary tract diseases, and 6 (40%) were also serum HBsAg positive. They should all be closely followed up by AFP determination and ultrasound examination of the liver. In contrast to the low resection rate of PHC in symptomatic patients who were admitted through the outpatient clinic during the period of this survey, the four cases with small PHC discovered by AFP screening had their tumors successfully removed (5/57 vs. 4/4, p less than 0.005). Our preliminary results showed that this method is a simple, sensitive and convenient assay for AFP and may be used as a first-line screening test in mass population surveillance programs for PHC, particularly in areas where PHC is highly prevalent.

Adult↗
PubMed1995

Failure to detect dopaminergic neuroblastoma in a mass-screening system.

Dopaminergic neuroblastoma comprised 12% of the patients under 1 year of age, and 83% of the older ones. Seven cases were missed by the mass-screening system performed at age 6 months and were detected after 16 months. Three of these advanced cases were positive only for dopamine. These findings supports our second mass-screening system using dopamine evaluation at age 14 months.

Age Factors↗
PubMed2002

Performance of glaucoma mass screening with only a visual field test using frequency-doubling technology perimetry.

PURPOSE: To report the performance of glaucoma mass screening with only a visual field test utilizing frequency- doubling technology (FDT) perimetry in general populations. DESIGN: Hospital and population-based cross-sectional study. METHODS: This study took place in a multicenter setting. One hundred three consecutive glaucomatous patients and 14,814 persons were randomly selected. We had created a glaucoma screening protocol (GSP) using FDT perimetry (FDT-GSP). Frequency-doubling technology-glaucoma screening protocol was tested on consecutive glaucoma patients diagnosed with Humphrey visual field analyzer (30-2 SITA standard), and then FDT-GSP was applied to general populations. Frequency-doubling technology-glaucoma screening protocol positive subjects were ophthalmologically diagnosed. Detection ability of FDT-GSP was determined in consecutive patients, and the positive predictive value (PPV) of FDT-GSP to detect definitive glaucoma was estimated in general populations. RESULTS: Frequency-doubling technique-glaucoma screening protocol detected 83.3% and 100% of definitive glaucoma patients with an early (mean deviation [MD] > -6 dB) and more advanced stage (MD < or = -6 dB), respectively. In the population-based screening, there were 660 (4.5%) subjects who had positive FDT-GSP, including 512 in whom no visual field abnormalities (VFA) had been pointed out previously. Of them, 370 subjects underwent ophthalmologic diagnosis. Then, 266 (71.9%, 266/370) subjects had a glaucomatous disk and 167 had definitive glaucomatous VFA. Fifty-five (14.9%) and 39 (10.5%) subjects were diagnosed as having other diseases and as normal, respectively. The PPV of FDT-GSP ranged from 32.6% (167/512)-45.1% (167/370). CONCLUSIONS: Frequency-doubling technology-based screening with only a visual field test showed reasonable performance on mass screening for detection of definitive glaucoma in this study population, considering the glaucoma prevalence.

Aged↗
PubMed1991

[Mass screening of breast cancer with imaging diagnosis].

Westernization of our life-style and diet has caused a higher incidence of breast cancer in Japan. Although mass screenings such as anamnesis, visual and palpable examinations are provided by local government in Japan, no curable cancer in the early stage can be detected without the use of imaging diagnosis. Furthermore, the image can be saved as a record. Mammography yields images that are best suited for breast cancer examination in terms of sensitivity, specificity and accuracy. However, the large volume of information collected from the images makes diagnosis extremely difficult. In order to ease the burden on the diagnosing physician and to reduce the examination cost, CRT diagnosis by digital images and image selection by an automatic diagnosis supporting system with neuro-computer must replace the present filming method. On the other hand, 100% accuracy can not be achieved by either mammography or ultrasonic examination due to the limitation in depicting images on a display monitor. The accuracy rates of mammography and ultrasonic examination are 91.5% and 87.5% in our hospital. Imaging diagnosis, however, must be efficiently applied in addition to the visual and palpable examinations in promoting mass screening for breast cancer.

Breast Neoplasms↗
PubMed1981

An autopsied case of an elementary school boy with sudden death four years after Kawasaki disease: on the problem of present method of cardiac mass screening of school children.

An 8 year-old boy died suddenly 4 years after the onset of Kawasaki disease. He was examined by a cardiac mass screening for school children one and a half year before the death, and was evaluated as having no sequela of Kawasaki disease. The autopsy showed coronary arterial aneurysms and obstruction with fresh and old myocardial infarction. One of the problems of the present method for cardiac mass screening for school children is that it is performed only with history taking, physical findings and electrocardiograms. This method is completely insufficient to find out coronary involvement as a sequela of Kawasaki disease. All the children with history of Kawasaki disease should be examined by two dimensional echocardiography, which is the most sensitive and specific noninvasive method to detect the coronary involvement in our experience.

Autopsy↗
PubMed1993

[An evaluation of tumor markers and risk factors in mass screening for various cancers].

The borderline values of tumor markers and the clarification of risk factors for cancer are problems to be solved in the development of mass screening tests for various cancers. A tiny abnormality may be overlooked in an evaluation based upon traditional reference standards obtained by surveying healthy subjects. Both negative and positive values are required in mass screening for various cancers. That is, cut-off values should minimize the incidence of false negatives and false positives in the screening test. A modified combination assay using tumor markers and risk factors was used to screen 967 healthy subjects over age 50 for nonspecific cancers and the results were analyzed. Positive rates based on ordinary cut-off values for each tumor marker were about 6 to 7% in CEA, CA19-9 and BFP, 2.7% in SPAN-1, 1.3% in PAP, and less than 1% in AFP, SCC, CA125 and NCC -ST-439. For pepsinogen, a risk factor of various cancers especially in the digestive tract, the cut-off value was determined as the mean-SD in 967 healthy subjects over 50 years old. That is, the cut-of value for pepsinogen I was 18.7 ng/ml. A lower value was found in 149 subjects (15.4%). The cut-off value for pepsinogen II was 7.4 ng/ml and a lower value was found in 227 subjects (23.5%). The cut-off value for the pepsinogen I/II ratio was 1.2 and 108 subjects showed lower values (11.2%). Positive cases were referred to specialists in various fields to detect the specific suspected cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[The value of CW Doppler and Doppler-color-echocardiography in the mass screening for atherosclerotic carotid lesions].

BACKGROUND: The availability of non invasive ultrasound technologies for the diagnosis of extracranial carotid atherosclerotic disease allowed designing and applying mass screening programmes devoted to uncover and study unknown carotid stenosis in resident populations. OBJECTIVE: To evaluate usefulness and correct application of Continuous Wave Doppler (CWD) and Color Coded Echo Flow Imaging (CCEF) examinations during different levels of the screening programme OPI (Obiettivo Prevenzione Ictus). METHODS: Between January 29th 1990 and March 31st 1992 the screening programme OPI has been applied to 16.379 subjects of both sexes, aged 45 to 75, enrolled in a sanitary district of Lombardia. They underwent first level screening (anamnesis, physical examination, CWD of carotid arteries). 1.661 (10.1%) were suspected of harboring carotid lesions and invited to second level screening (physical examination, biohumoral sampling, CCEF): 1.587 attended. The results of CWD and CCEF examination of 3.174 carotid arteries are discussed. RESULTS: An overall sensitivity and specificity of 63.6% and 66%, respectively, was found as CWD and CCEF were compared for lesions detectable by CWD (i.e. excluding kinkings and aneurysms). Of 1.815 carotid arteries classified as negative at CWD the absence of lesions was confirmed by CCEF for 1.450 (79.9%); CWD failed to reveal 146 (8%) stenosis < 50% and 52 (2.9%) severe lesions, of which only 5 (0.3%) could possibly undergo surgical treatment. CONCLUSIONS: Despite low accuracy, CWD has proven to be useful for the purpose of a mass screening of carotid occlusive disease, that is selection of a contained group of subjects (10.1%), with increased risk for carotid stenosis, for further non invasive examination, with low cost (hardware cost: 1.430 lire per exam v/s 24.000 lire per exam for CCEF) and low risk of missing severe stenosis with possible surgical indication (0.3%).

Aged↗
PubMed2003

Evaluation of PCR as a diagnostic mass-screening tool to detect Leishmania (Viannia) spp. in domestic dogs (Canis familiaris).

Several studies have suggested that the PCR could be used in epidemiological mass-screening surveys to detect Leishmania (Viannia) spp. infection in human and animal hosts. Dogs from an area of Leishmania braziliensis and Leishmania peruviana endemicity were screened for American cutaneous leishmaniasis (ACL) infection by established PCR-based and enzyme-linked immunosorbent antibody test (ELISA) protocols. PCR detected Leishmania (Viannia) infection in a total of 90 of 1,066 (8.4%) dogs: 32 of 368 (8.7%), 65 of 769 (8.5%), and 7 of 42 (16.7%) dogs were PCR positive by testing of whole blood, buffy coat, and bone marrow aspirates, respectively. ELISA detected infection in 221 of 1,059 (20.9%) tested dogs. The high prevalence of Leishmania (Viannia) detected by PCR and ELISA in both asymptomatic (7.5 and 19.2%, respectively) and symptomatic (32 and 62.5%, respectively) dogs is further circumstantial evidence for their suspected role as reservoir hosts of ACL. However, the low sensitivity of PCR (31%) compared to ELISA (81%) indicates that PCR cannot be used for mass screening of samples in ACL epidemiological studies. Unless more-sensitive PCR protocols were to be developed, its use should be restricted to the diagnosis of active (canine and human) cases and to the parasitological monitoring of patients after chemotherapy.

Animals↗
PubMed1976

[Mass screening in the diagnosis of precancerous diseases of the stomach].

The authors emphasize the importance of diagnosticating and systematic observation of cancer preneoplasms for earlier detection of stomach cancer. For this purpose a clinico-laboratory test for thiocompounds in the urine has been used. The former has been found to be convenient for mass screening because of its prompt performance. Nearly 3.5% of 10000 healthy persons under examination have been screened by means of the mentioned test. The effectiveness of the test was checked up through an x-ray examination of the stomach of the screened persons, i.e. of those who have shown the positive result. Cancer preneoplasms have been detected in 32.5% of the x-ray screened persons. It is concluded that the used mass screening test, followed by an x-ray examination of those patients who showed a positive result for thiocompounds in the urine, could be used as a pattern for the detection of pretumor lesions.

Adult↗
PubMed2004

Usefulness of an automated urinary flow cytometer in mass screening for nephritis.

We aimed to assess the utility of a newly developed automated urinary flow cytometer (UFCM) in differentiating the origin of hematuria in the mass screening system for renal diseases in school children. In total, 4,620 children aged 6-14 years with abnormal urinary findings by the screening program in Tokyo were enrolled. Tentative diagnoses were made based on the criteria for this screening program: nephritis in 11, suspected nephritis in 104, hematuria in 771, minimal hematuria in 1,506, proteinuria in 477, urinary tract infection in 83, and healthy in 1,668. Glomerular hematuria, assessed by UFCM, was found in 81.8% of nephritis, 58.7% of suspected nephritis, 59.7% of hematuria, 57.4% of minimal hematuria, 13.4% of proteinuria, and 21.5% of the healthy group. The presence of glomerular hematuria assessed by UFCM had a sensitivity of 61.0%, specificity of 78.5%, positive predictive value of 16.3%, and negative predictive value of 96.7% for the diagnosis of nephritis and suspected nephritis. Thus, our results imply that the absence of glomerular hematuria as assessed by UFCM is highly predictive of the absence of nephritis. If "healthy" children with non-glomerular hematuria by UFCM could be excluded, the total annual cost saving would be approximately 147.4 million JPY, which is equivalent to 5.2% of the current system. In conclusion, a simple, automated and rapid test for glomerular hematuria using UFCM is useful for mass screening. It can precisely predict children with only transient hematuria who do not have any serious illness, and therefore can exclude further unnecessary examinations, resulting in the improvement of cost-effectiveness of the current program.

Adolescent↗
PubMedDate not supplied

[Evaluation of mass screening activity for cardiovascular disease risk factors in a rural environment].

The aim of this study was to evaluate the immediate and short-term impacts of a cardiovascular mass screening activity in a rural environment. A posttest-only control group design was used. Concerning the immediate impact, the results showed that the participants of the experimental group had, compared to the participants in the control group, a higher intention to participate regularly in physical activities and a higher intention to reduce their fat consumption. The participants' intention to stop smoking was not modified by the screening activity. After four months, the results revealed an increase in participation in physical activities and a decrease in fat consumption. The proportion of participants who smoked did not decrease. In conclusion, it is suggested that a cardiovascular mass screening activity such as the one performed in this study could be effective in motivating a population to adopt heart health-related behaviours. Others studies are necessary however to confirm the short-term impact of this type of activity on behaviour modification with regard to cardiovascular health.

Adult↗