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Results for “Screening programs”

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PubMed1997

Prostate-specific antigen levels from a mass screening program using highly sensitive RIA kits.

BACKGROUND: This study was designed to evaluate the distribution of prostate-specific antigen (PSA) levels of men in a mass screening program for prostatic disease. METHODS: A total of 763 men over 40 years of age underwent mass screening for prostatic disease in a Japanese prefecture using the highly sensitive Eiken kit and the Hybritech (Tandem-R) kit. The screening tests consisted of serum PSA determination, digital rectal examination, a questionnaire on symptoms, evaluation of prostate volume, and determination of the obesity rate. RESULTS: Serum PSA levels of all subjects were measured with both kits. The correlation between the values obtained by the Eiken kit and those of the Tandem-R kit was high (r = 0.990), but the values of the former were slightly higher than those of the latter. Serum PSA weakly correlated with age, however, when estimated within decade age brackets, the levels of PSA showed significant differences among only 1 pair of groups stratified by age. In contrast, the levels of PSA showed significant differences among 9 pairs of groups stratified by prostate volume. CONCLUSION: A highly sensitive assay kit is useful to evaluate both the distribution of PSA levels and the relationship of PSA values to age and prostate volume of men in mass screening programs for prostatic disease, since approximately 40% of the subjects who underwent the present mass screening showed PSA values under 1.0 ng/mL, which have been the the lower limit of detection of many PSA kits.

Adult↗

PubMedDate not supplied

Promoting participation in a population screening program for breast and cervical cancer: a randomized trial of different invitation strategies.

AIMS AND BACKGROUND: Attendance level has been identified as a major determinant of cost-effectiveness of organized screening programs. We tested the effectiveness of 4 different invitation systems in the context of an organized population screening program for cervical and breast cancer. METHODS: Women eligible for invitation--8385 for cervical and 8069 for breast cancer screening--listed in the rosters of 43 and 105 general practitioners (GP), respectively, who had accepted to collaborate in the program, were randomized to 4 invitation groups: Group A--letter signed by the GP, with a prefixed appointment; Group B--open-ended invitation, signed by the GP, prompting women to contact the screening center to arrange an appointment; Group C--letter (same as for group A), signed by the program coordinator, with a prefixed appointment; Group D--extended letter (highlighting the benefits of early cancer detection) signed by the GP, with a prefixed appointment. Assignment to the interventions was based on a randomized block design (block=GP). RESULTS: Assuming Group A as the reference, the overall compliance with cervical cancer screening was reduced by 39% in Group B (RR=0.61; 95% CI, 0.56-0.68) and by 14% in Group C (RR=0.86; 95% CI, 0.78-0.93); no difference was observed for Group D (RR=1.03; 95% CI, 0.95-1.1). The response pattern was similar for breast screening (Group B: RR=0.71; 95% CI, 0.65-0.76; Group C: RR=0.87; 95% CI, 0.81-0.94; Group D: RR=1.01; 95% CI, 0.94-1.08). CONCLUSIONS: Personal invitation letters signed by the woman's GP, with preallocated appointments, induce a significant increase in compliance with screening. Efficiency can be ensured through the adoption of overbooking, provided that attendance levels are regularly monitored.

Adult↗

PubMed1979

Improved case finding for pediatric hearing loss: cost analysis of school screening programs.

The majority of school hearing conservation programs employ pure tone identification audiometry as a basis of referral for further evaluation. An analysis of the cost impact of school screening programs is presented and a method of relating costs to screening program accuracy is described. This type of analysis may be used as a model for estimating cost impact and cost-benefit for pure tone audiometry and other techniques of screening for hearing loss.

Child↗

PubMed2003

Improving participation in Chlamydia screening programs: perspectives of high-risk youth.

BACKGROUND: Many young people at highest risk for chlamydial infection do not use chlamydia screening services. OBJECTIVES: To describe young people's beliefs and opinions about obstacles to and motivators for obtaining testing and to provide recommendations for how to improve youth participation in chlamydia screening programs. METHODS: Eight focus group interviews (4 male and 4 female groups) were conducted with young people using a semistructured interview guide. Thirty-two male and 23 female volunteers (mean age, 18.2 years; age range, 15-24 years) were recruited from Job Corps and Department of Youth Services sites. The main outcome measure was categorization of textual data using content analysis techniques. Data were coded by 2 investigators into categories of responses based on research questions and spontaneously offered comments. Satisfactory intercoder agreement was achieved. RESULTS: Participants described many obstacles to testing, including concern that someone will know they were tested or tested positive, fear about discovering they have a sexually transmitted disease, and fear of acquired immunodeficiency syndrome. Many participants were unsure what physical effects chlamydia produced or thought it was possible to die of a chlamydial infection. Participants recommended providing more information about the effects of chlamydia, availability of urine testing, and ease of treatment to motivate more young people to seek testing. They also emphasized the need to make sexually transmitted disease screening services more private and confidential. There was an overwhelming interest in using a home Chlamydia test (much like a home pregnancy test) if one were available. CONCLUSIONS: To increase youth participation in screening programs, it will be necessary to address their concerns, dispel misconceptions, and provide more information about chlamydia. A home Chlamydia test might be one way to increase screening.

Adolescent↗

PubMed1996

Twenty-year outcome analysis of genetic screening programs for Tay-Sachs and beta-thalassemia disease carriers in high schools.

Programs for education, screening, and counseling of senior-high-school students, in populations at high risk for Tay-Sachs and beta-thalassemia diseases, have existed for >20 years in Montreal. Four process and outcome variables are reported here: (i) voluntary participation rates in the high-school cohort; (ii) uptake rates for the screening test; (iii) origin of carrier couples seeking the prenatal diagnosis option in the programs; and (iv) change in incidence of the two diseases. Between 1972 and 1992, we screened 14,844 Ashkenazi-Jewish students, identified 521 HexA-deficient carriers (frequency 1:28), reached 89% of the demographic cohort in the educational component of the program, and achieved 67% voluntary participation in the subsequent screening phase. The corresponding data for the beta-thalassemia program are 25,274 students (mainly of Mediterranean origin) representing 67% of the cohort with 61% voluntary participation in the screening phase (693 carriers; frequency 1:36). From demographic data, we deduce that virtually all the carriers identified in the high-school screening program remembered their status, had their partner tested if they did not already know they were a carrier couple, and took up the options for reproductive counseling/prenatal diagnosis. In Montreal, the current origin of all couples using prenatal diagnosis for Tay-Sachs and beta-thalassemia diseases is the corresponding genetic screening/testing program, whereas, at the beginning of the programs, it was always because there was a history of an affected person in the family. Incidence of the two diseases has fallen by 90%-95% over 20 years; the rare new cases are born (with two exceptions) outside the target communities or to nonscreened couples.

Adolescent↗

PubMed1994

Utilization of a questionnaire to provide follow-up services in an infant hearing screening program.

An important goal of any neonatal hearing screening program is to provide adequate monitoring and follow-up services for all newborns tested. This is often the most difficult component of the program to administer. An attempt was made to obtain follow-up information through the use of a questionnaire modeled after Jacobson and Jacobson (1990). This questionnaire was administered by mail or telephone to 119 parents whose infants had passed a hearing screening as neonates in four hospitals. Forty-four percent of all parents contacted by either means responded to the questionnaire; however, response rates varied by as much as 36 percent, depending on the hospital in which a child was born. Our results suggest that the successful use of follow-up questionnaires depends greatly upon hospital demographics. When limitations are considered, however, they may provide an alternative to on-site follow-up services for infants who pass initial screening.

Hearing Disorders↗

PubMed1987

Screening for secretory otitis media: evaluation of some impedance screening programs for long-lasting secretory otitis media in 7-year-old children.

In an unselected cohort of 387 seven-year-old children 90% had all 9 planned impedance audiometries during their first year at school. The results from these 348 children were analyzed in different impedance screening programs, as 3 consecutive screening series, each comprising two or 3 tests at an interval of 4-8 weeks. The specificity of the ASHA and Nashville programs was too low in finding long-lasting secretory otitis media, namely about 70%, so that there were too many false positive cases. Therefore, a new impedance screening program was designed. It had about the same sensitivity (80%) but a far better specificity (95%) than the ASHA and Nashville programs. The predictive value of a positive test was 15% in the ASHA and Nashville programs, but 3 times better (48%) in the designed Hirtshals program. The Hirtshals program had a referral rate of 9% compared with the 32-36% in the ASHA and Nashville programs. The frequencies of retesting were 31% in the ASHA program, 52% in the Nashville Program and 45% in the Hirtshals program. Before general screening for long-lasting secretory otitis media can be recommended, additional information is needed.

Acoustic Impedance Tests↗

PubMed1996

Evaluation of the utility of spirometry in a regional public health screening program for workers exposed to welding fumes.

The objective of this study was to determine the usefulness of spirometry in the screening of chronic pulmonary problems related to exposure to welding fumes, in a regional public health-based screening program. Pulmonary questionnaires and spirometric tests were administered twice at 5-year intervals on 229 welders/cutters (mean age, 39.9 years from 31 metal manufacturing plants. The baseline mean value at the first test for the forced expiratory volume in one second (FEV1) was 102% of predicted, the forced vital capacity (FVC) was 107%, and the FEV1/FVC ratio was 79%. The mean annual changes in the three spirometric indicators were -47 mL, -46 mL, and -0.3%, respectively. The usefulness of spirometry was assessed by looking at the relationship between exposure to welding fumes and changes in spirometric indices, in multivariate linear regression analysis, accounting for age, height, and smoking. A high lifetime exposure to welding fumes was associated with better lung functions in the cross-sectional approach (healthy worker effect) but not in the longitudinal approach, where no association was found. We concluded that the public health regional application of this screening program generated too many sources of variation for spirometry to fulfill the objective of early detection of pulmonary function decline related to exposure to welding fumes. Based on these observations, we recommend that maintaining questionnaire screening, with spirometry reserved as a second-line diagnostic intervention.

Adult↗

PubMed2006

Performance measures from 10 years of breast screening in the Ontario Breast Screening Program, 1990/91 to 2000.

Performance measures for the Ontario Breast Screening Program (OBSP) by age group, time period and screening modality from 10 years of breast screening were evaluated. Data were available from routine information collected on 283,962 women aged 50 to 69 screened at 73 screening centres between 1 July 1990 and 31 December 2000. Although, initially, participation in the OBSP was low, this rate increased over time and the majority of women screened returned for subsequent screening. Abnormal call rates increased slightly over the time period, were higher in women aged 50 to 59, and for women with mammographic abnormalities. Detection rates of invasive cancer were higher and prognostic features of cancers were better for women age 60 to 69, and those referred by mammography. Along with the prognostic features of cancers, the benign to malignant surgical ratio and diagnostic interval improved over the time periods and for women aged 60 to 69. Greater proportions of women had shorter diagnostic intervals and were more likely to have a diagnosis of breast cancer after surgery if they were referred by both clinical breast examination and mammography. Although some enhancements of the programme are necessary, the OBSP met or exceeded Canadian targets for most performance measures.

Age Factors↗

PubMed2005

Assessment of intra-individual variation in prostate-specific antigen levels in a biennial randomized prostate cancer screening program in Sweden.

BACKGROUND: The degree of variability in prostate-specific antigen (PSA) measurements is important for interpreting test results in screening programs, and particularly for interpreting the significance of changes between repeated tests. This study aimed to determine the long-term intra-individual variation for PSA in healthy men. METHODS: A randomly selected cohort of men in a biennial prostate cancer screening program (ERSPC) conducted in Sweden from 1995-1996 to 2001-2002. We studied men who had total PSA (tPSA) levels < 2.0 ng/ml in 2001-2002. This included 791 men with tPSA < or = 0.61 ng/ml (group A), 1,542 men with tPSA < or = 0.99 ng/ml (group B), and 1,029 men with tPSA 1.00-1.99 ng/ml (group C). The intra-individual variability of free PSA (fPSA) and tPSA was assessed by calculating coefficients of variation (CV) for each individual's PSA measurements from the first and second round of screening (1995-1996 and 1997-1998). RESULTS: Intra-individual CV (geometric means) for tPSA were 13.7%, 12.7%, and 11.5% in groups A, B, and C, respectively. Corresponding CVs for fPSA were significantly lower, ranging from 12.1% to 10.4%. The estimated biological variation of tPSA and fPSA in groups A to C were 12.5%, 11.4%, 10.0% and 9.7%, 7.8%, 7.5%, respectively. CONCLUSIONS: In healthy men with PSA levels less than 2 ng/ml, the natural long-term variability for tPSA was less than 14%, and with 95% probability, a change in tPSA greater than 30% indicates a change beyond normal random variation.

Aged↗

PubMed2005

[Controlling retests in a universal hearing screening program].

INTRODUCTION: To evaluate the influence of several factors in the need for retesting in the first stage of a universal auditory screening program, a prospective and statistic study is presented, specially remarking the differences found between two health systems (public and private). PATIENTS AND METHODS: 18,073 children born in the 1999-2004 period were included in the study, in the context of a universal screening protocol based on Otoacoustic emissions and ABR, and distributed into three groups depending on their place of birth (A: public hospital; B: private hospital; C: children from other region). RESULTS: Significant differences were found between the groups (7.3% retesting in the public system and 2.4% in the private), explained by the fact that in the first group the test was performed in 74.9% of cases within 3 days after birth (when the need for repetition was 7,7%), and in the other groups the exploration was delayed up to 4-10 days in most cases (when retesting was performed only in 4.9%). DISCUSSION AND CONCLUSIONS: Proportion of retesting in the first stage of a universal screening program is an important factor for the cost estimation of these protocols. We assume that the age at testing varies significantly this factor, and on the contrary, we know that precocious exploration (before the child leaves the hospital) increases the program covering. Therefore we conclude that the test should be delayed only in health systems needing to save resources or not able to test before discharge, and not in those wanting to guarantee the maximum covering.

Female↗

PubMed2005

Newborn hearing screening programs: overview.

Implementation of systematic programs for early identification of hearing impairment in the newborn and infant is increasing in Canada and worldwide. This article outlines the rationale for these programs, methods of screening, audiologic assessment and intervention, program outcomes and the crucial role of physicians. Sources of high-quality, current evidence on key aspects of these programs are identified. There is an emerging, evidence-based consensus that a systematic approach based on universal newborn hearing screening (UNHS) and timely, appropriate follow-up services is practicable and will yield substantial net benefit for many affected children and families. Early identification programs lead to physicians being faced with infants under six months of age who already have detailed and accurate audiometry. Important challenges include a systematic approach to etiologic evaluation of the young infant with permanent hearing impairment and the facilitation of prompt, non-medical interventions.

Canada↗

PubMed2004

[The use of interactive medical data transfer to increase effectiveness of a mass screening program].

Cervical cancer is still called the most frequent neoplasm refer to women's genital tract (incidence rate 30-35/100,000/year). Scandinavian countries experiences have shown that effective screening program especially used multimedia (radio, TV, Internet) is one of the based elements, which should improve situation in prevention of cervical cancer. The aim of this study was an attempt to create medical Website including specialized and basic informations for doctors and patients about cervical and breast cancer, their prophylactic and treatment. An influence of these data to increase active participation in screening program was also analysed. Material covers a random sample of 1200 women (30-59 years of age) who were invited to participate in cytology screening in two edition of the program (1997-99, 2000-02). In the years of 2000-02 information about Website was added to the invitation. Medical Website was created as server information. A special questionnaire prepared by Sociology Department was distributed to 1200 women. In both group participation during two screening edition was compared and analysed. All data were statistically correlated. Website address was created: http://pkzr.ac.bialystok.pl. From the group of 1200 questioned (mean age--41.8) answered 1059 women (88.25%). 6.98% (n=74) have never used this Website but 20 of them have done cytology test after receiving an invitation which were posted to all 1200 women. The last of 985 women analysed Website. 80.4% (n=792) have received enough informations about cervical and breast cancer (4.67 point) and decided to participate in cervical cancer screening. From this group only 428 women actively took part in cytology exams in 1997-99. 189 women participated in the screening programme from the last 193 patients (19.6%) who analysed server informations (4.89 point). From 141 people who have not answered for the questionnaire 23 have done cytology test. Participation in the second edition of cervical cancer screening programme (1997-99) was 41.9%. It was really two times lower than in the same group who could used Internet and was estimated on 85.3%. Internet site--http://pkzr.ac.bialystok.pl seems to be a basic digital textbook about cervical and breast neoplastic disease and their prophylactic. It is also interactive transferring data source that could create healthy attitude to increase effectiveness of screening programmes.

Adult↗

PubMed1977

An eye screening program in a Chinese-Canadian community.

A screening program staffed by ophthalmologists, ophthalmology residents, ophthalmic assistants, social workers and Chinese-speaking volunteers and directed at a Chinese immigrant community, was conducted at the Mount Sinai Hospital, Toronto. The Chinese population had been hesitant to use our hospital facilities and we hoped to overcome their fears, as well as to detect previously undiagnosed ocular problems. The program succeeded in finding many eye problems, some serious, and in encouraging this immigrant group to come for proper medical care. We describe the method of setting up and conducting such an undertaking, which involved the Departments of Ophthalmology and Social work, hospital administrators and volunteers from the community.

China↗

PubMedDate not supplied

[Congenital hip dysplasia. The controversial results of a screening program].

The authors report their experience in a screening program for congenital hip dislocation. Goal of this study is to recognize the best technique for early diagnosis in this disease. The result show that we need further study and complete cooperation between pediatrician, radiologist and orthopedist to realize the best cost/benefit ratio.

Female↗

PubMed1999

Pilot neonatal screening program for lysosomal storage disorders, using lamp-1.

We have demonstrated that the lysosome associated membrane protein (LAMP-1) is elevated in plasma from approximately 70% of lysosomal storage disorder patients. As part of the development of a newborn screening program for lysosomal storage disorders we have developed a first tier screening assay based upon the level of LAMP-I in blood spots taken from newborn Guthrie cards. To determine the effectiveness of the first-tier marker a prospective pilot Guthrie neonatal screening program for the identification of LSD was commenced in April 1998. Prior to commencement of the pilot program ethical approval was obtained and information leaflets regarding the neonatal screening of LSD were distributed to parents at the time of their infant's Guthrie collection. The LAMP-1 assay utilizes a chicken polyclonal and a mouse monoclonal in a sandwich time resolved fluorescent immunoassay. LAMP-1 blood-spot calibrators and quality control specimens were developed and shown to be stable and reproducible. To date 11,183 infants have been screened using LAMP-1. The population distribution is described with a median and 98th percentile of 220pg/l whole blood and 483microg/l whole blood respectively. Acceptable CV% for intra and inter assay of 8.9% and 10% respectively were obtained.

Antigens, CD↗

PubMed2002

Parasitic infections in Thai workers that pursue overseas employment: the need for a screening program.

Stool examination is a requirement of the screening program for Thai workers seeking overseas employment. We report on the prevalence of intestinal parasitic infections among these workers; the stool examination results of 2,213 Thai workers who visited the Out-patients Department of the King Chulalongkorn Memorial Hospital between September 2000 and January 2001 were analysed. One hundred and thirty-five (6.1%) were found to be infected with 1 or 2 species of parasite. There were 54 (40%), 47 (34.8%), and 25 (18.5%) cases infected with nematodes, platyhelminths and protozoa, respectively. The commonest parasite was Opisthorchis viverrini (28.9%). Most nematode infections were due to Strongyloides stercoralis (19.2%); most protozoal infections were due to Giardia lamblia (17.0%). Mixed infections were found in 9 cases. Not unexpectedly, the rate of intestinal parasitic infection among Thai workers remains high. Screening for the parasitic infections among these workers can help to decrease their rate of rejection by the countries in which overseas employment is sought.

Employment↗

PubMed1979

Evaluation of a mass screening program for stomach cancer.

To evaluate a mass screening program for stomach cancer, we followed 32,789 subjects for 6.1 years by means of a record linkage to a population-based cancer registry. The results show that the mortality from stomach cancer among those studied decreased by 9% as compared with the expected number calculated on the basis of the sex- and age-specific rates among the general population. When the study subjects were limited to those aged 40-59 years, the decrease in stomach cancer deaths became more marked, i.e., a 26% decrease was observed. Because this study is not a controlled trial, the results must be interpreted with the reservation that some biases were present in the study subjects.

Adult↗