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Results for “Cancer screening”

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At least 433 records · Page 24Linked to original sources

PubMed2006

Colorectal cancer screening among obese versus non-obese patients in primary care practices.

BACKGROUND: Obesity is associated with increased colorectal cancer incidence and mortality. Previous studies using telephone survey data showed that obese women were less likely to receive colorectal cancer screening. It is unknown if this is true among patients in primary care practices. METHODS: Retrospective chart reviews were conducted in 2003-2004 of men and women in 22 suburban New Jersey and Pennsylvania primary care practices. Data from patients age 50 years and over (n=1297) were analyzed using hierarchical logistic regression. The outcome measure was receipt of colorectal cancer screening (fecal occult blood test within 1 year, sigmoidoscopy within 5 years, colonoscopy within 10 years, or barium enema within 5 years) among obese and non-obese patients. RESULTS: Overall, 39% of patients were obese and 29% received colorectal cancer screening. After controlling for age, gender, total number of co-morbidities, number of visits in the past 2 years, and number of years in the practice, obese patients had 25% decreased odds of being screened for colorectal cancer compared to non-obese patients (OR 0.75, 95% CI, 0.62-0.91). The relationship of obesity and colorectal cancer screening did not differ according to gender. Number of visits (OR 1.04, 95% CI, 1.01-1.06) and male gender (OR 1.53, 95% CI, 1.19-1.97) was associated with increased odds of receiving colorectal cancer screening. CONCLUSION: Identification of physician and patient barriers to colorectal cancer screening is needed, particularly in obese patients, so that effective interventions may be developed to increase screening in this high-risk group.

Aged↗

PubMed1995

A review of the technical features of breast cancer screening illustrated by a specific model using South Australian cancer registry data.

This paper illustrates many of the concepts and issues relating to breast cancer screening by reference to a case study of screening in South Australia and by a survey of the mathematical screening models. This work is motivated by the observation that, for some women, the prospects for a breast cancer cure appear to be enhanced if the disease is detected early. We use data from the South Australian Cancer Registry to estimate some of the parameters which describe the pattern of this disease in the South Australian female population, and the underlying model is then used to estimate the impact of various screening designs on the efficacy of a variety of breast cancer screening programmes.

Breast Neoplasms↗

PubMed2002

Successful colorectal cancer screening starts with primary care.

Colorectal cancer screening is effective. Screening rates remain low, but that will change. All guidelines now recommend colorectal cancer screening, the value of screening is being promoted in the popular media, and insurers are beginning to pay for screening tests. For screening programs to be successful, good intentions must be backed by reminder systems, readily available patient information, and other changes in office practice. Currently recommended screening options accommodate a broad range of patient preferences and save lives, but none is ideal. Newer tests, such as virtual colonoscopy and stool-based DNA tests, will help if they offer greater sensitivity, specificity, or patient acceptability than current screening options.

Barium Sulfate↗

PubMed2004

Prostate cancer screening among military service members.

This retrospective study investigated the characteristic of military male beneficiaries age 50 years and older who were screened for prostate cancer at a medical center in the Pacific Regional Command. Data were collected on male patients who were seen in three adult outpatient clinics from December 1999 through November 2001. Two research questions were asked: What are the characteristics of men age 50 and older who were screened for prostate cancer? Are there variations in prostate cancer screening based on age, ethnicity, and military status? Data were analyzed using descriptive statistics. The sample was predominantly Caucasian and Asian/Pacific Islander who were over age 67. Although there was evidence of screening in 68% of the sample, 13% of the men had been screened according to the American Cancer Society's recommendations. The findings support the need for a prostate cancer screening policy for the Department of Defense.

Aged↗

PubMed1999

The validity of male patients' self-reports regarding prostate cancer screening.

BACKGROUND: Despite the high rate of prostate cancer screening, the accuracy of male patients' self-reports of screening has not been investigated. This study assessed the concordance between patients' self-reports of prostate screening and the medical record. METHODS: Focus groups were conducted to obtain male patients' perceptions of prostate cancer screening and salient terminology. A sample of males (n = 276), 40 years of age or older, completed a 15-item questionnaire. Patients' self-reports of PSA and DRE screening were then compared with medical records. RESULTS: Results showed that patients' self-reports of DRE and PSA were discordant with the medical record 32 and 29% of the time, respectively. Sensitivity of patients' self-reports for DRE and PSA was 82 and 74%, respectively. Specificity of patients' self-reports for DRE and PSA was 56 and 65%, respectively. One in five patients reported that they were not sure how a doctor checks a man's prostate gland. Only 39% of patients knew that the prostate gland can be checked by a blood test. CONCLUSIONS: There were significant differences between patients' self-reports and the medical record. The results should be of concern to primary care practitioners and to those who evaluate the efficacy of prostate cancer screening programs.

Adult↗

PubMed2001

Racial and ethnic colorectal cancer patterns affect the cost-effectiveness of colorectal cancer screening in the United States.

BACKGROUND & AIMS: Colorectal cancer screening beginning at age 50 is recommended for all Americans considered at "average" risk for the development of colorectal cancer. METHODS: We used 1988-1995 California Cancer Registry data to compare the cost-effectiveness of two 35-year colorectal cancer screening interventions among Asians, blacks, Latinos, and Whites. RESULTS: Average annual age-specific colorectal cancer incidence rates were highest in blacks and lowest in Latinos. Screening beginning at age 50 was most cost-effective in blacks and least cost-effective in Latinos (measured as dollars spent per year of life saved), using annual fecal occult blood testing (FOBT) combined with flexible sigmoidoscopy every 5 years and using colonoscopy every 10 years. A 35-year screening program beginning in blacks at age 42, whites at age 44, or Asians at age 46 was more cost-effective than screening Latinos beginning at age 50. CONCLUSIONS: Colorectal cancer screening programs beginning at age 50, using either FOBT and flexible sigmoidoscopy or colonoscopy in each racial or ethnic group, are within the $40,000-$60,000 per year of life saved upper cost limit considered acceptable for preventive strategies. Screening is most cost-effective in blacks because of high age-specific colorectal cancer incidence rates.

Adult↗

PubMed2005

Reduced likelihood of cancer screening among women in urban areas and with low socio-economic status: a multilevel analysis in Japan.

OBJECTIVES: To elucidate socio-economic predictors of participation in cancer screening in Japanese women, paying attention to regional variations. METHODS: In a nationally representative sample of women aged 40--64 years (n=15,224) in Japan, the relationships of self-reported attendance at screening for stomach, colon, uterine and breast cancers with individual characteristics (marital status, occupation and household income) and regional variables (living in a metropolitan area or not, and per capita income) were examined using multilevel analysis. RESULTS: The participation rate ranged from 21.6% for colon cancer to 32.5% for uterine cancer. Being married, employed and having a higher household income were significantly associated with a higher likelihood of cancer screening for all types of cancer: the adjusted odds ratio in the lowest income quintile ranged from 0.45 for uterine cancer to 0.53 for colon cancer compared with the highest income quintile. There was significant regional variance, and living in a metropolitan area and per capita income were associated with a reduced likelihood of cancer screening. CONCLUSIONS: Women with lower socio-economic status and living in urban areas are less likely to participate in cancer screening in Japan. Cancer screening should be encouraged in urban areas, taking account of the socio-economic inequalities.

Adult↗

PubMed2006

Measuring the quality of colorectal cancer screening: the importance of follow-up.

PURPOSE: As evidence mounts for effectiveness, an increasing proportion of the United States population undergoes colorectal cancer screening. However, relatively little is known about rates of follow-up after abnormal results from initial screening tests. This study examines patterns of colorectal cancer screening and follow-up within the nation's largest integrated health care system: the Veterans Health Administration. METHODS: We obtained information about patients who received colorectal cancer screening in the Veterans Health Administration from an existing quality improvement program and from the Veterans Health Administration's electronic medical record. Linking these data, we analyzed receipt of screening and follow-up testing after a positive fecal occult blood test. RESULTS: A total of 39,870 patients met criteria for colorectal cancer screening; of these 61 percent were screened. Screening was more likely in patients aged 70 to 80 years than in those younger or older. Female gender (relative risk, 0.92; 95 percent confidence interval, 0.9-0.95), Black race (relative risk, 0.92; 95 percent confidence interval, 0.89-0.96), lower income, and infrequent primary care visits were associated with lower likelihood of screening. Of those patients with a positive fecal occult blood test (n = 313), 59 percent received a follow-up barium enema or colonoscopy. Patient-level factors did not predict receipt of a follow-up test. CONCLUSIONS: The Veterans Health Administration rates for colorectal cancer screening are significantly higher than the national average. However, 41 percent of patients with positive fecal occult blood tests failed to receive follow-up testing. Efforts to measure the quality of colorectal cancer screening programs should focus on the entire diagnostic process.

Aged↗

PubMed2001

[Lung cancer screening--what now?].

BACKGROUND: Lung cancer is the most common cause of cancer death in developed countries. Because of the lack of efficient diagnostic tools for early detection and of efficient treatment for advanced disease, the prognosis of lung cancer is generally poor, with 10-15% surviving 5 years after diagnosis. Still, the majority of patients present with advanced disease. Stage IV disease is beyond cure and stage III disease is rarely curable with current therapies. Over the course of the last decade, rapid advances in molecular biology, pathology, bronchoscopy and radiology have provided a rational basis for earlier diagnosis and improved outcome. MATERIAL AND METHODS: This article reviews recent advances in the early detection of lung cancer by low-dose spiral CT scanning. The review is based on a literature search in Medline and data presented at the 3rd International Conference on Screening for Lung Cancer in New York in October 2000. RESULTS: The most promising advent has been the development of low-dose spiral CT as a screening tool for lung cancer. The advantage of this method is the possibility of diagnosing small peripheral tumours before they have spread to regional or distant areas. INTERPRETATION: A shift in the therapeutic paradigm from targeting clinically manifest advanced lung cancer towards asymptomatic preinvasive and early invasive cancer is occurring. If the altered stage distribution (87% stage I) as seen in three non-randomized population-based studies is real, CT screening may raise the lung cancer cure rate above 60%.

Clinical Trials as Topic↗

PubMedDate not supplied

Costs and benefits of prostate cancer screening. Investigators of the American Cancer Society--National Prostate Cancer Detection Project.

Optimal combinations of digital rectal examination (DRE), transrectal ultrasound (TRUS) and prostate specific antigen (PSA) may better detect patients at high risks, as well as those in whom continued screening may not be cost effective. Our recent cost analysis of prostate cancer early detection used current data from three consecutive years of the American Cancer Society's National Prostate Cancer Detection Project. Marginal cost analysis showed marked increased costs for the DRE by year three due to significantly reduced sensitivity for incident cancers. The benefit-cost equation acknowledges that many parameters of both cost and probability are not definitive at this time, yet illustrated major points for discussion. The cost parameters most sensitive to incremental change in decreasing order are: the specificity of the screening test > benefits obtained from early therapy > prevalence of the disease. Benefit-cost calculations demonstrated that DRE, when performed by highly skilled examiners, had the lowest cost. However, DRE became one of the most costly detection scenarios when a minor decrease in DRE performance was assumed for more general examiners. If slightly more specific PSA usage (or assay) is developed, the higher prevalence of clinically detectable prostate cancer could make screening less costly than breast cancer screening. If we assume minimized future expenditures for terminal cancer care via reductions in therapy choices or coverage, no economic benefit for screening exists. If we also assume that potential costs to society are not roughly approximated by any benefits, we may engender inappropriate attempts at cost reduction by effectively discouraging screening in the highest risk groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗

PubMed2005

Factorial validity and invariance of a survey measuring psychosocial correlates of colorectal cancer screening among African Americans and Caucasians.

BACKGROUND: Psychosocial constructs are widely used to predict colorectal cancer screening and are targeted as intermediate outcomes in behavioral intervention studies. Reliable and valid instruments for measuring general colorectal cancer screening psychosocial constructs are needed; yet, few studies have conducted psychometric analyses. This study replicated a five-factor structure for 16 theory-based, general colorectal cancer screening items measuring salience and coherence, cancer worries, perceived susceptibility, response efficacy, and social influence. In addition, we examined factorial invariance across race and sex. METHODS: African American and Caucasian patients (n = 1,413) attending an urban, primary care clinic were included in this study. These individuals completed a baseline survey as part of a colorectal cancer screening intervention trial. Single and multigroup confirmatory factor analyses using maximum-likelihood estimation were done. RESULTS: The five-factor general colorectal cancer screening model provided excellent fit and was invariant across race-sex subgroups. CONCLUSIONS: The findings of invariance across sex and race subgroups support the use of these scales to measure group differences.

Black or African American↗

PubMed2000

Cancer screening behaviors among Korean-American women.

The goals of this study were to evaluate breast and cervical cancer screening tests and to examine the correlates of cancer screening behaviors. A cross-sectional face-to-face survey of 438 Korean-American women residing in Maryland was conducted. About 50% of women age 18 and older had had a Pap smear and 46.6% of these women age 40 and older had had a mammogram in the past 2 years. In multiple logistic regression analyses, the strongest correlate of screening behaviors was having a regular medical checkup. Age and acculturation were found to be important correlates of cancer screening tests: Women less than 50 years of age were more likely to have cancer screening tests than those 50 years and older. English language proficiency was associated with having a mammogram and the proportion of life spent in the United States was associated with having a Pap smear. Employment interacted with marital status for a Pap smear, with those married and unemployed being less likely to have a Pap smear than women who were both married and employed. For strategies to increase cancer-screening tests among Korean-American women, we need to aim at developing culturally appropriate educational programs about cancer for less acculturated and recent immigrants.

Adult↗

PubMedDate not supplied

Current and evolving strategies for colorectal cancer screening.

BACKGROUND: Colorectal cancer is a major cause of cancer mortality and morbidity. Screening can potentially prevent most colorectal cancers by detection and removal of precursor adenomas. METHODS: The literature and clinical practice guidelines are reviewed, with an emphasis on advances of the last 10 years and evolving screening methods. RESULTS: Colonoscopy has come to be used for screening in persons at average risk for colorectal cancer because of the comparative ineffectiveness of other methods, although these methods continue to be recommended. Virtual colonoscopy and fecal DNA testing are emerging technologies with promise to be more effective than fecal occult blood testing or sigmoidoscopy in selecting those persons who should undergo colonoscopy. Next to age, family history is the most common risk factor for colorectal cancer and one that warrants more aggressive screening and, in some instances, genetic counseling and testing. Hereditary nonpolyposis colorectal cancer accounts for as many as 1 in 20 colorectal cancers, but to take advantage of recent advances in genetic testing for this disorder, a high level of clinical suspicion must be maintained. CONCLUSIONS: If we are to reduce mortality and morbidity from colorectal cancer, practicing clinicians need to be aware of current and evolving strategies for colorectal screening, and assertively recommend the appropriate strategy to their patients.

Colonography, Computed Tomographic↗

PubMedDate not supplied

[Economic approach to breast cancer screening in Belgium].

In Belgium, the breast cancer screening by mammography involves a great number of women. It is largely non organized and regarded to the small number of data, it is impossible to determine if this screening is useful and if it has a good "cost-benefit" ratio. This work studies the economical aspects of breast cancer screening in the belgian health care system. From information found in other countries, we build 4 models corresponding to an organized and a spontaneous screening. We studied the total processus from screening to diagnosis, including the quality assurance and the evaluation of effectiveness in the organized models. We then applied the reimbursements of the belgian health insurance in the models and compared the costs. It appears that a screening for breast cancer must be organized to give a best "cost-effectiveness" ratio. Pilot projects should be the best way to study the best organization modalities in Belgium.

Adult↗

PubMed2001

[Economic approach to breast cancer screening in Belgium].

In Belgium, the breast cancer screening by mammography involves a great number of women. It is largely non organized and regarded to the small number of data, it is impossible to determine if this screening is utile and if it has a good "cost-benefit" ratio. This work studies the economical aspects of breast cancer screening in the belgian healthcare system. From information found in other countries, we build four models corresponding to an organized and spontaneous screening. We studied the total processes from screening to diagnosis, including the quality assurance and the evaluation of effectiveness in the organized models. We then applied the reimbursements of the belgian health insurance in the models and compared the costs. It appears that a screening for breast cancer must be organized to give a best "cost-effectiveness" ratio. Pilot projects should be the best way to study the best organization modalities in Belgium.

Age Factors↗

PubMed2007

Trends in colonoscopy for colorectal cancer screening.

BACKGROUND: A major health priority is to increase colorectal cancer screening, and colonoscopy has become an increasingly important method of screening. The Medicare program began coverage for colonoscopy for average risk individuals in 2001. OBJECTIVES: We sought to examine whether overall colorectal cancer screening increased over time and whether these increases were a result of increased utilization of all methods or a result of greater use of colonoscopy but reduced use of other methods, whether the enactment of Medicare coverage was associated with an increase in colonoscopy among Medicare enrollees, and whether these trends equally affected subpopulations. METHODS: We used nationally representative data from the 2000 and 2003 National Health Interview Surveys and analyzed data using used chi, difference-in-differences tests, and logistic regression analyses to examine whether screening rates differed between 2000 and 2003. RESULTS: The percentage of individuals being screened for colorectal cancer using any method increased modestly from 2000 to 2003 (3%), with increases a result of increased use of colonoscopy and a reduction in the use of other methods. Increases in colonoscopy use were significant among all populations except the insured, non-Medicare population with low incomes. Among Medicare enrollees with high/middle incomes, colonoscopy use increased 14% from 2000 to 2003 compared with an increase of only 7% among low-income groups, which was a significant difference (P < 0.01). Similarly, among insured, non-Medicare enrollees with high/middle incomes, colonoscopy use increased 11% from 2000 to 2003 compared with an increase of only 4% among low-income groups, which also was a significant difference (P < 0.01). CONCLUSIONS: Colorectal cancer screening utilization increased modestly from 2000 to 2003, with the increases that primarily were the result of increased colonoscopy use. Increases in colonoscopy use, however, were primarily among high/middle income groups. Although Medicare coverage may have indirectly facilitated the increase in colonoscopy, we could not determine that coverage directly increased screening rates. Screening rates remain modest and lower income individuals continue to be screened less. Topics for future research include approaches to facilitating screening among low-income individuals and evaluating the impact of policy coverage decisions.

Aged↗

PubMed2005

Cancer screening among jail inmates: frequency, knowledge, and willingness.

OBJECTIVES: We determined jail inmates' knowledge of cancer screening tests, their frequency of screening, and their willingness to undergo screening in jail in order to assess preventive health services for jail inmates. METHODS: We performed a cross-sectional interview survey of random samples of county jail inmates (n=133). RESULTS: Approximately half (53%) the participants were African American, 17% were White, 11% were Latino, and 9% reported multiple ethnicities. Among women aged 18 years and older, 90% had had a Papanicolaou (Pap) test within 3 years, and 94% were willing to be screened in jail. Having ever had a Pap test while incarcerated was significantly associated with being up to date on cervical cancer screening. For women aged 40 years and older, 41% reported having had a mammogram within 2 years, and 88% were willing to have one. Among men (n=51) and women (n=4) aged 50 years and older, 25% had knowledge of colon cancer screening, 31% were up to date, and 69% were willing to be screened. Increased knowledge about colon cancer screening was significantly associated with being White and having insurance. Jail inmates, particularly African Americans, had significantly lower frequency of sigmoidoscopy and colonoscopy than the general population. CONCLUSIONS: Jail could be an appropriate venue in which to provide cancer screening for a high-risk population. Inmates were receptive to jail-based screening.

Adult↗

PubMed1991

Nurses' practice of breast cancer screening and early detection: results of a pilot survey.

Nursing has a professional responsibility to participate in cancer screening and early detection. Nurses represent the largest professional group in the health care workforce and are presently an underutilized potential resource for implementing breast cancer screening and early detection. Development of a reliable and valid instrument which could be used to evaluate the effectiveness of mechanisms designed to increase nursing's role in breast cancer screening and early detection is needed. The questionnaire tested in this pilot study represents an initial attempt at fulfilling this need. This questionnaire in its present form may be used to evaluate the results of intervention studies aimed at increasing nurses' practice of breast cancer screening and early detection. For example, the questionnaire could be used as an evaluation tool to examine the effectiveness of educational programs regarding breast cancer screening and early detection. It may also be used as an outcome measure to evaluate change in practice activities such as the effect on nursing practice of including questions on the nursing history and assessment form related to BSE, clinical breast exam and mammography. Results of nursing action in breast cancer screening and early detection could have a significant impact on the achievement of the NCI's year 2000 goal of a 30% reduction in breast cancer mortality.

Adult↗