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 505 records · Page 28Linked to original sources

PubMed2005

Volume of screening mammography and performance in the Quebec population-based Breast Cancer Screening Program.

BACKGROUND: In the Quebec Breast Cancer Screening Program (Programme quebecois de depistage du cancer du sein [PQDCS]), radiologists' and facilities' volumes of screening mammography vary considerably. We examined the relation of screening-mammography volume to rates of breast cancer detection and false-positive readings in the PQDCS. METHODS: The study population included 307,314 asymptomatic women aged 50-69 years screened during 1998-2000. Breast cancer detection rates were analyzed by comparing all women with screening-detected breast cancer (n = 1709) and a 10% random sample of those without (n = 30,560). False-positive rates were analyzed by comparing the 3159 women with false-positive readings and the 27,401 others in the 10% random sample. Characteristics of participants, radiologists and facilities were obtained from the PQDCS information system. Data were analyzed by means of logistic regression. RESULTS: The rate of breast cancer detection appeared to be unrelated to the radiologist's screening-mammography volume but increased with the facility's screening-mammography volume. The breast cancer detection rate ratio for facilities performing 4000 or more screenings per year, compared with those performing fewer than 2000, was 1.28 (95% confidence interval [CI] 1.07-1.52). In contrast, the frequency of false-positive readings was unrelated to the facility's screening volume but was inversely related to the radiologist's screening volume: the rate ratio for readers of 1500 or more screenings per year compared with those reading fewer than 250 was 0.53 (95% CI 0.35-0.79). INTERPRETATION: Radiologists' and facilities' caseloads showed independent and complementary associations with performance of screening mammography in the PQDCS. Radiologists who worked in larger facilities and read more screening mammograms had higher breast cancer detection rates while maintaining lower false-positive rates.

Aged↗

PubMed2001

Health beliefs and illness attitudes as predictors of breast cancer screening attendance.

BACKGROUND: This paper considers the breast cancer screening programme in the autonomous community of Navarre, Northern Spain. Women from different areas of Northern, Central and Southern Navarre are involved. METHODS: A sample of 512 women participants and 196 non-participants was taken from a total of 60,908 women between 45 and 65 years of age who received an invitation to attend the breast cancer screening programme. The participants were asked to fill in an individual structured questionnaire in their local Health Centre and the non-participants in their homes. This was done retrospectively. RESULTS: The response rate was 100% for participants and 83.9% for non-participants. This study investigates the attitude profiles of the women attending mammography mass screening, with non-attending women (matched in educational and occupational levels) as controls. Subjects were assessed on dimensions such as attitudes towards health and illness. The results support Rosenstock's 1974 model that perceived severity of breast cancer and perceived susceptibility to breast cancer are related to participation in screening. Furthermore, results demonstrated that hypochondriacal beliefs, disease phobia and feared effects of symptoms were related to decreased participation levels. CONCLUSION: This study has explored the implication of health belief attitudes and the attitudes toward illness variables with women's participation in a breast cancer screening programme. It assesses the relative contribution of these variables to levels of participation, and the results of the study indicate that belief sets and attitudes are important components of women's cancer prevention behaviours.

Aged↗

PubMedDate not supplied

Cancer screening of older women : a primary care issue.

PURPOSE: The purpose of this retrospective chart review was to examine whether family practice physicians and residents were screening older women for breast, gynecologic, and colorectal cancers as recommended by the American Cancer Society, the Guide to Clinical Preventive Services, and Healthy People 2000. METHODS: A retrospective chart review of women 60 years and older who were seen at least twice between July 1, 1992, and June 30, 1993, in a midwestern family practice residency program was completed. From the original sample of 660 potential subjects, a systematic random selection of every third chart was identified for review, resulting in a sample of 201. Analysis of the data was performed by descriptive statistics and chi-square tests. A series of multiple regression models using age, number of visits, type and gender of provider, and personal or family history of cancer as predictor variables was performed. RESULTS: Breast cancer screening was offered to approximately 70% of the sample, with only about one third of the older women receiving mammography or clinical breast examination. Recommendations for gynecologic cancer screening were given to 63% of the sample, with less than one third receiving Papanicolaou smears. Recommendations for digital rectal examination, fecal occult blood test, and flexible sigmoidoscopy were 58%, 59%, and 30%, respectively. The percentages of patients who actually received these tests were considerably lower. CLINICAL IMPLICATIONS: Barriers for appropriate cancer screening for older women exist for both the provider and the patient; however, many of these obstacles can be overcome. Improving the resident's exposure to the current recommendations, increasing geriatric content in the training program, and initiating a reminder system may reduce some of the provider barriers. The use of midlevel providers may increase the preventive services offered to older women as well as educate and empower these women to become responsible for their own healthcare. Together, physicians and midlevel providers can become patient advocates through political activism, encouraging legislation that guarantees payment for cancer screening tests. Finally, primary care providers can become actively engaged in research that explores the healthcare concerns of older women.

Aged↗

PubMed2000

Performance of ultrasound as a second line test to serum CA125 in ovarian cancer screening.

OBJECTIVE: To assess the performance of ultrasonography in a multimodal ovarian cancer screening strategy. DESIGN: Prospective ovarian cancer screening trial between December 1986 and June 1993. SETTING: General practice, occupational health departments and an ovarian cancer screening clinic at a London teaching hospital. POPULATION: Postmenopausal women, > or = 45 years with a raised CA125. METHODS: Volunteers with a CA125 > or = 30 U/mL underwent a pelvic ultrasound. Scans were classified as normal, abnormal (ovarian volume > or = 8.8 mL) or equivocal (normal volume with abnormal morphology). Abnormal ovarian morphology was subclassified as simple cyst (single, thin walled cyst with no septa or papillary projections) or complex (all other abnormalities). Volunteers with abnormal scans were referred for a gynaecological opinion. Follow up was via the cancer registry and postal questionnaires. MAIN OUTCOME MEASURES: Sensitivity, specificity and positive predictive value of different ultrasound criteria for detection of index cancer (e.g. primary invasive epithelial carcinoma of the ovary and fallopian tube). RESULTS: Seven hundred and forty-one women underwent 1,219 scans and 20 index cancers occurred during a median follow up of 6 x 8 years. The sensitivity for detection of ovarian cancer of different ultrasound criteria was 100% for abnormal morphology, 89 x 5% for abnormal volume and 84% for complex morphology. The highest specificity (97%) and positive predictive value (37 x 2%) was achieved using complex morphology. CONCLUSION: A variety of ultrasound criteria can achieve high sensitivity, specificity and positive predictive value for index cancers in postmenopausal women with an elevated CA125. Use of ovarian morphology to interpret ultrasound may increase sensitivity and use of complex ovarian morphology may increase the positive predictive value.

Aged↗

PubMed1999

Follow-up and evaluation of skin cancer screening in British Columbia.

BACKGROUND: Skin cancer screening is thought to be a useful public health tool for the early detection of skin cancers. However, few studies have reported on follow-up and outcome of subjects who have a positive screen. OBJECTIVE: The aims of this study were to evaluate attendance at skin cancer screening clinics in British Columbia for the period 1994 and 1995 and to assess follow-up outcome among participants who were identified to have a potentially serious skin lesion that warranted further medical review. METHODS: A self-administered questionnaire was sent to participants screening positive for skin cancer and to their attending physicians. RESULTS: Five hundred twenty people were screened. Of these, 105 were referred for evaluation of a potential malignancy or precursor lesion. One melanoma, 3 basal cell carcinomas, 4 atypical nevi, and 1 actinic keratosis were histologically confirmed in 76 referred participants for whom follow-up information was available. The positive predictive values ranged from 17% to 89% depending on the screening diagnosis. Several false-positive results and one false-negative result were observed. Reasons for not seeking recommended follow-up were addressed. CONCLUSIONS: Our yield and positive predictive values for different screening diagnoses were virtually identical to those previously reported in larger US studies. Improved communication between screening physicians and screening participants may improve follow-up rates in those people who would benefit from further medical care.

Adult↗

PubMed2004

Does patient cost sharing matter? Its impact on recommended versus controversial cancer screening services.

OBJECTIVES: To examine whether there are differential impacts of patient cost sharing and health plan organizational characteristics on the use of a recommended cancer screening service (mammography) versus a controversial cancer screening service (prostate cancer screening [PCS]). STUDY DESIGN: Observational cohort using the 1996 Medical Expenditure Panel Survey. PATIENTS AND METHODS: A nationally representative sample of privately insured individuals was examined. Outcome measures were the receipt of mammography and PCS. Logistic regression was used to assess the impact of patient cost sharing and health plan organizational characteristics on the receipt of mammography and PCS, controlling for other covariates. RESULTS: Patient cost sharing and gatekeeper requirements were strong predictors of PCS but were statistically insignificant predictors of mammography. Men in health plans with a copayment over dollar 10 (odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.19-0.78) or with deductibles over dollar 250 (OR = 0.38, 95% CI = 0.23-0.62) were significantly less likely to receive PCS than men in plans with no or lower copayments and deductibles. Men in gatekeeper plans were less likely to receive PCS than those without gatekeepers (OR = 0.48, 95% CI = 0.29-0.81). CONCLUSIONS: We found the impact of cost sharing on utilization is different between mammography and PCS. Prostate cancer screening utilization appears to respond to financial incentives while mammography utilization does not. The use of copayments, deductibles, and gatekeepers may discourage controversial services but may not have an adverse effect on more recommended services. These findings have implications for the design of insurance benefits and plan organizational structure.

Breast Neoplasms↗

PubMed2003

Nonadherence to breast and cervical cancer screening: what are the linkages to chronic disease risk?

BACKGROUND: Several preventive practices that reduce chronic disease risk have been associated with breast and cervical cancer screening, including maintenance of normal weight and avoidance of cigarette smoking. A history of certain chronic illnesses such as diabetes and cardiovascular disease has also been related to cancer screening. Nevertheless, studies that have attempted to identify women who are less likely to have had a recent breast or cervical cancer screening test have infrequently examined the associations of breast and cervical cancer screening with multiple health factors that influence chronic disease risk. METHODS: To clarify relationships between cancer screening and health behaviors and other factors that influence chronic disease risk, we examined the self-reported breast and cervical cancer screening practices of women in the United States by using data from the 1999 Behavioral Risk Factor Surveillance System. The women were described according to their recent use of mammography and the Papanicolaou test, physician visits within the past year, health insurance coverage, and preventive practices that reduce chronic disease risk. RESULTS: Overall, 74.5% (95% CI, 73.9%-75.1%) of the women in this sample aged 40 years or older (n = 56,528) had received a mammogram within the past 2 years. The percentage of women who had been screened for breast cancer, however, varied widely by factors associated with reducing the risk of chronic disease (e.g., cholesterol check in the past 2 years, blood pressure check in the past 2 years, normal weight, avoidance of cigarette smoking) and having access to health care (e.g., health insurance coverage, recent physician visit). Similarly, 84.4% (95% CI, 83.9%-84.9%) of all women aged 18 years or older who had not undergone a hysterectomy (n = 69,113) had received a Papanicolaou test in the past 3 years, and factors associated with reduced chronic disease risk and health care access were related to having had a recent Papanicolaou test. CONCLUSION: The results of this study suggest that underscreened women who are at risk for breast and cervical cancer are likely to benefit from programs that identify and address coexisting prevention needs. The identification of coexisting prevention needs might assist in developing interventions that address multiple risks for chronic disease among women and might subsequently help improve the efficiency and effectiveness of prevention programs.

Adolescent↗

PubMed2001

Rural physicians' perspectives on cervical and breast cancer screening: a gender-based analysis.

Several studies highlight the role of physicians in determining cervical and breast cancer screening rates, and some urban studies report higher screening rates by female physicians. Rural women in North America remain underscreened for breast and cervical cancers. This survey was conducted to determine if there were significant gender differences in practices and perceptions of barriers to breast and cervical cancer screening among rural family physicians in Ontario, Canada. One hundred ninety-one family physicians (response rate 53.1%) who practiced in rural areas, small towns, or small cities completed a mail questionnaire. The physicians' mean age was 44.4 years (SD 9.9), and mean number of years in practice was 16.6 years (SD 10.3). Over 90% of physicians reported that they were very likely to conduct a Pap test and clinical breast examination (CBE) during a periodic health examination, and they had high levels of confidence and comfort in performing these procedures. Male (68%) and female (32%) physicians were similar in their likelihood to conduct screening, levels of confidence and comfort, and knowledge of breast and cervical cancer screening guidelines. However, the self-reported screening rates for Pap tests and CBE performed during last year were higher for female than male physicians (p < 0.01). Male physicians reported they were asked more frequently by patients for a referral to another physician to perform Pap tests and CBE (p < 0.001). Also, male physicians perceived patients' embarrassment as a stronger barrier to performing Pap tests (p < 0.05) and CBE (p < 0.01) than female physicians. No gender differences were observed in screening rates or related barriers to mammography referrals. These findings suggest that physicians' gender plays a role in sex-sensitive examination, such as Pap tests and CBE. There is a need to facilitate physician-patient interactions for sex-sensitive cancer screening examinations by health education initiatives targeting male physicians and women themselves. The feasibility of providing sex-sensitive cancer screening examinations by a same-sex health provider should also be explored.

Adolescent↗

PubMed1998

Cancer screening in the elderly.

Population-based cancer screening is effective only for a few tumour types. For these categories the screening programs have upper age limits. Arguments are provided for why population-based cancer screening is contraproductive in the elderly, even for cancers with a high incidence in old age.

Aged↗

PubMed2001

Lung cancer screening: an update.

Two prominent and timely issues in lung cancer screening are discussed in this article. First, findings from extended mortality follow-up of participants enrolled as part of the Mayo Lung Project are reviewed. These findings suggest that overdiagnosis-the identification, through screening, of clinically unimportant lung cancer lesions-may occur when screening for lung cancer. Second, the question of whether sufficient evidence exists to advocate mass lung cancer screening with low radiation dose spiral computed tomography (CT) is discussed. Given the absence of lung cancer mortality data for spiral CT, it is concluded that such activities should not be advocated at this point in time. The Lung Screening Study, an ongoing randomized controlled trial of lung cancer screening with spiral CT, also is described.

Cost-Benefit Analysis↗

PubMed2005

Understanding immigrant Chinese Americans' participation in cancer screening and clinical trials.

The purpose of this study was to identify potential barriers and facilitators to Chinese immigrant participation in cancer screening and clinical trials. A series of focus groups, in English, Cantonese, and Mandarin, were conducted with physicians, community leaders, and first generation members of the Manhattan Chinatown community. Participants were asked to discuss their beliefs about cancer, cancer screening, clinical trials, and cancer health education materials. Focus group data were stratified by respondent group and analyzed for thematic content. Eleven physicians, 15 community leaders, and 38 community members participated. Some community members were not familiar with cancer screening as a preventive measure and had not received common screens such as PAP smears or mammograms. They described widespread misconceptions about cancer that act as screening deterrents, e.g. testing for cancer can cause cancer. Community members were unfamiliar with clinical trials and would not participate in a clinical trial unless "sick," and only on the recommendation of their physicians. Physicians did not see the relevance or value of clinical trials for their patients. Among first generation Chinese immigrants, there are many perceptual barriers to cancer screening and clinical trials recruitment. There is a need for effective culturally tailored health education on these health topics to address persistent misconceptions about cancer and to increase knowledge about cancer screening and clinical trials. Health education efforts and clinical trial recruitment in this community must involve community physicians.

Adult↗

PubMed1993

Characteristics of men reporting for prostate cancer screening.

A survey to determine demographics, prostate cancer screening practices, and prostate cancer-related knowledge and beliefs was administered to over 1,700 participants at five sites during Prostate Cancer Awareness Week (1991) screening events. Findings are presented by site since significant differences in demographics existed. Results suggest that screenings conducted at the major medical centers attract primarily white males, a number of whom already practice adequate secondary prevention. Thus, if optimal benefit is sought through mass prostate cancer screening, innovative strategies to reach populations that are currently underserved and at risk are necessary.

Adult↗

PubMed1999

Cervical cancer screening among Cambodian-American women.

Southeast Asian women have higher invasive cervical cancer incidence rates and lower Pap testing frequencies than most other racial/ethnic groups in the United States. However, there is little information about the cervical cancer screening behavior of Cambodian-American women. Cambodian residents of Seattle were surveyed in person during late 1997 and early 1998. The PRECEDE model was used to guide the development of items that assessed predisposing, reinforcing, and enabling factors associated with cervical cancer screening participation. The estimated overall survey response was 72%. Four hundred thirteen women completed our questionnaire. Approximately one-quarter (24%) of the respondents had never had a Pap test, and over one-half (53%) had not been screened recently. The following variables were positively associated with a history of at least one Pap smear: younger age, greater number of years since immigration, belief about Pap testing for postmenopausal women, prenatal care in the United States, and physician recommendation. Women who believed in karma were less likely to have ever been screened for cervical cancer than those who did not. Six variables independently predicted recent screening: age; beliefs about regular checkups, cervical cancer screening for sexually inactive women, and the prolongation of life; having a female doctor; and a previous physician recommendation for Pap testing. The study findings indicate that culturally specific approaches might be effective in modifying the cervical cancer screening behavior of immigrant women. Programs targeting Cambodian-Americans are likely to be more effective if they are multifaceted and simultaneously address predisposing, reinforcing, and enabling factors.

Adolescent↗

PubMed2003

Racial and ethnic disparities in cancer screening: the importance of foreign birth as a barrier to care.

CONTEXT: Racial/ethnic groups comprised largely of foreign-born individuals have lower rates of cancer screening than white Americans. Little is known about whether these disparities are related primarily to their race/ethnicity or birthplace. OBJECTIVE: To determine whether foreign birthplace explains some racial/ethnic disparities in cancer screening. DESIGN, SETTING, AND SUBJECTS: Cross-sectional study using 1998 data from the National Health Interview Survey. MAIN OUTCOME MEASURES: Completion of cervical, breast, or colorectal cancer screening. RESULTS: Of respondents, 15% were foreign born. In analyses adjusted for sociodemographic characteristics and illness burden, black respondents were as or more likely to report cancer screening than white respondents; however, Hispanic and Asian-American and Pacific Islander (AAPI) respondents were significantly less likely to report screening for most cancers. When race/ethnicity and birthplace were considered together, U.S.-born Hispanic and AAPI respondents were as likely to report cancer screening as U.S.-born whites; however, foreign-born white (adjusted odds ratio [AOR], 0.58; 95% confidence interval [CI], 0.41 to 0.82), Hispanic (AOR, 0.65; 95% CI, 0.53 to 0.79), and AAPI respondents (AOR, 0.28; 95% CI, 0.19 to 0.39) were less likely than U.S.-born whites to report Pap smears. Foreign-born Hispanic and AAPI respondents were also less likely to report fecal occult blood testing (FOBT); AORs, 0.72; 95% CI, 0.53 to 0.98; and 0.61; 95% CI, 0.39 to 0.96, respectively); and sigmoidoscopy (AORs, 0.70; 95% CI, 0.51 to 0.97; and 0.63; 95% CI, 0.40 to 0.99, respectively). Furthermore, foreign-born AAPI respondents were less likely to report mammography (AOR, 0.49; 95% CI, 0.28 to 0.86). Adjusting for access to care partially attenuated disparities among foreign-born respondents. CONCLUSION: Foreign birthplace may explain some disparities previously attributed to race or ethnicity, and is an important barrier to cancer screening, even after adjustment for other factors. Increasing access to health care may improve disparities among foreign-born persons to some degree, but further study is needed to understand other barriers to screening among the foreign-born.

Adolescent↗

PubMed1997

Patient preferences for colorectal cancer screening.

BACKGROUND: New guidelines include several options for colorectal cancer screening. The goal of this study was to assess patient preferences for five approaches: no screening, fecal occult blood testing (FOBT), flexible sigmoidoscopy, barium enema, and colonoscopy. METHODS: Patients from offices of primary care providers listened to a scripted oral presentation while viewing a table describing five screening methods and their outcomes. Immediately following the presentation, the subjects completed a questionnaire assessing their most preferred screening option and their likelihood of undergoing each option. RESULTS: One hundred subjects aged 50 to 75 years participated. The average age was 64 years; 54 of the subjects were women, and 87 were white. Ninety-six percent of patients preferred to be screened by some method. When asked which test they would choose as their primary method of screening, 38% preferred colonoscopy, 31% preferred FOBT, 14% preferred barium enema, and 13% preferred flexible sigmoidoscopy. When asked how likely they would be to undergo each procedure on a 5-point scale, patients rated FOBT highest with an average score of 4.4, followed by colonoscopy (3.4), barium enema (3.4), flexible sigmoidoscopy (3.4), and no screening (1.5). Acceptance rates for these tests when recommended by their physician were 96% (FOBT), 82% (flexible sigmoidoscopy), 92% (barium enema), and 86% (colonoscopy). CONCLUSIONS: Patients indicated a strong preference for colorectal cancer screening, but they did not indicate a dominant preference for any single screening test. Physicians need to take into account individual patient preferences when making recommendations regarding colorectal cancer screening.

Aged↗

PubMed1996

The quality of cervical cancer screening: a primary care perspective.

The bulk of cervical cancer screening is performed by primary care providers; mostly nurses and physicians. The literature regarding the quality of this screening is largely described from three perspectives; clinical, laboratory, and public health. This article describes the primary care perspective regarding issues of quality in cervical cancer screening and suggests areas for improvement. The authors discuss how effectiveness of the test, sampling methods, interpretation by the laboratory, and reporting results impact on the quality of cervical cancer screening. Other factors which influence the quality of screening such as access to care, recall intervals, communication with the patient, costs of testing, and organizational issues are also reviewed.

Communication↗

PubMed1998

Breast cancer screening knowledge and skills of students upon entering and exiting a medical school.

PURPOSE: To assess needs for breast cancer screening education by comparing medical students' training and knowledge of breast cancer screening upon their entry to and exit from medical school. METHOD: Seventy-seven medical students at one medical school completed questionnaires as first-year students (in 1992) and again as fourth-year students (in 1996) that assessed their breast cancer screening knowledge. The fourth-year questionnaire included additional questions about the students' clinical training in breast cancer screening skills and their perceptions of needs for further training. RESULTS: Although the students performed significantly better on the knowledge-based questions in their fourth year than they did in their first year, considerable room for improvement remained. The students reported learning the most from surgery rotations and more from standardized patients than from faculty. Women medical students performed significantly more clinical breast examinations than did men students. CONCLUSIONS: Most of the medical students reported needing additional training in clinical breast examination. More curricular time devoted to education about breast cancer screening is needed.

Breast Neoplasms↗

PubMed1999

Predictors of compliance with recommended cervical cancer screening schedule: a population-based study.

BACKGROUND: The prevalence of routine cervical cancer screening and compliance with screening schedules are low compared to the Year 2000 objectives. Identifying predictors of routine screening and screening schedule compliance will help achieve these objectives. METHODS: We analyzed data from probability samples of 1,609 Missouri women responding to both the 1994 Behavioral Risk Factor Surveillance System (BRFSS) and the Missouri Enhanced Survey (ES). We generated prevalence odds ratios to identify predictors of non-compliance to cervical cancer screening guidelines. Also, among a sample of women reporting a reason for last Pap test, we estimated the relative odds of a screening v. diagnostic exam. RESULTS: In the combined probability sample, compliance with screening schedule was likely among women younger than 50 years of age and women who had either a recent mammography or a clinical breast exam. Being African-American, not experiencing a cost barrier when seeking medical care, having at least a high-school education and health coverage were each associated with an increased compliance with a screening schedule in the combined probability sample. Among women in the combined probability sample, whites, those who experienced no cost barrier to seeking medical care, the non-obese, and those who had a recent mammography were each more likely to have had a screening as opposed to a diagnostic exam. DISCUSSION: Cancer control and cardiovascular (CVD) prevention programs should consider jointly targeting those at high risk for cervical cancer and CVD because of aging and associated high-risk behavior such as non-compliance with cervical cancer screening, smoking, and obesity. Also, further research is needed to examine whether the increased compliance with cervical cancer screening guidelines among African American women may be in part due to higher occurrence of diagnostic Pap smears.

Adult↗