PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Screening programs”

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 595 records · Page 33Linked to original sources
PubMed2001

Two distinct groups of non-attenders in an organized mammography screening program.

OBJECTIVE: To find out reasons for non-attendance and to study subgroup differences of the non-attenders in an organized mammography screening program. DESIGN: Prospective for background and psychosocial factors, retrospective for reasons of non-attendance. SETTING: Finnish screening based on personal first round invitations, with 89% attendance rate. PARTICIPANTS: Four hundred thirty six women with both pre-screening response to socioeconomic and psychosocial measures, and post-screening response reporting reasons of non-attendance. MAIN RESULTS: Most common single reason for non-attendance was previous recent mammogram (53%), but also reasons related to practical obstacles, worry and fear, knowledge and attitudes, and organization of screening were mentioned. Two distinct groups of non-attenders were found based on the reasons for non-attendance. Those who did not attend because a mammogram taken elsewhere (ELSE, n = 233) were urban, well-to-do women, who took care of their health by own initiation and felt more susceptible to breast cancer, and also expected mammogram to be painful. Other (real) non-attenders (REAL, n = 155) were less compliant with health recommendations and services, more socially isolated, depressed and anxious than ELSE. Level of depression among REAL was clearly higher (10.80) than the mean value (7.91, SD = 7.28) of the age group, and was also slightly above the cut-off score of 10 indicating mild or moderate depression. Trait anxiety was also markedly higher (40.18) than that of the same age group (37.76, SD = 8.95). CONCLUSIONS: Further research should clarify determinants and consequences of depression and anxiety among real non-attenders. Knowledge gaps and attitudinal barriers among non-attenders require more targeted campaigns.

Breast Neoplasms↗
PubMed2004

Identifying children with dental care needs: evaluation of a targeted school-based dental screening program.

OBJECTIVES: It has been suggested that changes in the distribution of dental caries mean that targeting high-risk groups can maximize the cost effectiveness of dental health programs. This study aimed to assess the effectiveness of a targeted school-based dental screening program in terms of the proportion of children with dental care needs it identified. METHODS: The target population was all children in junior and senior kindergarten and grades 2, 4, 6, and 8 who attended schools in four Ontario communities. The study was conducted in a random sample of 38 schools stratified according to caries risk. Universal screening was implemented in these schools. The parents of all children identified as having dental care needs were sent a short questionnaire to document the sociodemographic and family characteristics of these children. Children with needs were divided into two groups: those who would and who would not have been identified had the targeted program been implemented. The characteristics of the two groups were compared. RESULTS: Overall, 21.0 percent of the target population were identified as needing dental care, with 7.4 percent needing urgent care. The targeted program would have identified 43.5 percent of those with dental care needs and 58.0 percent of those with urgent needs. There were substantial differences across the four communities in the proportions identified by the targeted program. Identification rates were lowest when the difference in prevalence of need between the high- and low-risk groups was small and where the low-risk group was large in relation to the high-risk group. The targeted program was more effective at identifying children from disadvantaged backgrounds. Of those with needs who lived in households receiving government income support, 59.0 percent of those with needs and 80.1 percent of those with urgent needs would be identified. CONCLUSIONS: The targeted program was most effective at identifying children with dental care needs from disadvantaged backgrounds. However, any improvements in cost effectiveness achieved by targeting must be balanced against inequities in access to public health care resources.

Adolescent↗
PubMed1986

Use of data from X-ray screening program for coal workers to evaluate effectiveness of 2 mg/m3 coal dust standard.

The National Institute for Occupational Safety and Health administers the X-ray Screening Program for underground coal miners, a program mandated by the Federal Mine Health and Safety Act of 1969. The screening file, with over 200,000 x-ray films, affords an excellent source for the study of prevalence and progression of Coal Workers' Pneumoconiosis. Two epidemiological analyses have recently been completed. One, a prevalence study of miners with 10 or fewer years of mining tenure, converted screening readings to median epidemiological readings. Converted prevalences were 0.44% for the group with 0 to 1 year tenure and 0.79% for the group with 1 to 9 years tenure. This result is similar to prevalence observed in a study of nonexposed blue collar workers. A second analysis reread x-ray films of a subgroup of 1,834 repeat miners with roughly 9 years exposure only under mandated dust standards. Net progression from category 0/0 was observed to be 1.2%. This value is consistent with 1.9%, based on an average dust exposure, predicted by British research. Results must be interpreted in light of several possible sources of bias.

Coal↗
PubMed1984

Temporal effects of prompting on acceptance and follow-up in a community-based hypertension screening program.

This study evaluated the effects of prompts and reinforcement on two aspects of hypertension control: a) attendance at a community-based blood pressure screening program and b) follow-up visits to a physician's office by persons identified through screening as at-risk clients. Baseline data showed a decreasing trend in attendance at the screening sessions and a 51% "no show" rate for physician follow-ups. Screening session attendance increased following intervention; however, attendance rates across weeks appeared to vary mainly as a function of the prompting schedule (monthly newsletter announcements ) rather than the availability of reinforcement. Finally, the intervention not only increased the percentage of at-risk clients who saw a physician, but also decreased the latency between the time of initial screening and the follow-up appointment.

Adolescent↗
PubMed2001

A type 2 diabetes screening program by general practioners in a Belgian at risk population.

OBJECTIVE: This study was designed to set up in Belgium a national screening program in order to evaluate the prevalence of undiagnosed impaired glucose tolerance and type 2 diabetes in a general population with at least one risk factor. MATERIAL AND METHODS: 10.201 individuals were screened by 1.466 general practioners between 1995 and 1998 (age: 57 +/- 16 years; BMI: 28 +/- 5 kg/m2; mean +/- 1SD). A three step diagnosis protocol was followed (blood glucose at random; fasting plasma glucose and, if needed, a 75 g oral glucose tolerance test). WHO criteria were used for diagnosis. RESULTS: Impaired glucose tolerance was found in 3% of individuals, while 11% had diabetes. Patients with abnormal glucose metabolism were older (P<0.001) and had an higher BMI (P<0.001) than non-diabetic subjects. The prevalence of undiagnosed diabetes was slightly higher (14 vs. 11%) when using a fasting plasma glucose threshold of 126 mg/dl (instead of 140 mg/dl) as recommended by the ADA experts. CONCLUSION: Undiagnosed abnormal glucose metabolism, in particular diabetes, is particularly frequent in a Belgian at risk population.

Adult↗
PubMed2005

[Reattendance of women for breast cancer screening programs. A review].

BACKGROUND: In France, breast cancer is the most frequently occurring cancer and the leading cause of cancer deaths in women. Breast cancer screening has been shown to reduce breast cancer mortality by 30% provided attendance rate is 70% and re-screening interval is two to three years. Maintaining a high rate of reattendance is also important. The decline with time of completion rates of re-screening will lessen the benefits of a breast cancer screening program. METHODS: A review of published studies examining factors associated with attendance and reattendance to breast cancer screening. RESULTS: Positive views about initial screening are determining factors in reattendance: mammography should not be painful and embarrassing, appointments should be punctual and clinic staff courteous and supportive. Psychological factors influencing attendance also influence reattendance as does intention to participate, a major predictor of repeat participation and as do perceived susceptibility of breast cancer, perceived benefits of mammography, absence of emotional barriers. These factors can be modified by experience of previous screening. Other predicting factors of attendance continue to influence reattendance: practice of other preventive health behaviors, outside support from physicians, knowledge of breast cancer and screening. CONCLUSION: A better understanding of factors influencing attendance is necessary to increase the impact of breast cancer screening. Field studies are necessary to support the elaboration of publicity campaigns aimed at increasing participation.

Attitude to Health↗
PubMed2006

Breast cancer screening, outside the population-screening program, of women from breast cancer families without proven BRCA1/BRCA2 mutations: a simulation study.

PURPOSE: We assessed the cost-effectiveness of mammography screening for women under the age of 50, from breast cancer families without proven BRCA1/BRCA2 mutations, because current criteria for screening healthy women from breast cancer families are not evidence-based. METHODS: We did simulation studies with mathematical models on the cost-effectiveness of mammography screening of women under the age of 50 with breast cancer family histories. Breast cancer screening was simulated with varying screening intervals (6, 12, 18, and 24 months) and screening cohorts (starting at ages 30, 35, 40, and 45, and continuing to age 50). Incremental costs of screening were compared with those of women ages 50 to 52 years, the youngest age group currently routinely screened in the nationwide screening program of the Netherlands, to determine cost-effectiveness. Sensitivity analyses were done to explore the effects of model assumptions. The cost-effectiveness of breast cancer screening for women over the age of 50 was not debated. RESULTS: The most effective screening interval was found to be 12 months, which, however, seems only to be cost-effective in a small group of women under the age of 50 with at least two affected relatives, including at least one affected in the first degree diagnosed under the age of 50. Significantly, early breast cancer screening never seemed to be cost-effective in women with only one affected first-degree or second-degree relative. CONCLUSION: Annual breast cancer screening with mammography for women under the age of 50 seems to be cost-effective in women with strong family histories of breast cancer, even when no BRCA1/BRCA2 mutation was found in affected family members.

Adult↗
PubMedDate not supplied

The first breast cancer screening program in southern Italy: preliminary results from three municipalities of the Naples Province.

AIMS AND BACKGROUND: It has been demonstrated that breast cancer screening induces a 30% reduction of specific mortality. In May 1990, we started a pilot screening program to assess the feasibility of carrying out such a program in Campania (southern Italy). Herein we report the results of the first round of the program from three municipalities (Giugliano, Mugnano and Qualiano) that lie within the local health district no. 23, close to the city of Naples. METHODS: Women between the ages of 50 and 69 years were sent a personalized letter inviting them to attend the screening test; those not responding were sent a second invitation. The screening test consisted of clinical examination followed by two-view mammography. Second-level diagnostic tools were sonography, fine needle aspiration (manual, echo-guided and stereotaxic) and surgical biopsy. RESULTS: Out of 5,732 women invited for the first round, 1,813 (31.6%) attended the screening. Attendance rate was higher among younger women. Ninety-one women were positive at the screening test and underwent further examination (recall rate, 5.0%). Among them, 19 had surgical biopsy (biopsy rate, 1.0%) that led to breast cancer diagnosis in 11 cases. The benign/malignant biopsy rate was 0.73. Detection rate was 6.07 x 1,000 screened women and varied among age categories, increasing within the 60-69 subgroup; detection rate/expected incidence ratio in the overall group was 4.5 and also increased within the older age category. Seven out of 11 cancers were at UICC stage O-I. Among 327 self-referring women, 38 were positive (recall rate, 11.6%), and 14 underwent biopsy (biopsy rate, 4.3%), which showed cancer in 7 cases (benign/malignant biopsy rate, 1.0). In addition, 2 inflammatory cancers were diagnosed without surgical biopsy. Thus 9 cancer cases were detected in this group. Self-referring women differed from responding women in that they had a higher frequency of symptoms or familiar history of cancer, and a higher educational level and awareness of preventive medicine. Clinical examination added no diagnostic advantage in the responding group but did not significantly worsen the recall rate. In the self-referring group, one case of inflammatory cancer was missed by mammography and diagnosed by clinical examination. CONCLUSION: The early results (recall rate = 5%, detection rate/expected incidence ratio = 4.5, benign/malignant biopsy rate = 0.73, advanced cancers = 36.4%) are encouraging and indicate the validity of the program. Strategies to improve attendance rate are planned.

Aged↗
PubMedDate not supplied

Community-directed cancer screening program.

The Atlanta Project, one of six American Cancer Society demonstration projects, is a community-designed and -directed breast and cervical cancer screening program focused on empowering African-American women to accept responsibility for their health maintenance. This article reports the project's goals, objectives, intervention strategies, roles of key project personnel, and outcomes. A total of 3852 women older than 40 years received breast clinical examinations, were taught breast self-examination, and had a screening mammogram; 2689 women obtained a pelvic examination and were screened for cervical cancer with a Papanicolaou smear. Of those women screened, 12 breast and 1 cervical cancers were identified and treated. Important lessons learned and successes achieved from this project were: (1) there is a need for joint planning with community representatives and their involvement in all aspects of the program's implementation and evaluation; (2) in addition to the commitment of the major participants, the community must "buy in" to the proposed health intervention; (3) the focus of the intervention should be on positive health messages; (4) cancer education materials should be culturally and literacy-appropriate; (5) the project's activities were planned to be sustained after the project period; (6) women can be empowered to accept responsibility for and control over their health.

Adult↗
PubMed2005

Levels of, and factors associated with, C-reactive protein in employees attending a company-sponsored cardiac screening program.

BACKGROUND: Relatively limited contemporary information is available about the distribution of, and factors associated with, levels of C-reactive protein (CRP) in adult men and women. The purpose of our descriptive study was to examine the prevalence and predictors of this marker of inflammation in a sample of employed adults attending a worksite cardiovascular screening program. METHODS: The study sample consisted of 876 men and women between the ages of 21 and 77 years from 6 locations of the parent company. These individuals attended an employer-sponsored cardiovascular screening and wellness program during 2003. A standardized questionnaire was administered to all study participants, and a number of different coronary risk factors were measured. RESULTS: Approximately 25% of the study sample was classified as having elevated CRP levels (> or =3 mg/l). Women, obese individuals, subjects with increasing heart rate and higher levels of serum triglycerides were more likely to have elevated concentrations of CRP than the corresponding comparison groups. Subjects who reported regularly exercising, individuals with a history of heart disease and those with lower total cholesterol levels were less likely to have elevated CRP levels. A relatively similar risk factor profile was noted in individuals without a self-reported history of prior cardiovascular disease. CONCLUSIONS: The results of our cross-sectional observational study suggest that the prevalence of elevated CRP levels in the general adult population is considerable. A number of demographic, comorbid and other factors are associated with this inflammatory marker of increased risk of cardiovascular disease, which demands increased attention and modification of potential predisposing factors.

Adult↗
PubMed2004

[First trimester Down syndrome screening program using nuchal translucency and maternal serum markers: the Echo PAPP-A.78 study].

Successive development of different methods to screen down syndrome (DS) have had unexpected effects, leading to an inflation in the number of karyotypes ordered and the number of induced abortions. In our district (Yvelines, France), DS screening leads to perform 16% karyotypes rate. Rapid progress in biology and ultrasonography has enabled us to correct this overprescription by conducting an early screening program using a combination of ultrasound graphic and new biochemical markers (Pregnancy-associated plasma protein A and the free fraction of ss-hCG) which allow an overall evaluation of risk. This method has high sensitivity (85%) and leads to a false positive rate karyotypes in about 5% of pregnancies. The purpose of the study conducted between January 1, 2001 and December 31, 2002 in the Yvelines was to confirm the validity of this method and determine its reproducibility in routine practice. Five partners contributed to the study: the Regional delegation for clinical research of the Paris-public assistance hospitals (AP-HP), the district health insurance fund (CPAM 78), the Yvelines maternity network which includes all ten maternity wards in the district, and the Echo 78 association which includes all ultrasoundgraphists working in the district who accepted to participate as investigators, as well as five biology laboratories where DS screening was performed.

Adult↗
PubMed1980

Thyroxine-binding globulin capacity and concentration evaluated from blood spots on filter-paper in a screening program for neonatal hypothyroidism.

We describe a simple method for evaluating thyroxine-binding globulin capacity and concentration from a single 1-cm blood spot on filter-paper used in a screening program for neonatal hypothyroidism. This method permits prompt diagnosis of about 90% of the infants with thyroxine-binding globulin deficiency in our abnormal low-thyroxine, low-thyrotropin population. There was excellent equivalence between results obtained by our method and by the method of Chopra et al. (J. Clin. Endocrinol. Metab. 35:565, 1972), and minimal overlap between the population with low thyroxine-binding globulin and the low-thyroxine, normal thyrotropin population. We recommend this method to all programs in which a primary thyroxine measurement is used in screening for congenital hypothyroidism.

Blood Specimen Collection↗
PubMed1991

A critical analysis of the largest reported mass fecal occult blood screening program in the United States.

Fecal occult blood testing for the detection of colon cancer remains controversial. We performed a mass screening program from January 24, 1988, to February 19, 1988, with intensive media promotion, including 121 minutes of televised air time. A total of 5,000 primary practitioners were notified by mail. Hemoccult-II tests were distributed to 156,000 individuals; 55,051 (35%) were returned. Ninety-five percent of the respondents were informed of the program by television. A total of 3,375 persons (6%) tested positive for fecal occult blood; of these, 2,469 (73%) informed the center that they saw their physician to initiate a work-up. Information from physicians regarding work-ups was returned on only 1,356 (55%) patients. Diagnostic tests numbered 2,227 (1.6 tests per patient). However, 5% had no testing, 16% had a repeat Hemoccult only, and 35% had neither a barium enema nor colonoscopy performed. Thirty-six colorectal cancers and 212 polyps were identified. The predictive value (i.e., number of cancers per number of patients who tested positive) increased directly by decade. Thirty-three of 36 patients (92%) with cancer underwent either a barium enema or colonoscopy versus only 185 of 438 (42%) patients with a "negative" work-up. Cancers found were carcinoma in situ in 10 patients (29%), Dukes A in 12 (35%), Dukes B in 4 (12%), and Dukes C in 8 (24%); distant metastases were not found in any participant. Thirty-six percent of the tumors were located in either the right or transverse colon. We conclude that: (1) Screening identified early cancers. All were potentially curable and 64% were limited to the bowel wall. (2) Massive Hemoccult distribution was possible over a short interval, but patient and physician compliance was disturbingly low. (3) Total colonic evaluation is mandatory, since at least 36% of tumors were beyond the reach of the flexible sigmoidoscope. (4) Many work-ups were unnecessary (repeat Hemoccults) or inadequate, indicating a need for physician education.

Adult↗
PubMed1994

Immunochemical versus guaiac occult blood stool tests: results of a community-based screening program.

This study was designed to investigate two guaiac-based and one immunochemical faecal occult blood test in a community screening program. A total of 39,000 test kits consisting of Hemoccult II, Hemoccult Sensa and HemeSelect were distributed and of these 8933 (23%) were returned for testing. Follow-up contact with 1165 individuals who tested positive on at least one of the nine test slides was successful in 1076 cases (92.4%). Physician verification in 631 individuals revealed 25 patients (4%) diagnosed with colorectal cancer and 145 (23%) with polyps, of which 120 (82.7%) were adenomatous. The percentage of smaller adenomatous polyps detected relative to the percentage of large polyps (> 1 cm) was: Hemoccult II 31% versus 60%, Hemoccult Sensa 73% versus 80% and HemeSelect 34% versus 57%, respectively. The proportion of adenomatous polyps greater than 2 cm detected by individual tests was even more striking with Hemoccult II positive for 83%, Hemoccult Sensa for 100% and HemeSelect for 75%. Of the 25 patients diagnosed with cancer, 17 (68%) were diagnosed with early-stage disease. A statistically significant trend (P < 0.001) was observed with positive predictive values ranging from 3.3% for individuals with only one positive test to one approaching 40% for individuals with 7 or more positive tests. In this study, the most sensitive predictor of colorectal cancer was found to be the combination of Hemoccult II/HemeSelect. While there was no increase in the positive predicted value for adenomatous polyps < or = 1 cm, there was a direct linear increase for adenomatous polyps > 1 cm.

Adenomatous Polyps↗
PubMed1984

The Walton report and its subsequent impact on cervical cancer screening programs in Canada.

A summary and discussion of some of the important and controversial recommendations in the original Walton report of 1976 on cervical cancer screening programs in Canada are presented. The reactions to the report in Canada are briefly outlined, particularly as related to the frequency of screening. The subsequent modifications in the recommendations by the reconvened task force of 1980, in response to the concerns of the profession and to newly available data, are highlighted.

Adolescent↗
PubMed1999

Psychosocial stress and social support are associated with prostate-specific antigen levels in men: results from a community screening program.

Perceived stress and satisfaction with social support were assessed in 318 men participating in a prostate-specific antigen (PSA) screening program. We predicted that high stress would be associated with high PSA and high social support with low PSA. We also predicted a Stress x Support interaction (buffering). Hypothesized main effects were confirmed and were not explained by recency of previous rectal examinations or current urinary symptoms. There was no evidence of buffering. Stress and social support were not associated with results of digital rectal examinations. These findings raise the possibility that psychosocial factors promote prostate disease through direct physiologic pathways. However, it is also possible that the data reflect effects of stress on health-related behaviors or that stress scores were affected by participants' anticipation of prostate problems on the basis of prior PSA tests or symptoms.

Adult↗
PubMed1991

Cervical cancer screening program in a Muslim country: three-year experience at the Aga Khan University Medical Center, Karachi.

A systematic cervical cancer screening program was initiated in January 1987 at The Aga Khan University Medical Center, Karachi, Pakistan. The 8,784 cervical smears obtained in 3 subsequent years from 8,412 consecutive women attending the gynecology and antenatal clinics were reviewed. "Positive" smears were found in 111 (1.3%) patients; 107 (1.27%) smears showed squamous epithelial dysplasia and 4 smears showed adenocarcinoma. The highest incidence of abnormal smears was found in the 45-54 years age group. Colposcopy and biopsy was performed on all patients with "positive" smears except on those with atypical or mildly dysplastic ones, in whom only the persistence of the abnormality on repeated smears was considered an indication for tissue evaluation. The histopathologic diagnosis of these biopsy specimens revealed cervical intra-epithelial neoplasia in 60 patients and invasive cervical cancer in 6 patients.

Adenocarcinoma↗