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PubMed1992

Asymptomatic urinary abnormalities found via the Japanese school screening program: a clinical, morphological and prognostic analysis.

Clinicohistopathologically, we observed 109 patients with asymptomatic urinary abnormalities found via the Japanese school medical screening process. Follow-up was for a mean period of 9.3 +/- 4.0 years. More than 80% of the patients had either IgA nephropathy (IgAN, 47 cases, 43.1%), thin membrane disease (TMD; 21 cases, 19.3%) or normal glomerulus (NG; 20 cases, 18.3%). Complete remission appeared in 60.0% of the NG cases, 14.3% of the TMD cases and in 19.1% of the IgAN cases, and remission was significantly high in the NG group (p less than 0.01). No patient with TMD and NG ever progressed to the extent of pronounced proteinuria or renal failure. One patient deteriorated and required hemodialysis, and 2 patients developed renal insufficiency in IgAN. All of these cases possessed severe glomerular sclerotic change when the initial biopsies were performed. All IgAN cases that went into remission, however, had minor glomerular abnormalities. A positive family history of urinary abnormality was observed in 14.1% of both the IgAN group and the NG group, whereas we observed 71.4% in the TMD group, which was significantly high (p less than 0.01). Other cases included 4 each with non-IgA proliferative glomerulonephritis, focal segmental glomerular sclerosis, membranoproliferative glomerulonephritis and Alport's nephritis. It was concluded that the majority of patients (80.7%) with urinary abnormalities found via the school screening program had IgAN, NG or TMD. 74.5% of the IgAN group and 85.7% of the TMD group had long histories of urinary abnormalities extending into adulthood with no deterioration of the renal function.

Adult↗
PubMed2004

Community-based cancer screening programs in older populations: making progress but can we do better?

BACKGROUND: Older individuals have higher rates of most types of cancer. Community-based cancer screening programs offer one avenue for addressing the need to prevent or detect cancers in early stages in this population. Identifying characteristics of successful interventions can assist researchers in the development of future studies. METHODS: A comprehensive literature review of community-based cancer screening interventions was undertaken and 114 behavioral interventions for breast, cervical and colorectal cancer screening published prior to 2000 and 42 studies published during 2000-2003 were identified. From these, 17 studies were identified as model interventions that were effective in significantly increasing screening rates among older populations. RESULTS: Effective interventions employed a variety of strategies including the use of social networks and lay health care workers, mass media, community-based education, reminder notices/behavioral cues, and health care provider assistance. CONCLUSION: Although subgroups of individuals still have lower rates of screening, the results indicate that older populations can be encouraged to engage in appropriate cancer screening behaviors through community-based interventions. The next round of interventions could be strengthened by evaluating intervention components, integrating theory and community participation into designs, focusing on those most at need, and considering program sustainability and costs.

Aged↗
PubMed2004

Influences on participation in a community-based colorectal neoplasia screening program by virtual colonoscopy in Australia.

OBJECTIVE: To determine the effect of certain personal and health behaviour characteristics on participation in a community-based colorectal neoplasia (CRN) screening program using virtual colonoscopy. METHODS: The study population comprised randomly selected subjects from the State electoral roll; screening by virtual colonoscopy was offered through letter of invitation. For non-responders, a further invitation was sent a month later. Non-response after a further month led to subjects being considered non-participants. Non-participants were contacted by letter to complete a structured questionnaire; participants completed a similar questionnaire immediately after their screening virtual colonoscopy. RESULTS: Discussing the invitation to screening with someone else increased the likelihood of participation by 63% (prevalence ratio 1.63, 95% CI 1.38-1.93); knowing someone with cancer increased the likelihood of participation by 23% (PR 1.23, 95% CI 1.07-1.42). Among participants who discussed screening with another individual, the spouse was the most common (71%). Subjects who were single were less likely to participate (PR 0.79, 95% CI 0.67-0.94). The strongest reported influence for participation was information provided in the letter of invitation (29.8%). The most common reasons for non-participation were lack of time and perceived good health. CONCLUSIONS AND IMPLICATIONS: This study suggests that a simple strategy to facilitate participation is to encourage subjects to discuss screening with others; further, to recognise that this may be most difficult for those who are single. Information provided to subjects prior to screening positively contributes to participation.

Colonoscopy↗
PubMed2003

Risk perception of participants in a family-based genetic screening program on familial hypercholesterolemia.

The aim of this article is threefold. First, we describe the accuracy of people's risk perception who have been screened on familial hypercholesterolemia (FH) in a family-based screening program. Second, we identify factors that modify risk perception. Finally, we show the influence of risk perception on subsequent preventive behavior. The risk perception of 556 screenees (677 participants, overall response = 82%) was measured by postal questionnaires on three occasions: at screening and 3 days and 7 months after the test result was reported to the patient. Presentation of the risk was precategorized and given both as numerical (1 in x) and as verbal probability. In addition, medication use and attitudes toward gene therapy were determined 7 months after screening. On average, the screenees underestimated their numeric risk of having FH and getting a myocardial infarction (MI). Furthermore, FH-positive screenees perceived that they were at greater risk of MI than FH negatives, and screenees with the highest actual risk used medication more, perceived a greater risk, and opted more often for future gene therapy. Risk perception of having FH was influenced by cholesterol level, while MI risk perception was affected by age, education, cholesterol level, and cardiovascular disease (CVD) in the family. We conclude that FH-positive screenees correctly perceive a higher risk of getting a heart attack than do FH-negative screenees. Screenees did not believe that MI was inevitable, and risk perception was associated with both medication use and the intention to opt for gene therapy, but not with other preventive measures. Thus, genetic risk notification seems to be acceptable and does not lead to aversion to preventive behavior.

Adolescent↗
PubMedDate not supplied

The costs and benefits of a screening program to detect dementia in older drivers.

A Markov model was used to assess the cost-benefit ratios of six strategies of screening older drivers for mental status, beginning at age 65. Probabilities of motor vehicle collisions (MVCs), injuries, and fatalities were obtained from national data. Dementia prevalence, test characteristics, and costs were obtained from the literature. Costs included lost wages, car ownership, alternative transportation, and injuries. Using a relative risk of MVC for those with dementia of 5 and a 5% annual discounting rate, the average cost per driver ranged from $51,600 (no testing) to $58,400 (testing every five years). The benefit was < one day of life gained, and the benefits of screening cost approximately 2.8 million dollars per life-year gained. Increasing the relative risk from 5 to 20 substantially improved the cost-benefit of mental status screening. However, mental status screening of older drivers would also be cost-beneficial if physician referral costs were lowered to $60 per evaluation. The authors conclude that a dementia screening program for older drivers would be cost-beneficial if physician evaluations were limited or their cost lowered to < or = $60.

Accidents, Traffic↗
PubMed1996

Attitude of women towards early cancer detection and estimation of the compliance to a screening program for cervix and breast cancer.

Before the start of a feasibility study for cervical and breast cancer screening in two towns (Genoa and Rome) in Italy, a random sample (N = 349) of the target population was interviewed with the aim of evaluating (i) the degree of knowledge as to the purpose of the screening tests; (ii) the attitude towards early detection of these cancers; and (iii) the potential compliance to the program. Pap test: 48.7% of women were correctly informed about the object of the test; information was associated with the degree of education (p < 0.0001). Periodic Pap test was reported by 77.9% of women: the proportion was higher among younger (p = 0.013) and married women (p = 0.001). A 1-year interval between two tests was more frequently reported by younger women (p < 0.001). Estimated participation in the cervical cancer screening program was 63.3%. Increasing age (OR = 0.78; CI = 0.6-1.0), the married status (OR = 0.39; CI = 0.18-0.83) and lack of knowledge of the object of the test (OR = 0.47; CI = 0.25-0.87) hindered participation in the program. Mammography: 53.3% of women reported that it is a method used for early detection of breast cancer. Well-educated women were more likely to be correctly informed (p < 0.0001). Previous mammography was reported by 49.3% of women aged 50 to 69 years who never experienced breast cancer symptoms; married women more frequently reported having had the test (p = 0.02). Estimated participation in the breast cancer screening program was 59%. Women aged 60 years and over were less prone to participate (OR = 0.44; CI = 0.22-0.89). Increasing age was the most relevant barrier to participation in screening programs, and strong efforts should be made to involve older women, due to their greater chance of getting cancer.

Adult↗
PubMed1990

[Glomerular ultrastructures and prognosis of the patients with urinary abnormalities found by school screening program].

Detailed histopathological study were performed and compared with clinical features in 120 children with serial renal biopsies who were found by school screening program. 41 cases (34.2%) of IgA nephropathy (IgAN), 26 cases (21.7%) of thin membrane disease (TMD) and 22 cases (18.3%) of normal glomeruli [( Normal]) accounted for 74.2% of all biopsies. 81 cases (67.5%) were revealed to be minor glomerular abnormalities by light microscopy and which contained 26 cases (32.1%) of TMD, 22 cases (27.2%) of [Normal] and 19 cases (23.4%) of IgAN. The frequency and the severity of proteinuria was significantly higher in IgAN than in TMD and [Normal] (P less than 0.01, P less than 0.05). Hematuria was significantly greater in [Normal] than in IgAN. In the 71 follow-up cases, no patient went to renal insufficiency, moreover, urinary abnormalities had disappeared in 25.4% of the patients including IgAN, TMD, [Normal], nonIgA proliferative glomerulonephritis, incomplete foot process disease and MPGN. [Normal] consisted of stationary or exercised urinary abnormality.

Adolescent↗
PubMed1976

A resurvey of hypertensive patients detected in a dental office screening program.

In order to ascertain the fate of hypertensive patients who were discovered through the Medical College of Virginia School of Dentistry Hypertension Screening Program, a telephone survey was conducted whereby the first 128 patients discovered to be hypertensive through the program were interviewed concerning their current state of care. All 128 patients were at least three months postreferral. Patients were asked whether or not they were still under a physician's care; those responding positively were further questioned regarding medications prescribed, medication consumption, and frequency of physician visits. In all, 109 patients were contacted. The 109 patients consisted of 18 patients treated at the hypertension clinic at Medical College of Virginia and 91 patients being treated by private physicians. Of the 18 clinic patients contacted, 17 (94 percent) were still being treated. Of the patients being treated by private physicians 62 (68.1 percent) were still being followed. Of the 109 patients contacted, 79 (72.5 percent) were still under care and 30 (27.5 percent) were no longer under care. Of the patients still under care 56 (71 percent) had been prescribed medicine and only two had discontinued medication. Forty-one patients saw their physician more frequently than every three months; 21 saw their physician every three to four months and 17 saw their physician semiannually or annually. Of the delinquent hypertensives in this study, 72 percent were still under care at the time of survey and of the previously undetected hypertensives 73 percent were still under care. It is concluded that there is still a significant drop-out-rate among hypertensives after refereral and that some void exists in the follow-up of hypertensives. The suggestion is made that the dentist may be able to assist in follow-up and possibly reduce the drop-out-rate.

Dentists↗
PubMed2005

Screening program of prostate cancer at Tokai University Hospital: characterization of prostate-specific antigen measurement.

A total of 67,214 men participated in screening for prostate cancer (PC) using serum prostate-specific antigen (PSA) from April 1996 to March 2003 at Tokai University Hospital. In 3.5% (2330 / 67,214) of the men, an elevated PSA level (> 4.0 ng/ml) was found and 68.1% (1586/2330) of these subjects were examined at our Urological Outpatient Clinic. Re-testing of PSA showed that 8.4% (133/1586) had a normal level. Needle biopsy of the prostate was performed in 45.2% (633/1453) of the remaining men. As a result, 142 PCs were found and the detection rate was 0.2% (142 / 67,214). The age of the patients with PC was over 50 years. During this period, 135 individuals with voiding dysfunction were also diagnosed as having PC. Comparison of the patients detected by screening with those found at the outpatient clinic revealed significant differences of the age (64.8 vs. 71.9 years, p < 0.0001), serum PSA level (14.6 vs. 154.9 ng/ml, p < 0.0001), and clinical stage (p < 0.0001). In conclusion, a health screening program that includes serum PSA testing is useful for detection of PC at an earlier stage and in younger individuals. We recommend that all men aged 50 years or older undergo testing for PSA to detect PC at an early stage.

Aged↗
PubMed1999

[Results of a screening program for prostatic cancer].

OBJECTIVE: To set up the epidemiology of prostate cancer in the geographical area of Getafe, Madrid (Spain) and to detect curable prostate cancer. The results of screening 2.576 men are reported. PATIENTS & METHODS: Patients underwent digital rectal examination (DRE) and PSA determination. Patients with suspicious DRE or PSA greater than 4 ng/ml were further evaluated with transrectal ultrasonography (TRUS) and biopsy. The diagnostic performances of the tests or combinations of tests were determined. RESULTS: Mean age was 59.9 years (median 58 years). Ninety-four patients (3.6 per cent) had abnormal DRE while PSA was higher than 4 ng/ml in 169 patients (6.5% of the total). 6.8 biopsies were needed to prove one cancer. The higher sensitivity corresponded to the PSA (93%). The test of greatest specificity was the rectal examination (97%). Positive predictive value raised to 78.9% when both DRE and PSA were abnormal. Advanced tumor stages were more common (39.4%) than in previous experiences. CONCLUSIONS: PSA should be the first diagnostic test when screening for prostate cancer. Neither the DRE nor the TRUS have any place in patients with PSA below 4 ng/ml. In summary we can't encourage screening programs for prostate cancer so far.

Aged↗
PubMed1979

The influence of clinical judgment on the rate of referral from a school vision screening program.

It has been observed that black preschool children low income families have a higher than average rate of referral from a school vision screening program. One potential contributing factor results from the fact that examiners often modified the referral criteria based on their clinical judgment. This study was designed to investigate the influence of the application of clinical judgment on the proportion of referrals as a function of ethnicity and socioeconomic income level. The results suggest that modifying the referral criteria based on clinical judgment does not significantly influence the proportion of referrals based on ethnicity or socioeconomic income level.

Black or African American↗
PubMed2004

Do the results of the process indicators in the Norwegian Breast Cancer Screening Program predict future mortality reduction from breast cancer?

Continuous emphases of quality control are required to achieve reduction in mortality from breast cancer as a consequence of breast cancer screening. Results of the process indicators in the first 6 years in 4 counties in the Norwegian Breast Cancer Screening Program are evaluated and will be presented. Data from women who had their initial (n = 173402) and subsequent (n = 220 058) screening provide the basis for the analysis. The breast cancer detection ratio was 3.2 the expected incidence (based on the incidence before the screening started, 1991-1995) among the initially screened women, decreasing to 2.3 among the subsequently screened. The ratio of interval cancer among the initially screened was 0.25 and 0.72 of the expected incidence, 0-12 and 13-23 months after screening, respectively. For those subsequently screened the proportions were 0.22 and 0.64, respectively. More than 50% of the invasive tumors were less than 15 mm in size, and more than 75% were lymph node negative, among both the initially and subsequently screened. The process indicators achieved in the NBCSP are promising as regards future mortality reduction. The incidence of interval cancer 13-24 months after screening is higher than recommended in the European guidelines.

Aged↗
PubMed1994

Recruitment activities and sociodemographic factors that predict attendance at a mammographic screening program.

A random sample of 2266 women aged 50 to 69 years was used to investigate factors that predict attendance at a free Australian mammographic screening program. The most important predictor was receipt of a personal invitation letter. A letter that included an appointment time increased attendance 132-fold initially and decreased to 20 times baseline after 14 days. A letter that did not include an appointment time increased attendance 12-fold, and a second letter to nonattenders increased attendance approximately 13-fold. Attendance declined with increasing distance from the program and with increases in the percentage of non-English speaking women in a neighborhood, but was higher in areas of higher socioeconomic status.

Age Factors↗
PubMed1979

Blood-spot thyrotropin radioimmunoassay in a screening program for congenital hypothyroidism.

We describe a highly sensitive and precise radioimmunoassay for thyrotropin in dried blood spots on filter paper cards. In a screening program for congenital hypothyroidism, blood-spot thyrotropin concentrations are measured in infants whose blood-spot thyroxine concentrations are in the lower 10%, and this strategy has reduced the recall rate from 1.7% (thyroxine assay alone) to 0.17%. Thyrotropin assay samples consist of discs 4.5-mm in diameter, containing about 6 microL of blood, punched from blood spots. By appropriate attention to assay conditions, a mean least-detectable thyrotropin concentration equivalent to 2.5 milliunits/L plasma has been achieved. Concomitant measurement of thyrotropin by plasma and blood-spot assays in 91 subjects yielded a Spearman rank correlation coefficient of 0.9732. An analysis of variance of the distribution volume of thyrotropin in blood spots and a covariance analysis of factors affecting blood-spot thyroxine results are presented.

Birth Weight↗
PubMed1994

Explanatory models for cancer among African-American women at two Atlanta neighborhood health centers: the implications for a cancer screening program.

This paper examines cultural models for breast and cervical cancer among low-income African-American women over 40, in order to better understand how those models might affect cancer screening behavior. The study is part of The Community-Based Cancer Screening Project, which is sponsored by Emory University, Grady Memorial Hospital, and the American Cancer Society. The Screening Project attempts to increase the use of mammography, clinical and self-examination of the breast, and cervical Pap smear among women aged 40 or older in a predominantly African-American, low-income, low educational level population that is currently underserved by any screening activities. The study of cultural models of cancer within the project was prompted by the recognition that if screening programs targeted at specific, underserved, populations are to succeed, cultural as well as logistical barriers to screening must be overcome. Patients and clinicians must each understand how the other perceives cancer, its prevention, and its treatment. Only with this mutual understanding as a foundation, can physicians and their clients cooperate to improve cancer screening rates. Our research results indicate that the cancer models held by the patient population differ significantly from those held by clinicians. Women attending the clinics endure cancer screening tests that to them seem to serve only as heralds of a disease that will ultimately kill them. Most women doubt there is a cure for cancer, though some believe a person may live if the disease is caught in time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Application of the polymerase chain reaction for the detection of HIV in specimens from newborn screening programs.

The use of the polymerase chain reaction (PCR) permits detection of HIV proviral DNA in the universally collected "dried blood spot specimens" of newborn screening programs. Detection of HIV proviral DNA among the annual cohorts of seropositive specimens from ongoing anonymous newborn HIV seroprevalence studies can provide a laboratory-based estimate of maternal-infant transmission rates. Preliminary data suggest that maternal-infant transmission rates may be higher in areas where the newborn seroprevalence rates are highest.

DNA, Viral↗
PubMed1987

Ultrasonic investigation of the hip in newborns in the diagnosis of congenital hip dislocation: classification and results of a screening program.

The method of ultrasonic examination of the hip is described, the latest updated Graf classification is explained, and the results of a prospective screening program are described. One thousand four hundred and sixty newborn infants were examined by ultrasound and clinically by independent observers. The distribution of the ultrasound types was determined. Recommendations are given for the use of ultrasonic investigation of the hip for groups at risk in the neonatal period.

Female↗