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PubMed1991

Does cholesterol screening result in negative labeling effects? Results of the Massachusetts Model Systems for Blood Cholesterol Screening Project.

Several previous studies that looked at the effects of labeling individuals as hypertensive found increases in psychosocial distress, diminished feelings of well-being, or absenteeism. Other studies found no such effects. Thus far, similar studies relating to labeling for high blood cholesterol levels have not been published. The Massachusetts Model Systems for Blood Cholesterol Screening Project investigated whether labeling effects occurred as a result of the community-based screening, education, and referral programs it conducted in Worcester and Lowell. Nine questions concerning perceptions of physical and psychological well-being were asked on a questionnaire given to screening participants. The same questions were asked as part of a follow-up questionnaire given to all individuals identified as having high blood cholesterol levels at one of the screenings. Comparison of the baseline and follow-up results did not demonstrate significant overall negative effects among any age, sex, racial, income, or educational groups. On the contrary, responses to many of the questions revealed small but statistically significant improvements in perceptions of physical and psychological well-being. The absence of negative labeling effects may be attributable to the positive, supportive approach to participant counseling taken by the project.

Adult↗

PubMed1990

[Results of multiphasic oncology screening of the population in the community of Beĕj 1986-1987. II. Questionnaire screening].

In the framework of the multiphase oncologic population screening in the community of Becej in the period from 1986-1987, the inquiry screening comprised 16,895 persons, whereby the following results were obtained: two malignant breast neoplasms, one uterine corpus neoplasm, one carcinoma of the larynx, and out of the non-target locations, not included in the specific questionnaire, there was one carcinoma of the lower lip and one malignant neoplasm of the salivary gland. Besides, 10 benign breast neoplasms and 12 benign uterine neoplasms were also detected. These specific results lagged behind the expected ones on the basis of the known average incidence and mortality in locations of Vojvodina included by this questionnaire. The elucidation of all possible causes leading to this disaccordance, was the task of specific studies intended for the improvement of this questionnaire as a method for the early detection of malignant and premalignant lesions. Other numerous mass pathological states were detected during the screening of either the characteristic signs of specific malignant neoplasm locations, or of risk factors of particular importance for the appearances of these malignant neoplasms. These health problems with clarified epidemiological dimensions in the population studied, necessitated planned solution according to the accepted doctrinary principals (protocols). Data on these diseases gave new dimensions to the inquiry (and the overall multiphase) oncologic population screening. The target-health educational effect of this inquiry which reached every man over 40 years of age in the population studied should not be neglected, either.

Female↗

PubMedDate not supplied

The limitation of screening effect. A review of cervical disorders in previously screened women.

In the Frederiksberg screening program from 1962 to 1972 invasive carcinoma, carcinoma in situ or severe dysplasia of the cervix were found in 155 previously unscreened women. In previously screened women 137 lesions were later elucidated, 53 of these at rescreening. If a failure of method of 10 per cent is anticipated, 21 cases were probably missed due to the method chosen. Patient failure was noted in six cases and two cases were missed by insufficient follow-up by the doctor. The importance of a high participation rate is emphasized. The cytologist's error was 19 per cent. Sixty-four cases were estimated to represent new cases developed between screenings. A reduction of cytologist's error is assumed to be the most accessible way of improving screening results.

Adult↗

PubMed1985

Population screening for breast cancer by mammography in The Netherlands. Expectations, early results, negative effects and conditions for large-scale screening.

Recent publications have shown clearly that screening by mammography is the only method of reducing breast cancer mortality substantially. This can only be achieved, however, by regular annual screening of all women over 40 years of age. An efficiently organized screening program that guarantees optimal mammographic quality should be developed in order to avoid negative effects of population screening such as false-positive and false-negative reports.

Adult↗

PubMedDate not supplied

Impedance screening. An integral part of hearing screening.

Rationale is presented for including tympanometry as an integral part of all hearing screening programs. Impedance screening will yield more accurate screening results in the identification of middle ear disease than traditional hearing testing or otoscopic examination. Medical complications often result from unidentified otitis media which also contributes to speech, language, and educational delays in children. Although additional research information is needed on the significance of early identification of children with otitis media, it is argued that tympanometry will foster such research efforts, while providing improved identification and potential management of middle ear disease in screening programs.

Acoustic Impedance Tests↗

PubMedDate not supplied

Vision screening requirements under 52 Early and Periodic Screening Diagnosis and Treatment (EPSDT) Programs.

A 1979 survey of vision screening requirements in 52 Early and Periodic Screening Diagnosis and Treatment (EPSDT) programs revealed that 17 percent of the programs had no requirements, and 17 percent required only distance visual acuity testing. An additional 25 percent required distance vision and ocular muscle-fusion tests only, and the remaining programs required various combinations of three or more tests. Fewer than two-thirds of the programs with requirements had referral criteria for the tests. The ages at which initial testing was required also varied among the programs. The differences in requirements were not related to the demographic, socioeconomic, and other variables analyzed in this study. Programs with specific referral criteria, however, had a higher percentage of referrals for vision screening than those without such criteria. Because of the variability in vision screening standards and referral criteria observed among the programs, the authors conclude that national standards are needed.

Adolescent↗

PubMed1994

[Mass screening for prostate cancer at a local town--five-year results and screening system].

The results of a mass screening examination for prostate cancer conducted from 1989 to 1993 at a local town, Kawagoe-cho, in Mie Prefecture were evaluated. Among the 216 examinees, 4 were found to have prostate cancer. The most accurate examination was the prostate specific antigen (PSA), which was followed by digital examination and transrectal ultrasound. The applicants for the prostate cancer screening accounted for only 8% of the Kawagoe-cho male residents over 40 years old. An educational campaign of prostate disease in the area must be started to increase the number of applicants. We concluded that the most effective modality for the screening program was a combination of PSA and digital examination in the field study, and transrectal ultrasound accompanied by systemic biopsy results in the second tool for screening.

Adult↗

PubMedDate not supplied

Canadian National Breast Screening Study: first screen results as predictors of future breast cancer risk.

Characteristics of women aged 40-59, recorded at an initial breast screen, were compared with the outcome of incident, invasive breast cancer occurring up to 3 years after the initial screen. The study design was case-control, nested within the study population of the Canadian National Breast Screening Study. Screening consisted of a two-view mammographic examination and physical examination of the breasts; additional risk factor information was obtained from self-administered questionnaires. Of the etiological risk factors considered only age at entry or years menstruating were significant risk factors for breast cancer (P < 0.0025). Years menstruating accounted for much of the age effect and all of the menopausal status effect. Risk factors obtainable from mammography and physical examination were more significant than self-reported risk factors, other than age or years menstruating. In spite of possible misclassification of the variable parenchymal pattern, women with a mammographic film classified as either P2 or DY had a 2-fold risk of breast cancer (odds ratio = 2.1; 95% confidence interval = 1.5-2.9, P = 2.9E-05). An abnormality reported by either the radiologist [odds ratio = 1.7 (1.3-2.3)] or nurse examiner [odds ratio = 1.9 (1.4-2.6)] was also associated with an independent significant risk.

Adult↗

PubMed1993

Management of screen-detected breast cancer: audit of the first 100 cases in the Southampton and Salisbury breast screening programme.

With the natural history and optimal treatment of a high proportion of screen-detected breast cancers yet to be determined, treatment poses the management team with a number of therapeutic dilemmas. This study surveys the management policy and treatment of a consecutive series of 100 screen-detected cancers treated in a single breast unit. The problems encountered are discussed. There were 87 women with stage Tis or T1 tumours, including 26 women with in situ cancers, four with invasive cancers less than 5 mm in size, and seven with tubular cancers. Sixty-six women were managed with breast-conserving surgery and 36 women underwent localisation biopsy as the sole surgical treatment of the breast. With selection bias for high-grade and lateral tumours, only 2/13 cancers up to 10 mm in size were lymph node positive on axillary clearance. All lymph node positive women received adjuvant therapy. No adjuvant therapy was given in 43 cases, including those with in situ cancer. Thirty-six had extensive intraductal component (EIC). Patient and surgeon choice tends to be a major factor both in type of surgery and adjuvant therapy for screen-detected breast cancer. The optimal treatment for tumours detected by breast cancer screening is debatable and randomised trials on their management need to be expedited.

Breast Neoplasms↗

PubMed1996

Cervical cancer screening: are the 1989 recommendations still valid? National Workshop on Screening for Cancer of the Cervix.

Although screening for cervical cancer has been shown to be effective in reducing the morbidity and mortality associated with this disease, and despite many attempts to encourage the development of provincial programs, as of 1995 no province had a comprehensive screening program for cervical cancer. Participants at the Interchange '95 workshop, held in Ottawa in November 1995, reviewed the recommendations of the 1989 National Workshop on Screening for Cancer of the Cervix and identified factors that have impeded their implementation. Participants discussed the need for comprehensive information systems, quality control and strategies to increase recruitment of unscreened and underscreened women. They concluded that the formation of a Cervical Cancer Prevention Network involving key stakeholders will facilitate the development and implementation of provincial programs to ensure optimal screening. They agreed that, in the interim, recommendations for practising physicians should remain as they were following the 1989 workshop.

Canada↗

PubMedDate not supplied

Cystic fibrosis newborn screening: impact of early screening results on parenting stress.

Newborn screening for cystic fibrosis (CF) is currently available through dried blood analysis for immunoreactive trypsinogen (IRT). The possible parenting stress associated with false-positive results or the early diagnosis of an asymptomatic infant has yet to be systematically addressed. This exploratory study examined levels of parenting stress among mothers of these infants. Results indicated significantly less total parenting stress but greater defensiveness in responding among families of false-positive screened children relative to their healthy comparison families. Parents of children diagnosed with CF through newborn screening did not show significantly higher stress scores than their healthy or "traditionally-diagnosed" CF comparison families. They did however have high frequencies of "at-risk scores" warranting referral based on clinical cut-off levels for Total Parenting Stress scores (45%) and Child Demandingness subscale score (50%). As the possibility for expanding CF neonatal screening to other states is considered, the need for further exploration of psychosocial sequelae affecting parenting will be increasingly important.

Adult↗

PubMed1998

Nasopharyngeal swab and PCR for the screening of nasopharyngeal carcinoma in the endemic area: a good supplement to the serologic screening.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is a common head and neck cancer in Taiwan. Early detection is the best way to improve survival for this disease. A prospective study was designed to assess the feasibility of a new screening method for NPC by use of polymerase chain reaction (PCR) based on the close association of NPC and Epstein-Barr virus (EBV). METHODS: One hundred thirty-three different tissues from nasopharynx, nose, and sinus were investigated by use of PCR to check for the presence of EBV genome. Subsequently, from April 1996 to March 1997, 55 patients were enrolled in a prospective screening study. All patients underwent nasopharyngeal swabs before biopsy. Polymerase chain reaction detection of EBV genome was conducted on swab samples. Anti-EBV viral capsid antigen (VCA) in IgA and IgG class were checked at the same visit. RESULTS: The EBV genome was present in 91.4% (85/93) of NPC tissues and in 25.0% (10/40) of non-NPC tissues (p < .001, chi2 test). Of the 55 swabs, 49 (89.1%) specimens obtained enough cells for PCR examination. Thirty of these 49 patients were pathologically proved NPC. The presence of EBV were 86.7% (26/30) in NPC group and 42.1% (8/19) in non-NPC group. The sensitivity and specificity were 86.7% and 57.9%, respectively, which were similar to those of serologic method (87.5% and 43.5%) when the cut-off point was set at anti-VCA IgG > or = 160 and IgA > or = 10. Combining both methods elevates the specificity to 84.2%. CONCLUSIONS: The sensitivity of this PCR screening method is similar to that of the serologic method. Combining both methods can greatly increase the specificity, indicating this new method is a good supplement to the serologic screening of this endemic disease.

Antibodies, Viral↗

PubMedDate not supplied

Underusers of mammogram screening: stage of adoption in five U.S. subpopulations. The NCI Breast Cancer Screening Consortium.

BACKGROUND: The purpose of this report is to describe the characteristics of women ages 50 to 80 who do not follow commonly accepted mammography screening guidelines. It provides unique understanding of the robustness of characteristics of underusers across five different U.S. subpopulations. METHODS: The data are from the baseline surveys of the five studies of the NCI Breast Cancer Screening Consortium. Stage of adoption of mammography screening and other characteristics of underusers are presented. Polytomous logistic regression analysis was used to explore multivariable associations with stage of adoption in each study site. RESULTS: The five samples studied by the Consortium range in size from 259 to 4,477 women (n = 11,292). The relationship of the perceptions of the pros and cons of mammography with stage of adoption was strikingly similar across the five samples. Other variables consistently associated with stage were a recent receipt of a breast physical examination and recommendation for mammography by a physician. CONCLUSIONS: The findings suggest a need to encourage regular screening through effective communication from a health care provider. Intervention messages should be designed to increase the pros of mammography, decrease the cons, and highlight these differentially according to the woman's stage of adoption.

Aged↗

PubMed2005

Long term follow-up of HNPCC gene mutation carriers: compliance with screening and satisfaction with counseling and screening procedures.

Hereditary non polyposis colorectal cancer (HNPCC) is a hereditary predisposition to colorectal and endometrial cancer, caused by mutations of the mismatch repair (MMR) genes MSH2, MLH1 and MSH6. Regular colonoscopy reduces the incidence of colorectal cancer in mutation carriers dramatically. The aim of this study was to evaluate the use of colonoscopy by proven HNPCC mutation carriers. We also evaluated the satisfaction with the counseling and screening procedures at the long term. A questionnaire survey was performed among 94 proven MMR gene mutation carriers. Data were analyzed using univariate and multivariate analysis. The average time of follow-up was 3,5 years (range 0.5-8.5 years). The response rate was 74%. The proportion of unaffected mutation carriers under colonoscopic screening increased from 31 to 88% upon genetic testing, and for gynecological screening from 17 to 69%. However, more than half of the responders experienced colonoscopy as unpleasant or painful. About 97% felt well informed during counseling, and 88% felt sufficiently supported. Ten percent of the responders reported a high cancer worry that was significantly (P = 0.007) associated with a high perceived cancer risk. Six responders (9%) regretted being tested. Remarkably, of 4 of these 6 a close relative died recently of cancer. Problems with obtaining a disability or life insurance or mortgage were experienced by 4 out 10 healthy carriers opting for these services. In conclusion, genetic testing for HNPCC considerably improves compliance for screening, which will result in a reduction of HNPCC-related cancer morbidity and mortality in mutation carriers. Most HNPCC gene mutation carriers cope well with their cancer susceptibility on the long term.

Adult↗

PubMed1989

Development of a novel screening device permitting immunocytochemical screening of numerous culture supernatants during hybridoma production.

A novel screening device is described which permits the simultaneous immunocytochemical processing of several hundreds or even thousands of hybridoma culture supernatants. The core of the screening apparatus is a foam-coated polymer plate that carries a 96-well pattern representing a modification of the actual 96-well template. This modification permits the use of conventional 26 X 76 mm microscopy glass slides. Each of these slides carries 24 carefully arranged histological sections. One 96-well plate is thus screened by mounting four of these slides in the apparatus during the primary antibody (i.e., culture supernatant) incubation stage. At all other stages of the immunocytochemical protocol, the slides are processed in the classical way. The screening apparatus has been used during the production of monoclonal antibodies against chicken pituitary glycoprotein hormones and against bovine neurohypophyseal peptides. In both instances, it proved to be the major contributory factor in the successful production of antibodies.

Animals↗

PubMed1986

Screening for urinary tract infection using Bac-T-Screen bacteriuria device.

The Bac-T-Screen was used to process 795 urine specimens. Tests for urine specimens took slightly more than two minutes. The Bac-T-Screen predicted with 99 per cent accuracy if a specimen was negative for bacteriuria or pyuria. Thus, approximately one half of all carefully collected urine specimens need no further laboratory culture. In addition, the Bac-T-Screen detected bacteriuria with a sensitivity of 96 per cent at the 10(5) CFU/ml level of probability. Pyuria (1 +) was detected with a sensitivity of 98 per cent. The Bac-T-Screen can be used in an office practice as well as in the clinical laboratory.

Bacteriuria↗

PubMed2005

Multiple target screening method for robust and accurate in silico ligand screening.

We developed a new in silico multiple target screening (MTS) method, based on a multi-receptor versus multi-ligand docking affinity matrixes, and examined its robustness against changes in the scoring system. According to this method, compounds in a database are docked to multiple proteins. The compounds among these proteins that are likely bind to the target protein are selected as the members of the candidate-hit compound group. Then, the compounds in the group are sorted into descending order using the docking score: the first (n-th) compound is expected to be the most (n-th) probable hit compound. This method was applied to the analysis of a set of 142 receptors and 142 compounds using a receptor-ligand docking program, Sievgene [Y. Fukunishi, Y. Mikami, H. Nakamura, Similarities among receptor pockets and among compounds: analysis and application to in silico ligand screening, J. Mol. Graphics Modelling, 24 (2005) 34-45], and the results demonstrated that this method achieves a high hit ratio compared to uniform sampling. We prepared two new scores: the DeltaG score, designed to reproduce the protein-ligand binding free energy, and the hit-optimized score, designed to maximize the hit ratio of in silico screening. Using the Sievgene docking score, DeltaG score and hit-optimized score, the MTS method is more robust than the multiple active-site correction scoring method [G.P.A. Vigers, J.P. Rizzi, Multiple active site corrections for docking and virtual screening, J. Med. Chem., 47 (2004) 80-89].

Databases, Factual↗

PubMed1985

Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare.

A randomised controlled trial to investigate the efficacy of mass screening with single-view mammography in reducing mortality from breast cancer was started in Sweden in 1977. 162 981 women aged 40 years or more and living in the counties of Kopparberg and Ostergötland were enrolled in the study and divided at random into 2 groups. Each woman in the study group was offered screening every 2 or 3 years depending on age. Women in the control group were not offered screening. This report is confined to the 134 867 women aged 40-74 years at date of entry. The results to the end of 1984 show a 31% reduction in mortality from breast cancer and a 25% reduction in the rate of stage II or more advanced breast cancers in the group invited to screening. 7 years after the start of the study the excess of stage I cancers in the study group largely outweighs the deficit of advanced cancers.

Aged↗