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At least 775 records · Page 43Linked to original sources

PubMed2006

Screening for postpartum depression in military women with the Postpartum Depression Screening Scale.

Each year, approximately 16,000 women on active duty in the U.S. military experience the birth of a child. A descriptive, longitudinal, prospective design was used to gather data with the Postpartum Depression Screening Scale. Depression was measured after delivery but before hospital discharge (time 1), 2 weeks after delivery (time 2), and 6 to 8 weeks after delivery (time 3). Mothers were found to be experiencing the greatest severity of symptoms in the category of sleeping and eating disturbances. Almost one-half of the mothers in this study scored either significant postpartum depressive symptoms or positive screening for postpartum depression after delivery. This number remained virtually unchanged at time 2. By time 3, 40% of women still reported depressive symptoms. At 2 weeks and 6 weeks after delivery, 13% and 11% of mothers, respectively, had positive screening for postpartum depression, consistent with the national average of 10 to 15%. Future research is needed to examine issues surrounding postpartum depression of military women.

Adolescent↗

PubMed1992

Breast cancer screening among women from 65 to 74 years of age in 1987-88 and 1991. NCI Breast Cancer Screening Consortium.

OBJECTIVE: To compare breast cancer screening rates from the 1991 survey with data from 1987-88 for women aged 65 to 74. DESIGN: Surveys of women from five communities. SETTINGS: Five control communities of the National Cancer Institute's Breast Cancer Screening Consortium. PARTICIPANTS: White, non-Hispanic women, ages 65 to 74; 499 in 1987-88 and 2156 in 1991. Response rates for the first survey wave ranged by area from 65% to 77% and for the second survey wave, from 62% to 85%. MAIN OUTCOME MEASURE: Mammogram and clinical breast examination during the past year and performance of monthly breast self examination, with the screening rates in wave 2 directly standardized to the income and education distribution of wave 1 in each area. RESULTS: Mammography use between waves increased significantly (P < 0.05 after adjusting for education, income, and age) in all but one area (from 19% to 33% in wave 1 to 35% to 59% in wave 2). Among women who had a mammogram, the percent who also had a clinical breast examination decreased between waves from 95% to 85% (P = 0.001). CONCLUSIONS: Mammography in older women increased dramatically over 3 years, although the use of clinical breast examination may be decreasing.

Aged↗

PubMed2002

The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up. A randomized screening trial of mammography in women age 40 to 49 years.

BACKGROUND: The efficacy of breast cancer screening in women age 40 to 49 years remains controversial. OBJECTIVE: To compare breast cancer mortality in 40- to 49-year-old women who received either 1) screening with annual mammography, breast physical examination, and instruction on breast self-examination on 4 or 5 occasions or 2) community care after a single breast physical examination and instruction on breast self-examination. DESIGN: Individually randomized, controlled trial. SETTING: 15 Canadian centers. PARTICIPANTS: 50 430 volunteers age 40 to 49 years, recruited from January 1980 to March 1985, who were not pregnant, had no previous breast cancer diagnosis, and had not had mammography in the preceding 12 months. INTERVENTIONS: Breast physical examination and instruction on breast self-examination preceded random assignment of 25 214 women to receive mammography and annual mammography, breast physical examination, and breast self-examination and 25 216 women to receive usual community care with annual follow-up. MEASUREMENTS: Verified breast cancer incidence and cohort mortality through 31 December 1993 and deaths from breast cancer through 30 June 1996. RESULTS: The 105 breast cancer deaths in the mammography group and 108 breast cancer deaths in the usual care group yielded a cumulative rate ratio, adjusted for mammography done outside the study, of 1.06 (95% CI, 0.80 to 1.40). A total of 592 cases of invasive breast cancer and 71 cases of in situ breast cancer were diagnosed by 31 December 1993 in the mammography group compared with 552 and 29 cases, respectively, in the usual care group. The expected proportions of nonpalpable and small invasive tumors were detected on mammography. CONCLUSION: After 11 to 16 years of follow-up, four or five annual screenings with mammography, breast physical examination, and breast self-examination had not reduced breast cancer mortality compared with usual community care after a single breast physical examination and instruction on breast self-examination. The study data show that true effects of 20% or greater are unlikely.

Adult↗

PubMedDate not supplied

Unoccluded bone conduction screening as an alternative to impedance screening.

The present study was undertaken to determine which intensity level of an unoccluded bone-conducted (BC) signal might be best suited for use as a supplemental procedure to an individual pure-tone air-conduction school screening program. Four intensity levels (0, 5, 10, 15 dB hearing level) of a 500 Hz BC tone were presented in ascending order to a public school population in addition to screening by impedance audiometry and pure-tone air conducted signals. Tetrachoric analysis using impedance screening results as a standard comparison revealed that a 10-dB unoccluded BC signal at 500 Hz provided an effective supplemental procedure for identifying conductive pathology in the population studied.

Audiometry↗

PubMed1999

[Opportunistic screening for genital infections with Chlamydia trachomatis among the sexually active population in Amsterdam. III. Cost-effectiveness analysis of screening women and the role of reinfection and partner treatment].

The role of reinfection and the importance of partner treatment were added to a pharmacoeconomic model for the analysis of a GP-based opportunistic screening programme for Chlamydia trachomatis (CT) in sexually active women in Amsterdam. A favourable cost-effectiveness was found for partner treatment. Partner treatment was cost saving and overall net costs per major outcome averted by the screening programme were reduced by 40% or more due to partner treatment. From a pharmacoeconomic point of view partner treatment should be routinely provided in the framework of a CT screening programme for Amsterdam women.

Adolescent↗

PubMed2000

Screening for hyperglycaemia in pregnancy: analysis of two screening protocols and review of current methods.

We assessed the ability of two screening protocols to detect varying degrees of hyperglycaemia in pregnancy and to compare fetal outcome in those found to have normal and abnormal glucose metabolism by either protocol. 493 pregnant women were identified by one of two screening protocols to be at risk of hyperglycaemia in pregnancy. Pregnancy complications, induction of labour, method of delivery, birth weight, incidence of congenital anomalies and neonatal complications were assessed; there were no significant differences between those with normal and abnormal glucose metabolism detected by either protocol apart from a significant linear trend for the incidence of large for gestational infants with increasing hyperglycaemia in both groups. Protocol B was as effective in detecting new hyperglycaemia in pregnancy as Protocol A. It involved the use of a breakfast meal profile in the initial assessment of those screened positive, reducing the need for glucose tolerance tests in the vast majority of cases. In the population studied, hyperglycaemia in pregnancy was not associated with adverse fetal outcome.

Diet↗

PubMed2001

[Screening for breast cancer on basis of individual risk assessment for women ineligible for the national population screening program].

For healthy women, without malignancies in their personal histories, a positive family history for breast cancer is the single indication for individual breast surveillance outside the population screening. Management of women is based on individual risk assessment. A cumulative risk of 20% and more, as a result of a positive family history, will in practice be an indication for breast surveillance. This threshold is not evidence-based yet, nor are data available on the benefits of this surveillance efficacy. When a personal cumulative risk of more than 30% exists to develop breast cancer, a consultation with a clinical geneticist involved in a family cancer clinic should be offered. Surveillance of women with a high-risk cumulative risk should preferably be included in a prospective study design. Only in this way will data about compliance and the estimates of different ways of surveillance become available. There is no convincing evidence that population screening for women aged 40-49 years does lead to important mortality reduction in combination with a good balance between pros and cons for the women involved. Women in the age category 50-75 years, with breast cancer in their personal histories, who are not followed anymore, should be informed by their specialist about participating (again) in the population breast screening. There is no evidence of mortality reduction as a result of breast self-examination nor of palpation performed by a physician. However, awareness of the own body can be useful for early recognition of breast abnormalities; it may reduce the delay between the first recognizable symptom and the subsequently initiated therapy.

Adult↗

PubMed1999

Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group.

From June 1996 to June 1998 a total of 62.841 newborn infants were screened for congenital hypothyroidism with thyroid stimulating hormone assay as a primary test. The method used was an immunofluorescent assay using the DELFIA TSH Kit on dried blood specimens collected by heelprick on filter paper. All infants with TSH values greater than 20 microU/ml were retested. If the results remained abnormally high, confirmatory testing was done by radioimmunoassay. All infants who were confirmed to be hypothyroid were referred to pediatric endocrinologists for initial management. The overall weighted incidence of congenital hypothyroidism obtained in this study was 0.000277 (95% CI; 0.000122 - 0.000432) or 1:3,610 which may be higher than that reported by most screening programs worldwide. The recall rate was 0.16%. The higher recall rate may be explained by early testing in a number of cases and by the possibility of iodine deficiency in some of the mothers. On the basis of the results of this study, we would recommend (1) screening on a greater number of infants to verify the incidence of CH and (2) establishing normal TSH values at different hours of life to improve our recall rate.

Congenital Hypothyroidism↗

PubMed1992

[An epidemiological evaluation of the efficacy of mass screening for uterine cancer in Japan. The relationship between coverage rate of mass screening and reduction in death rate from uterine cancer].

To evaluate the efficacy of mass screening for uterine cancer, the relationship between the coverage rate of mass screening and the reduction in mortality rate from uterine cancer was analyzed. The percent change in the AADR (Age-adjusted death rate) from 1979-1983 to 1984-1988 were compared between the high coverage rate areas and the control areas with relatively lower coverage rates, and among the high coverage rate areas with varied coverage rates. The main results were: (a) the decreases of AADR from uterine cancer were greater in three groups of high coverage rate areas than in control areas with low coverage rates. (b) Among three groups of high coverage rate areas with variation in coverage rates (> or = 20%, > or = 30%, > or = 40%), the higher the coverage rate was, the greater was the percent reduction (-45.9%, -52.3%, -63.5%) of AADR. These results suggest that systematic mass screening may be effective in reducing mortality from uterine cancer.

Adult↗

PubMed2005

The New Zealand Hepatitis B Screening Programme: screening coverage and prevalence of chronic hepatitis B infection.

AIM: To report on screening coverage and the distribution of HBsAg (a marker of chronic hepatitis B virus infection) among participants in the New Zealand Hepatitis B Screening Programme. METHOD: Coverage and crude and age-standardised prevalence rates of HBsAg by age group, sex, ethnic group, and region were calculated from data held by the two providers and the New Zealand 2001 Census. RESULTS: 177,000 people were tested for hepatitis B virus infection (51% of the programme targets and 27% of Census 2001 eligible population), with highest coverage among women (28.9%) and Pacific people (34.9%). Overall, 5.7% (10,176) of participants were HBsAg-positive and there were significant regional, ethnic group, and gender differences. 5.6% of Maori, 7.3% of Pacific people, and 6.2% of Asians were HBsAg-positive, and men were more likely to test HBsAg-positive (6.1%) than women (5.4%). CONCLUSIONS: Previous estimates of HBsAg prevalence among Maori and Pacific people from smaller surveys were confirmed and new information obtained about the distribution of hepatitis B virus infection among Pacific Islands and Asian populations in New Zealand. Opportunistic screening of adults in these populations should continue in order to identify others with (as yet undetected) infection. Regular follow-up of people with chronic hepatitis B virus infection should also continue. Ongoing outcome monitoring is now needed to judge whether this unique programme has been an effective component of New Zealand's hepatitis B control strategy and whether it is a worthwhile investment of resources.

Adolescent↗

PubMed2005

Abandoning isolated free PSA screenings for more comprehensive cardiovascular and cancer screening and education.

The time is ripe to abandon free PSA screenings and replace them with free comprehensive health screenings. For example, cardiovascular disease (CVD) risk screening (cholesterol, blood pressure) that could also include PSA, weight measurement, and a variety of other tests and educational assessments just make more sense in terms of the larger picture of influencing all-cause morbidity and mortality. Numerous reasons are proffered for this important change. Abandoning this myopic single-disease only approach must be embraced by numerous medical centers and health professionals before this comprehensive approach can be successfully implemented.

Cardiovascular Diseases↗

PubMed2005

[Silent myocardial ischemia in diabetic patients: to screen or not to screen?].

Cardiovascular diseases are the leading cause of death in patients with diabetes and silent myocardial ischemia occurs more frequently in diabetics than non-diabetics. Thus American Diabetes Association guidelines recommend screening for coronary artery disease in high-risk, asymptomatic diabetic patients. However these recommendations are the result of expert consensus panels instead of being evidence-based. The selection criteria for patients who should be included in screenings programs and the most appropriate treatment of silent ischemia in diabetics have to be clarified. In particular further studies are necessary to assess if myocardial revascularization is more beneficial than full medication alone. Screening of silent ischemia should be more individualized rather than systematic.

Coronary Disease↗

PubMedDate not supplied

Reflotron performance in a community screening program: results of the Massachusetts Model Systems for Blood Cholesterol Screening Project.

We evaluated the precision, accuracy, and durability of the Reflotron portable analyzer as part of the National Heart, Lung, and Blood Institute's Model Systems for Blood Cholesterol Screening Program. We conducted screenings in a wide variety of settings in four Massachusetts communities over a 16-month period. Fingerstick samples from 10,428 individuals were tested on the Reflotron at the screening sites. For comparison, we drew venous samples from 972 participants and analyzed them in a reference laboratory, which had met the requirements of the Centers for Disease Control's Lipid Standardization Program. All four Reflotrons tested met the 1988 guidelines for precision and accuracy established by the Laboratory Standardization Panel (LSP) of the National Cholesterol Education Program (NCEP). None of the analyzers consistently met the 1992 LSP standards for precision, although two met the 1992 standards for accuracy. More than 40% of Reflotron values differed from the reference laboratory values by more than 5%. As a consequence, more than 16% of individuals were misclassified in terms of the NCEP risk category into which their Reflotron readings fell. All four instruments malfunctioned at some point during the project, precluding their further usage. We recommend improvements in the precision, accuracy, and durability of this analyzer.

Adult↗

PubMedDate not supplied

Screening for HBsAg in pregnant women: a cost analysis of the universal screening policy in the province of Quebec.

We carried out a cost analysis of a universal prenatal screening policy for hepatitis B virus infection in pregnant women. A universal screening policy in the province of Quebec (87,000 births per year) would cost about $473,000 per year and the prevention of one chronic carrier, $8,915. The cost varied greatly according to the ethnic origin of the mother and the cost of the serologic test. Strategies to reduce the cost of the serologic test could greatly reduce the cost of this screening policy.

Cost-Benefit Analysis↗

PubMed1990

Screening mammography: a missed clinical opportunity? Results of the NCI Breast Cancer Screening Consortium and National Health Interview Survey Studies.

Data from seven studies sponsored by the National Cancer Institute (NCI) were used to determine current rates of breast cancer screening and to identify the characteristics of and reasons for women not being screened. All seven studies were population-based surveys of women aged 50 to 74 years without breast cancer. While over 90% of non-Hispanic white respondents had regular sources of medical care, 46% to 76% had had a clinical breast examination within the previous year, and only 25% to 41% had had a mammogram. Less educated and poorer women had had fewer mammograms. The two most common reasons women gave for never having had a mammogram were that they did not know they needed it and that their physician had not recommended it. Many physicians may have overlooked the opportunity to recommend mammography for older women when performing a clinical breast examination and to educate their patients about the benefit of screening mammography.

Aged↗

PubMed1989

[Mammography screening in Tromsö. Realization and results of the first mammography screening in Norway].

The screening was carried out as a part of a health survey. Women aged 40 or more, (N = 4,290), were eligible. The acceptance rate were 84.4%. Altogether 5.3% was selected fro detailed mammographic examination, 1.7% were referred to a surgeon and 1.1% underwent surgery. In ten (25%) of them breast cancer was proven histologically. The mammograms were read independently by two radiologists. The predictive value was highest if only women on which both radiologists agreed were referred to detailed mammography. Of the women attending the health survey, 98% in the urban and, 79% in the rural part of the municipality were screened for breast cancer. The latter group had to make an appointment and travel to the city center to have their mammograms taken. The interpretation of the breast cancer screening was centrally administered. The follow-up was organized locally.

Adult↗

PubMed1989

Accuracy of the Michigan Alcoholism Screening Test for screening of alcoholism in patients of a medical department.

To measure the applicability and validity of the Michigan Alcoholism Screening Test in a medical hospital department situated in the French-speaking part of Switzerland, the test was administered to 300 patients. The results of the test were validated in relation to the clinical diagnosis of alcohol abuse or alcoholism through a concordance analysis. The applicability rate was 89% and the agreement between test and clinical diagnosis was good, especially in young men. Positive and negative predictive values of the test were 0.69 and 0.92, respectively. These results suggest, therefore, that the Michigan Alcoholism Screening Test could be considered as a standardized, valuable, and transcultural screening and research instrument.

Adult↗

PubMed1986

Organization of screening programs in developing countries with reference to screening for cancer of the uterine cervix in India.

Cancer of the uterine cervix is the leading female malignancy in developing countries such as India. Efforts for early detection by cervical cytology smears have been few, restricted to special situations, or short-term. No measurement of impact in terms of decline in mortality or incidence rates has been possible in India. However, a study by the Cytology Research Centre, New Delhi, on the natural history and biological behaviour of dysplasias provides evidence of the usefulness of screening to detect malignancy at early stages; both routine follow-up by cervical smears of women with dysplasia as well as screening of women attending gynaecological out-patient departments were used. This paper reviews the magnitude of the problem of uterine cervical cancer, the epidemiological aspects of the present situation in India, the efforts made for its control in different parts of the country and the problems encountered in organizing cervical cancer screening programs. Models of the approaches adopted are described, and guidelines are suggested which include the utilization of several approaches, including institution-based programs, extension of services to peripheral areas through mobile units, links with maternal care services, and establishment of referral systems. The need to develop human resources in cytology, in both medical and paramedical categories, is highlighted.

Adult↗