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PubMed1997

Reduced breast cancer mortality in women under age 50: updated results from the Malmö Mammographic Screening Program.

This article provides additional follow-up data of two cohorts from the Malmö Mammographic Screening Trial (MMST). The first cohort, MMST I, contained 7,984 women under age 50 at entry into MMST who were born between 1927 and 1932. Half were assigned to a control group and were not invited for examination until four years after the code was broken in the MMST in 1988. The second cohort, MMST II, contained 17,786 women born between 1933 and 1945. Fifty four percent of these women were randomly invited to screening between 1978 and 1990. The remaining 46%--the control group--was invited to screening between 1991 and 1994. Nine screening rounds were completed in MMST I, and a mean of five rounds were completed in MMST II; the screening interval ranged from 18 to 24 months. The effect of screening on breast cancer mortality was assessed by pooling the two cohorts. At the end of follow-up--December 1993 for MMST I and December 1995 for MMST II--there was a statistically significant 36% reduction in breast cancer mortality in the intervention groups (relative risk = 0.64; 95% CI: 0.45-0.89; P = 0.009). A harm-benefit analysis showed, however, that for every two breast cancer deaths prevented, one clinically insignificant cancer was diagnosed; for each breast cancer death prevented, 63 cancer-free women had been called back for further examinations; and for every 20 lives saved, one radiation-induced breast cancer death may have occurred. Recommendations for screening must therefore weigh mortality benefits against these negative effects.

Breast Neoplasms↗
PubMed2006

Evaluating the usefulness of self-reported risk factors in a skin cancer screening program.

The objective of this study was to describe the risk factor profile of skin cancer screening participants and to determine whether there is an association between the number of skin cancer/melanoma risk factors and the likelihood of diagnosis of a malignant melanoma. Seventy skin cancer screening clinics were held by the Lions Cancer Institute in predominantly rural areas of Western Australia between 1996 and 2003. Participants were self-selected and voluntary, responding to an advertisement seeking people at 'high-risk' of melanoma. The Lions Cancer Institute skin screening clinics targeted participation by individuals with three or more of the established risk factors for skin cancer/melanoma. Questionnaires collecting information on the self-report of nine risk factors were completed by 5950 participants who were screened for melanoma between 1996 and 2003. The number and type of risk factors, and of provisionally diagnosed and histopathologically confirmed malignant melanomas were measured. Of 5950 participants, 18 histopathologically confirmed malignant melanomas were detected. A participant's total number of risk factors showed some association with the provisional melanoma diagnosis given at the time of screening. No relationship, however, was observed between the number of risk factors and a melanoma that was histopathologically confirmed after screening. The risk factor method is effective in selecting a 'high risk' population, but does not seem to have high value in predicting who will be diagnosed with melanoma as a result of screening. Further studies are needed to verify this finding owing to the rarity of melanoma and the small number of confirmed melanomas in this study.

Data Collection↗
PubMedDate not supplied

Population-based dementia screening program in Kuopio: the effect of education, age, and sex on brief neuropsychological tests.

A neuropsychological screening battery including the Mini-Mental State Examination and four other brief cognitive tests (Russell's Adaptation of the Visual Reproduction Test, Trail Making Test, Verbal Fluency Tests on letters and category, and the Buschke Selective Reminding Test) was administered to a randomly selected population sample of 403 subjects aged 68 to 77 years to evaluate the effect of education, age, and sex on test scores. The difference in neuropsychological screening tests between various education groups (3 years or less, 4 to 6 years, 7 years or more) was statistically highly significant, even after the adjustment for the effect of age. The subscores and total scores were lowest in the minimal education group on every neuropsychological test. Education correlated more strongly than age with all neuropsychological test scores and subscores. The effect of sex on test results was seen only in some subscores of brief neuropsychological tests but not in a single item of the Mini-Mental State Examination. On the basis of our results, the effects of education, age, and sex have to be evaluated before using brief neuropsychological tests in population-based dementia screening.

Age Factors↗
PubMed1992

[Psychosocial consequences of screening programs in children].

Owing to improved possibilities of early diagnosis, there has been increasing interest in screening children, particularly newborns. However, in the event of false-positive results or certain hereditary risk factors there is a danger of adverse psychosocial consequences, especially negative stigmatization (both of children and their families). Accordingly, except where neonatal screening may be essential for medical reasons, such screening programmes should preferably be scheduled for a later stage in life when the parents are less prone to anxiety about anything that might be interpreted as a threat to the well-being of their offspring.

Anxiety↗
PubMed1990

[Observed effects of the mass screening program for breast cancer in Nijmegen in 1975-1986].

Since January 1975, the start of the screening programme for breast cancer in the city of Nijmegen, The Netherlands, over 14 years have elapsed. Data up to the end of 1986 have been processed and are presented in this article. The younger the birth cohort, the higher the attendance rate. In the course of the screening programme, attendance rates decline. Referral rates are highest in the first screening round and for the eldest birth cohort. Detection rates increased during the most recent screening rounds, after an initial decrease during the earliest rounds. They are higher for the eldest birth cohort also. The relative number of interval carcinomas is highest among younger women (as related to the screening-detected carcinomas).

Adult↗
PubMed1998

[The role of the medical corps in a mass screening program for cervical cancer. The program "Female Health Action in 3 urban districts of Lyons].

A pilot study of cervical cancer screening has been initiated in three districts of Lyons suburbs. This campaign aims to increase women participation, specially for high risk groups, helped by an intensive collaboration of general practitioners and gynecologists. Despite several campaign of information, a low rate of participation (13%) was noted. A survey has been performed on the medical population, notably for their participation, eventual changes, encountered problems and perception of such a screening. At time of survey, only half of the general practitioners and 75% of gynecologist still participated. Complexity of administrative procedures, involvement in an epidemiologic survey, lack of time or non-gynecological practice were important obstacles. Volunteer practitioners, enhanced value of public health and university formation of doctors could be necessary in the future for such mass screening.

Adult↗
PubMed1995

A community-based cervical screening program in a remote Aboriginal community in the Northern Territory.

We established a culturally appropriate, community-based women's health service in Yuendumu, Northern Territory, to improve women's health and to remedy the low rate of cervical screening. During the 16 months of the program 419 cervical smears were taken, increasing coverage of the women eligible from 51 to 78 per cent. Acceptance of the program was excellent, with only 2 per cent of the women approached refusing to have a smear. Over 70 per cent of the Pap smears were done by the nursing staff in the clinic; quality control was good, with 9 per cent of smears reported as having no endocervical cells. Sixty-four per cent of screened women had normal smears and 0.9 per cent showed evidence of cervical intraepithelial neoplasia (CIN). Three women were referred for treatment of CIN, two for CIN I and one for CIN III. The program illustrates how a combination of community involvement, staff stability, teamwork, and cross cultural understanding can achieve a comprehensive and successful cervical screening service in a remote Aboriginal community.

Adolescent↗
PubMed1992

The British Columbia Mammography Screening Program: evaluation of the first 15 months.

We report our experiences in the first 15 months of a government-funded pilot project begun in 1988 to study the feasibility of rapid throughput, low-cost screening mammography in British Columbia. The primary goals of the project were (1) to determine the unit cost of screening mammography within the context of the program; (2) to design and put into operation a centralized system of data collection, analysis, and quality control to enable calculations of cancer detection rates, biopsy rates, biopsy yield ratios, staging, and other specific cancer characteristics; and (3) to study compliance in the community where the program was offered. A total of 11,824 women had mammography at a unit cost of U.S. $32.66. Computerized analysis revealed that (1) 11% of women had known primary risk factors; (2) findings on mammograms were interpreted as abnormal in 9% of screening examinations; (3) breast cancers were confirmed in 47 (22%) of 211 patients who had biopsies, and 87% of these were stage 0-1. The overall cancer detection rate was four per 1000, with five per 1000 for women who had not had mammography in the preceding 2 years and one per 1000 for women who had had mammography in the past 2 years. The results show that screening mammography can be conducted at low cost. Data collection and analysis and compliance were sufficiently convincing to initiate province-wide expansion.

Adult↗