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Results for “MASS SCREENING”

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PubMed1998

[The significance and limitation of prostate specific antigen in the mass screening for prostate cancer].

The ultimate aim of the mass screening program is to decrease the prostate cancer mortality, which can be demonstrated only in a well designed and well controlled trial comparing screened and unscreened populations. However, there are not any trials which prove the effectiveness of mass screening for prostate cancer. Among the 3 modalities, prostate specific antigen (PSA) had the highest sensitivity and positive predictive value. However, PSA had the 20% probability to diagnose incorrectly the patient with prostate cancer as a normal. PSA had 10% possibility to detect clinically insignificant cancer. It is important to inform subjects not only the significance but also limitation of mass screening by PSA.

Biomarkers, Tumor↗

PubMed2001

Clinical and biologic characteristics for recurring neuroblastoma at mass screening cases in Japan.

BACKGROUND: It is said that most cases detected by neuroblastoma mass screening at 6 months of age tend to have a favorable clinical course after a surgical resection either with or without mild chemotherapy. However, a few cases have an unfavorable outcome. In the current study, the authors analyzed the clinical and biologic characteristics for recurring neuroblastoma in mass screening cases. METHODS: In 245 cases detected through mass screening in the Kyushu area in Japan, the clinical data and biologic features (N-myc status, DNA ploidy, Shimada histology, neuron-specific enolase (NSE), ferritin) were investigated, whereas, in particular, the data for recurring cases also were analyzed. RESULTS: Of 245 cases, 28 tumors had one or more biologically unfavorable prognostic factors, and 6 patients experienced recurrence. Three of the six patients with recurring disease underwent a complete resection of the primary tumor, whereas three cases had undergone an incomplete resection of the tumor. Regarding the initial chemotherapy, three cases received mild chemotherapy, two cases received no chemotherapy, and one case had high-dose multidrug chemotherapy. Regarding biologic prognostic factors, four of six cases with recurring disease had one or more unfavorable factors, whereas two cases had no unfavorable factors. Regarding the outcome after recurrence, four cases are CR, one case has a stable residual tumor, and one case died of disease with N-myc amplification. CONCLUSIONS: Most neuroblastomas detected by mass screening at 6 months of age have biologically favorable factors. However, approximately 10% of the cases had one or more unfavorable factors and thus might have a higher risk of recurrence than the patients with no unfavorable factors. Conversely, some cases with recurring disease had no unfavorable factors; however, the reason for this is still unclear. A long-term follow-up for mass screening cases is important, and it also might be necessary to research the established biologic factors and identify other new prognostic factors.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1989

Mother's attitudes towards the mass screening of neuroblastoma.

Two hundred and two mothers whose infants participated in mass screening of neuroblastoma in Sapporo City, and 200 mothers whose infants did not, were interviewed about their attitudes towards the mass screening. Only a few non-participants (3.5%) thought the mass screening was unnecessary. More than half of non-participations (56.0%) were due to mothers' forgetfulness or to loss of the "Neuroblastoma Screening Examination Set" during the two months' interval between the delivery of the set and the sample submission. Mailing of the set at six months for the purpose of eliminating this interval would greatly reduce such neglect of the mass screening. On the other hand, not many infants would participate in re-screening for detection of false negative cases, since the percentage of mothers who were willing to make their children take part in re-screening for a fee of 1,000 yen (about 7 U.S. dollars, which would be administratively necessary) was less than 60%.

Attitude to Health↗

PubMed1998

Is screening for abdominal aortic aneurysm acceptable to the population? Selection and recruitment to hospital-based mass screening for abdominal aortic aneurysm.

BACKGROUND: The aim of the study was to analyse whether the selection and recruitment for hospital-based mass screening for abdominal aortic aneurysms (AAA) is acceptable for the population according to the criteria from the Council of Europe. METHODS: A random sample of 4404 65-73-year-old males were invited to hospital-based mass screening for AAA. As methods of secondary recruitment, they could change their time of appointment, and non-responders were reinvited once. RESULTS: The attendance rate was 76 per cent; 4.2 per cent had AAA. Men with cardiopulmonary and vascular diseases had higher attendance rate (80.5 per cent), and prevalence of AAA (9.1 per cent). Men with potentially mobility-disabling diseases also had a higher attendance rate (80.4 per cent). However, possible unfavourable social selection was noticed in the group of retired men with no information of former occupation. They had 68.5 per cent attendance, and 7.6 per cent AAA. If true, this selection decreases the number of potentially diagnosed AAA by only 2 per cent. Opportunity of revised appointment and reinvitation of non-responders increased the primary attendance of 65 per cent to 76 per cent. More AAA were found at secondary scans (6.3 per cent compared with 3.9 per cent). CONCLUSION: The attendance rate fell markedly with age, but the recruitment was high even at the age of 73, and travel distance and social class did not markedly influence uptake. A positive morbidity selection to screening for AAA was observed for cardiovascular or pulmonary diseases and potentially mobility-disabling diseases. Furthermore, higher prevalence of AAA was found for initial nonattenders. Thus, screening for AAA seems acceptable to the population, and extra efforts to increase the attendance are beneficial without increased costs per diagnosed AAA. Finally, if mass-screening proves to be cost-ineffective, selective screening of patients with hypertension or ischaemic heart disease might be beneficial.

Age Distribution↗

PubMed1984

[Problems in mass screening program for prostatic diseases].

We developed transrectal ultrasonotomography for practical use in 1967 and started a model trial mass screening program for prostatic diseases with the method in 1975. A mobile unit "Dolphin" for mass screening, in which two sets of special chair-type scanner for the method was loaded, was developed successfully in 1980. Up to March, 1983, 2394 males over the age of 55 were submitted to the primary study. Among them, 12 cases (0.5%) of prostatic cancer (PC) and 755 cases (31.5%) of benign prostatic hypertrophy (BPH) were finally detected in the secondary study. Thus the prevalence of BPH was significant and even the detection rate of PC was still remarkably higher than that in mass screening for other malignancies. The diagnostic accuracy in transrectal ultrasonotomography in PC was calculated from the results of patients visiting our out-patient clinic during 7 years until March, 1983. The sensitivity was 96.5% and the specificity was 84.6%. On the other hand, the sensitivity of digital examination in the same series was 80.7%. We concluded from this study that the efficacy of digital examination was thought to be insufficient for the screening of PC. The cost-benefit balance in our mass screening system was estimated from the above mentioned results. We needed yen 2,000,000 to find out each case of early PC in the system. In our clinic, patients with early PC paid yen 2,000,000 in average for treatments including radical surgery and were cured. On the contrary, patients with advanced PC paid yen 5,000,000 approximately yen 8,000,000 and died eventually. The minimum difference of treatment fee between early and advanced PC was yen 3,000,000, accordingly. Since the cost of detecting each early PC in mass screening was yen 2,000,000, we are contributing approximately yen 1,000,000 to the national finance on each time when we pick up one case of early PC. This doesn't include benefits from detecting BPH and from life prolongation. Thus the balance seems to be sufficiently positive. In conclusion, a mass screening program for prostatic diseases is promising because it can detect the diseases accurately by transrectal ultrasonotomography with a good cost-benefit balance. The only remaining problem is how to transfer this to national political measures.

Aged↗

PubMed1989

[Risk-benefit analysis for mass screening of breast cancer utilizing mammography as a screening test].

Incidence of breast cancers in Japanese women is increasing steadily. Mass screening of breast cancer was started in Japan under auspices of Adult Health Promotion Act of the Japanese Government from 1987. As the first screening method, the palpation of breasts is employed at present, but it is expected to be replaced by the mammography. In this report, the risk-benefit analysis is presented between risk of breast carcinogenesis due to radiation and benefit of mass screening of breast cancer. The benefit of mass screening is taken as the net elongation of average life expectancy of women due to survival from breast cancers. The risk of mammography is taken as the net loss of average life expectancy of women due to breast carcinogenesis. In the latter, the latency time and plateau period of radiation carcinogenesis were taken into consideration in the calculation. The results show that the ages at which the benefit and risk become equal are between 30 and 35 years old when dose equivalent of mammography is between 10 and 20 mSv, that are conventionally used. However, the critical age will be reduced to 20 years old if the dose equivalent becomes 1 mSv. Therefore, it is strongly recommended that a low dose mammographic system should be developed in order to achieve 1 mSv for the mass screening of breast cancer of Japanese women. In author's opinion, this is quite feasible by employing a new digital radiography with imaging plate.

Adolescent↗

PubMed2006

Comparing mass screening techniques for gastric cancer in Japan.

AIM: To discuss the efficacy of endoscopic mass screening for gastric cancer. METHODS: The data used in this study were the results of mass screening programs for gastric cancer in Niigata City from 2002 to 2004. The number of participants was 35,089 in 2002, 34,557 in 2003 and 36,600 in 2004. The finding ratio referred to the final diagnosis of gastric cancer after a double check of endoscopic files and histological findings. The costs of identifying one case of gastric cancer were calculated based on the total expense for each screening program and additional close examinations. RESULTS: From the analysis of individual screening program with endoscopy, individual screening program with X-ray (ISX) and mass screening program with photofluorography (MSP) in reference to the finding ratio of gastric cancer, endoscopic examination was the best for detecting early gastric cancer, the finding ratio was 0.87% in 2004, approximately 2.7 and 4.6 times higher than those of the ISX and MSP groups. In addition, this novel method was the cheapest means regarding the cost of identifying one case of gastric cancer, which was estimated to be 1,608,000 Japanese yen in 2004. CONCLUSION: Endoscopic mass screening is a promising method and can be effectively applied if a sufficient number of skilled endoscopists become available to staff the system and if city offices support it.

Endoscopy↗

PubMed1993

[An applied study on the method of multi-factorial quantitative-risk assessment (MFQRA) for mass screening of colorectal cancer].

This paper reported an actual effectiveness evaluation for MFQRA, as a primary screening procedure, applied in a mass screening for colorectal cancer since 1989 to 1990 among a general population with the age of 30 and above in Jia-shan county where is a high incidence area of colorectal cancer in this nation. Results of this paper demonstrated that (1) attributable degree (AD) can identify subpopulations or subgroups with different incidence risks from a general population, and provide evidence for decision-making of advanced screening procedures and even for prevention of colorectal cancer; (2) Sensitivity of MFQRA was much higher, compared to conventional fecal occult blood test (FOBT) and symptomatic screening methods (65.89% vs 34%-50%); (3) Multiple tests with FOBT by reverse passive hemagglutination (RPHA) were effective and practical method for mass screening of colorectal cancer.

Adult↗

PubMed2006

[Factors affecting national health insurance mass screening participation in the disabled].

OBJECTIVES: As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. METHODS: In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income; disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. RESULTS: The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan regions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health insurance program for the self-employed than for employees (95% CI=2.56-2.63); 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23); 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI= 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). CONCLUSIONS: The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

Adolescent↗

PubMed2005

Body mass index and lung cancer: a case-control study of subjects participating in a mass-screening program.

STUDY OBJECTIVES: An inverse relationship between body mass index (BMI) and the risk of lung cancer, suggesting that leanness is a risk factor for lung cancer, has been reported in previous studies. In order to evaluate the risk of lung cancer associated with lower levels of BMI in preclinical patients, we conducted a case-control study based on the results of community mass screening. DESIGN: The relationship between BMI (at the time of diagnosis, and at 1 to 5 years prior to diagnosis) and lung cancer was investigated in a case-control study of 363 lung cancer cases and 1,089 control subjects conducted between April 1993 and March 2003. Control subjects were selected from mass-screening subjects with no abnormalities on chest radiography and routine laboratory tests. RESULTS: In men, an inverse association between BMI and lung cancer was observed after adjustment for age and smoking (BMI < 20.8; range of the referent group, > or = 22.9 to < 25.0; odds ratio, 1.9; p = 0.0025; 95% confidence interval, 1.3 to 2.9). In women, however, no association was found between BMI and lung cancer (BMI < 20.8, p = 0.3868; and BMI </= 25.0, p = 0.4603, respectively). In addition, a negative association between BMI at 4 to 5 years prior to diagnosis and lung cancer was not observed in either gender (men, p = 0.2937 to 0.5783; women, p = 0.2042 to 0.9326). CONCLUSIONS: Our present study indicated the possibility that the previously reported association between leanness and the risk of lung cancer in women was not correct, and this apparent association might be influenced by other factors such as smoking and smoking-related respiratory diseases. A larger-scale cohort study combined with mass-screening project will confirm our results.

Aged↗

PubMed1989

[Mass screening for breast cancer in Gunma prefecture--the results for 8 years and future problems].

In Gunma prefecture, mass screening for both breast and thyroid cancer at the same time was conducted between April 1980 and March 1988 with the cooperation of the Gunma Cancer Society. In this paper, the results of mass screening for breast cancer and further problems are reported and discussed. The total number of subjects during these eight years was 191, 603 on the first screening with physical examination alone. Of these, 18,208 (9.5%) examinees were required to attend the second examination. Breast cancer was detected in 159 cases. The detection rate was 0.08% among total subjects. Also thyroid cancer was detected in 244 (0.13%). The detection rate for breast cancer was approximately twice as high at the initial screening (0.11%) than at the subsequent periodic screening (0.06%). Patients with breast cancer detected by mass screening showed an earlier stage and a better prognosis compared with those of our ordinary outpatients. The 8-year disease-free survival rate in mass screening and in outpatient cases was 94.9% and 83.2%, respectively, but there was no significant difference between the two groups. Interval breast cancer was also found in 19 cases (Tis; 1, Stage I; 8 and Stage II; 10) and 5 patients had nodal metastases. This mass screening program is a useful means for early discovery and early treatment of breast cancer. Hereafter, we should intend to increase the number of initial examinees and women aged 60 and over. Also it is important to make and train physicians for such screening, and to educate women about the practice of breast self-examination.

Adult↗

PubMed1991

Mass screening for colorectal cancer in Japan.

A mass screening program for colorectal cancer has been conducted in Japan for several years, and the nationwide statistics showed a total of 416,382 participants in 1988. This paper describes the present status of mass screening program for colorectal cancer in Japan and related issues as follows: annual trend of the number of examinees, age distribution of examinees, screening methods, diagnostic methods, evaluation of screening accuracy for fecal occult blood tests, and screening interval.

Adult↗

PubMedDate not supplied

[General practitioners' experience in a mass screening campaign of colorectal cancers].

In a mass screening campaign of colorectal cancer, general practitioners play an essential role for obtaining a high rate of participation from people. It is important to analyze the reasons for the participation and their actual experiences in the campaign. Out of 71 GPs participating in the campaign, 67 have been interviewed by a sociologist and 51 GPs (76%) considered themselves "motivated" for participating after an instruction course in small groups. Sixteen GPs were sceptical about the outcome or not highly motivated. However thirteen of them participated by moral obligation vis à vis their patients or for not being different from their colleagues. All GPs appreciated being actively involved in the organization of the screening campaign and considered that the public had been well informed. Such information covered the information leaflet, the press campaign at the beginning of the campaign and the recall letter for those who had not been consulted during the time when the test was distributed by GPs. The main constraint was the time spent to convince the patients to do the screening test and explain its importance. The additional time, 5 to 10 minutes per consultation was important to the GPs. They thought it was fair to be paid for their active participation. These data suggest that it is possible to motivate GPs for a mass screening campaign, on the condition that they are actively involved and participate in an instruction course for small groups.

Aged↗

PubMed2006

Outcomes of mass screening for gastric carcinoma.

BACKGROUND: Therapeutic results of gastric cancer have been improved by early detection of gastric cancer with the mass screening system in Japan. The objective of our study was to assess the efficacy of mass screening for gastric cancer by using a barium meal. METHODS: A series of 1050 patients (364 in the screened group and 686 in the nonscreened group) were included in this study from April 1992 to March 2000. Patient characteristics, therapeutic results, and prognostic factors were compared in the two groups. RESULTS: The screened patients tended to be younger and male, with tumors in the middle third of the stomach that were of a macroscopically superficial type, with a smaller diameter, and at an earlier stage. They had fewer metastatic lymph nodes and underwent more frequent curative resection. Among the screened patients with curatively resected disease, tumors tended to be of a smaller diameter, and there were fewer metastatic lymph nodes in both early and advanced cases. Disease-specific survival was significantly better in the screened cases among all registered and curatively resected patients. Mass screening achieved significantly better surgical results in early or advanced gastric cancer patients who received curative resection. Multivariate analysis revealed that mass screening was an independent prognostic factor (hazard ratio, .3949; P < .0001), together with depth of invasion, lymph node metastasis, age, and tumor diameter. CONCLUSIONS: Mass screening by using barium meal examination for gastric cancer detects cancer at an early stage and produces good therapeutic results.

Barium Sulfate↗

PubMed1992

Outcome of patients with lung cancer detected via mass screening as compared to those presenting with symptoms.

We performed lung cancer resection in 721 patients between 1980 and 1989. Cancers were detected via mass screening programs by annual chest X-ray examination in the majority of cases. We evaluated the surgical results in patients with tumors detected by mass screening and compared them to those in whom the malignancy was detected by symptoms. Lesions in the mass screened group were T1 to T2 tumors in 90% of the cases, and NO in 73%. Stage I disease accounted for 65.3% in the mass screened group. The overall 5-year survival rate was 56.2% in the mass screened group, which was significantly better than the 25.3% for the symptom group (P less than 0.001). The surgical results in the lung cancer cases detected by the mass screening program had better results than the cases who presented with symptoms.

Aged↗

PubMed1986

Heart diseases discovered by mass screening in the schools of Shimane Prefecture over a period of 5 years.

Mass screening by ECG for heart diseases in pupils and students was performed in Shimane Prefecture; all the children had primary screening and were under the supervision of a pediatric cardiologist in all phases, from primary to precise (tertiary) examination. The precise examination was performed with 2D echo, exercise ECG and/or cardiac catheterization when indicated, and an important feature of this mass screening was the ability to carry out an accurate follow-up in all the phases from primary to precise examination. The number of subjects in the primary screening from 1980 to 1984 was 50758 primary school pupils, 44216 junior high school students and 33480 senior high school students; organic heart diseases not under the supervision of the pediatric cardiologist at the time of mass screening were found in 22 primary school pupils (0.04% of participants in the primary screening), 14 junior high school students (0.03%) and 5 senior high school students (0.01%). Clinically significant arrhythmias without underlying organic heart diseases were discovered by mass screening in 8 primary school pupils (0.02%), 13 junior high school students (0.02%) and 16 senior high school students (0.05%).

Adolescent↗

PubMed1996

Risk of developing end-stage renal disease in a cohort of mass screening.

The prognostic significance of abnormal findings has not been demonstrated in a setting of mass screening. To evaluate the relative risk of end-stage renal disease (ESRD) indicated by various results of community-based mass screening, we utilized the registries of both community mass screening and chronic dialysis programs. In 1983, a total of 107,192 subjects over 18 years of age (51,122 men and 56,070 women) participated in dipstick urinalysis and blood pressure measurement in Okinawa, Japan. During ten years of follow-up, we identified 193 dialysis patients (105 men and 88 women) among them. Logistic regression analysis of clinical predictors of ESRD over 10 years was done and the adjusted odds ratio and 95% confidence interval were calculated in each of the predictors with adjustment to others. In the clinical predictors such as sex, age at screening, proteinuria, hematuria, systolic and diastolic blood pressure, proteinuria was the most potent predictor of ESRD (adjusted odds ratio 14.9, 95% confidence interval 10.9 to 20.2), and the next most potent predictor was hematuria (adjusted odds ratio 2.30, 95% confidence interval 1.62 to 3.28). Being of male gender was a significant risk factor for ESRD (adjusted odds ratio 1.41, 95% confidence interval 1.04 to 1.92). Diastolic blood pressure was also a significant predictor of ESRD (adjusted odds ratio 1.39, 95% confidence interval 1.17 to 1.64), but systolic blood pressure was not. In a mass screening setting, positive urine test, high diastolic blood pressure, and male sex were identified as the significant predictors of ESRD. Effect of glycosuria and other possible predictors of ESRD remained to be determined.

Adolescent↗

PubMedDate not supplied

Feasibility study of the early detection and treatment of renal disease by mass screening.

AIM: To determine whether mass screening for proteinuria may be worthwhile in the detection of early renal disease in Australians. METHODS: A feasibility study was conducted using systematic review, meta-analysis and cost-effectiveness methods. RESULTS: End-stage renal disease (ESRD) develops in about 1500 Australians each year. Of these, about 1000 are over 50 years of age (an incidence of about 200 per million, per year). Proteinuria, which is present in about 5% of the general population, confers an approximately 15-fold increased risk for ESRD. Twelve randomized trials of angiotensin-converting enzyme inhibitors (ACEi), in 1943 patients with varying degrees of renal impairment, hypertension and proteinuria, showed that the risk of developing ESRD can be reduced by about 30% over a 2- to 3-year period. In a general-practice-based screening model involving: (i) an opportunistic single dipstick test for protein, (ii) a confirming 24-h urine test for protein and (iii) commencement of ACEi in appropriate individuals, 20 000 people over 50 years of age would need to be screened to prevent one case of ESRD. To achieve this, approximately 100 people would need to be treated with ACEi for 2 to 3 years, and 1,000 would need to have a 24-h urine protein test (and of these, 700 would be false positives). Such a strategy may save health dollars but some critical research questions are still unanswered. What is an individual's risk of developing ESRD, given values for proteinuria, blood pressure and renal function? What is the benefit of ACEi in screen-detected cases, which are at low risk of ESRD? What psychological and physical harm is caused by screening, including the specific renal investigations and treatments that follow on from proteinuria detection? CONCLUSIONS: Given available data, screening middle-aged and older Australians for proteinuria and treating some with ACEi is, at best, a promising primary prevention strategy for preventing ESRD. However, a large population-based cohort study, with nested trial of ACEi, is still required to evaluate whether this model of screening for renal disease does more harm than good.

Aged↗