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At least 1,297 records · Page 72Linked to original sources
PubMed1992

Prediction of affected MEN2A gene carriers by DNA linkage analysis for early total thyroidectomy: a progress in clinical screening program for children with hereditary cancer syndrome.

The gene predisposing to multiple endocrine neoplasia type 2A (MEN 2A) has been assigned to chromosome 10, and affected gene carriers can be identified before the development of associated malignancy in some informative families. We applied these advances in gene mapping to clinical screening for possible pediatric surgery. A family with MEN 2A, consisting of 88 members and their spouses, was studied to test the reliability of the provocation of plasma calcitonin with pentagastrin and the possibility of DNA diagnosis of mutated gene carriers with DNA probes closely linked to the MEN2A gene including RBP3 and FNRB genes. Nineteen of the 88 were diagnosed as MEN 2A carriers. Twelve of them were treated surgically and the others died of medullay thyroid carcinoma (MTC) or pheochromocytoma. A strikingly sensitive response of calcitonin was observed in all those with MTC. The genotypes cosegregating with the abnormal allele at MEN2A in this family could be deduced from clinically established affected members. The early detection of gene carriers allows us to concentrate our screening efforts on children at high risk and to release non gene carriers from repeated unnecessary testing. MEN2A is one of the first cancer syndromes for which DNA screening permits early detection of members at high risk.

Adolescent↗
PubMedDate not supplied

Predictors of random sextant biopsy outcome in screened men with PSA > 4 ng/mL and a negative sextant biopsy at previous screening. Experience in a population-based screening program in Florence.

The aim of this study was to evaluate possible pedictors of the outcome of repeat random sextant biopsy of the prostate prompted by a rise in prostate-specific antigen (PSA). Random biopsies performed for PSA elevation (>4 ng/mL) in the course of a randomized study of screening efficacy were reviewed, and 87 consecutive biopsies (carcinoma = 13, high-grade prostatic intraepithelial neoplasia = 6, negative = 68) performed in subjects with a negative random biopsy at the previous screening round were considered. Findings at digital rectal examination or transrectal ultrasonography and total PSA value were not useful predictors of repeat biopsy outcome, whereas PSA velocity was significantly associated with biopsy outcome. The positive predictive value for a cancer biopsy was 2.7% (1/36), 28.5% (2/7), and 22.7% (10/44) for PSA velocity values of <0.1, 0.1-0.19, and >0.19 ng/mL/yr, respectively. A cutoff of 0.1 ng/mL/yr for PSA velocity would have allowed to avoid approximately half (35/74 = 47.2%) of the benign biopsies while decreasing the sensitivity by 7.6% (1/13), and is thus suggested as a possible criterion for the indication of repeat random biopsy for persistent PSA elevation.

Aged↗
PubMed2002

Self-reported differences in daily raw vegetable intake by ethnicity in a breast screening program.

PURPOSE: While the literature has no conclusive causal relationship between nutrition and breast cancer, diet is believed to play a role in the development of breast cancer. This investigation focuses on differences of dietary practice between Caucasians and African Americans in a cohort of women presenting for breast cancer screening. METHODS: Over a one-year period, 675 women presenting to the Breast Health Center at Tulane University Medical Center for an initial visit were given a self-reported health behavior questionnaire. Included in this survey were questions concerning the frequency of raw vegetable consumption and fat/oil intake. MAIN FINDINGS: The overall proportion of women who presented for breast cancer screening that reported daily raw vegetable consumption in the study group was 40%. There were statistically significant differences between proportions of Caucasian women's and African American women's consumption of daily raw vegetable (51% versus 29%, respectively; P < 0.0001). These differences were not seen in daily fat/oil intake. No differences were seen in socioeconomic measures. CONCLUSIONS: There is a substantial difference in the consumption of potentially protective foods among major ethnic groups. These dietary differences should be taken into account when investigating the ethnic differences in women with breast cancer, as well as the relationship between breast cancer and nutrition.

Adult↗
PubMedDate not supplied

Analysis of false-negative and underreported smears in the Florence district screening program for cervical carcinoma.

AIMS AND BACKGROUND: To review false-negative or underreported (reactive changes, squamous or glandular atypia) smears performed in women developing histologically proven CIN2 or more severe lesions within 24 months and evaluate error causes. The study setting was the Florence District cervical cancer population-based screening: about 60,000 women age 25-60 years screened per year. METHODS: 118 false-negative or underreported cases were identified at screening files-cancer Registry matching, and the original smears were reviewed by six independent readers to judge smear adequacy and error type. RESULTS: Sampling errors (reported as inadequate, negative or less severe than CIN1 at review) accounted for 74% and screening/interpretation errors (reported as CIN1 or more severe at review) accounted for 26% of studied cases. Screening/interpretation errors were more likely ascribed to misinterpretation and underreporting than to misperception of cellular abnormalities. CONCLUSIONS: Quality control should above all address the problem of sampling adequacy. Due to the rarity of misperceived abnormalities (true screening errors), manual or automated rescreening of negative smears would not be an effective procedure for quality control.

Adult↗
PubMed1978

Case-control study of antihypertensive and diuretic use by women with malignant and benign breast lesions detected in a mammography screening program.

A significant but low-level association (relative odds, 2.0; P less than 0.05) was observed between the occurrence of breast cancer and the use of rauwolfia derivatives for 5 or more years in the study of 481 breast cancer cases and 1,268 controls from a joint national mammography screening project of the National Cancer Institute and the American Cancer Society. This association was confined to women over age 50 years who were also heavier than average. No confounding effects could be held responsible for this association after adjustment was made for variables such as presence of hypertension, weight, age at first pregnancy, and other breast cancer risk factors. Other antihypertensive and diuretic drugs as well as multiple drug use also exhibited some suggestive associations with breast cancer. Another group of 421 women with benign lesions at breast biopsy were also compared to the 1,268 controls. They showed a significant association between benign lesions and use of thiazides for 5 or more years (relative odds, 2.4; P less than 0.001) whether employed to treat edema or hypertension. Other antihypertensive and diuretic agents also seemed to show this association, but most of them were being used together with thiazides.

Adult↗
PubMed1996

[Minimal endometrial cancer and its detection in selective screening programs].

The study involved 1,256 cases of endometrial carcinoma. Minimal tumor (up to 2 cm in diameter, invasion- up to 0.5 cm) was diagnosed in 30%. This pattern showed a low potential for progression and metastasis spreading. Feasibility of identification of minimal cancer of the endometrium in the course of screening for hormone-dependent tumors of the reproductive system is discussed.

Endometrial Neoplasms↗
PubMedDate not supplied

Student nurses participate in public health research and practice through a school-based screening program.

Obesity has reached epidemic proportions among children in minority populations, placing them at risk for diabetes and hypertension. The importance of educating a generation of nurses who have the knowledge, skills, and passion to address this public health need is crucial to the profession and to America's health. This article describes the use of a Community Partnership Model to frame baccalaureate nursing students' (B.S.N.) service learning within the context of a research study to screen middle- and high-school students for health risks. The missions of education, research, and practice are linked together in the model by three processes: evidence-based practice, service learning, and scholarly teaching. The aim of the project was early identification of obesity, hypertension, and type 2 diabetes and their predictors in a high-risk student population, between 12 and 19 years of age. Early evidence indicates that the model is feasible and effective for directing student learning and addressing public health problems in the community.

Adolescent↗
PubMed2003

Personalised risk communication for informed decision making about entering screening programs.

BACKGROUND: There is a trend towards greater patient involvement in health care decisions. Adequate discussion of the risks and benefits associated with different choices is often required if involvement is to be genuine and effective. Achieving adequate involvement of consumers and informed decision making are now seen as important goals for any screening programme. Individualised risk estimates have been shown to be effective methods of risk communication in general, but the effectiveness of different strategies has not previously been examined. OBJECTIVES: To assess the effects of different types of individualised risk communication for consumers making decisions about participating in screening. SEARCH STRATEGY: We searched the Cochrane Consumers and Communication Review Group specialised register (searched March 2001), MEDLINE (1985 to 2001), EMBASE (1985 to 2001), CancerLit (1985 to 2001), CINAHL (1985 to 2001), ClinPSYC (1989 to 2001), and the Science Citation Index Expanded (searched March 2002). Follow-up searches involved hand searching Preventive Medicine, citation searches on seven authors, and searching reference lists of articles. SELECTION CRITERIA: Randomised controlled trials addressing the decision by consumers of whether or not to undergo screening, incorporating an intervention with a 'personalised risk communication element' and reporting cognitive, affective, or behavioural outcomes. A 'personalised risk communication element' is based on the individual's own risk factors for a condition (such as age or family history). It may be calculated from an individual's risk factors using formulae derived from epidemiological data, and presented as an absolute risk or as a risk score, or it may be categorised into, for example, high, medium or low risk groups. It may be less detailed still, involving a listing, for example, of a consumer's risk factors as a focus for discussion and intervention. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Data about the nature and setting of the intervention, and the relevant outcome data were extracted, along with items relating to methodological quality. MAIN RESULTS: Thirteen studies were included. Personalised risk communication (whether written, spoken or visually presented) was associated with increased uptake of screening tests (odds ratio (OR) 1.5 (95% confidence interval (CI) 1.11 to 2.03). There was no evidence from these studies that this increase in uptake of tests was related to informed decision making by consumers. More detailed personalised risk communication was associated with a smaller increase in uptake of tests. That is, for personalised risk communication which used and presented numerical calculations of risk, the OR for test uptake was 1.22 (95% CI 0.56 to 2.68). For risk estimates or calculations which were categorised into high, medium or low strata of risk, the OR was 1.42 (95% CI 1.07 to 1.88). For risk communication that simply listed risk personal risk factors the OR was 1.7 (95% CI 1.17 to 2.48). Most of the included studies addressed mammography programmes. These studies showed slightly smaller effects than the overall dataset, again with numerical calculated risk estimates being associated with lower ORs for uptake of tests (OR 1.13; 95% CI 0.98 to 1.29) than the other categories of (less detailed) personalised risk communication. The four studies examining risk communication in high risk individuals showed larger odds ratios for uptake of tests than the other studies. The OR for numerical calculated risk estimates was 1.48 (95% CI 1.06 to 2.07), compared to 4.66 (95% CI 2.24 to 9.69) for categorised risk estimates and 2.64 (95% CI 1.42 to 4.9) for listed personal risk factors. There were insufficient data from the included studies to report odds ratios on other key outcomes such as: intention to take tests, anxiety, satisfaction with decisions, decisional conflict, knowledge and risk perception. REVIEWER'S CONCLUSIONS: Personalised risk communication (as currently implemented in the included studies) is associated with increased uptake of screening programmes, but this may not be interpretable as evidence of informed decision making by consumers.

Communication↗