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PubMed1996

A statistical study of the American Urological Association symptom index for benign prostatic hyperplasia in participants of mass screening program for prostatic diseases using transrectal sonography.

PURPOSE: A study was done on the prevalence of urinary symptoms in community based populations in Japan regarding the influences of aging and benign prostatic hyperplasia (BPH) as evaluated by transrectal sonography. MATERIALS AND METHODS: In 961 Japanese men 55 to 87 years old who underwent mass screening for prostatic diseases the American Urological Association symptom index scores were compared with age and ultrasonic diagnosis of the prostate. RESULTS: Moderate to severe symptoms (symptom score 8 or more) were found in 265 of our 961 samples (27.6%), while BPH was also recognized ultrasonically in 197 (20.5%). Frequencies of urinary symptoms and BPH increased significantly with age. BPH related increase in total symptom scores occurred only in select men when adjusted by age. CONCLUSIONS: The ability of the American Urological Association symptom index to characterize BPH in an individual was limited because of the lack of specificity to the disease along with the considerable influence of aging on the symptom score. Currently, transrectal sonography is the most reliable method for the definitive diagnosis of BPH.

Age Distribution↗
PubMed1975

Gonorrhea screening program in New York State.

Of 171,089 mailed specimens examined for Neisseria gonorrhoeae, 88% were submitted by family planning clinics, physicians in private practice, and other non-VD clinics. To process a large volume of specimen bottles, we developed a swab-oxidase test and demonstrated it to be reliable for the initial screening of all specimens. Our protocol permitted the isolation and confirmation by sugar fermentation of 95% of all presumed N. gonorrhoeae cultures within 1 or 2 days after growth was observed. The results obtained over a 2-year period indicate that the positivity rate is directly related to the lag period between specimen collection and examination. There was no adverse effect of cold weather on the positivity rate, but, irrespective of the season, 3 to 9% of the positive specimens required incubation for 3 days before gonococcal growth appeared.

Gonorrhea↗
PubMed2003

Follow-up of abnormal results in an urban community-based breast cancer screening program.

OBJECTIVE: Determine the rates of follow-up for abnormal mammograms and see how they compare with rates of similar programs elsewhere. DATA: Records from 1990-2000 of the Breast Cancer Awareness Program were analyzed and reviewed to determine follow-up rates. RESULTS: The follow-up rate for all 11 years was 85%; during the last 7 years the rate has been 90%. CONCLUSION: Follow-up rates were as good and generally better than those reported in the literature for similar programs. The rates, though good to begin with, improved with the more rigorous training and requirements of the Wisconsin Well Women's Program.

Adult↗
PubMed2004

Measurement characteristics of anal cytology, histopathology, and high-resolution anoscopic visual impression in an anal dysplasia screening program.

BACKGROUND: The study aims were (1) to estimate agreement between consecutive anal cytologic examinations, between concurrent cytologic examination and histopathology, and between high-resolution anoscopy (HRA) visual impression and histopathology and (2) to estimate the prevalence of severe dysplasia by concurrent cytologic category. METHODS: Prospective study of HIV-infected patients receiving anal dysplasia screening as part of routine care. Agreement between measures was estimated by weighted kappa-statistics. RESULTS: Between July 2000 and September 2003, 1864 patients underwent 2947 anal cytology tests. Excluding unsatisfactory tests (6%), 642 patients had repeat cytologic evaluation and 154 had concurrent cytology tests and biopsy. Using 4-category cytology grading, kappa-agreement between the first 2 cytologic measurements was 0.36. Comparing concurrent cytology tests and biopsy, kappa-agreement was 0.36. Comparing the most severe HRA visual impression and biopsy, kappa-agreement was 0.32. The prevalence of anal intraepithelial neoplasia 3 at biopsy by concurrent cytology category was 0 (cytology normal), 21% (atypical squamous cells of uncertain significance), 27% (low-grade squamous intraepithelial lesion), and 54% (high-grade squamous intraepithelial lesion). CONCLUSIONS: These data suggest that the reproducibility of key screening measures is moderate at best but of similar magnitude to that of other studies of anal and cervical dysplasia screening. As candidate interventions to treat or prevent precursor lesions enter clinical development, standardization and improvement of measurement methods are essential.

Anal Canal↗
PubMed2003

Long-term impact of worker notification: qualitative assessment of a community-based notification and screening program in Augusta, Georgia.

BACKGROUND: Evaluation of high-risk worker notification programs often focuses on their immediate effectiveness in communicating information to individual workers. This approach leaves unexamined some important social processes that can influence worker notification's impact and public health consequences over time. METHODS: To explore long-term effects, ethnographic methods were used for qualitative assessment of a community-based program carried out by the National Institute for Occupational Safety and Health (NIOSH) in Augusta, Georgia, during the early 1980s. More than a decade after the original NIOSH intervention, lengthy taped interviews were conducted with 70 members of the notified cohort (chemical workers exposed to beta-naphthylamine (BNA)) and 32 members of their families. RESULTS: The notified workers expressed extremely positive feelings about having received the risk information. However, for non-obvious and unanticipated reasons, most had failed to implement the notification's primary health advice (annual screening for bladder cancer). Both the workers and their family members reported a number of ongoing concerns related to the program. CONCLUSIONS: The study findings suggest four strategies, all relatively low in cost, that are likely to increase the long-term public health benefits of worker notifications that rely on individually mailed written materials: (1) in designing worker notifications, take into account the information (accurate or not) that the workers already have, and determine what kind of information they most want and need; (2) define the notification audience broadly to include not only the study cohort but also family members and/or other similarly exposed workers; (3) when notifications recommend secondary disease prevention measures over long time periods, follow up the notification health advice with periodic reminders; (4) inform a wide range of community organizations and service providers (non-medical as well as medical) about the notification, and encourage them to provide appropriate support to the notified workers and their families.

Chemical Industry↗