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At least 19 recordsLinked to original sources
PubMed1976

Cervical cancer in women belonging to a cytologically screened population.

Women belonging to the cytologically screened population of Stockholm in 1968 to 1974 and developing cervical cancer of stage I to IV were studied. The purpose was to find out the number of women, in whom the cancer or its preclinical stage was not detected at routine screening, and the reasons for this fact. It was found that 34 out of 177 women had never been cytologically screened. The remaining 143 women had been checked at mass screening and/or at private specialists or hospitals. In 51 screened women the cancer was not detected until the women themselves attended a doctor because of symptoms. Thus in 85 women, or 48% of the series, the cancer escaped detection at an asymptomatic stage. Errors causing a delay or interruption of the follow-up of patients with suspicious smears or colposcopic atypia were observed in 25 cases. Sixty-four patients, or 45% of all screened women, had had at least one negative smear within 4.5 years prior to discovery of the malignancy. Out of these, 53 patients had got a negative smear within 3 years. Whatever might be the true evaluation of these negative smears, their influence on the continued management of the women was important. In view of the results of this study the 4 years interval of rescreening practiced in Stockholm seems to be too long. Moreover the statement is supported, that the value of health screenings is counteracted by the fact that the people most at risk are the least likely to attend.

Adult↗
PubMed2026

International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process.

Type 1 diabetes is an autoimmune disease that targets and destroys insulin-producing beta cells in the pancreatic islets. The incidence of type 1 diabetes is rising globally. At the clinical diagnosis of type 1 diabetes, between 20% and 67% of children and adolescents present with diabetic ketoacidosis (DKA) requiring hospitalisation, and one-third of these require intensive care. Type 1 diabetes can be detected in early stages, prior to the insulin-requiring clinical diagnosis, through screening for islet autoantibodies (IAbs). Identifying individuals with early-stage type 1 diabetes, combined with monitoring of and education on disease progression, prevents DKA and results in a milder clinical onset. This allows for timely insulin initiation in outpatient settings and improved long-term glucose management. Early diagnosis also enables access to novel disease-modifying therapies that can delay the clinical onset of diabetes. In this international consensus, we provide guidance on the principles and practice of implementing general population screening for IAbs to diagnose early-stage type 1 diabetes. We also outline the minimum requirements for establishing effective population screening programmes to diagnose early-stage type 1 diabetes through IAb detection. This consensus statement has been endorsed by the following professional associations: Advanced Technologies & Treatments for Diabetes (ATTD); Association of Diabetes Care and Education Specialists (ADCES); Association Belge Du Diabète; Associazione Medici Diabetologi (AMD); Australian Diabetes Society (ADS); Belgian Diabetes Liga; Breakthrough T1D; Czech Diabetes Society (ČDS); EASD; Finnish Diabetes Association (FDS); Fondazione Italiana Diabete (FID); International Diabetes Federation (IDF)-Europe; International Society of Paediatric and Adolescent Diabetes (ISPAD); Paediatric Endocrinology Nursing Society (PENS); Polish Diabetes Society; Portuguese Diabetes Association (APDP); Sociedade Portuguesa de Diabetologia (SPD); Società Italiana di Diabetologia (SID); Société Francophone du Diabète (SFD) and Type 1 Diabetes Exchange (T1D Exchange).

Consensus report↗
PubMed1979

Ratio of 11-desoxy 17-oxosteroids to creatinine in a population screened for breast cancer.

During a population-based screening project for breast cancer, almost 15,000 women aged 50 years and over have provided a 12 h (overnight) sample of urine for research purposes. In 3,789 women the excretion of 11-desoxy-17-oxosteroids (DOOS) and creatinine was measured. Results were analysed in terms of urinary concentrations and of a ratio between DOOS and creatinine. Age had an effect on DOOS, creatinine and their ratio. Body weight and body surface area had an effect on creatinine excretion and therefore on the ratio. The following variables did not have an appreciable effect on the above-mentioned ratio: a family history of breast cancer, parity and age at first pregnancy, menopause and oestrogenic drugs, and parenchymal pattern of the breast as observed on the xeromammogram. Breast cancer was found at first screening in 106 out of 14,697 women. In 100 of these cases DOOS and creatinine were measured. Excretion values expressed as the ratio between the two, allowing for body surface area, did not differ materially from those of 100 age-matched controls. These results lead the authors to the conclusion that the determination of androgen metabolite excretion in women over 50 years of age is of no help in selecting a group at high risk of breast cancer.

17-Ketosteroids↗
PubMed1979

Population screening for breast cancer by single-view mammography in a geographic region in Sweden.

Single-view mammography was used for the screening of a total population of women living in a defined geographic region in Sweden; 37,640 women were invited and 31,074 participated. The average participation rate was 82.6%, and in the age group 40-69 years it was 91.7%. The rate of referrals from screening to clinical examination was 1.2%. Of 209 surgical biopsies performed, 130 primary mammary carcinomas were detected, 91% of which had no clinically detectable metastatic nodes. Because of the few false-positive cases, the low rate of benign biopsy specimens, the high rate of early detected carcinomas, and the low costs, screening by single-view mammography is considered a satisfactory method, provided the positioning of the oblique view is correct and the image quality is high.

Adult↗
PubMed1977

The pathology of breast cancer detected by mass population screening.

Breast cancer was detected in 156 of 17,526 asymptomatic women, (8.9/1000), aged 45-64 years, screened by mammography, thermography, and physical examination, Twenty-six percent of 149 pathologically reviewed cases metastasized to axillary nodes. Thirty-six percent of tumors were in situ, minimally invasive, or low grade tubular carcinomas, none of which metastasized. Increased rates of detection were shown for intraductal and tubular types. Frankly invasive ductal and lobular carcinomas had a mean diameter of 2.3 cm., 46% of which had axillary lymph node metastases. Seventy-percent of these were to only one to three nodes, however. Multicentricity with intraductal and lobular carcinoma in situ was frequently observed. Metastatic potential was related to tumor size, degree of stromal invasion, lymphatic permeation, and histologic grade. Few histological parameters other than size could be considered favorable. Forty-two percent of tumors were not palpable, the majority being in situ, minimally invasive, and tubular types. Only five nonpalpable invasive carcinomas metastasized. While the initial results of mass screening appear favorable, prolonged follow-up is needed to determine its impact on the population at risk.

Adult↗
PubMed1978

Population screening for beta-thalassemia minor. Report of cooperative trials based on two approaches.

In a cooperative intrastate program based upon experience with sickle-cell anemia screening, the authors explored the feasibility of applying hemoglobin electrophoresis for detection of beta-thalassemia gene carriers. Initially, blood samples collected in capillary tubes were analyzed by cellulose acetate electrophoresis with densitometric quantitation of hemoglobin A2 (Hb A2), followed by selective spectrophotometric quantitation. This approach proved insufficiently specific or reproducible. Follow-up hematologic and family studies of presumptive beta-thalassemia gene carriers indicated that coordinate measurement of erythrocytic indices and Hb A2 values would have discriminated a subpopulation with a high incidence of beta-thalassemia trait more specifically. This approach was tested prospectively by the use of 731 venous blood samples collected in a county with a large population of Mediterranean ancestry. Of 31 individuals (4.2%) with presumptive thalassemia trait, 13 returned for a repeat testing, and the initial results for 11 were confirmed. These findings lend support to an empirical screening sequence suggested by Pearson (erythrocytic indices followed by Hb A2 quantitation), but they also indicate that a significant subpopulation of beta-thalassemia gene carriers with limited phenotypic expression may elude detection in any single-pass approach.

Blood Protein Electrophoresis↗
PubMed2025

Modeling Early-Onset Cancer Kinetics Reveals Changes in Underlying Risk and the Impact of Population Screening.

UNLABELLED: Recent studies have reported increases in early-onset cancer cases (diagnosed less than 50 years of age) and raised questions about whether the increase is related to earlier diagnosis from nonspecific medical tests as reflected by decreasing tumor-size-at-diagnosis (apparent effects) or actual increases in underlying cancer risk (true effects), or both. The classic Multistage Clonal Expansion (MSCE) model assumes cancer detection at the first malignant cell's emergence, although later modifications have included lag-times or stochasticity in detection to represent the delay in tumor detection. In this study, we introduced an approach to explicitly incorporate tumor-size-at-diagnosis in the MSCE framework accounting for improvements in cancer detection over time to distinguish between apparent and true increases in early-onset cancer incidence. The model was structurally identifiable and provided better parameter estimation than the classic model. The model was applied to colorectal, breast, and thyroid cancers to examine changes in cancer risk while accounting for detection improvements over time in three representative birth cohorts (1950-1954, 1965-1969, and 1980-1984). The analyses suggested accelerated carcinogenic events and shorter mean sojourn times (the average time from the first malignant cell emergence to cancer detection) in more recent cohorts. Furthermore, using this model to examine the screening impact on the incidence of breast and colorectal cancers, for which both have established screening protocols, provided results that align with well-documented differences in screening effects between these cancers. These findings underscore the importance of incorporating tumor-size-at-diagnosis in cancer modeling and support true increases in early-onset cancer risk in recent years for breast, colorectal, and thyroid cancers. SIGNIFICANCE: A model of early-onset cancer trends that distinguishes true risk from detection effects accurately captures cancer kinetics, trends in cancer progression, and the impact of screening, which could inform cancer prevention strategies. This article is part of a special series: Driving Cancer Discoveries with Computational Research, Data Science, and Machine Learning/AI .

Humans↗