Journal of Medical Screening最新文献

{"title":"Long-term colorectal cancer incidence in a post-endoscopic screening cohort, accounting for surveillance, by baseline polyp group, anatomic subsite, and sex.","authors":"Emma C Robbins, Kate Wooldrage, Brian P Saunders, Amanda J Cross","doi":"10.1177/09691413251316442","DOIUrl":"https://doi.org/10.1177/09691413251316442","url":null,"abstract":"<p><strong>Objectives: </strong>Colonoscopy surveillance is often performed in post-polypectomy cohorts, likely altering colorectal cancer (CRC) outcomes, but this is often not addressed in CRC incidence analyses. We examined CRC incidence post-endoscopic screening, accounting for surveillance.</p><p><strong>Methods: </strong>We examined UK Flexible Sigmoidoscopy Screening Trial participants who had no, low-risk, or high-risk (≥10 mm, ≥3 adenomas, adenomas with villous features/high-grade dysplasia) distal polyps at screening. Participants with high-risk polyps had an index colonoscopy and 81% had ≥1 surveillance colonoscopies post-screening; <1% of those with no/low-risk polyps had an index or surveillance colonoscopy. We examined CRC incidence over 21 years by anatomic subsite and sex. Standardised incidence ratios (SIRs) compared incidence to general population incidence.</p><p><strong>Results: </strong>Of 39,417 participants, 29,792 (76%), 8162 (21%), and 1463 (4%) had no, low-risk, and high-risk polyps, respectively. In the high-risk group, all-site CRC incidence was non-significantly different from that in the general population, when including all participants, just those who attended surveillance, or just those who did not attend surveillance (SIRs: 0.81 [95% confidence interval: 0.60-1.07]; 0.75 [0.54-1.03]; 1.12 [0.56-2.01], respectively). Without surveillance, compared to the general population, distal cancer incidence was lower among women and men without polyps (SIRs: 0.30 [0.24-0.37]; 0.24 [0.20-0.29], respectively) and women and men with low-risk polyps (SIRs: 0.52 [0.34-0.76]; 0.27 [0.19-0.37], respectively); proximal cancer incidence was lower among men without polyps (SIR: 0.75 [0.64-0.88]), non-significantly different among women without polyps (SIR: 1.07 [0.93-1.22]) and men with low-risk polyps (SIR: 1.22 [0.98-1.51]), but higher among women with low-risk polyps (SIR: 2.22 [1.77-2.76]).</p><p><strong>Conclusions: </strong>Women with low-risk distal polyps at flexible sigmoidoscopy screening had double the risk of proximal colon cancer, compared to the general population.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413251316442"},"PeriodicalIF":2.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of frailty and comorbidity on initial response to lung cancer screening invitation and low-dose CT screening uptake: Findings from the Yorkshire Lung Screening Trial.","authors":"Anas Almatrafi, Rhian Gabe, Rebecca J Beeken, Richard D Neal, Andrew Clegg, Kate E Best, Samuel Relton, Martel Brown, Hui Zhen Tam, Neil Hancock, Philip A J Crosbie, Matthew E J Callister","doi":"10.1177/09691413251315087","DOIUrl":"https://doi.org/10.1177/09691413251315087","url":null,"abstract":"<p><strong>Background: </strong>Low-dose computed tomography screening reduces lung cancer-specific mortality in high-risk individuals. Lung cancer risk factors overlap with comorbid diseases, highlighting the significance of frailty and comorbidities for lung cancer screening (LCS). Here, we describe the prevalence of frailty and comorbidity in those invited for LCS and evaluate their associations with response to telephone risk assessment invitation and subsequent uptake of LCS.</p><p><strong>Methods: </strong>Analysis was based on the intervention arm of the Yorkshire Lung Screening Trial, where ever-smoked individuals aged 55-80 were invited to telephone risk assessment followed by community-based LCS if at higher risk. The electronic frailty index (eFI) was used to compute individual frailty scores (categorised as fit, mild, moderate and severe) and derive comorbidity data.</p><p><strong>Results: </strong>Of 27,761 individuals invited, 24.1% (<i>n</i> = 6702), 8.5% (<i>n</i> = 2353) and 1.7% (<i>n</i> = 459) had mild, moderate and severe frailty, respectively. Over half responded to the invitation to telephone risk assessment (<i>n</i> = 14,523, 52.5%) with frailty associated with a higher response rate compared to fit individuals: adjusted odds ratio (OR_adj) 1.34, 95% confidence interval (CI) 1.26-1.42 for mild frailty; OR_adj 1.28, 95%CI 1.16-1.40 for moderate frailty; and OR_adj 1.32, 95%CI 1.08-1.61 for severe frailty. Similar patterns were seen with comorbidity counts. After assessment, moderate (OR_adj 0.75, 95%CI 0.59-0.96) and severe (OR_adj 0.67, 95%CI 0.43-1.04) frailty were associated with reduced screening uptake.</p><p><strong>Conclusion: </strong>The presence of frailty was associated with increased response to LCS invitation. Given the strong association between frailty and reduced life expectancy, these results suggest that people with potentially more life years to be gained from LCS may be less inclined to take part. Further research is needed to explore the interactions between frailty and LCS decision-making to inform future invitation strategies.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413251315087"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of combined screening algorithm for early detection of congenital heart disease among term newborns in India.","authors":"Hassan S Rajani, Doddaiah Narayanappa","doi":"10.1177/09691413241313434","DOIUrl":"https://doi.org/10.1177/09691413241313434","url":null,"abstract":"<p><strong>Objective: </strong>To determine the validity of a screening algorithm based on combination of clinical examination and pulse oximetry, for early detection of congenital heart disease (CHD) in term newborns. CHD is the most frequent major congenital anomaly, with prevalence of 6-12 per 1000 live births. Clinical examination alone may fail to detect CHD in more than 50% of affected newborns. Recent studies have concluded that pulse oximetry has a high sensitivity and specificity as a screening tool for critical CHD.</p><p><strong>Setting: </strong>JSS Hospital, Mysuru, Karnataka, India.</p><p><strong>Methods: </strong>In this prospective observational study, all term neonates delivered at the hospital were included. The screening algorithm consisted of seven clinical parameters and pulse oximetry screening guidelines recommended by the American Academy of Paediatrics. Term newborns with the presence of any one of the above parameters in the algorithm were considered screen-positive. Echocardiography was done in all screen positives. Newborns were classified into those with and without CHD, based on echocardiography findings at birth and clinical examination and echocardiography findings at follow-up at 6 weeks.</p><p><strong>Results: </strong>Among 1009 term neonates included in the study, CHD was detected in 57 (5.6%) with cyanotic CHD in 12. The sensitivity and specificity of combined screening to detect CHD was 71.93% and 95.8%, respectively. The positive predictive value was 50.62% and the negative predictive value was 98.28%.</p><p><strong>Conclusion: </strong>Screening for CHD with a simple comprehensive algorithm, integrating clinical evaluation and pulse oximetry, has moderate sensitivity and high specificity in detecting CHD in term newborns. Further work is needed to evaluate this form of screening.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413241313434"},"PeriodicalIF":2.6,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary human papillomavirus testing by clinician- versus self-collection: Awareness and acceptance among cervical cancer screening-eligible women.","authors":"Kathy L MacLaughlin, Gregory D Jenkins, Jennifer St Sauver, Chun Fan, Nathaniel E Miller, Amanda F Meyer, Robert M Jacobson, Lila J Finney Rutten","doi":"10.1177/09691413241260019","DOIUrl":"10.1177/09691413241260019","url":null,"abstract":"<p><strong>Objectives: </strong>Primary human papillomavirus (HPV) testing by clinician-collection is endorsed by U.S. guideline organizations for cervical cancer screening, but uptake remains low and insights into patients' understanding are limited. This study aims to primarily address patient awareness of primary HPV screening by clinician-collection and acceptance of primary HPV screening by clinician- and self-collection, and secondarily assess factors associated with awareness and acceptance.</p><p><strong>Setting: </strong>Primary care practices affiliated with an academic medical center.</p><p><strong>Methods: </strong>A cross-sectional survey study of screening-eligible women aged 30-65 years was conducted to assess awareness and acceptability of primary HPV screening. We analyzed bivariate associations of respondent characteristics with awareness of primary HPV screening by clinician-collection, willingness to have clinician- or self-collected primary HPV testing, and reasons for self-collection preference.</p><p><strong>Results: </strong>Respondents (n = 351; response rate = 23.4%) reported cervical cancer screening adherence of 82.8% but awareness of clinician-collected primary HPV as an option was low (18.9%) and only associated with HPV testing with recent screening (<i>p</i> = 0.003). After reviewing a description of primary HPV screening, willingness for clinician-collected (81.8%) or home self-collected (76.1%) HPV testing was high, if recommended by a provider. Acceptability of clinician-collected HPV testing was associated with higher income (<i>p</i> = 0.009) and for self-collection was associated with higher income (<i>p</i> = 0.002) and higher education (<i>p</i> = 0.02). Higher education was associated with reporting self-collection as easier than clinic-collection (<i>p</i> = 0.02). Women expected self-collection to be more convenient (94%), less embarrassing (85%), easier (85%), and less painful (81%) than clinician-collection.</p><p><strong>Conclusions: </strong>Educational interventions are needed to address low awareness about the current clinician-collected primary HPV screening option and to prepare for anticipated federal licensure of self-collection kits. Informing women about self-collection allows them to recognize benefits which could address screening barriers.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"223-231"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer screening programs in Japan: Progress and challenges.","authors":"Chisato Hamashima, Hirokazu Takahashi","doi":"10.1177/09691413241240564","DOIUrl":"10.1177/09691413241240564","url":null,"abstract":"<p><p>National screening programs for gastric, colorectal, lung, breast, and cervical cancers are offered in Japan. The initial introduction of cancer screening programs was decided based on experts' opinions. Since 2003, the research groups funded by the National Cancer Center have published screening guidelines for gastric, colorectal, lung, prostate, cervical, and breast cancers. Although such guidelines have increasingly contributed to promoting evidence-based screening, it is still insufficient. Cancer screenings have mainly been provided in communities and workplaces. Compared with the average of OECD countries, participation rates in breast and cervical cancer screening are lower. Participation rates cannot be accurately calculated due to a lack of comprehensive cancer screening registries at the national level. Alternatively, estimates are derived from questionnaire surveys conducted on randomly selected samples from the national population. The quality assurance system has been limited to community-based screening and was not adapted to workplace screening until 2018. While there is a long history of cancer screening, the complex program delivery system might be a barrier to increasing the participation rate. Continued efforts are necessary to offer evidence-based cancer screening and establish an effective quality assurance system.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"207-210"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics of screening promotion: A slippery slope to forced marketing?","authors":"Alain Braillon","doi":"10.1177/09691413241264480","DOIUrl":"10.1177/09691413241264480","url":null,"abstract":"","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"266-267"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin cancer screening recommendations by U.S. cancer centers: Inconsistency with national guidelines.","authors":"Joyce Lee, Lynn K Han, Luc G T Morris, Deborah Korenstein, Jennifer L Marti","doi":"10.1177/09691413241259991","DOIUrl":"10.1177/09691413241259991","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of melanoma has increased dramatically over the past four decades, while overall mortality has remained stable. This increase in incidence without a change in overall mortality may be due to overdiagnosis through skin cancer screening. Despite the USPSTF citing insufficient evidence for or against professional skin cancer screening in average-risk adults, U.S. skin cancer screening practices may be leading to overdiagnosis of skin cancers.</p><p><strong>Methods: </strong>Two reviewers examined the online recommendations for skin cancer screening of 1113 U.S. cancer centers accredited by the Commission on Cancer, including 66 designated by the National Cancer Institute (NCI). Recommendations on skin cancer screening, such as age, frequency, and patient population (i.e. high-risk of developing skin cancer, \"people of color\") were documented.</p><p><strong>Results: </strong>We found that 18% of centers (202) recommended professional screening in average-risk adults, 35.8% (399) advised regular self-examination, and only 3.4% (38) cited insufficient evidence for screening practices; 49% of NCI centers (32/66) recommended screening in high-risk adults compared to 13% of non-NCI centers (135/1047; <i>p</i> = 0.0004); 0.45% of centers (5) mentioned the potential harms of screening, while 3.5% (39) specifically recommended screening for people of color.</p><p><strong>Conclusion: </strong>Our study reveals that many U.S. cancer centers advise some form of skin cancer screening despite a lack of evidence for or against these practices. Few centers mentioned the potential harms of screening, including overdiagnosis. This indicates a need for stronger evidence for specific screening guidelines and for greater public awareness of the potential benefits and harms of routine skin cancer screening.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"263-265"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow-charting to improve clarity in describing screening protocols.","authors":"Nicholas J Wald","doi":"10.1177/09691413241263530","DOIUrl":"10.1177/09691413241263530","url":null,"abstract":"","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"205-206"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strong association between reduction of late-stage cancers and reduction of cancer-specific mortality in meta-regression of randomized screening trials across multiple cancer types.","authors":"James Y Dai, E Georg Luebeck, Ellen T Chang, Christina A Clarke, Earl A Hubbell, Nan Zhang, Stephen W Duffy","doi":"10.1177/09691413241256744","DOIUrl":"10.1177/09691413241256744","url":null,"abstract":"<p><strong>Background: </strong>Late-stage cancer incidence has been proposed as an early surrogate for mortality in randomized controlled trials (RCTs) of cancer screening; however, its validity has not been systematically evaluated across screening RCTs of different cancers.</p><p><strong>Methods: </strong>We conducted a meta-regression analysis of cancer screening RCTs that reported both late-stage cancer incidence and cancer mortality. Based on a systematic literature review, we included 33 RCTs of screening programs targeting seven cancer types, including lung (<i>n</i> = 12), colorectal (<i>n</i> = 8), breast (<i>n</i> = 5), and prostate (<i>n</i> = 4), among others. We regressed the relative reduction of cancer mortality on the relative reduction of late-stage cancer incidence, inversely weighted for each RCT by the variance of estimated mortality reduction.</p><p><strong>Results: </strong>Across cancer types, the relative reduction of late-stage cancer incidence was linearly associated with the relative reduction of cancer mortality. Specifically, we observed this association for lung (<i>R² </i>= 0.79 and 0.996 in three recent large trials), breast (<i>R² </i>= 0.94), prostate (<i>R² </i>= 0.98), and colorectal cancer (<i>R² </i>= 0.75 for stage III/IV cancers and 0.93 for stage IV cancers). Trials with a 20% or greater reduction in late-stage cancers were more likely to achieve a significant reduction in cancer mortality. Our results also showed that no reduction of late-stage cancer incidence was associated with no or minimal reduction in cancer mortality.</p><p><strong>Conclusions: </strong>Meta-regression of historical screening RCTs showed a strong linear association between reductions in late-stage cancer incidence and cancer mortality.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"211-222"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with private or public breast cancer screening attendance in Queensland, Australia: A retrospective cross-sectional study.","authors":"Tong Li, M Luke Marinovich, Nick Ormiston-Smith, Brooke Nickel, Andrea Findlay, Nehmat Houssami","doi":"10.1177/09691413241248528","DOIUrl":"10.1177/09691413241248528","url":null,"abstract":"<p><p>This study aimed to estimate participation in private breast screening in Queensland, Australia, where public-funded screening is implemented, and to identify factors associated with the screening setting, using an online survey (999 female respondents aged 40-74). Screening-specific and socio-demographic factors were collected. Multivariable logistic regression was used to identify factors associated with screening setting (public vs private) and screening recency (<2 vs ≥2 years). Participation estimates were 53.2% (95% confidence interval, CI: 50.0%-56.3%) and 10.9% (9.0%-13.0%) for national screening program and private screening, respectively. In the screening setting model, participation in private screening was significantly associated with longer time since last screening (>4 versus <2 years, odds ratio (OR) = 7.3, 95%CI: 4.1-12.9, <i>p</i> < 0.001), having symptoms (OR = 9.5, 5.8-15.5, <i>p</i> < 0.001), younger age (40-49 versus 50-74 years, OR = 1.8, 1.1-3.0, <i>p</i> = 0.018) and having children <18 years in household (OR = 2.4, 1.5-3.9, <i>p</i> < 0.001). In the screening recency model, only screening setting was statistically significant and private screening was associated with screening recency ≥2 years (OR = 4.0, 2.8-5.7, <i>p</i> < 0.001). Around one in nine women screen outside of the BreastScreen Queensland program. Clinical and socio-demographic factors associated with participation in private screening were identified, providing knowledge relevant to the program's endeavours to improve screening participation.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"258-262"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}