Journal of Medical Screening最新文献

{"title":"Ripple effect of temporary self-sampling HPV test on screening uptake in the next round: A secondary analysis of the ACCESS randomized controlled trial.","authors":"Misuzu Fujita, Kengo Nagashima, Minobu Shimazu, Misae Suzuki, Ichiro Tauchi, Miwa Sakuma, Setsuko Yamamoto, Hideki Hanaoka, Makio Shozu, Nobuhide Tsuruoka, Tokuzo Kasai, Akira Hata","doi":"10.1177/09691413251352999","DOIUrl":"https://doi.org/10.1177/09691413251352999","url":null,"abstract":"<p><p>The self-sampling human papillomavirus (HPV) test improves participation in cervical cancer screening. However, the ripple effect of this test on participation in the next screening round has not yet been examined. This study, a secondary analysis of the Accelerating Cervical Cancer Elimination by Self-Sampling test (ACCESS) trial, aims to clarify this effect. Women who had not participated in the cervical cancer screening program of Ichihara City for 3 years or more were included. The participants were randomly assigned to intervention (<i>n</i> = 7337) and control groups (<i>n</i> = 7770). In the initial round, the intervention group could perform a self-sampling HPV test or undergo cytology as the primary screening method, while the control group could undergo cytology only. In the next round, both groups could undergo cytology. In intention-to-screen analysis, screening uptake in the next round was 10.0% (95% confidence interval [CI]: 9.3%, 10.7%) in the intervention group and 10.2% (95% CI: 9.5%, 10.8%) in the control group, with no significant difference between groups (<i>p</i> = 0.717). In conclusion, offering a one-time self-sampling HPV test had no effect on screening uptake in the next round, suggesting that the test needs to be offered on an ongoing basis to continuously improve screening uptake.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413251352999"},"PeriodicalIF":2.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499112","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":"Identifying barriers and facilitators to participation in cancer screening among Irish travellers, a minority ethnic group in Ireland, using a codesigned approach.","authors":"Patricia Fitzpatrick, Aela O'Flynn, Reuel Jalal, Kate Frazer, Lynsey Kavanagh, Mary B Collins, Una Kennedy, Triona McCarthy, Maria McEnery, Aine Lyng, Regina Joye, Brigid Quirke, Patricia Fox","doi":"10.1177/09691413251352402","DOIUrl":"https://doi.org/10.1177/09691413251352402","url":null,"abstract":"<p><p>IntroductionThis study sought to determine participation by eligible Irish Travellers, a minority ethnic group, in the cancer screening programmes in Ireland (bowel, breast and cervical screening) and to determine barriers/facilitators to screening.MethodologyThis study was co-designed with the National Cancer Control Programme (NCCP) and Pavee Point Traveller and Roma Centre, Ireland. A survey questionnaire, adapted from the NCCP's 2022 National Survey on Cancer Awareness, was disseminated to Travellers via Traveller Community Health Workers (TCHWs).ResultsA total of 574 survey questionnaires were distributed across 12 different Primary Health Care Traveller Projects in the Republic of Ireland and 483 (84%) were returned completed; 148 (30.6%) were from men and 306 (63.1%) from women (6.3%, missing data). High proportions had ever attended breast (72.6%) and cervical (65.4%) screening. Bowel screening uptake was low in both men (12.5%) and women (19.2%). Low proportions recalled receiving an invitation to programmes. The faecal immunochemical test test used in the BowelScreen programme prompted embarrassment as a barrier in eligible men (62.5%); embarrassment was lower in women for bowel (38.5%), breast (32.9%) and cervical (30.4%) screening. Fear was the second highest barrier. The main facilitators of screening attendance were talking to TCHW and an invitation respectively, particularly in women eligible for bowel (50%; 53.8%), breast (49.3%; 50.7%) and cervical screening (47.6%; 48.2%), but lower in men (25%; 37.5%); 25% cited the family doctor as facilitator.ConclusionTravellers face barriers accessing mainstream health services; easy access to screening must be ensured<b>.</b> The TCHW is a key facilitator. There is a need for universal ethnic identifiers to facilitate routine monitoring of participation and outcomes for Travellers in screening.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413251352402"},"PeriodicalIF":2.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499111","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":"Is GP practice bowel, breast and cervical cancer screening coverage correlated with GP practice list inflation?","authors":"Sue M Hudson, Cathryn Hudson","doi":"10.1177/09691413251347408","DOIUrl":"https://doi.org/10.1177/09691413251347408","url":null,"abstract":"<p><p>ObjectiveGP list inflation occurs when the number of patients registered at a GP practice exceeds the number of residents. It may be associated with out-of-date patient contact data, affecting invitations for cancer screening. We examined whether bowel, breast and cervical screening coverage was associated with list inflation after adjusting for deprivation and ethnicity.MethodsWe used ecological data, with GP practice the unit of analysis. Outcomes were NHS Fingertips 2019-2020 screening programme performance data. List inflation/deflation was calculated as the difference between GP-registered patients in July 2021 and Office for National Statistics population estimates in their Lower Super Output Areas (LSOA). Percentage White population was calculated using census (2021) data. Index of multiple deprivation (IMD) score was available from NHS Fingertips. Linear regression models were used to examine correlations between outcomes and list inflation before and after adjustment for deprivation and ethnicity.ResultsThe study included 6085 GP practices covering the whole of England. Median list inflation was 8.6% (interquartile range (IQR) 4.7%-16.9%). List inflation was a significant independent predictor of screening coverage. For each 10 percentage points increase in list inflation, coverage declined as follows: -1.96% (95% CI: -2.19, -1.73), -2.20% (95% CI: -2.39, -2.02), -0.99% (95% CI: -1.15, -0.84) and -1.59% (95% CI: -1.75, -1.43) for breast, cervical (aged 25-49), cervical (aged 50-64) and bowel cancer screening, respectively.ConclusionsIt is important to control for variations in list inflation as well as population demographics when comparing screening programme coverage. Uptake improvement initiatives should include strategies for overcoming issues with out-of-date registration data.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413251347408"},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318632","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":"Evaluating the diagnostic accuracy of faecal immunochemical testing in the two-week wait referral pathway for colorectal cancer in the UK.","authors":"Sarala Janarthanan, Nilanga Nishad, Ciaran Padhiar, Madeleine Frank, Joshua Elias, Bianca Hanganu, Ahlam-Nourelhouda Boussaid Othmani, Dylan McClurg, Irene Jessel, Matthew Denton, Sikandar Khan, Ioanna Panagiotopoulou, Juan De La Revilla Negro, Gareth Corbett","doi":"10.1177/09691413251347724","DOIUrl":"https://doi.org/10.1177/09691413251347724","url":null,"abstract":"<p><p><b>Objective:</b> Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the UK. Early identification and timely intervention rely heavily on the faecal immunohistochemical test (FIT). However, FIT diagnostic accuracy varies, with a sensitivity ranging between 85% and 94% and a noteworthy negative predictive value (NPV) of 99%. The objective of this study was to evaluate the diagnostic accuracy of FIT in detecting CRC and advanced adenomas in patients referred through the 2-week wait (2WW) referral pathway following the National Institute for Health and Care Excellence (NICE) NG12 criteria. <b>Method:</b> A retrospective analysis was conducted on 1841 patients who were referred through the 2WW pathway. Data on clinical characteristics, FIT test positivity (faecal haemoglobin ≥ 10 µg/g), and subsequent investigations were obtained. The sensitivity, specificity, positive predictive value (PPV), and NPV were calculated based on the presence of adenomas (≥10 mm) or malignancies. <b>Results:</b> Positive FIT results were observed in 73.4%, negative FIT in 25.9%, and 0.65% of patients lacked FIT availability. The sensitivity, specificity, PPV, and NPV for CRC detection compared to the presence of advanced adenoma or CRC were 96.49% vs. 93.6%, 26.56% vs. 30.2%, 7.31% vs. 21.8%, and 99.18% vs. 95.8%, respectively. <b>Conclusion:</b> FIT showed the expected performance for CRC detection with an NPV of 99.18%, but a negative FIT result should not exclude investigation with colonoscopy due to a 4.2% likelihood of missing advanced adenomas. There is still a need for other types of testing for CRC screening.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413251347724"},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303496","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":"Couple screening for autosomal recessive inherited diseases: Current and historical perspectives.","authors":"Glenn E Palomaki","doi":"10.1177/09691413251335144","DOIUrl":"10.1177/09691413251335144","url":null,"abstract":"","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"59-60"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045124","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":"Attitudes towards being offered a choice of self-sampling or clinician sampling for cervical screening: A cross-sectional survey of women taking part in a clinical validation of HPV self-collection devices.","authors":"Laura Marlow, Hannah Drysdale, Jo Waller","doi":"10.1177/09691413241283356","DOIUrl":"10.1177/09691413241283356","url":null,"abstract":"<p><p>ObjectivesPrimary human papillomavirus (HPV) testing in cervical screening offers the opportunity for women to be given a choice between HPV self-sampling and traditional clinician screening. This study assessed attitudes towards a choice and anticipated future preference among women who had collected a vaginal self-sample alongside their usual cervical screen.SettingThirty-eight general practices across five areas in England.MethodsOverall, 2323 women (24-65 years; response rate: 48%) completed a survey after collecting a self-sample and having a clinician screen at their GP practice. We asked which test they preferred and assessed attitudes to being offered a choice. We explored age, education, ethnicity and screening experience as predictors of attitudes towards a choice and anticipated future choice.ResultsMost participants felt they would like a choice between self-sampling and clinician screening (85%) and thought this would improve screening for them (72%). However, 23% felt it would be difficult to choose, 15% would worry about making a choice, and nearly half would prefer a recommendation (48%). Compared with women with degree-level education, those with fewer qualifications were more likely to say they would worry about having a choice or would not want a choice (p < 0.001). The majority said they would choose to self-sample at home if offered a choice in the future (69%; n = 1602/2320).ConclusionsSelf-sampling is likely to be popular, but offering a choice could cause worry for some people and many would prefer a recommendation. Supporting people to make a choice will be important, particularly for those with lower levels of education.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"93-99"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395033","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":"The new NHS England 'ping and book' screening service is set to exclude thousands of women.","authors":"Hannah A Long, Lorna McWilliams, David P French","doi":"10.1177/09691413251316429","DOIUrl":"10.1177/09691413251316429","url":null,"abstract":"","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"106-107"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049742","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":"Percentage mammographic density or absolute breast density for risk stratification in breast screening: Possible implications for socioeconomic health disparity.","authors":"Sue Hudson, Nahid Kamangari, Louise S Wilkinson","doi":"10.1177/09691413241274291","DOIUrl":"10.1177/09691413241274291","url":null,"abstract":"<p><p>ObjectivesObesity levels and mortality from breast cancer are higher in more deprived areas of the UK, despite lower breast cancer incidence. Supplemental imaging for women with dense breasts has been proposed as a potential improvement to screening, but it is not clear how stratification by percentage mammographic density (%MD) would be reflected across socioeconomic groups. This study aims to clarify the associations between breast composition (dense and fatty tissue) and socioeconomic status in a multi-ethnic screening population.MethodsDemographic characteristics were collected for 62,913 participants in a UK breast screening programme (age, ethnicity, Index of Multiple Deprivation (IMD)). Automated mammographic measurements were derived: dense volume (DV), non-dense volume (NDV) and percent density (%MD). Correlations between deprivation and mammographic composition were examined before and after adjustment for age, ethnicity and NDV, using non-dense breast volume as a proxy for body mass index (BMI).ResultsThere was negligible correlation between deprivation and DV (r = 0.017; <i>P</i> < 0.001 in all cases), but NDV increased with increasing deprivation (Pearson r = 0.101). Correlations were weaker in the Asian and Chinese ethnic groups. %MD decreased with deprivation (r = -0.094) and adjustment for ethnicity did not alter the association between %MD and IMD (relative change, most to least deprived quintile IMD: 1.18; 95% confidence interval: 1.16, 1.21).ConclusionsDeprivation-related differences in %MD in the screening population are largely explained by differences in breast fat volume (NDV) which reflects BMI. Women in more deprived areas, where obesity and breast cancer mortality rates are higher, have increased breast adiposity and may miss out on risk-adapted screening if stratification is based solely on %MD or BIRADS classification.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"76-84"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127252","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":"Newborn screening for biliary atresia using direct bilirubin: An implementation science study.","authors":"Tebyan Rabbani, Jay Shah","doi":"10.1177/09691413241284243","DOIUrl":"10.1177/09691413241284243","url":null,"abstract":"<p><p>ObjectiveBiliary atresia (BA) is a liver disease of infancy characterized by obstruction of the biliary tree. Infants with BA have the best outcomes when identified early and the Kasai portoenterostomy is performed before 45 days of life (DoL). In our hospital system, the average age at Kasai was 60 DoL. To address the problem of late presentation, we implemented a two-stage BA screening strategy utilizing direct bilirubin (DB).MethodsNew institutional policies were established that all newborns were tested at 24-48 h of life, and those with levels ≥0.5 mg/dL were followed further. The infant's primary care provider was contacted to recommend a repeat DB at 2 weeks of life. If the repeat DB was ≥1.0 mg/dL, the patient was evaluated by gastroenterology.ResultsOver the 16 months, 3880 infants were born and 3861 (99.5%) were screened; 53 infants (1.3%) had DB levels ≥0.5 mg/dL initially. Upon repeat testing at 2 weeks, there were three groups of infants: not retested (<i>n</i> = 1), retested <1.0 mg/dL (<i>n</i> = 40), and retested ≥1.0 mg/dL (<i>n</i> = 12). The average time to be seen by gastroenterology was 4.3 days or 18.3 DoL.DiscussionThe screening included a series of steps that needed to be implemented effectively. Screening had a net false positive rate of 0.3% (12 out of 3861) and identified causes of cholestasis other than BA. BA was excluded by 28 DoL on average. Our results can provide a template for other institutions interested in implementing a BA screening protocol in their practice.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"61-66"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331923","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":"Anxiety and disease awareness in individuals with heredity for abdominal aortic aneurysm.","authors":"Nina Fattahi, Olga Nilsson, Sverker Svensjö, Joy Roy, Anneli Linné, Rebecka Hultgren","doi":"10.1177/09691413241278224","DOIUrl":"10.1177/09691413241278224","url":null,"abstract":"<p><p>ObjectiveThe psychological consequences of being aware of an increased risk of developing abdominal aortic aneurysm as a first-degree relative of a person with abdominal aortic aneurysm are hitherto unexplored. This study investigates the awareness of heritability and anxiety in male and female adult offspring of abdominal aortic aneurysm patients compared to controls. Health-related quality of life among participants with aortic pathology was compared to participants with normal aortic diameters.MethodsThis was a cross-sectional point prevalence study based on the participants examined in the Detecting Abdominal Aortic Aneurysm in First Degree Relatives Trial (DAAAD; 752 adult offspring, 756 matched controls), 2020-2022. Questionnaires about health-related quality of life and study-specific questions regarding awareness of heritability were collected prior to the aortic ultrasound.ResultsAttendance rate was higher among individuals with heredity compared to controls (67% vs. 52%, <i>p</i> < 0.001). Of 1508 adult offspring examined, 65% reported having a close relative with abdominal aortic aneurysm (6% in controls). Female adult offspring reported higher awareness of heritability than controls (38% vs. 12%, <i>p</i> < 0.001), as did males (32% vs. 8%, <i>p</i> < 0.001). A slight majority of participants with awareness reported anxiety (54% of female offspring; 51% of male). There were no measured differences in health-related quality of life between the groups when standard health-related quality of life instruments were used.ConclusionThe higher-than-expected proportion of adult offspring with awareness of heritability and anxiety about such risk indicates that we fail to communicate risk to this group appropriately via the current channels of information within the healthcare system. This calls for the development of dedicated strategies for improved communication of abdominal aortic aneurysm risk to patients and their next of kin.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"67-75"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156576","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}