Mass screening

About: Mass screening is a research topic. Over the lifetime, 34508 publications have been published within this topic receiving 1365148 citations.

Using sonography to screen women with mammographically dense breasts.

Abstract: OBJECTIVE. Mammographically dense breast tissue has been reported both as a cause of false-negative findings on mammography and as an indicator of increased breast cancer risk. We conducted this study to evaluate the role of breast sonography as a second-line screening test in women with mammographically dense breast tissue.MATERIALS AND METHODS. Between January 2000 and January 2002, 1517 asymptomatic women with dense breasts and normal mammography and physical examination findings underwent physician-performed breast sonography as an adjunct screening test. Within the study group, 318 women had a first-degree family history or personal history of breast cancer. The high-risk subgroup comprised these women. The detection rate of breast cancer in this subgroup was compared with the detection rate in the remaining study population with baseline risk.RESULTS. Of 1517 women examined, seven breast cancers were diagnosed (cancer-detection rate, 0.46%). Four carcinomas were detected in high-risk women and three...

Morbidity and rate of undiagnosed physical illnesses in a psychiatric clinic population.

Abstract: • Major medical illnesses remain undiagnosed and patients' ailments are being labeled "psychosomatic" at an alarming rate. A careful screening of 2,090 psychiatric clinic patients showed that 43% of this population suffered from one or several physical illnesses. Almost half of the physical illnesses (46%), remained undiagnosed by the referring source. Morbidity in the psychiatric clinic patients far surpassed the expected rate found in the general population. Among others, diabetes mellitus was a frequently overlooked diagnosis and proved, particularly, to produce emotional disturbances. Physicians other than psychiatrists missed one third and psychiatrists one half of the major medical illnesses in patients they referred. Self-referred and social agency-referred patients almost always had undiagnosed physical illnesses. The causes for failing to recognize medical illnesses are discussed. Based on the obtained data, the necessity for a medical orientation on the part of the psychiatrist in evaluating all patients is stressed.

Prevalence screening for ovarian cancer in postmenopausal women by CA 125 measurement and ultrasonography.

Abstract: OBJECTIVE--To assess the performance of the sequential combination of serum CA 125 measurement and ultrasonography in screening for ovarian cancer. DESIGN--The serum CA 125 concentration of each subject was determined and those with a concentration > or = 30 U/ml were recalled for abdominal ultrasonography. If ultrasonography gave abnormal results surgical investigation was arranged. Volunteers were followed up by annual postal questionnaire. SETTING--General practice, occupational health departments, ovarian cancer screening clinic. SUBJECTS--22,000 women volunteers who were postmenopausal and aged over 45 years. MAIN OUTCOME MEASURES--Apparent sensitivity, specificity, positive predictive value, years of cancer detected. RESULTS--41 women had a positive screening result and were investigated surgically. 11 had ovarian cancer (true positive result) and 30 had other disorders or no abnormality (false positive result). Of the 21,959 volunteers with a negative screening result, eight subsequently presented clinically with ovarian cancer (false negative result) and 21,951 had not developed ovarian cancer during follow up (apparent true negative result). The screening protocol achieved a specificity of 99.9%, a positive predictive value of 26.8%, and an apparent sensitivity of 78.6% and 57.9% at one year and two year follow up respectively. The estimated number of years of cancer detected by the prevalence screen was 1.4 years. CONCLUSIONS--This screening protocol is highly specific for ovarian cancer and can detect a substantial proportion of cases at a preclinical stage. Further investigation is required to determine the effect of the screening protocol on the ratio of early to late stage disease detected and on mortality from ovarian cancer.

Development of a Brief Diabetes Distress Screening Instrument

Abstract: PURPOSE Previous research has documented that diabetes distress, defined as patient concerns about disease management, support, emotional burden, and access to care, is an important condition distinct from depression. We wanted to develop a brief diabetes distress screen instrument for use in clinical settings. METHODS We assessed 496 community-based patients with type 2 diabetes on the previously validated, 17-item Diabetes Distress Scale (DDS17) and 6 biobehavioral measures: glycated hemoglobin (HbA1c); non–high-density-lipoprotein (non-HDL) cholesterol; kilocalories, percentage of calories from fat, and number of fruit and vegetable servings consumed per day; and physical activity as measured by the International Physical Activity Questionnaire. RESULTS An average item score of ≥3 (moderate distress) discriminated high- from low-distressed subgroups. The 4 DDS17 items with the highest correlations with the DDS17 total (r = .56–.61) were selected. Composites, comprised of 2, 3, and 4 of these items (DDS2, DDS3, DDS4), yielded higher correlations (r=.69–.71). The sensitivity and specificity of the composites were .95 and .85, .93 and .87, and .97 and .86, respectively. The DDS3 had a lower sensitivity and higher percentages of false-negative and false-positive results. All 3 composites significantly discriminated subgroups on HbA1c, non-HDL cholesterol, and kilocalories consumed per day; none discriminated subgroups on fruit and vegetable servings consumed per day; and only the DDS3 yielded significant results on the International Physical Activity Questionnaire. Because of its psychometric properties and brevity, the DDS2 was selected as a screening instrument. CONCLUSIONS The DDS2 is a 2-item diabetes distress screening instrument asking respondents to rate on a 6-point scale the degree to which the following items caused distress: (1) feeling overwhelmed by the demands of living with diabetes, and (2) feeling that I am often failing with my diabetes regimen. The DDS17 can be administered to those who have positive findings on the DDS2 to define the content of distress and to direct intervention.

CDC/AHA Workshop on Markers of Inflammation and Cardiovascular Disease Application to Clinical and Public Health Practice: Report From the Clinical Practice Discussion Group

Abstract: This article summarizes epidemiological studies of inflammation markers, particularly C-reactive protein, and cardiovascular disease as of early 2002. Gaps in the research and the public health practice implications are also discussed. Although considerable work has been published since this review was completed, the perspectives and issues presented are still useful in evaluating the use of inflammation markers for risk stratisfication and prevention.