Mass screening

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

Screening mammography with computer-aided detection: prospective study of 12,860 patients in a community breast center.

Abstract: PURPOSE: To prospectively assess the effect of computer-aided detection (CAD) on the interpretation of screening mammograms in a community breast center. MATERIALS AND METHODS: Over a 12-month period, 12,860 screening mammograms were interpreted with the assistance of a CAD system. Each mammogram was initially interpreted without the assistance of CAD, followed immediately by a reevaluation of areas marked by the CAD system. Data were recorded to measure the effect of CAD on the recall rate, positive predictive value for biopsy, cancer detection rate, and stage of malignancies at detection. RESULTS: When comparing the radiologist’s performance without CAD with that when CAD was used, the authors observed the following: (a) an increase in recall rate from 6.5% to 7.7%, (b) no change in the positive predictive value for biopsy at 38%, (c) a 19.5% increase in the number of cancers detected, and (d) an increase in the proportion of early-stage (0 and I) malignancies detected from 73% to 78%. CONCLUSION: The u...

Colorectal Cancer Mortality: Effectiveness of Biennial Screening for Fecal Occult Blood

Abstract: Background In 1993, a randomized controlled trial in Minnesota showed, after 13 years of follow-up, that annual fecal occult blood testing was effective in reducing colorectal cancer mortality by at least 33%. Biennial screening (i.e., every 2 years) resulted in only a 6% mortality reduction. Two European trials (in England and in Denmark) subsequently showed statistically significant 15% and 18% mortality reductions with biennial screening. Herein, we provide updated results-through 18 years of follow-up--from the Minnesota trial that address the apparent inconsistent findings among the trials regarding biennial screening. Methods From 1976 through 1977, a total of 46551 study subjects, aged 50-80 years, were recruited and randomly assigned to an annual screen, a biennial screen, or a control group. A screen consisted of six guaiac-impregnated fecal occult blood tests (Hemoccult) prepared in pairs from each of three consecutive fecal samples. Participants with at least one of the six tests that were positive were invited for a diagnostic examination that included colonoscopy. All participants were followed annually to ascertain incident colorectal cancers and deaths. Results The numbers of deaths from all causes were similar among the three study groups. Cumulative 18-year colorectal cancer mortality was 33% lower in the annual group than in the control group (rate ratio, 0.67; 95% confidence interval [CI] = 0.51-0.83). The biennial group had a 21% lower colorectal cancer mortality rate than the control group (rate ratio, 0.79; 95% CI = 0.62-0.97). A marked reduction was also noted in the incidence of Dukes' stage D cancers in both screened groups in comparison with the control group. Conclusion The results from this study, together with the other two published randomized trials of fecal occult blood screening, are consistent in demonstrating a substantial, statistically significant reduction in colorectal cancer mortality from biennial screening.

Gastric cancer: Asia and the world.

Abstract: We are living in an era of unprecedented rapid change for gastric cancer. For a long time it was the commonest cancer, but its occurrence started to decline suddenly in the 1950s. The reason was unknown at first, but in any case the sharp decrease in mortality without any active measures was welcomed in the USA as ‘‘an unplanned triumph’’ [1]. It is now clear that the decreasing trend in gastric cancer occurrence paralleled the decrease of Helicobacter pylori infection. This bacterium has inhabited the human stomach since humans left Africa 58,000 years ago [2], but its existence was revealed only recently. Its carcinogenic mechanism has been rigorously investigated in the past 20 years, and as if it were a criminal whose crime had been uncovered, it started to leave the human stomach before an eradication policy was launched. After an interval following the decline in the occurrence of of H. pylori-related gastric cancer, a new disease entity, lower esophageal adenocarcinoma, appeared and has rapidly increased in frequency together with esophagogastric junction cancer in Western countries. Most Eastern countries still seem to be in the final phase of the interval before the increase in the frequency of these troublesome diseases, and today the difference between East and West in clinical approaches to esophagogastric junction cancer seems to be the largest in history. Asian gastroenterologists and surgeons detect and treat early disease, mostly in the distal part of the stomach, by developing new diagnostic devices and function-preserving treatments. Their Western counterparts, on the other hand, desperately struggle against advanced tumors in the proximal part of the stomach, making full use of a multimodal, multidisciplinary approach. Bridging these two groups is worthwhile and beneficial, especially for the minority populations of patients in each group, but needs mutual understanding based on common points of view. Researchers and pathologists are highly expected to play a role in establishing a common language for these differing practices. Face-to-face meetings and discussions in recognition of the other’s standpoint would be particularly profitable. We organized the 88th Annual Meeting of the Japanese Gastric Cancer Association in March 2016, setting the congress theme as ‘‘Gastric cancer: Asia and the world.’’ Although this was essentially a domestic meeting, 70% of the sessions were conducted in English, and were attended by more than 2000 physicians and pathologists, including those from 14 countries. This special issue of Gastric Congress President of the 88th Annual Meeting of the Japanese Gastric Cancer Association.

Recommendations for identification and public health management of persons with chronic hepatitis B virus infection.

Abstract: Serologic testing for hepatitis B surface antigen (HBsAg) is the primary way to identify persons with chronic hepatitis B virus (HBV) infection. Testing has been recommended previously for pregnant women, infants born to HBsAg-positive mothers, household contacts and sex partners of HBV-infected persons, persons born in countries with HBsAg prevalence of >/=8%, persons who are the source of blood or body fluid exposures that might warrant postexposure prophylaxis (e.g., needlestick injury to a health-care worker or sexual assault), and persons infected with human immunodeficiency virus. This report updates and expands previous CDC guidelines for HBsAg testing and includes new recommendations for public health evaluation and management for chronically infected persons and their contacts. Routine testing for HBsAg now is recommended for additional populations with HBsAg prevalence of >/=2%: persons born in geographic regions with HBsAg prevalence of >/=2%, men who have sex with men, and injection-drug users. Implementation of these recommendations will require expertise and resources to integrate HBsAg screening in prevention and care settings serving populations recommended for HBsAg testing. This report is intended to serve as a resource for public health officials, organizations, and health-care professionals involved in the development, delivery, and evaluation of prevention and clinical services.