Topic
Mass screening
About: Mass screening is a research topic. Over the lifetime, 34508 publications have been published within this topic receiving 1365148 citations.
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TL;DR: Multianalyte technologies such as MS/MS are suitable for newborn screening and other mass screening programs because they improve the detection of many diseases in the current screening panel while enabling expansion to disorders that are now recognized as important and need to be identified in pediatric medicine.
Abstract: Background: Over the past decade laboratories that test for metabolic disorders have introduced tandem mass spectrometry (MS/MS), which is more sensitive, specific, reliable, and comprehensive than traditional assays, into their newborn-screening programs. MS/MS is rapidly replacing these one-analysis, one-metabolite, one-disease classic screening techniques with a one-analysis, many-metabolites, many-diseases approach that also facilitates the ability to add new disorders to existing newborn-screening panels.
Methods: During the past few years experts have authored many valuable articles describing various approaches to newborn metabolic screening by MS/MS. We attempted to document key developments in the introduction and validation of MS/MS screening for metabolic disorders. Our approach used the perspective of the metabolite and which diseases may be present from its detection rather than a more traditional approach of describing a disease and noting which metabolites are increased when it is present.
Content: This review cites important historical developments in the introduction and validation of MS/MS screening for metabolic disorders. It also offers a basic technical understanding of MS/MS as it is applied to multianalyte metabolic screening and explains why MS/MS is well suited for analysis of amino acids and acylcarnitines in dried filter-paper blood specimens. It also describes amino acids and acylcarnitines as they are detected and measured by MS/MS and their significance to the identification of specific amino acid, fatty acid, and organic acid disorders.
Conclusions: Multianalyte technologies such as MS/MS are suitable for newborn screening and other mass screening programs because they improve the detection of many diseases in the current screening panel while enabling expansion to disorders that are now recognized as important and need to be identified in pediatric medicine.
587 citations
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TL;DR: Mortality from all causes is increased in asymptomatic patients with diabetes in proportion to the screening CCS, Nonetheless, subjects without coronary artery calcium have a low short-term risk of death even in the presence of diabetes mellitus.
584 citations
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University of California, San Francisco1, National Institutes of Health2, University of Washington3, Group Health Cooperative4, University of Vermont5, University of Nevada, Reno6, University of North Carolina at Chapel Hill7, University of New Mexico8, Dartmouth College9, Fred Hutchinson Cancer Research Center10
TL;DR: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS, and the clinical significance of screen-detected DCIS needs further investigation.
Abstract: Background: With the large number of women having mammography—an estimated 28.4 million U.S. women aged 40 years and older in 1998—the percentage of cancers detected as ductal carcinoma in situ (DCIS), which has an uncertain prognosis, has increased. We pooled data from seven regional mammography registries to determine the percentage of mammographically detected cancers that are DCIS and the rate of DCIS per 1000 mammograms. Methods: We analyzed data on 653 833 mammograms from 540 738 women between 40 and 84 years of age who underwent screening mammography at facilities participating in the National Cancer Institute’s Breast Cancer Surveillance Consortium (BCSC) throughout 1996 and 1997. Mammography results were linked to population-based cancer and pathology registries. We calculated the percentage of screen-detected breast cancers that were DCIS, the rate of screen-detected DCIS per 1000 mammograms by age and by previous mammography status, and the sensitivity of screening mammography. Statistical tests were two-sided. Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screendetected breast cancers that were DCIS decreased with age (from 28.2% [95% confidence interval (CI) = 23.9% to 32.5%] for women aged 40–49 years to 16.0% [95% CI = 13.3% to 18.7%] for women aged 70–84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95% CI = 0.41 to 0.70] for women aged 40–49 years to 1.07 [95% CI = 0.87 to 1.27] for women aged 70–84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0% [95% CI = 83.2% to 88.8%]) than it was for detecting invasive breast cancer (75.1% [95% CI = 73.5% to 76.8%]). Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation. [J Natl Cancer Inst 2002;94: 1546–54]
581 citations
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TL;DR: It is concluded that PSA represents an important adjunct to digital rectal examination for the early detection of prostatic carcinoma and the efficacy of this or any other early detection test to decrease prostate cancer mortality necessitates the results of prospectively randomized clinical trials.
581 citations
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TL;DR: Although C-reactive protein, lipoprotein(a), fibrinogen, and homocysteine are associated with vascular disease risk, their optimal use in routine screening and risk stratification remains to be determined.
Abstract: ContextAtherosclerotic vascular disease is an enormous public health problem.
A number of emerging risk factors for atherosclerosis have recently been proposed
to help identify high-risk individuals.ObjectiveTo review the epidemiological, basic science, and clinical trial evidence
concerning 4 emerging risk factors: C-reactive protein, lipoprotein(a), fibrinogen,
and homocysteine.Data SourcesUsing the terms atherosclerosis, cardiovascular disease, risk factors, prevention, screening, C-reactive protein, lipoprotein(a), fibrinogen, and homocysteine,
we searched the MEDLINE database from January 1990 to January 2003. Conference
proceedings, abstract booklets, bibliographies of pertinent articles and books,
and personal files were hand searched to identify additional articles.Study SelectionOriginal investigations and reviews of the epidemiology of atherosclerosis
and the association of conventional and novel risk factors with vascular risk
were selected. On the basis of the search strategy, 373 relevant studies were
identified.Data ExtractionA diverse array of studies were examined, including randomized controlled
trials, prospective cohort studies, systematic overviews, case-control, cross-sectional,
and mechanistic studies. Data extraction was performed by one of the authors.Data SynthesisThe available epidemiological and basic science evidence supports, to
varying degrees, independent associations between these 4 candidate risk factors
and atherosclerotic vascular disease. However, there is relatively little
data regarding the additive yield of screening for these factors over that
of validated global risk assessment strategies currently in use. Furthermore,
controlled intervention studies targeting individuals with these factors for
proven risk-reduction therapies, or specifically treating these factors with
available therapies, are few. The explanatory power of the major, established
cardiovascular risk factors has been systematically underestimated.ConclusionsAlthough C-reactive protein, lipoprotein(a), fibrinogen, and homocysteine
are associated with vascular disease risk, their optimal use in routine screening
and risk stratification remains to be determined.
577 citations