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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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Journal ArticleDOI
TL;DR: Logistic regression analyses indicated that insurance coverage and, to a greater extent, usual source of care had strong independent associations with screening usage when age, sex, racial/ethnic group, and educational level were taken into account.
Abstract: Background Screening to detect cancer early, an increasingly important cancer control activity, cannot be effective unless it is widely used. Methods Use of Pap smears, mammography, fecal occult blood tests (FOBTs), sigmoidoscopy, and digital rectal examination (DRE) was evaluated in the 1987, 1992, and 1998 National Health Interview Surveys. Levels and trends in screening use were examined by sex, age, and racial/ethnic group. The effects of income, educational level, and health care coverage were examined within age groups. Logistic regression analyses of 1998 data were used to develop a parsimonious, policy-relevant model. Results Use of all screening modalities increased over the period examined; for mammography and DRE, the increase was more rapid in the first half of the decade; for the Pap test and sigmoidoscopy, the increase was more rapid in the second half of the decade. Levels of colorectal cancer screening (both sigmoidoscopy and FOBTs) in 1998 were less than the level that prevailed a decade earlier for mammography. Patterns of change for all screening modalities differed between age, sex, and racial/ethnic groups, but prevalence of use during the study, within recommended time intervals, was consistently lower among groups with lower income and less education. Logistic regression analyses indicated that insurance coverage and, to a greater extent, usual source of care had strong independent associations with screening usage when age, sex, racial/ethnic group, and educational level were taken into account. Conclusions While cancer screening is generally increasing in the United States, usage is relatively low for colorectal cancer screening and among groups that lack health insurance or a usual source of care.

517 citations

Journal Article

516 citations

Journal ArticleDOI
TL;DR: The validity of the five-item Mental Health Inventory (MHI-5) screening test using DSM-IV Axis I diagnoses as a gold standard is tested and its performance in different diagnostic groups is analyzed.
Abstract: Short screening questionnaires for mental health are useful tools for research and clinical practice, e.g. they could play a major role in detecting patients with psychiatric disorders in primary care. The present study tests the validity of the five-item Mental Health Inventory (MHI-5) screening test using DSM-IV Axis I diagnoses as a gold standard and analyzes its performance in different diagnostic groups. A random sample was drawn from the resident registration office files in northern Germany. Personal interviews with a response rate of 70% were conducted. Of the sample, 4036 respondents filled in the MHI-5. DSM-IV diagnoses were assessed using the Munich Composite International Diagnostic Interview (M-CIDI). The area under the receiver operating characteristics curve (AUC) of 0.72 in identifying any DSM-IV Axis I disorder (except substance use) is not satisfying. The MHI-5 revealed best performance for mood (AUC: 0.88) followed by anxiety disorders (AUC: 0.71). Sensitivity and specificity were poor for somatoform and substance use disorders, especially in cases without comorbid mood or anxiety disorder. The power to detect mood and anxiety disorders of the MHI-5 was better for the 4-week compared with the 12-month diagnoses. The MHI-5 can be recommended to screen for mood disorders. Data have to be confirmed for primary care settings.

516 citations

Journal ArticleDOI
TL;DR: The detection of methylated genes in sputum could lead to the development of a screening test to non-invasively identify early cancer in high-risk people.
Abstract: Silencing of genes by aberrant promoter hypermethylation is now recognized as a crucial component in cancer initiation and progression. Highly sensitive assays have been developed to assess gene-promoter methylation in biological fluids. The detection of methylated genes in sputum could lead to the development of a screening test to non-invasively identify early cancer in high-risk people.

514 citations

Journal ArticleDOI
12 Mar 2008-JAMA
TL;DR: A universal, rapid MRSA admission screening strategy did not reduce nosocomial MRSA infection in a surgical department with endemic MRSA prevalence but relatively low rates of MRSA infections.
Abstract: Context Experts and policy makers have repeatedly called for universal screening at hospital admission to reduce nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection. Objective To determine the effect of an early MRSA detection strategy on nosocomial MRSA infection rates in surgical patients. Design, Setting, and Patients Prospective, interventional cohort study conducted between July 2004 and May 2006 among 21 754 surgical patients at a Swiss teaching hospital using a crossover design to compare 2 MRSA control strategies (rapid screening on admission plus standard infection control measures vs standard infection control alone). Twelve surgical wards including different surgical specialties were enrolled according to a prespecified agenda, assigned to either the control or intervention group for a 9-month period, then switched over to the other group for a further 9 months. Interventions During the rapid screening intervention periods, patients admitted to the intervention wards for more than 24 hours were screened before or on admission by rapid, multiplex polymerase chain reaction. For both intervention (n=10 844) and control (n=10 910) periods, standard infection control measures were used for patients with MRSA in all wards and consisted of contact isolation of MRSA carriers, use of dedicated material (eg, gown, gloves, mask if indicated), adjustment of perioperative antibiotic prophylaxis of MRSA carriers, computerized MRSA alert system, and topical decolonization (nasal mupirocin ointment and chlorhexidine body washing) for 5 days. Main Outcome Measures Incidence of nosocomial MRSA infection, MRSA surgical site infection, and rates of nosocomial acquisition of MRSA. Results Overall, 10 193 of 10 844 patients (94%) were screened during the intervention periods. Screening identified 515 MRSA-positive patients (5.1%), including 337 previously unknown MRSA carriers. Median time from screening to notification of test results was 22.5 hours (interquartile range, 12.2-28.2 hours). In the intervention periods, 93 patients (1.11 per 1000 patient-days) developed nosocomial MRSA infection compared with 76 in the control periods (0.91 per 1000 patient-days; adjusted incidence rate ratio, 1.20; 95% confidence interval, 0.85-1.69; P = .29). The rate of MRSA surgical site infection and nosocomial MRSA acquisition did not change significantly. Fifty-three of 93 infected patients (57%) in the intervention wards were MRSA-free on admission and developed MRSA infection during hospitalization. Conclusion A universal, rapid MRSA admission screening strategy did not reduce nosocomial MRSA infection in a surgical department with endemic MRSA prevalence but relatively low rates of MRSA infection. Trial Registration isrctn.org Identifier: ISRCTN06603006

511 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20223
2021736
2020871
2019821
20181,027
20171,365