Patients and general practitioner knowledge and perception of testicular self-examination for cancer.

PURPOSE: Testicular cancer (TC) predominantly affects young men and early detection enhances survival. However, uncertainty surrounds the impact of population-wide screening. Testicular self-examination (TSE) is a simple detection method but there is a gap in current practices that needs to be assessed. Our goal was to assess the perceptions and knowledge of male subjects in the general population (MP) and general practitioners (GPs) regarding TSE for TC. METHODS: Two distinct surveys evaluating knowledge and perceptions of TSE for TC were administered to GPs and MP, aged 15‒45-years. Factors that could favour the realisation of TSE or improve the knowledge of TC were evaluated by multivariable logistic regression. RESULTS: Overall, 1048 GPs (mean (SD) age: 35.1 ± 10.3 years) and 1032 MP (mean (SD) age: 27 ± 8.2 years) answered the survey. Among the GPs, only 93 (8.9%) performed scrotal examination for TC screening. Although the majority (n = 993, 94.8%) were aware of the age of onset of TC, most (n = 768, 73.3%) did not know the overall survival rate from TC. GPs familiar with the guidelines were more likely to explain TSE to their patients (OR = 2.5 [95% CI 1.5‒4.1]; p < 0.01). Among the MP, 800 (77.5%) admitted that they did not know how to perform TSE and 486 (47.1%) did not know the main symptoms associated with TC. MP who had already undergone TC screening were more likely to be familiar with the main symptoms (OR = 2.1 [95% CI 1.6‒2.7]; p < 0.001) and MP who knew someone with TC or who had already undergone TC screening were more likely to be aware of the correct prevalence of TC (OR = 1.9 [95% CI 1.3‒2.7], p < 0.01; and OR = 1.6 [95% CI 1.2‒2.1], p < 0.01; respectively). CONCLUSION: The knowledge of both GPs and MP regarding TC could be improved. TSE screening and knowing someone close with TC improved the awareness of our subjects.

Evaluating the Frequency of Mole Checks by a Dermatologist and Correlated Variables in a Global Survey across 17 Countries: HELIOS Project.

Secondary prevention of skin cancer consists in early detection of malignant lesions through patients' mole self-examination and medical examination. The objective of this study was to assess the self-reported  frequency of mole examination in a large, representative sample of the adult general population of 17 countries from all continents. Of a total of 17,001 participants, 4.8% had their moles checked by a dermatologist more than once a year, 11.3% once a year, 8.4% every 2-3 years, 12.4% once in a while, 10.3% once in lifetime, and 52.6% of participants had never performed a mole examination. Egypt was the country with the highest prevalence of people who performed a moles check more than once a year (15.9%), followed by Brazil and the USA. A higher frequency of mole checks was associated with sex (man vs woman), higher education, higher income, fair phototype, history of skin cancer, medical insurance, and sun-protective behaviours. Despite recommendations by health providers, it appears that the frequency of mole checks in the general population is still low. It is necessary for dermatologists to keep informing at-risk populations about the importance of moles check, with particular care regarding categories that less frequently adhere to secondary prevention measures.

The Representation of Skin Tones in Google Images of Skin Cancers.

Skin self-examinations play a vital role in skin cancer detection and are often aided by online resources. Available reference photos must display the full spectrum of skin tones so patients may visualize how skin lesions can appear. This study investigated the portrayal of skin tones in skin cancer-related Google Images, discovering a significant underrepresentation of darker skin tones. J Drugs Dermatol. 2024;23(5):e132-e133.     doi:10.36849/JDD.7886e.

Effectiveness of two educational interventions based on the theory of planned behavior on oral cancer self-examination in adults: a randomized controlled trial.

BACKGROUND: The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022. METHODS: This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17. RESULTS: Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (ß = 1.47), attitude (ß = 0.66), subjective norm (ß = 2.82), and perceived behavioral control (ß = 1.19) in both groups (p < 0.001). CONCLUSIONS: The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer. TRIAL REGISTRATION: The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

Enhancing Men's Awareness of Testicular Diseases (E-MAT) using virtual reality: A randomised pilot feasibility study and mixed method process evaluation.

INTRODUCTION: Testicular cancer is among the most common malignancies in men under the age of 50 years. Most testicular symptoms are linked to benign diseases. Men's awareness of testicular diseases and testicular self-examination behaviours are suboptimal. In this pilot feasibility study and process evaluation we examine the feasibility of conducting a future definitive randomised controlled trial (RCT) to test the effect of the Enhancing Men's Awareness of Testicular Diseases using Virtual Reality intervention (E-MATVR) compared to the Enhancing Men's Awareness of Testicular Diseases using Electric information control (E-MATE). The study protocol is registered on ClinicalTrials.gov (NCT05146466). METHODS: Male athletes, engaged in Gaelic games, and aged 18 to 50 years were included. Recruitment was via FacebookTM, XTM (formerly TwitterTM), and posters. Participants were individually randomised to either E-MATVR or E-MATE. Data were collected at baseline (T0), immediately post-test (T1), and three months post-test (T2) using surveys. Qualitative interviews were conducted with participants and researchers. RESULTS: Data were collected from 74 participants. Of those, 66 were retained. All E-MATVR participants and most E-MATE participants (n = 33, 89.2%) agreed/strongly agreed that the device was easy to use and that they were engaged to learn by the device. Most E-MATVR participants (n = 34, 91.9%) and all E-MATE participants agreed/strongly agreed that the time it took them to complete the intervention was reasonable. All 74 participants were extremely satisfied/somewhat satisfied with their overall participation in the study. E-MATVR was described as interactive, easy, fun, and close to real life. Initial difficulty using VR equipment, nausea, and technical issues were identified as challenges to engaging with E-MATVR. Recommendations were made to make VR more accessible, shorten the survey, and incorporate more interactivity. Across all participants, mean testicular knowledge scores (range 0-1) increased from 0.4 (SD 0.2) at T0 to 0.8 (SD 0.2) at T1. At T2, overall mean scores for participants were 0.7 (SD 0.2). Mean knowledge scores did not differ by trial arm at any timepoint. At T2, all E-MATVR participants and 29/32 E-MATE participants (90.6%) reported purposefully examining their testes within the past three months. CONCLUSION: Findings are promising, highlighting the feasibility of using VR to promote young athletes' awareness of testicular diseases. Considering the strengths, limitations, and lessons learned from this study, some modifications are required prior to conducing an RCT. These include but are not limited to shortening survey questions, incorporating more interactivity and visual content, and targeting more heterogenous male-dominated environments.

Melanoma prevention using an augmented reality-based serious game.

OBJECTIVES: The purpose of this study was to field-test a recently developed AR-based serious game designed to promote SSE self-efficacy, called Spot. METHODS: Thirty participants played the game and answered 3 questionnaires: a baseline questionnaire, a second questionnaire immediately after playing the game, and a third questionnaire 1 week later (follow-up). RESULTS: The majority of participants considered that the objective quality of the game was high, and considered that the game could have a real impact in SSE promotion. Participants showed statistically significant increases in SSE self-efficacy and intention at follow-up. Of the 24 participants that had never performed a SSE or had done one more than 3 months ago, 12 (50.0%) reported doing a SSE at follow-up. CONCLUSIONS: This study provides supporting evidence to the use of serious games in combination with AR to educate and motivate users to perform SSE. Spot seems to be an inconspicuous but effective strategy to promote SSE, a cancer prevention behavior, among healthy individuals. PRACTICE IMPLICATIONS: Patient education is essential to tackle skin cancer, particularly melanoma. Serious games, such as Spot, have the ability to effectively educate and motivate patients to perform a cancer prevention behavior.

RISKOCA: A Smartphone-Based Digital Platform for Oral Cancer Self-Examination.

We pioneered a smartphone-based digital platform for oral cancer self-examination, namely RISKOCA. It enabled anyone to self-submit their own oral images to evaluate the potential risk of oral lesions. Integrative artificial intelligence (AI) could immediately report if the image might have a type of oral cancer as well as the precise locations of the lesions. Participating specialist dentists would have to re-evaluate and confirm the results before sending back recommendation to the patients. High participation and satisfaction indicated the success of this pilot study. This project aims to promote oral public health and health surveillance, both nationally and globally.

Outdoor workers' perceptions of skin cancer prevention: a qualitative study.

OBJECTIVES: Outdoor workers are at increased risk for skin cancer and melanoma. This qualitative study aimed to explore outdoor workers' perspectives and experiences of primary (i.e. sun protection) and secondary prevention, i.e. skin self-examination (SSE) of skin cancer. METHODS: Purposive, snowball, and theoretical sampling was used to recruit outdoor workers in Kentucky and Indiana. Semi-structured interviews via telephone or videoconference of approximately 45 min were conducted with interviewer probes and questions about perceptions of cancer risk, prevention, and screening techniques conducted, perceived barriers and facilitators, and preferences for health dissemination venues. The recordings were transcribed verbatim and de-identified. Analysis involved constructivist grounded theory coding strategies. Using peer debriefing and consensus building around themes, the researcher established a codebook for all interviews to utilize within Dedoose software for systematizing and organizing data. RESULTS: Eighteen interviews were conducted. Interviewees (N = 18) ranged in age from 35 to 78 yr, with 3 females. Outdoor industries included agriculture, maintenance, and grounds maintenance. Themes derived from the data showed the underlying factors and perceptions that influence outdoor workers to conduct primary and secondary cancer prevention activities. The level of alarm attributed to disease and the level of trust in information contribute to intentions to conduct activities. The intentions and trust toward healthcare institutions and providers drive the primary or secondary prevention behaviors. Cultural and contextual factors included masculinity and self-sufficiency, familial and occupational priorities, and community ties. CONCLUSIONS: These data provide a basis for developing future communications and interventions to decrease skin cancer incidence in outdoor workers. They indicate that secondary prevention and building self-efficacy in conducting SSE should be emphasized in tandem or over primary skin cancer prevention methods in this population. Trusted local healthcare providers should primarily provide prevention information, and materials should utilize testimonials from the local community to best influence this population. Communications and training interventions are needed in this population to induce a proactive level of alarm about cancer and result in the performance of SSE.

Using the Behaviour Change Wheel to identify barriers and targeted strategies to improve adherence in randomised clinical trials: The example of MEL-SELF trial of patient-led surveillance for melanoma.

BACKGROUND: Adherence to self-management interventions is critical in both clinical settings and trials to ensure maximal effectiveness. This study reports how the Behaviour Change Wheel may be used to assess barriers to self-management behaviours and develop strategies to maximise adherence in a trial setting (the MEL-SELF trial of patient-led melanoma surveillance). METHODS: The Behaviour Change Wheel was applied by (i) using the Capability, Opportunity, Motivation-Behaviour (COMB) model informed by empirical and review data to identify adherence barriers, (ii) mapping identified barriers to corresponding intervention functions, and (iii) identifying appropriate behaviour change techniques and developing potential solutions using the APEASE (Affordability, Practicability, Effectiveness and cost-effectiveness, Acceptability, Side-effects and safety, Equity) criteria. RESULTS: The target adherence behaviour was defined as conducting a thorough skin self-examination and submitting images for teledermatology review. Key barriers identified included: non-engaged skin check partners, inadequate planning, time constraints, low self-efficacy, and technological difficulties. Participants' motivation was positively influenced by perceived health benefits and negatively impacted by emotional states such as anxiety and depression. We identified the following feasible interventions to support adherence: education, training, environmental restructuring, enablement, persuasion, and incentivisation. Proposed solutions included action planning, calendar scheduling, alternative dermatoscopes, optimised communication, educational resources in various formats to boost self-efficacy and motivation and optimised reminders (which will be evaluated in a Study Within A Trial (SWAT)). CONCLUSION: The Behaviour Change Wheel may be used to improve adherence in clinical trials by identifying barriers to self-management behaviours and guiding development of targeted strategies.

Patients poorly recognize lesions of concern that are malignant melanomas: is self-screening the correct advice?

Background: Australia is known for its outdoor culture, with a large percentage of its population engaging in outdoor recreational activities, aquatic, non-aquatic and outdoor occupational activities. However, these outdoor enthusiasts face increased exposure to ultraviolet radiation (UVR), leading to a higher risk of skin cancer, including malignant melanoma (MM). Over the past 40 years, there has been a significant rise in skin cancer rates in Australia, with two out of three Australians expected to develop some form of skin cancer by age 70. Currently, skin cancer examinations are not endorsed in asymptomatic or low-risk individuals in Australia, with only high-risk individuals recommended to undergo regular skin examinations. Notably, the Melanoma Institute Australia suggests that one-half of patients identify MMs themselves, although this claim appears to be based on limited Australian data which may not reflect contemporary practice. Therefore this study sought to determine the percentage of patients who were able to self-identify MMs as lesions of concern when presenting for a skin cancer examination. Methods: Multi-site, cross-sectional study design incorporating a descriptive survey and total body skin cancer screening, including artificial intelligence by a skin cancer doctor. Results: A total of 260 participants with suspect MM lesions were biopsied, with 83 (31.9%) found to be melanomas. Of the true positive MMs only a small percentage of participants (21.7% specificity) correctly had concerns about the suspect lesion being a MM. These MMs were located primarily on the back (44.4%), shoulder (11.1%) and upper leg (11.1%). There was no significant difference in the size between those participants aware of a MM versus those who were not (P = 0.824, 24.6 vs 23.4 mm2). Significantly more males identified lesions of concern that were MMs as compared to females (P = 0.008, 61.1% vs 38.9%, respectively). With regard to true negatives males and females were similar (52.1% vs 47.9%, respectively). With regard to false negatives (n = 65), a greater percentage of males than females did not recognize the MM as a lesion of concern (66.2% vs 33.8%, respectively). Participants were more likely to correctly identify an invasive MM as opposed to an in situ MM (27.3% versus 21.3%). Conclusions: Only a small percentage of participants in this study were able to self-identify either in situ or invasive MM as a lesion of concern with a tendency to identify the more advanced, thicker MMs. Given that MM is associated with a high mortality and cost of treatment, particularly when invasive, the inability of lay persons to identify these cancerous lesions will likely lead to delayed treatment and a possible adverse outcome. We believe the current melanoma screening practices in Australian general practice should be revisited to improve patient outcomes with regard to MM. Additionally, prevention campaigns should include images and primary risk factors for MM.

Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents.

BACKGROUND: Adolescents infrequently use sun protection and engage in intentional tanning more frequently compared to other age groups, leading to increased ultraviolet radiation (UVR) exposure that heightens skin cancer risk across the lifespan. High schools are therefore an ideal setting for offering skin cancer preventive interventions. Yet, there are limited UVR protection interventions for high school students, especially those that are personalized, tested using randomized designs, and include long-term outcome assessment to determine the durability of intervention effects. METHOD: The Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial will test a novel, personalized intervention that targets high school adolescents' sun protection and tanning behaviors, and tracks their outcomes for up to one year following intervention. Enrolled high schools will be randomized to receive either the personalized SHINE intervention, which includes facial UVR photographs and sun protection action planning, or standard education using publicly available materials. Students in both conditions will receive information about skin cancer, sun protection, and skin self-examination. Outcome variables will include students' sun protection and tanning behaviors and sunburn occurrence. Potential moderators (e.g., race/ethnicity) and mediators (e.g., self-efficacy) will also be assessed and tested. CONCLUSIONS: This trial examines the efficacy of a personalized intervention targeting sun protection and tanning of high school students. The project will lead to new scientific understanding of the theoretical mechanisms underlying outcomes and moderators of the intervention effects, which will inform future intervention tailoring to meet the needs of vulnerable subgroups.

Significados atribuídos por mulheres com câncer de mama ao grupo de apoio / Meanings attributed by women with breast cancer to a support group / Significados atribuidos por las mujeres con cáncer de mama al grupo de apoyo

A sobrevivência ao câncer de mama é um problema de saúde pública que demanda serviços especializados com foco na reabilitação psicossocial. Entre as necessidades identificadas nesse contexto está o incentivo à adoção de estratégias de promoção de autocuidados pelas mulheres. Uma das estratégias adotadas consiste no grupo de apoio psicológico, que auxilia as pacientes a enfrentar a longa jornada do tratamento. Assim, o objetivo deste estudo é compreender os significados produzidos por mulheres com câncer de mama sobre sua participação em um grupo de apoio. Trata-se de um estudo qualitativo, descritivo e exploratório realizado com dez mulheres com câncer de mama usuárias de um serviço de reabilitação para mastectomizadas. Como referencial metodológico foi utilizada a Teoria Fundamentada nos Dados. A coleta de dados foi realizada por meio de entrevista aberta em profundidade e os conteúdos foram transcritos e codificados. A análise indutiva e o método de comparação constante foram aplicados nos processos de codificação aberta, axial e seletiva, que permitiram identificar três categorias nucleares: percepção das atividades realizadas no grupo, identificação de benefícios e barreiras do convívio no grupo e transformações decorrentes da participação. As participantes significaram sua presença no grupo como fonte de acolhimento, apoio, desenvolvimento de recursos pessoais e amizades, contribuindo para promover sua qualidade de sobrevida. Além dos potenciais benefícios, também foram identificadas barreiras que podem dificultar a adesão e continuidade da participação no grupo, o que sugere a necessidade de incorporar no cuidado um olhar para as dimensões subjetivas da saúde da mulher.(AU)

Surviving breast cancer is a public health problem and depends on services focused on psychosocial rehabilitation. Healthcare providers must encourage women to adopt strategies to promote their self-care. The psychological support group is a resource that helps women to face the long journey of treatment. This study aimed to understand the meanings women with breast cancer produced about their participation in a support group. This exploratory cross-sectional study was carried out with 10 women with breast cancer who use a rehabilitation service for mastectomized patients. Grounded Theory was used as a methodological reference. An open in-depth interview was applied for data collection. The contents were transcribed and coded. Inductive analysis and the constant comparison method were applied in the open, axial, and selective coding processes, which enabled the identification of three core categories: perception of the activities carried out in the group, identification of benefits and barriers of living in the group, and transformations resulting from participation. Participants denote their involvement with the group as a source of shelter, support, development of personal resources and friendships that helps promoting quality of life. Besides these potential benefits, participants also evinced barriers that can hinder adherence and continuity of participation in the group, suggesting the importance of incorporating a look at the subjective dimensions of women's health into care.(AU)

Sobrevivir al cáncer de mama es un problema de salud pública que depende de los servicios centrados en la rehabilitación psicosocial. Entre las necesidades identificadas en esta materia se encuentra el uso de estrategias para promover el autocuidado. Uno de los recursos que ayuda a afrontar el largo camino del tratamiento es el grupo de apoyo psicológico. El objetivo de este estudio es conocer los significados que producen las mujeres con cáncer de mama sobre su participación en un grupo de apoyo. Se trata de un estudio cualitativo, descriptivo y exploratorio, realizado con diez mujeres con cáncer de mama usuarias de un servicio de rehabilitación para mastectomizadas. Como referencia metodológica se utilizó la teoría fundamentada en los datos. Se aplicó una entrevista abierta en profundidad para la recogida de datos, cuyos contenidos fueron transcritos y codificados. El análisis inductivo y el método de comparación constante se aplicaron en los procesos de codificación abierta, axial y selectiva, lo que permitió identificar tres categorías centrales: percepción de las actividades realizadas en el grupo, identificación de los beneficios y las barreras de vivir en el grupo y transformaciones resultantes de la participación. Las mujeres denotan su participación en el grupo como una fuente de acogida, apoyo, desarrollo de recursos personales y amistades, que ayuda a promover la calidad de vida. Además de los beneficios potenciales, también se identificaron barreras que pueden dificultar la adherencia y continuidad de la participación en el grupo, lo que sugiere la necesidad de incorporar en la atención una mirada centrada en las dimensiones subjetivas de la salud de las mujeres.(AU)

Impacto de una maniobra educativa sobre el conocimiento y actitud de la autoexploración testicular / Impact of an educational intervention on the knowledge of testicular self-examination and attitudes toward it

Introducción: Se ha descrito que la autoexploración testicular se realiza en un bajo porcentaje de los adolescentes. Objetivo: Evaluar el impacto de una maniobra educativa a corto y largo plazo (6 meses) sobre el conocimiento y la actitud de los adolescentes varones en la autoexploración testicular. Métodos: Se realizó un cuasiexperimento, antes y después en adolescentes varones. Se validó un cuestionario para evaluar el conocimiento y la actitud (conciencia, intenciones y comportamiento) sobre la autoexploración testicular. La maniobra educativa consistió en una charla informativa de manera grupal que incluía esquemas y folletos. Se les aplicó el cuestionario antes y después de la maniobra educativa. Se citaron a los 6 meses posteriores y se les dio nuevamente la charla aplicándose un cuestionario antes y después de la misma. Resultados: Se incluyeron 139 adolescentes con una mediana para la edad de 14 años. El conocimiento (18,3% vs. 78,9% p=0,02) y la actitud (5,6% vs. 53,5% p=0,02) mejoraron posteriormente a la primera charla informativa. A los 6 meses de seguimiento (n=98) el conocimiento no se modificó (87,0% vs. 93,0% p=0,671); sin embargo, la actitud mejoró tras la segunda charla (58,0% vs. 78,0% p=0,009). Conclusión: Una maniobra educativa sobre la autoexploración testicular mejoró la proporción de una adecuada actitud (5,6% vs. 53,5%) y conocimiento (18,3% vs. 78,9%) en los adolescentes. El reforzamiento de la maniobra a los 6 meses mejora la proporción de adolescentes con una adecuada actitud (53,5% vs. 86,4%). (AU)

Introduction: There is evidence that the percentage of adolescents that practice testicular self-examination is low. Objective: To assess the short-term and long-term (6 months) impact in male adolescents of an educational intervention on the knowledge of testicular self-examination and attitude toward it. Methods: We conducted a quasi-experimental pre-test post-test study in male adolescents. A questionnaire was validated to assess knowledge on testicular self-examination and attitudes towards it (awareness, intentions, and behaviour). The educational intervention was group-based and consisted in an instructional talk with the aid of diagrams and brochures. The questionnaire was administered before and after the intervention. A follow-up was scheduled 6 months later, and the talk was delivered again, with administration of the questionnaire before and after. Results: The study included 139 adolescents with a median age of 14 years. We found an improvement in knowledge (18.3% vs. 78.9%; P=.02) and attitude (5.6% vs. 53.5%; P=.02) after the initial intervention. At the 6-month follow-up (n=98), there was no change in knowledge (87.0% vs. 93.0%; P=.671), but attitude improved after the second intervention (58.0% vs. 78.0%; P=.009). Conclusion: An educational intervention on testicular self-examination improved the proportion of adolescents with an adequate attitude (5.6% vs. 53.5%) and adequate knowledge (18.3% vs. 78.9%). The repetition of the intervention at 6 months increased the proportion of adolescents with an adequate attitude (53.5% vs. 86.4%). (AU)

Frecuencia de la mamografía, ecografía, examen clínico y autoexamen de mama en población general / Frequency of mammography, ultrasound, clinical breast exam and self-exam in the general population

Introducción. El cáncer de mama es el cáncer que más afecta a las mujeres. Se estima que 1 en 8 mujeres desarrollarán cáncer de mama eventualmente. Una de las herramientas contra el cáncer de mama es crear estrategias de detección temprana de la enfermedad, y la mamografía ha demostrado ser de mucha utilidad. El objetivo del estudio fue determinar la frecuencia de la mamografía, ecografía, examen clínico y autoexamen mamario, y evaluar su uso como pruebas de tamización para cáncer de mama en una cohorte de pacientes atendidas en la Clínica del Prado en Medellín, Colombia. Metodología. Estudio descriptivo, transversal, efectuado a través de encuesta en 318 usuarias atendidas entre junio y diciembre de 2018. Se estimó la frecuencia de los diferentes métodos de tamización y se evaluaron las características sociodemográficas, antecedentes personales y antecedentes familiares. Adicionalmente, se buscó si había asociación significativa entre la práctica de la mamografía como prueba de tamización y las variables de estudio. Resultados. La media de la edad fue de 44,2 años. El método de tamización más usado fue el autoexamen (70,1%), en su mayoría mensual (76,7%), seguido por la mamografía (56%), en su mayoría ocasional (46%). El examen clínico de mama (ECM) se utilizó en el 45,9% de las pacientes, con una frecuencia anual en el 50% de ellas. Por último, la ecografía de mama se practicó en el 43,1% de las encuestadas, con una frecuencia en su mayoría ocasional (39,4%). Se realizó un análisis independiente para mujeres entre los 50 y 69 años, y aunque el 93,8% se habían realizado la mamografía, solo el 9,3% lo hizo bienal, como lo recomienda el Ministerio de Salud y Protección Social. No se hallaron diferencias estadísticamente significativas entre las variables de estudio y la realización de la mamografía como método de tamización. Conclusión. En la población estudiada, el autoexamen de mama es realizado por la mayoría de las mujeres con una frecuencia mensual. La frecuencia de la mamografía, el ECM y la ecografía de mama fue muy similar, y se esperaba encontrar un mayor porcentaje de mamografías realizadas como prueba de tamización. Se requiere fortalecer esta estrategia efectiva para la detección temprana de cáncer de mama, teniendo en consideración la situación particular de cada paciente, la efectividad y beneficio de la técnica, así como los costos asociados

Breast cancer is the most frequent cancer that affects women. It is estimated that 1 in 8 women will eventually develop breast cancer. One of the tools against breast cancer is to create early detection strategies, and mammography has proven to be very useful. The aim of this study was to determine the frequency of mammography, ultrasound, clinical breast exam and self-exam, and to evaluate their use as screening tests for breast cancer in a cohort of patients that attended at the Clinica del Prado in Medellin, Colombia. Methodology. Descriptive, cross-sectional study, carried out through a survey in 318 women between June and December 2018. The frequency of the different screening methods was estimated and the sociodemographic characteristics, personal history and family history were evaluated. Additionally, a possible association between the practice of mammography as a screening test and the different variables was analyzed. Results. Mean age was 44.2 years. The most used screening method was the self-exam (70.1%), mostly monthly (76.7%), followed by mammography (56%), mostly occasional (46%). The clinical breast exam was used in 45.9% of the patients, with an annual frequency in 50% of them. Lastly, breast ultrasound was performed in 43.1% of those surveyed, mostly occasional (39.4%). An independent analysis was carried out for women between 50 and 69 years old, and although 93.8% had mammograms, only 9.3% had them every 2 years, as recommended by the Ministry of Health and Social Protection guidelines. No statistically significant differences were found between the study variables and the use of mammography as a screening method. Conclusion. In the studied population, breast self-exam is performed by most women on a monthly basis. The frequency of mammography, clinical breast exam and ultrasound was very similar. A higher percentage of mammograms performed as a screening test was expected. It is necessary to strengthen this effective strategy for the early detection of breast cancer, taking into consideration the particular situation of each patient, the effectiveness and advantages of the technique, and the associated costs

Differentiated thyroid cancer clinical trends in Quito, Ecuador / Tendencias clínicas del cáncer diferenciado de tiroides en Quito, Ecuador

Introduction.Thyroid cancer is currently the first most common cancer in women in Ecuador. This study aimed to assess the changes in clinical presentation and diagnosis of differentiated thyroid cancer at a third level hospital in Quito, Ecuador.Methods and Materials.This is a retrospective case series performed in three consecutive periods from 1990 to 2019 at a tertiary level hospital, in Quito, Ecuador. The clinical records of 875 patients who had been diagnosed and surgically treated for differentiated thyroid cancer were reviewed. Demographic, clinical, imaging, and pathological data were collected and analyzed.Results. Significant trends toward older age, higher educational level, less palpable primary tumors, less palpable neck nodes, less distant metastases, more ultrasound, tomography and cytology exams, smaller primary tumors, more stage I patients, and more histological variant description, were found. Introduction.Thyroid cancer is currently the first most common cancer in women in Ecuador. This study aimed to assess the changes in clinical presentation and diagnosis of differentiated thyroid cancer at a third level hospital in Quito, Ecuador.Methods and Materials.This is a retrospective case series performed in three consecutive periods from 1990 to 2019 at a tertiary level hospital, in Quito, Ecuador. The clinical records of 875 patients who had been diagnosed and surgically treated for differentiated thyroid cancer were reviewed. Demographic, clinical, imaging, and pathological data were collected and analyzed.Results. Significant trends toward older age, higher educational level, less palpable primary tumors, less palpable neck nodes, less distant metastases, more ultrasound, tomography and cytology exams, smaller primary tumors, more stage I patients, and more histological variant description, were found.

Introducción. El cáncer de tiroides es actualmente el cáncer más frecuente en la mujer en Ecuador. El presente estudio ha tenido como objetivo evaluar los cambios en la presentación clínica y el diagnóstico del cáncer diferenciado de tiroides en un hospital de tercer nivel de Quito, Ecuador. Material y Métodos. El presente es un estudio retrospectivo de casos realizado en tres períodos consecutivos desde 1990 a 2019 en un hospital del tercer nivel en Quito, Ecuador. Los expedientes clínicos de 875 pacientes tratados quirúrgicamente por un cáncer diferenciado de tiroides fueron revisados. Los datos demográficos, clínicos, de imagen y patología fueron extraídos y analizados. Resultados. Se encontraron tendencias significativas hacia una edad más avanzada, nivel educativo más alto, menos tumores palpables, menos adenopatías regionales palpables, menos metástasis a distancia, más exámenes de ultrasonido y tomografía, más estudios de citología, más tumores pequeños y pacientes con estadío I y más descripciones de las variantes histológicas. Conclusiones. El cáncer de tiroides no sólo que ha aumentado continuamente en su frecuencia en los años recientes, sino que la presentación clínica, el manejo diagnóstico y terapéutico ha cambiado significativamente en las tres últimas décadas.

Educação em saúde e prevenção do câncer de mama no município de Itaúna, Minas Gerais / Health education and breast cancer prevention in the city of Itaúna, Minas Gerais / Educación en salud y prevención del cáncer de mama en la ciudad de Itaúna, Minas Gerais

Objetivo: Relatar a experiência de ações educativas realizadas com profissionais da Estratégia de Saúde da Família, sobre a prevenção do câncer de mama e o incentivo ao autoexame. Métodos: Trata- se de um estudo descritivo, do tipo relato de experiência, realizado com 28 profissionais da saúde no município de Itaúna, Minas Gerais, entre setembro à outubro de 2019. Foi utilizado um questionário de pré e pós-intervenção para comparar conhecimentos prévios e adquiridos, além de uma atividade prática de palpação em próteses de mamas. Resultados: Houve predominância de participantes com idade entre 31 a 38 anos (35,71%), seguida de profissionais entre 23 a 30 anos (32,14%). Os resultados mostraram que 60,71% dos participantes relataram ter conhecimento sobre o assunto, 28,57% afirmaram não saber do que se trata e 10,72% não responderam a essa questão. Conclusão: A intervenção aplicada serve de base para que estes profissionais disseminem os novos saberes para população.(AU)

Objective: To report the experience of educational actions carried out with professionals from the Family Health Strategy, on the prevention of breast cancer and the encouragement of self-examination. Methods: This is a descriptive, experience report type study conducted with 28 health professionals in the city of Itaúna, Minas Gerais, between September and October 2019. A pre- and post-intervention questionnaire was used to compare knowledge and acquired, in addition to a practical palpation activity on breast prostheses. Results: There was a predominance of participants aged between 31 and 38 years old (35.71%), followed by professionals between 23 and 30 years old (32.14%). The results showed that 60.71% of the participants reported having knowledge about the subject, 28.57% said they did not know what it was about and 10.72% did not answer this question. Conclusion: The applied intervention serves as a basis for these professionals to disseminate new knowledge to the population.(AU)

Objetivo: Informar sobre la experiencia de las acciones educativas llevadas a cabo con profesionales de la Estrategia de Salud de la Familia, sobre la prevención del cáncer de mama y el fomento del autoexamen. Métodos: Este es un estudio descriptivo tipo informe de experiencia realizado con 28 profesionales de la salud en la ciudad de Itaúna, Minas Gerais, entre septiembre y octubre de 2019. Se utilizó un cuestionario previo y posterior a la intervención para comparar el conocimiento. y adquirido, además de una práctica actividad de palpación en prótesis mamarias. Resultados: predominaron los participantes de edades comprendidas entre 31 y 38 años (35,71%), seguidos por profesionales de entre 23 y 30 años (32,14%). Los resultados mostraron que el 60.71% de los participantes informaron tener conocimiento sobre el tema, el 28.57% dijo que no sabían de qué se trataba y el 10.72% no respondió a esta pregunta. Conclusión: La intervención aplicada sirve como base para que estos profesionales difundan nuevos conocimientos a la población.(AU)

Factores de riesgo, conocimiento y práctica de tamizaje para cáncer de mama en consulta externa / Risk factors, knowledge and practice of screening for breast cancer in outpatient clinic

Introducción. El cáncer de mama es el segundo cáncer más frecuente a nivel mundial. En Honduras sigue siendo la principal causa de cáncer en las mujeres. Hay factores de riesgo modificables y no modificables. Las pruebas de tamizaje disponibles para detectarlo son: mamografía, ultrasonido, re- sonancia magnética, tomo síntesis y autoexamen de mama. Objetivo. Describir los factores de riesgo y evaluar el conocimiento sobre práctica de tamizaje para la detección del cáncer de mama de las mujeres que asisten a la consulta externa del Hospital Nacional Mario Catarino Rivas (HMCR) de di- ciembre 2019 a enero 2020. Pacientes y métodos. Estudio cuantitativo, descriptivo y transversal con una muestra por conveniencia de 100 mujeres que asistieron a la consulta externa el 19 de diciembre del 2019 y 16 de enero 2020 entre las 8 a.m. y 12m en el HMCR. Se aplicó un cuestionario antes y después de una charla educativa sobre conocimiento y pruebas de tamizaje para cáncer de mama. Se procesaron los datos en Excel® 2013 y SPSS® V.22. Resultados. El 55% tenía entre 41-60 años. El 79% tenía un índice de masa corporal mayor a 25. El 45% refirió consumo de anticonceptivos orales alguna vez en su vida. El 41% conocía menos o igual a 3 métodos de tamizaje. El 65% se había reali- zado el autoexamen de mama, pero sólo el 29% se lo hacía una vez al mes. Conclusión. La mayoría de la población encuestada tenía más de 3 factores de riesgo para cáncer de mama. Las pruebas de tamizaje más conocidas fueron la mamografía y autoexame...(AU)