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3.
Cancer Imaging ; 20(1): 34, 2020 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-32393345

RESUMEN

BACKGROUND: The number of studies describing the use of whole-body magnetic resonance imaging (WB-MRI) for screening of malignant tumours in asymptomatic subjects is increasing. Our aim is to review the methodologies used and the results of the published studies on per patient and per lesion analysis, and to provide recommendations on the use of WB-MRI for cancer screening. MAIN BODY: We identified 12 studies, encompassing 6214 WB-MRI examinations, which provided the rates of abnormal findings and findings suspicious for cancer in asymptomatic subjects, from the general population. Eleven of 12 studies provided imaging protocols that included T1- and T2-weighted sequences, while only five included diffusion weighted imaging (DWI) of the whole body. Different categorical systems were used for the classification and the management of abnormal findings. Of 17,961 abnormal findings reported, 91% were benign, while 9% were oncologically relevant, requiring further investigations, and 0.5% of lesions were suspicious for cancer. A per-subject analysis showed that just 5% of subjects had no abnormal findings, while 95% had abnormal findings. Findings requiring further investigation were reported in 30% of all subjects, though in only 1.8% cancer was suspected. The overall rate of histologically confirmed cancer was 1.1%. CONCLUSION: WB-MRI studies of cancer screening in the asymptomatic general population are too heterogeneous to draw impactful conclusions regarding efficacy. A 5-point lesion scale based on the oncological relevance of findings appears the most appropriate for risk-based management stratification. WB-MRI examinations should be reported by experienced oncological radiologists versed on WB-MRI reading abnormalities and on onward referral pathways.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Neoplasias/diagnóstico por imagen , Imagen de Cuerpo Entero/métodos , Detección Precoz del Cáncer/métodos , Humanos , Guías de Práctica Clínica como Asunto
4.
Medicine (Baltimore) ; 99(16): e19676, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32311941

RESUMEN

RATIONALE AND OBJECTIVES: To evaluate the diagnostic performance of abbreviated screening breast magnetic resonance imaging (AB-MRI) for screening in women with previously treated breast cancer. MATERIALS AND METHODS: This retrospective study included consecutive AB-MRI from September 2015 to December 2016 in patients with previously treated breast cancer. Longitudinal medical record of patients' demographics, outcomes of imaging surveillance and results of biopsy was reviewed. Protocol consisted of T2-weighted scanning and dynamic contrast-enhanced imaging including one pre-contrast and two post-contrast scans. A positive examination was defined as final assessment of BI-RADS 4 or 5 and negative was defined as BI-RADS 1, 2, or 3. Abnormal interpretation rate, cancer detection rate (CDR), sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were analyzed. RESULTS: Among total 1043 AB-MRI, 29 (2.8%) AB-MRI had suspicious findings including 26 (2.5%) BI-RADS 4 and 3 (0.3%) BI-RADS 5 assessments. CDR was 9.59 per 1000. Performance outcomes were as follows: sensitivity, 71.4%; specificity, 98.2%; accuracy, 97.8%; PPV 1, 35.7%; PPV3 50%; and NPV 99.6%. Four cancers with false negative MRI were all early cancers of <1.0 cm with node negative. One was palpable interval cancer while the others were alternative screening modality-detected asymptomatic cancers before the next MRI screening. CONCLUSION: AB-MRI showed high accuracy and NPV for detecting cancer recurrence in women with previously treated breast cancer. Missed cancers were all minimal cancers with node negative.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Mama/diagnóstico por imagen , Detección Precoz del Cáncer , Imagen por Resonancia Magnética , Recurrencia Local de Neoplasia/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Mama/cirugía , Neoplasias de la Mama/cirugía , Medios de Contraste , Detección Precoz del Cáncer/métodos , Reacciones Falso Negativas , Femenino , Humanos , Estudios Longitudinales , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad
5.
An Acad Bras Cienc ; 92(1): e20181203, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32321013

RESUMEN

Circulating miRNAs presenting in plasma in a stable manner have been demonstrated their potential role as a promising biomarkers in many human diseases, such as Alzheimer's disease, melanoma and ovarian carcinoma. However, few circulating miRNAs could be used for breast ductal cancer diagnosis. Here, we identified miR-1273g-3p as a biomarker for detecting breast ductal cancer. We detected miR-1273g-3p levels in the plasma of 39 sporadic breast ductal cancer patients and 40 healthy donors by Stem-loop Quantitative Real-time PCR (qRT-PCR). The results showed the plasma miR-1273g-3p level were significantly up-regulated in breast ductal cancer patients compared with healthy donors (p=0.0139). Receiver operating characteristic (ROC) curve also revealed the significantly diagnostic ability of miR-1273g-3p in patients (p=0.0414). In addition, the plasma level of miR-1273g-3p was closely related to IIIB-IIIC TNM stage. We also confirmed the higher expression level of miR-1273g-3p in breast cancer cell lines MCF-7 (4.872±0.537) than normal breast cells (Hs 578Bst). Taken together, miR-1273g-3p could represent as a potential biomarker for early breast ductal cancer diagnosis.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Carcinoma Intraductal no Infiltrante/diagnóstico , MicroARNs/sangre , Biomarcadores de Tumor/sangre , Neoplasias de la Mama/sangre , Carcinoma Intraductal no Infiltrante/sangre , Detección Precoz del Cáncer , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Curva ROC , Reacción en Cadena en Tiempo Real de la Polimerasa , Sensibilidad y Especificidad
6.
Medicine (Baltimore) ; 99(17): e19954, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32332679

RESUMEN

The Hunan provincial government has implemented a free breast cancer screening program for rural women aged 35 to 64 years from 2016, under a 2015 policy aimed at of poverty eradication and improving women's health in China. However, there has been no population study of the breast cancer screening program in China to date, especially considering exploring differences related to the area's poverty status. We explored differences in risk factors, clinical examination results, and clinicopathological features among breast cancer patients in poor compared with non-poor counties in rural areas of Hunan province from 2016 to 2018 using χ and Fisher's exact test, and multivariate logistic regression analysis. A total of 3,151,679 women from rural areas participated in the screening program, and the breast cancer prevalence was 37.09/10. Breast cancer prevalence was lower in poor (29.68/10) than in non-poor counties (43.13/10). There were differences between breast cancers in poor and non-poor counties in terms of cysts, margins, internal echo, blood flow in solid masses in the right breast on ultrasound examination, lump structure in mammograms, and clinicopathological staging and grading in pathological examinations. Breast cancer in poor counties was more likely to be diagnosed at later stages as determined by ultrasound, mammography, and pathological examinations. Furthermore, indexes of the breast screening program including early detection, prevalence, pathological examination, and mammography examination were lower in poor compared with non-poor counties. Multivariate logistic regression analysis showed that education, ethnicity, reproductive history and the year 2017 were associated with an increased risk of breast cancer in poor counties (odds ratio >1, P < .05). In conclusion, women in poor areas were more likely to be diagnosed with breast cancer at a later stage compared with women in non-poor areas. Women in poor areas of Hunan province should therefore have better access to diagnostic and clinical services to help rectify this situation.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Gobierno Local , Tamizaje Masivo/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Adulto , Neoplasias de la Mama/epidemiología , China/epidemiología , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Modelos Logísticos , Mamografía/estadística & datos numéricos , Tamizaje Masivo/métodos , Persona de Mediana Edad , Áreas de Pobreza , Factores Socioeconómicos
7.
Ann Palliat Med ; 9(2): 420-427, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32233640

RESUMEN

BACKGROUND: To analyze whether face-to-face education before colonoscopy improves the quality of bowel preparation and increases the detection of adenomas. METHODS: A retrospective cross-sectional study of adult patients with colorectal polyps identified by colonoscopy as outpatients was performed. The patients underwent an added colonoscopy inpatient for resection of colorectal polyps. As outpatients, we gave the patients written bowel preparation instructions; however, when they were inpatients, we supplied face-to-face education. We analyzed the data from the two colonoscopies of the same group of patients out- and in-patients, including the quality of the intestinal preparation, the time to reach the ileocecal region, and the detection of adenomas. RESULTS: A total of 260 patients {age 63 [56, 68] years old, male/female (169/91)} were retrospectively included in our study. Two hundred fifty-two patients with a total of 685 adenomas were detected, 94 patients with 179 adenomas overlooked in the first colonoscopy. The BBPS Score during inpatient was higher than that during outpatient, {9 [8, 9] vs. 7 [6, 9]}, P<0.05, the Bubble Score during inpatient was lower than that during outpatient [0 (0.00, 0.00) vs. 0 (0.00, 1.00)], P<0.05. The time to reach the ileocecal region during inpatient is shorter than that during outpatient {6 [5, 9] vs. 7.5 [5, 11] min}, P<0.05. Poor bowel preparation, flat adenoma morphology, and adenoma diameter lower than 5mm were related adenoma misdiagnoses, P<0.05. CONCLUSIONS: Face-to-face patient education can improve the quality of bowel preparation, then shorten the time to reach the ileocecal region, and increase detection of colorectal adenomas.


Asunto(s)
Colonoscopía/métodos , Aceptación de la Atención de Salud/psicología , Educación del Paciente como Asunto/métodos , Irrigación Terapéutica/métodos , Adenoma/diagnóstico , Adulto , Anciano , Colonoscopía/psicología , Neoplasias Colorrectales/diagnóstico , Estudios Transversales , Errores Diagnósticos/prevención & control , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios/métodos , Estudios Retrospectivos
8.
Am Surg ; 86(3): 195-199, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32223797

RESUMEN

Patients presenting with localized breast cancer have a five-year survival of 99 per cent, whereas survival falls to 27 per cent in advanced disease. This obviates the importance of early diagnosis and treatment. Our study evaluates the impact of Ohio's Medicaid expansion and the passage of the Affordable Care Act (ACA) on the stage at which Ohioans were diagnosed with breast cancer. Data were collected for 3056 patients presenting with breast cancer between 2006 and 2016 in the Dayton area. Patients were divided into groups based on cancer stage. The percentage of patients presenting with advanced disease (stage 3 or 4) was compared both before and after ACA implementation and Ohio Medicaid expansion. These results were also compared with statewide data maintained by the Ohio Department of Health. Compared with pre-ACA, the number of uninsured patients post-ACA was noted to fall 83 per cent, the number of patients presenting with Medicaid increased by five times, and the proportion of patients younger than 65 years presenting with breast cancer increased by approximately 7 per cent. These changes notwithstanding, no difference was identified in the percentage of patients presenting with advanced breast cancer before and after ACA implementation or Ohio Medicaid expansion (P = 0.56). Statewide data similarly demonstrated no change (P = 0.88). Improved insurance access had a smaller-than-anticipated impact on the stage at which Ohioans presented with breast cancer. As significant morbidity and mortality can be avoided by earlier presentation, additional research is appropriate to identify factors affecting patients' decision to seek breast cancer screening and care.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer/economía , Costos de la Atención en Salud , Medicaid/economía , Evaluación de Resultado en la Atención de Salud , Adulto , Anciano , Neoplasias de la Mama/economía , Neoplasias de la Mama/mortalidad , Bases de Datos Factuales , Detección Precoz del Cáncer/métodos , Femenino , Humanos , Cobertura del Seguro/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Ohio , Patient Protection and Affordable Care Act , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia , Estados Unidos
9.
Cent Eur J Public Health ; 28(1): 65-69, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32228820

RESUMEN

OBJECTIVE: The study aimed at assessing the potential benefit of prostate health index (PHI) for early detection of prostate cancer (PCa) and the use of PHI as a marker predicting the presence of PCa before performing prostate biopsy. METHODS: The study comprised 55 males who underwent prostate biopsy. Before the procedure, blood samples were collected to test prostate specific antigen (PSA) and free/total PSA ratio (%fPSA) and PHI was calculated. Receiver operating characteristic (ROC) analysis was used to assess the benefit of these values for predicting the presence of PCa. RESULTS: Based on histological examination 31 males were diagnosed with PCa, the remaining 24 were negative. Among the PCa patients, 39% had a Gleason score of 6, 26% had a score of 7 and 35% had a score of 8-10. There were statistically significant differences in PHI and PSA between males with and without PCa. The areas under the ROC curve for %fPSA, total PSA and PHI were 0.712, 0.746 and 0.789, respectively. PHI showed the best predictive ability to estimate biopsy results. If the cut-off criterion PHI > 36.4 (77.42% sensitivity, 66.67% specificity) had been used, 41.7% of males would have avoided unnecessary biopsy. CONCLUSION: The use of PHI may considerably improve the accuracy of PCa detection in patients with elevated PSA and thus reduce the number of unnecessary biopsies.


Asunto(s)
Detección Precoz del Cáncer/métodos , Neoplasias de la Próstata/diagnóstico , Biopsia , Estudios Epidemiológicos , Humanos , Masculino , Antígeno Prostático Específico/sangre , Reproducibilidad de los Resultados
10.
Rev Med Suisse ; 16(688): 640-645, 2020 Apr 01.
Artículo en Francés | MEDLINE | ID: mdl-32239838

RESUMEN

The dermatofibrosarcoma protuberans (DFSP) is the most common form of low-grade cutaneous sarcoma; its infiltrating growth occurs by fingerlike projections, which explain the high rate of recurrence in case of inappropriate surgical procedure. Based on an extensive review of the existing literature, we propose here to discuss the actual criteria for early recognition, diagnosis and optimal take of care of DFSP.


Asunto(s)
Dermatofibrosarcoma/patología , Dermatofibrosarcoma/terapia , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapia , Dermatofibrosarcoma/diagnóstico , Detección Precoz del Cáncer , Humanos , Recurrencia Local de Neoplasia , Neoplasias Cutáneas/diagnóstico
11.
Zhonghua Zhong Liu Za Zhi ; 42(3): 222-227, 2020 Mar 23.
Artículo en Chino | MEDLINE | ID: mdl-32252201

RESUMEN

Objective: To analyze the risk factors related to lung cancer in participants with low-dose computed tomography (LDCT) screening, to provide data support for identifying high-risk groups of lung cancer and to improve the effectiveness of LDCT lung cancer screening. Methods: A total of 5 366 asymptomatic subjects (2 762 males and 2 604 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The result of LDCT and the risk factors of participants were analyzed. The LDCT positive results were defined as solid or part-solid nodules≥5 mm and non-solid nodule≥8 mm. A total of 12 factors were included and multivariate logistic regression was used to analyze the risk factors associated with lung cancer in the study. Results: Of the 5 366 asymptomatic subjects, 389 were positive and 4 977 were negative for LDCT screening. Among them, 26 of 389 positive cases were confirmed as lung cancers pathologically, and the detection rate of stage I lung cancer was 92.3% (24/26). Multivariate logistic regression showed that age, smoking, low level of education were the relevant risk factors for lung cancer and positive nodules. A stratified analysis of age showed that no risk factors were detected in the 40-49 years old group, while age, smoking, low level of education (primary school and below) were recognized as risk factors in the ≥50 years old group. No statistically significant risk factor was detected between the lung cancer group and the positive nodules group. Conclusions: Age, smoking, and low level of education (primary school and below) are related risk factors for lung cancer and positive nodules. People aged 50 years or older, smoking, and low level of education may be a high risk group for lung cancer. LDCT can effectively detect early lung cancer.


Asunto(s)
Detección Precoz del Cáncer/métodos , Neoplasias Pulmonares/diagnóstico por imagen , Tamizaje Masivo , Tomografía Computarizada por Rayos X/métodos , Adulto , China/epidemiología , Femenino , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Factores de Riesgo , Sensibilidad y Especificidad , Fumar/efectos adversos
12.
Zhonghua Zhong Liu Za Zhi ; 42(3): 252-256, 2020 Mar 23.
Artículo en Chino | MEDLINE | ID: mdl-32252206

RESUMEN

Objective: To evaluate the performance of Hybribio human papillomavirus (HPV) typing test kit for high risk HPV-DNA typing detection in screening of cervical precancer lesions. Methods: A total of 9 914 women were recruited in Henan, Shanxi, and Guangdong provinces from June to July 2017. All women underwent HPV DNA test. The women who diagnosed as HPV positive and cytological examination ≥ atypical squamous cells of undetermined significance (ASCUS) or HPV negative and cytological examination≥low-grade squamous intraepithelial lesions (LSIL) underwent colposcopy biopsy and pathological examination. Using the pathological diagnosis as the gold standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and 95% confidence interval (CI) of high-risk HPV and HPV16/18 tests were calculated. Results: The mean age of 9 914 subjects was (45.0±9.3) years old. Among them, 1 302 subjects were detected as high risk HPV positive, including 211 of HPV16 positive and 64 of HPV18 positive. According to the pathological gold standard of cervical intraepithelial neoplasia grade 2 (CIN2) or worse, the sensitivity and specificity of high risk-HPV and HPV 16/18 for triaging ASCUS women were 90.6% (95%CI: 75.8%-96.8%) and 78.0% (95%CI: 74.5%-81.2%) as well as 56.3% (95%CI: 39.3%-71.8%) and 95.7% (95%CI: 93.8%-97.1%), respectively. The sensitivity and specificity of high risk-HPV and HPV 16/18 for cervical precancer lesions screening were 95.1% (95%CI: 88.1%-98.1%) and 87.6% (95%CI: 86.9%-88.2%) as well as 65.9% (95%CI: 55.1%-75.2%) and 97.8% (95%CI: 97.5%-98.1%), respectively. Conclusions: The Hybribio HPV test kit has a relative high sensitivity and specificity for cervical precancer lesions screening and ASCUS triaging. It is reliable for HPV DNA detection and cervical cancer screening.


Asunto(s)
Neoplasia Intraepitelial Cervical/diagnóstico , Detección Precoz del Cáncer , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Prueba de Papanicolaou , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Neoplasias del Cuello Uterino/diagnóstico , Adulto , Biopsia , Neoplasia Intraepitelial Cervical/patología , Neoplasia Intraepitelial Cervical/virología , Cuello del Útero/patología , Cuello del Útero/virología , Colposcopía , ADN Viral/análisis , Femenino , Genotipo , Humanos , Persona de Mediana Edad , Papillomaviridae/clasificación , Papillomaviridae/genética , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/virología , Valor Predictivo de las Pruebas , Embarazo , Sensibilidad y Especificidad , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virología
14.
Lima; Perú. Ministerio de Salud; 20200300. 28 p. tab, ilus.
Monografía en Español | LILACS, LIPECS | ID: biblio-1087624

RESUMEN

El documento contiene los criterios y procedimientos técnicos para la detección temprana y atención de cáncer en la niñez y adolescencia.


Asunto(s)
Niño , Adolescente , Guías como Asunto , Detección Precoz del Cáncer
15.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 267-272, 2020 Feb 10.
Artículo en Chino | MEDLINE | ID: mdl-32164140

RESUMEN

Objective: To establish the key question list for the development of evidence- based guideline in China according to the content and limitation of current evidence-based guidelines around the world. Methods: First, we introduced the evidence-based guidelines in detail which met the criteria based on World Health Organization guideline development handbook and then formulated the draft list of key questions for the development of evidence-based guidelines. At last, the Delphi method was used to determine the list of key questions in developing evidence-based guidelines of colorectal cancer screening. Results: Totally, 34 questionnaires were collected, with experts from clinical and epidemiological fields. The average experts' authority coefficient was 0.81, indicating a high degree of authority. The concentration of opinions on all items in the questionnaire was relatively high, with the full score ratio greater than 75% and the coefficient of variation less than 0.3. The list of key questions on evidence-based guidelines for colorectal cancer screening has been divided into six parts: epidemiological problems, risk classification, screening age, screening tools, implementation and selection of steering group members, which covers the issues that need to be considered in the development of evidence-based colorectal cancer screening guidelines in China. Conclusion: The key question list for evidence-based guideline development in our study can be applied to the development of evidence-based guidelines for colorectal cancer screening in the future, as well as the development of evidence-based guidelines for other cancer screening in China.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer , Práctica Clínica Basada en la Evidencia , Guías de Práctica Clínica como Asunto , China , Técnica Delfos , Humanos
16.
Zhonghua Yi Xue Za Zhi ; 100(10): 767-770, 2020 Mar 17.
Artículo en Chino | MEDLINE | ID: mdl-32192290

RESUMEN

Objective: To investigate the significance of quantitative fecal immunochemical test (FIT) for opportunistic screening of colorectal neoplasia, and to propose the most optimal thresholds to improve the screening level of early colorectal neoplasia. Methods: The opportunistic screening participants were recruited from the Department of Gastroenterology & GI Endoscopy Center of the Seventh Medical Center of PLA General Hospital, and stool sample was collected before colonoscopy and the quantitative FIT was analyzed by OC-MICRO analysator for each patient. We assessed test performance in detecting colorectal neoplasia (advanced adenoma and CRC)with different thresholds on sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: A total of 1 448 objects were enrolled in this study, including 714 male (49.3%)and 734 female (50.7%).All participants were classified according to the result of colonoscopy and pathology, and 242 cases of colorectal neoplasia were found, containing 157 advanced adnoma and 85 colorectal cancer. The FIT threshold increased from 50 µg/L to 200 µg/L, while the positivity rate dropped from 11.5% to 8.6% and the sensitivity in detecting colorectal neoplasia dropped from 47.9% to 38.8%. However, the specificity increased from 96.8% to 98.2% and the positive predictive value increased from 82.3% to 87.0%.The miss rate of colorectal cancer increased from 11.8% (n=10) to 17.6% (n=15) along with the increase in FIT thresholds, but the miss rate of 100 µg/L and 150 µg/L was the same as 12.9% (n=11). Conclusions: Quantitative FIT,which is simple and fast,with the threshold of 100 µg/L for opportunistic screening, has a high sensitivity and specificity for the diagnosis of colorectal neoplasia,and is an important index in screening and diagnosis of colorectal neoplasia.


Asunto(s)
Neoplasias Colorrectales , Detección Precoz del Cáncer , Colonoscopía , Neoplasias Colorrectales/diagnóstico , Heces , Femenino , Humanos , Masculino , Tamizaje Masivo , Sangre Oculta
17.
Anticancer Res ; 40(3): 1705-1709, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32132078

RESUMEN

BACKGROUND/AIM: To investigate factors that affect colorectal polyp or colorectal cancer (CRC) detection amongst patients referred urgently to colorectal services for suspected bowel cancer. PATIENTS AND METHODS: This was a prospective observational study at a UK colorectal centre (2017-2018). Logistic regression determined odds ratios for colorectal polyp or CRC according to age, gender, previous polyp or cancer, and the 6 NICE referral (NG12) categories. RESULTS: A total of 605 patients were included in the study; median age 66 (IQR=54-76); 47.9% male. Nineteen (3.1%) patients had CRC and 64 (10.6%) had polyps. No individual variable increased the likelihood of CRC detection, but male patients had a higher likelihood of having either polyp or CRC (OR=1.72; 95%CI=1.07-2.80; p<0.05). CONCLUSION: At the point of an urgent referral to a colorectal clinic, the likelihood of CRC detection appears to be unaffected by age, gender, or any individual referral criterion. However, overall disease detection may be more likely amongst male patients.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Anciano , Pólipos del Colon/etiología , Pólipos del Colon/patología , Detección Precoz del Cáncer , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
20.
Clin Ter ; 171(2): e167-e177, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32141490

RESUMEN

OBJETCTIVE: The aim of this systematic review was to summarize the scientific literature concerning the use of the Precede-Proceed model (PPM) applied to educational programs and health screenings contextsV. STUDY DESIGN: Systematic review. METHODS: The search process was based on a selection of publications listed in Medline and Scopus. The keywords used were "Precede-Proceed" AND ("screening" OR "educational programs"). Studies included in the systematic review were subdivided into those applying the model in a screening context, and those applying it within educational programs. RESULTS: Twenty-seven studies were retrieved, mostly performed in the USA and, generally, the promoting center was the University. In the context of cancer screening, the PPM model was most of all applied to Mammography Screening (5 of 13 studies in cancer screening), and Cervical Cancer Screening (5 of 13). Another three studies within the cancer field investigated Menopause-Inducing Cancer Treatments, Oral cancer prevention, and cancer screening in general. In the remaining studies, the model was applied in various screening areas, particularly chronic and degenerative diseases. There were many different study designs, most of which cross-sectional (8), though several RTCs (8) and focus groups (5) were also found. For the cross-sectional studies the methodological quality varied between 3/10 and 9/10, whilst for the RCTs it ranged from 2/5 to 3/5. CONCLUSIONS: The PPM provides an excellent framework for health intervention programs especially in screening contexts, and could improve the understanding of the relationship between variables such as knowledge and screening. Given the complexity of a behavioral change process, certain important predisposing factors could be measured in future studies, and during health intervention planning.


Asunto(s)
Ciencias Bioconductuales , Tamizaje Masivo , Salud Pública , Estudios Transversales , Detección Precoz del Cáncer , Humanos , Neoplasias/diagnóstico
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