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1.
Zhonghua Nei Ke Za Zhi ; 58(10): 736-744, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31594171

RESUMO

The patients with colorectal cancer in Chinese population are increasing, which is a serious threat to human life and health. In order to improve the high incidence, high mortality and low early diagnosis rate of colorectal cancer and promote cancer screening program in China, leading by the National Clinical Research Center for Digestive Disease (Shanghai), relying on Gastrointestinal-Cancer Prevention & Treatment Center Alliance, in conjunction with a number of related societies, we organized multidisciplinary experts including gastroenterology, digestive endoscopy, oncology, health management and endoscopic quality control to jointly develop this consensus. This consensus aims to establish and refine early colorectal cancer screening protocol adapting to our national conditions and guide the screening practice.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Programas de Rastreamento , Guias de Prática Clínica como Assunto/normas , China , Consenso , Humanos
2.
Pan Afr Med J ; 33: 144, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565116

RESUMO

Introduction: Breast cancer is one of the most common cancers and cause of death among women globally. Mortality due to breast cancer was higher in lower (LMICs) and middle-income countries than high income countries (HICs) mostly due to lack of timely detection and treatment. There was limited evidence related to breast cancer screening practice among women in Eastern Ethiopia. Therefore, the aim of this study was to assess breast cancer screening practice and its associated factors among women in this area. Methods: A community based descriptive cross-sectional study design was conducted among 422 randomly selected women in Kersa district, Eastern Ethiopia using systematic sampling. Data were collected using pretested interviewer administered questionnaire. Logistic regression was used to analyse the association between the dependent and independent variables. Results: The overall breast cancer screening practice among women was 6.9%. Women with the age of 26 years and above were 2.3 times more likely to have breast cancer screening practice as compared to women with age of 20-25 years (AOR=2.3; 95% CI: 1.4, 3.7), and women who had good knowledge on breast cancer risk factors were 3.4 times more likely to had breast cancer screening as compared to their counterpart (AOR=3.4; 95% CI: 1.3, 9.4). The women who had ever heard about breast cancer screening were 2.8 times more likely to have breast cancer screening as compared to those who had never heard about breast cancer screening (AOR=2.8; 95% CI: 1.2, 6.5). Conclusion: The overall breast cancer screening practice was very low among women in the study area. Age and women's knowledge towards breast cancer risk factors and breast cancer screening information were identified as important factors for breast cancer screening practice.


Assuntos
Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/métodos , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/métodos , Adulto , Fatores Etários , Idoso , Estudos Transversais , Etiópia , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
3.
Medicine (Baltimore) ; 98(39): e17187, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574825

RESUMO

BACKGROUND: Surgical resection is the recommended procedure for colorectal cancer (CRC), but majority of the patients were diagnosed with advanced or metastatic CRC. Currently, there were inconsistent results about the diagnostic value of magnetic resonance colonography (MRC) and computed tomography colonography (CTC) in early CRC diagnosis. Our study conducted this meta-analysis to investigate the diagnostic value of MRC and CTC for CRC surveillance. METHODS: A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane library to select relevant studies. The summary sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the receiver operating characteristic curves (AUC) were calculated to evaluate the diagnostic value of MRC and CTC, respectively. RESULT: Twenty-five studies including 2985 individuals were selected in the final analysis. Eight studies evaluated the diagnostic value of MRC, and 17 studies assessed CTC. The summary sensitivity, specificity, PLR, NLR, DOR, and AUC in MRC for early detection of CRC were 0.98 (95% confidence interval, CI: 0.80-1.00), 0.94 (95% CI: 0.85-0.97), 15.48 (95% CI: 6.30-38.04), 0.02 (95% CI: 0.00-0.25), 115.09 (95% CI: 15.37-862.01), and 0.98 (95% CI: 0.97-0.99), respectively. In addition, the sensitivity, specificity, PLR, NLR, DOR, and AUC of CTC for diagnosing CRC were 0.97 (95% CI: 0.88-0.99), 0.99 (95% CI: 0.99-1.00), 154.11 (95% CI: 67.81-350.22), 0.03 (95% CI: 0.01-0.13), 642.51 (95% CI: 145.05-2846.02), and 1.00 (95% CI: 0.99-1.00). No significant differences were found between MRC and CTC for DOR in all the subsets. CONCLUSION: The findings of meta-analysis indicated that MRC and CTC have higher diagnostic values for early CRC diagnosis. However, the DOR for diagnosing CRC between MRC and CTC showed no significance.


Assuntos
Colonografia Tomográfica Computadorizada/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico por imagem , Detecção Precoce de Câncer/estatística & dados numéricos , Imagem por Ressonância Magnética/estatística & dados numéricos , Idoso , Colonografia Tomográfica Computadorizada/métodos , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Sensibilidade e Especificidade
4.
Medicine (Baltimore) ; 98(39): e17198, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574828

RESUMO

BACKGROUND: The aim of our study was to assess the value of serum human epididymis protein 4 (HE4) to diagnose lung cancer and provide reliable scientific conclusions to guide clinical practice. METHODS: A systematic search of the PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature, and WANFANG databases was conducted to identify all studies examining serum HE4 in the diagnosis of lung cancer published up to June, 2017. The Quality Assessment of Diagnostic Accuracy Studies tool was used to evaluate the methodological quality of each trial. The meta-analysis was performed using STATA software and Review Manager 5.3. RESULTS: There were 21 studies involving 1883 cases and 1696 controls included in our meta-analysis. The pooled sensitivity and specificity of HE4 for diagnosing lung cancer were 0.73 (95% confidence interval [CI] 0.68-0.78) and 0.86 (95% CI 0.81-0.91), respectively. The positive likelihood ratio and negative likelihood ratio were 5.4 (95% CI 3.8-7.5) and 0.31 (95% CI 0.26-0.37), respectively. The diagnostic odds ratio was 17 (95% CI 12-26). The area under the curve of the summary receiver-operating characteristic curve was 0.86 (95% CI 0.83-0.89). Race, assay method, type of cancer, sample size, and publication date might be sources of heterogeneity in our meta-analysis. Subgroup analyses showed that the sensitivity in Caucasians was higher than that in Asians (0.81, 95% CI 0.71-0.91; and 0.71, 95% CI 0.66-0.77, respectively), but the specificity in Asians was better than that in Caucasians (0.87, 95% CI 0.81-0.92; and 0.85, 95% CI 0.73-0.97, respectively). The chemiluminescent microparticle immunoassay had the highest sensitivity, with 0.79 (95% CI 0.73-0.97), and the enzyme-linked immunosorbent assay had the highest specificity, with 0.87 (95% CI 0.79-0.94). HE4 had high diagnostic efficacy when screening for small cell lung cancer with the highest specificity (0.90, 95% CI 0.77-1.00). CONCLUSIONS: HE4 is a relatively promising and effective biomarker for the diagnosis of lung cancer. Furthermore, given the limitations of our study, additional large-scale and well-designed studies are needed in the future.


Assuntos
Detecção Precoce de Câncer/métodos , Neoplasias Pulmonares/diagnóstico , Proteínas/análise , Biomarcadores Tumorais/sangue , Humanos , Razão de Chances , Sensibilidade e Especificidade
5.
Medicine (Baltimore) ; 98(39): e17293, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574850

RESUMO

Human papillomavirus (HPV) infection is the leading cause of cervical cancer and precancerous lesions. Knowledge regarding the prevalence and genotype distribution of HPV in women is important to establish strategies for cervical cancer screening and HPV vaccination. This study aimed to evaluate the characteristics of HPV infection in Taizhou, China. HPV genotype of 10,733 women who visited Taizhou People's Hospital from November 2016 to October 2018 was determined using a PCR and hybridization-based detection test. The prevalence of overall, high risk (HR), and low risk (LR) HPV infections was 34.58%, 29.92%, and 10.12%, respectively. Of HPV-positive cases, 2417 (65.13%) were infected with a single HPV genotype and 1294 (34.87%) were infected with multiple HPV genotypes. HPV-52 was the most prevalent genotype (6.21%), followed by HPV-16 (5.33%), HPV-53 (4.03%), HPV-58 (3.89%), and HPV-81 (3.75%). The highest prevalence of HPV infection was found in women aged ≥60 years (40.72%). Furthermore, the prevalence of HPV increased with the severity of cervical lesions. In conclusions, the prevalence and genotype distribution of HPV varied with age and cervical lesions. The findings might serve as a potential reference for guiding cervical cancer screening and vaccine-based HPV prevention in Taizhou.


Assuntos
Detecção Precoce de Câncer/métodos , Genótipo , Papillomaviridae/genética , Infecções por Papillomavirus/virologia , Neoplasias do Colo do Útero/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações , Prevalência , Estudos Retrospectivos , Neoplasias do Colo do Útero/diagnóstico , Adulto Jovem
6.
BMJ ; 367: l5383, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31578177

RESUMO

OBJECTIVE: To estimate benefits and harms of different colorectal cancer screening strategies, stratified by (baseline) 15-year colorectal cancer risk. DESIGN: Microsimulation modelling study using MIcrosimulation SCreening ANalysis-Colon (MISCAN-Colon). SETTING: A parallel guideline committee (BMJ Rapid Recommendations) defined the time frame and screening interventions, including selection of outcome measures. POPULATION: Norwegian men and women aged 50-79 years with varying 15-year colorectal cancer risk (1-7%). COMPARISONS: Four screening strategies were compared with no screening: biennial or annual faecal immunochemical test (FIT) or single sigmoidoscopy or colonoscopy at 100% adherence. MAIN OUTCOME MEASURES: Colorectal cancer mortality and incidence, burdens, and harms over 15 years of follow-up. The certainty of the evidence was assessed using the GRADE approach. RESULTS: Over 15 years of follow-up, screening individuals aged 50-79 at 3% risk of colorectal cancer with annual FIT or single colonoscopy reduced colorectal cancer mortality by 6 per 1000 individuals. Single sigmoidoscopy and biennial FIT reduced it by 5 per 1000 individuals. Colonoscopy, sigmoidoscopy, and annual FIT reduced colorectal cancer incidence by 10, 8, and 4 per 1000 individuals, respectively. The estimated incidence reduction for biennial FIT was 1 per 1000 individuals. Serious harms were estimated to be between 3 per 1000 (biennial FIT) and 5 per 1000 individuals (colonoscopy); harms increased with older age. The absolute benefits of screening increased with increasing colorectal cancer risk, while harms were less affected by baseline risk. Results were sensitive to the setting defined by the guideline panel. Because of uncertainty associated with modelling assumptions, we applied a GRADE rating of low certainty evidence to all estimates. CONCLUSIONS: Over a 15 year period, all screening strategies may reduce colorectal cancer mortality to a similar extent. Colonoscopy and sigmoidoscopy may also reduce colorectal cancer incidence, while FIT shows a smaller incidence reduction. Harms are rare and of similar magnitude for all screening strategies.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/normas , Programas de Rastreamento/normas , Modelos Estatísticos , Idoso , Colonoscopia/efeitos adversos , Colonoscopia/normas , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Incidência , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Noruega/epidemiologia , Sangue Oculto , Avaliação de Processos e Resultados (Cuidados de Saúde)/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Sigmoidoscopia/efeitos adversos , Sigmoidoscopia/normas , Sigmoidoscopia/estatística & dados numéricos , Análise de Sobrevida
7.
Sante Publique ; Vol. 31(3): 387-394, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31640326

RESUMO

Colorectal cancer (CRC) affects approximately 43,000 people each year in France and is responsible for nearly 18,000 deaths a year. The national organized screening program contributes to its early detection. The test is available to the preferred GP or, to the Regional Center in charge of the invited public. Often the process of going to his doctor to get the test is not well accepted and the participation in organized screening is low. Our project aims to evaluate the impact of the provision of this test in pharmacies on screening for colorectal cancer in Corsica. The article describes the method used to mobilize the primary care pharmacists of the territory, provide them the test kits and follow-up of the people who took part in the test. The results presented highlight a very positive impact of the experiment with a progression of the realized rate to 36% over the period of 9 months.


Assuntos
Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer/métodos , Farmácias , Atenção Primária à Saúde , França , Humanos , Avaliação de Programas e Projetos de Saúde
8.
Rev Prat ; 69(5): 529-534, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-31626462

RESUMO

In France, every year, HPVs cause approximately 6,300 cancers -cervix, anus, oropharynx, penis, vulva, vagina, oral cavity, larynx- representing 2% of all incident cancers, 35,000 precancerous le-sions of the cervix, and at least 50,000 condylomas in the under- 30s. All 3,000 new cases of cervical cancers are attributable to HPV infections. Cervical cancer prevention is based on the combination of two complementary strategies: vaccination of 11 to 14-years-old girls against HPV and organized screening of cervical cancer for women between 25 and 65 years old. In France, the vaccination coverage rate -VCR- against HPV for 2 vaccine doses is less than 25% while it reaches more than 80% in the United Kingdom, Portugal, Australia, etc. This low level of VCR can be explained by the mistrust in these vaccines especially regarding their effectiveness and safety. However, more than 10 years after their commercialization, HPV vaccines have already demonstrated, in many countries, their effectiveness against HPV infections, genital warts and precancerous cervical lesions. In addition, no association between vaccines and autoimmune diseases has been demonstrated, either by national or international surveillance authorities, or by scientific publications, after the commercialization of 200 million doses worldwide. As the International Papillomavirus Society has declared that the combination of a high VCR against HPV and a high participation in cervical cancer screening, combined with appropriate treatment, can lead to the elimination of cervical cancer as a public health problem, it is important to better communicate the scientific findings in order to better understand vaccination's benefits.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Adolescente , Adulto , Idoso , Criança , Detecção Precoce de Câncer , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Reino Unido , Neoplasias do Colo do Útero/prevenção & controle , Vacinação
9.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 415-419, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31631610

RESUMO

Objective: To observe the difference of circulating tumor cells (CTC) in peripheral blood of patients with different degrees of cervical lesions, and to evaluate the effectiveness of CTC detection in screening early invasive cervical cancer. Methods: From December 2015 to October 2017, 63 cases of cervicitis, low-grade and high-grade intraepithelial lesions (LSIL, HSIL) and early invasive cervical cancer were confirmed by histopathological and clinical stages in Zhongshan Boai Hospital and Zhongshan Hospital Affiliated to Zhongshan University. The immunomagnetic bead negative enrichment technique combined with immunofluorescence was used. In situ hybridization (imFISH) was used to detect CTC in peripheral blood of patients. The positive rate and quantity of CTC in four groups were analyzed. The diagnostic efficacy of CTC in early invasive cervical cancer was evaluated based on the results of histopathological diagnosis and clinical staging. Results: ①The positive rates of CTC in cervicitis group, LSIL group, HSIL group and early invasive cervical cancer group were 0, 0, 19.05% and 84.13% respectively. The overall difference was statistically significant ( χ 2=504.00, P<0.05). The positive rate of CTC in early invasive cervical cancer group was higher than that in other groups ( P<0.008 3). The positive rates of CTC in HSIL group were significantly different from those in LSIL group and cervicitis group ( P<0.008 3). ②The average number (median) of CTC positive in cervicitis group, LSIL group, HSIL group and early invasive cervical cancer group was 0, 0, 1/4 mL, 3/4 mL, respectively. The average number of positive CTC in early invasive cervical cancer group was higher than that in other groups, and the difference was significant compared with other groups ( P<0.008 3). The average number of CTC positive in HSIL group was significantly different from that in LSIL and cervicitis group ( P<0.008 3). ③The sensitivity, specificity, coincidence rate, positive predictive value and negative predictive value of CTC positive results in the diagnosis of early invasive cervical cancer were 84.13%, 93.65%, 91.27%, 81.54% and 94.65%, respectively. Conclusion: CTC exists in patients with HSIL and early invasive cervical cancer. With the aggravation of cervical lesions, the positive rate and number of CTC test results increase. CTC detection in early invasive cervical cancer screening has a certain practical value in clinic.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Células Neoplásicas Circulantes , Neoplasias do Colo do Útero/diagnóstico , Detecção Precoce de Câncer , Feminino , Humanos , Cervicite Uterina/diagnóstico
10.
BMJ ; 367: l5515, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31578196

RESUMO

CLINICAL QUESTION: Recent 15-year updates of sigmoidoscopy screening trials provide new evidence on the effectiveness of colorectal cancer screening. Prompted by the new evidence, we asked: "Does colorectal cancer screening make an important difference to health outcomes in individuals initiating screening at age 50 to 79? And which screening option is best?" CURRENT PRACTICE: Numerous guidelines recommend screening, but vary on recommended test, age and screening frequency. This guideline looks at the evidence and makes recommendations on screening for four screening options: faecal immunochemical test (FIT) every year, FIT every two years, a single sigmoidoscopy, or a single colonoscopy. RECOMMENDATIONS: These recommendations apply to adults aged 50-79 years with no prior screening, no symptoms of colorectal cancer, and a life expectancy of at least 15 years. For individuals with an estimated 15-year colorectal cancer risk below 3%, we suggest no screening (weak recommendation). For individuals with an estimated 15-year risk above 3%, we suggest screening with one of the four screening options: FIT every year, FIT every two years, a single sigmoidoscopy, or a single colonoscopy (weak recommendation). With our guidance we publish the linked research, a graphic of the absolute harms and benefits, a clear description of how we reached our value judgments, and linked decision aids. HOW THIS GUIDELINE WAS CREATED: A guideline panel including patients, clinicians, content experts and methodologists produced these recommendations using GRADE and in adherence with standards for trustworthy guidelines. A linked systematic review of colorectal cancer screening trials and microsimulation modelling were performed to inform the panel of 15-year screening benefits and harms. The panel also reviewed each screening option's practical issues and burdens. Based on their own experience, the panel estimated the magnitude of benefit typical members of the population would value to opt for screening and used the benefit thresholds to inform their recommendations. THE EVIDENCE: Overall there was substantial uncertainty (low certainty evidence) regarding the 15-year benefits, burdens and harms of screening. Best estimates suggested that all four screening options resulted in similar colorectal cancer mortality reductions. FIT every two years may have little or no effect on cancer incidence over 15 years, while FIT every year, sigmoidoscopy, and colonoscopy may reduce cancer incidence, although for FIT the incidence reduction is small compared with sigmoidoscopy and colonoscopy. Screening related serious gastrointestinal and cardiovascular adverse events are rare. The magnitude of the benefits is dependent on the individual risk, while harms and burdens are less strongly associated with cancer risk. UNDERSTANDING THE RECOMMENDATION: Based on benefits, harms, and burdens of screening, the panel inferred that most informed individuals with a 15-year risk of colorectal cancer of 3% or higher are likely to choose screening, and most individuals with a risk of below 3% are likely to decline screening. Given varying values and preferences, optimal care will require shared decision making.


Assuntos
Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/normas , Programas de Rastreamento/normas , Sangue Oculto , Sigmoidoscopia/estatística & dados numéricos , Idoso , Colonoscopia/normas , Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Avaliação de Processos e Resultados (Cuidados de Saúde)/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Sigmoidoscopia/normas , Fatores de Tempo
11.
Medicine (Baltimore) ; 98(40): e17451, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577771

RESUMO

INTRODUCTION: Prostate-specific antigen (PSA) is the main tool for early detection, risk stratification and monitoring of prostate cancer (PCa). However, there are controversies about the use of PSA as a population screening test because of the high potential for overdiagnosis and overtreatment associated. The net benefit of screening is unclear and according to the available recommendations, it should be offered to well-informed men with an adequate health status and a life-expectancy of at least 10 years or to men at elevated risk of having PCa. In addition, the factors that influence test results are unclear, as is impact of false positive or negative results on patient health.Our objective is to assess the clinical and analytical factors associated with the presence of false positive and false negative results and the diagnostic/therapeutic process followed by these patients. METHODS AND ANALYSIS: A prospective observational cohort study will be carried out. We will include a cohort of patients with a positive PSA result (1.081 patients) and a sample of patients with negative results (572 patients); both will be followed for 2 years by reviewing medical records to assess the variables associated with these results, as well as characteristics of patient management after a positive PSA value. We will include those patients with a PSA determination from 2 hospitals in the Valencian Community. Patients who have been previously diagnosed with prostate cancer or who are being followed for previous high PSA values will be excluded. DISCUSSION: The study will estimate the frequency of false positive and false negative PSA results in routine clinical practice, and allow us to quantify the potential harm caused. STUDY REGISTRATION: Clinicaltrials.gov (https://clinicaltrials.gov/): NCT03978299, June 7, 2019.


Assuntos
Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Protocolos Clínicos , Estudos de Coortes , Detecção Precoce de Câncer , Reações Falso-Negativas , Reações Falso-Positivas , Humanos , Masculino
12.
Adv Clin Exp Med ; 28(10): 1377-1383, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31638746

RESUMO

BACKGROUND: Poland is considered among the European countries with an average incidence of cervical cancer (CC; about 3,000-3,500/year) and at the same time with high mortality (5-year survival rate - 55.2%). For this reason, in 2006 Poland introduced a Population-Based Cervical Cancer Prevention and Early Detection Program addressed to women aged 25-59 years, in which a cytological test is carried out every 3 years. OBJECTIVES: The aim of the study was to assess the changes in the curability of CC patients brought by the introduction of the Screening Program in the Lower Silesian voivodeship and to identify the subpopulation of women for whom activities aimed at increasing adherence rates must be intensified. MATERIAL AND METHODS: The 5-year relative survival in 3,586 CC patients from 2000-2010 registered in the Lower Silesian Cancer Registry was analyzed. RESULTS: In the Lower Silesian voivodeship, a 55.1% 5-year survival rate was recorded in 2000-2004 and 70.5% in 2010. The highest increase in 5-year relative survival rates was found in rural communities (from 53.1% in 2000-2004 to 77.7% in 2010) and in Wroclaw (56.8% and 74.2%, respectively). In the study group, the number of patients with invasive CC (C53) detected in the local stage of the disease increased systematically from 61.5% in 2000-2004 to 74.3% in 2010. CONCLUSIONS: The introduction of the population-based screening program improved the curability rate in CC patients in the Lower Silesian voivodeship. In order to maintain the recent positive trends, further education should be continued, and activities aimed at increasing adherence to screening tests should be intensified, especially in urban-rural communities.


Assuntos
Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Detecção Precoce de Câncer , Feminino , Humanos , Incidência , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Cooperação do Paciente/psicologia , Polônia/epidemiologia , Vigilância da População , Avaliação de Programas e Projetos de Saúde , Taxa de Sobrevida/tendências , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/patologia
13.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1180-1187, out.-dez. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1022214

RESUMO

Objetivo: Analisar a trajetória percorrida pelas crianças e adolescentes da suspeição à confirmação diagnóstica de câncer. Métodos: Pesquisa qualitativa, desenvolvida em 2017, com entrevistas semiestruturadas junto a 19 familiares cuidadores de crianças e adolescentes com câncer, cujos dados foram submetidos à análise temática. Resultados: A trajetória de crianças e adolescentes é iniciada a partir de múltiplas e inespecíficas alterações clínicas e de desenvolvimento no âmbito sociofamiliar, posteriormente elas percorrem inúmeros serviços de saúde e são submetidas a diversos procedimentos biomédicos. Nesse caminho, barreiras no acesso aos serviços de saúde na busca pelo diagnóstico do câncer foram evidenciadas. Conclusão: É imprescindível que o sistema de saúde atenda as necessidades da população infantojuvenil em todos os seus níveis, incluindo o acesso adequado ao diagnóstico precoce do câncer, assim como melhor formação dos profissionais para a detecção. Garantindo, assim, o direito à saúde na perspectiva da integralidade do cuidado


Objective: The study's goal has been to analyze the trajectory of children and adolescents from cancer suspicion to its confirmed diagnosis. Methods: It is a descriptive-exploratory research with a qualitative approach, which was performed in 2017 through semi-structured interviews of 19 family caregivers of children and teenagers with cancer diagnosis. The data were subjected to thematic analysis. Results: Both children and adolescents' trajectories start from multiple and unspecific clinical and development alterations in the socialfamily settings, following that they go through countless healthcare services and are subjected to a variety of biomedical procedures. Along this path, there were evidenced barriers of access to healthcare services in the cancer diagnosis pursue. Conclusion: It is crucial that the healthcare system go towards attending the necessities of children and adolescents' population in all levels, including the appropriated access to an earlier diagnosis of cancer, and a better qualification of healthcare professionals for cancer detection. Hence, ensuring the right to health care under the care completeness standpoint


Objetivo: Analizar la trayectoria recorrida por los niños y los adolescentes de sospecha de confirmación diagnóstica del cáncer. Métodos: Pesquisa cualitativa, desarrollada en 2017, con entrevistas semiestructuradas junto a diecinueve familiares cuidadores de niños y adolescentes con cáncer, donde los dados han sido sometidos al analice temática. Resultados: La trayectoria de los niños y adolescentes empieza a partir de varias e inespecíficas alteraciones clínicas y del desarrollo en el ámbito sociofamiliar, posteriormente ellas recogen inúmeros servicios de salud y son sometidas a diversos procedimientos biomédicos. En este camino, barreras en el acceso a los servicios de salud en la busca por el diagnóstico del cáncer fueron evidenciadas. Conclusión: Es imprevisible que el sistema de salud atienda las necesidades de la población infantojuvenil en todos los niveles, incluyendo el acceso adecuado al diagnóstico precoz del cáncer, así como mejor formación de los profesionales para la detección. Garantizando, así, el derecho a la salud en la perspectiva de la integralidad del cuidado


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Saúde da Criança , Saúde do Adolescente , Detecção Precoce de Câncer , Neoplasias/diagnóstico , Brasil , Cuidadores
14.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 326-333, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496166

RESUMO

Early diagnosis is the key to improve the prognosis of gastric cancer. How to screen out high-risk subjects of gastric cancer in population is a hot spot. Serum-based early detection of gastric cancer is suitable for high-risk population screening, which is more convenient and safer. This article reviews the diagnostic value of serum biomarkers for gastric cancer, including serum DNA methylation, various RNAs, pepsinogen, gastrin, osteopontin, MG7-Ag and CA724. Until now, there is still lack of ideal biomarkers for gastric cancer, and searching for specific RNAs may be promising for early diagnosis and screening of gastric cancer.


Assuntos
Biomarcadores Tumorais , Detecção Precoce de Câncer , Neoplasias Gástricas , Biomarcadores Tumorais/sangue , Detecção Precoce de Câncer/tendências , Humanos , Sensibilidade e Especificidade , Neoplasias Gástricas/sangue , Neoplasias Gástricas/diagnóstico
15.
Z Gastroenterol ; 57(9): 1051-1058, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31525797

RESUMO

BACKGROUND AND AIM: Colorectal cancer (CRC) screening can effectively reduce cancer-associated mortality. In Germany, individuals over the age of 50 or 55 have access to CRC screening services. However, utilization rates are persistently low, particular in the male population. This observational study investigates the effect of standard versus gender-specific invitation letters on utilization of CRC screening services. METHODS: We analyzed utilization rates of individuals who were insured by a large health insurance fund in Bavaria, Germany. Persons who became eligible for CRC screening received a standard (2013-2014) or a gender-specific invitation letter (2015-2016). We compared utilization rates within 6 months after receipt of the invitation letter using billing codes of the health insurance fund. RESULTS: Invitation letters were sent to 49 535 individuals, of which 48.8 % were gender-specific. The overall utilization rate did not differ between recipients of the standard versus gender-specific invitation letter (11.6 % vs 11.1 %; RR: 0.97 [0.92-1.02], p = 0.19). However, uptake of screening colonoscopy was significantly higher among recipients of gender-specific invitations (2.9 % vs 3.5 %; RR: 1.21 [1.04-1.39], p = 0.01), whereas utilization of fecal occult blood tests declined (10.4 % vs 9.7 %; RR: 0.93 [0.88-0.99], p = 0.016). CONCLUSIONS: Gender-specific design of invitation letters can modify the patients' preference for specific CRC screening services and increase the acceptance of screening colonoscopy.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Participação do Paciente/estatística & dados numéricos , Colonoscopia , Neoplasias Colorretais/prevenção & controle , Feminino , Alemanha , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Sangue Oculto
16.
Z Gastroenterol ; 57(9): 1059-1066, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31525798

RESUMO

BACKGROUND: In Germany, colorectal cancer (CRC) screening includes a fecal blood test or colonoscopy, but not a sigmoidoscopy, which has been shown to reduce CRC incidences and mortality. Our aim was to compile physicians' experiences with sigmoidoscopy and their assessments of this procedure being an additional, possible screening method for early CRC detection. METHODS: At the end of 2015, gastroenterologists and internists in Lower Saxony and North Rhine-Westphalia who regularly perform screening colonoscopies in outpatient care were contacted per mail. Standardized telephone interviews consisting of 17 questions and lasting 10-15 minutes were conducted. RESULTS: Nearly two-thirds (56/87) of the respondents reject sigmoidoscopy as an acceptable early detection method. Compared to colonoscopy, key features of the sigmoidoscopy include more favorable patient-related aspects, while procedural aspects, except sedation, clearly rate in favor of the colonoscopy. In the instance that colonoscopy is rejected, 75 % of the physicians consider a sigmoidoscopy to be a possible alternative. CONCLUSIONS: The survey provides important practical insights into outpatient sigmoidoscopy. A majority of the physicians does not support evidence-based sigmoidoscopy for CRC screening. However, individuals who reject a colonoscopy are, in line with the current guideline, identified as a target group for a screening sigmoidoscopy. The benefit from an additionally offered sigmoidoscopy in CRC screening should be further analyzed with special consideration given to the preferences of insurees within the German healthcare system.


Assuntos
Atitude do Pessoal de Saúde , Neoplasias Colorretais/diagnóstico , Programas de Rastreamento/métodos , Médicos/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Sigmoidoscopia , Colonoscopia , Detecção Precoce de Câncer , Alemanha , Humanos , Sangue Oculto
17.
Pan Afr Med J ; 33: 106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489084

RESUMO

Introduction: Cervical cancer remains one of the leading health hazards affecting a majority women across the globe. The situation is even more, preoccupying particularly in areas where screening programmes and services are absent. The World Health Organization (WHO) says "cervical cancer is the fourth most frequent cancer in women, with an estimated 570,000 new cases diagnosed in 2018 which represents 6.6% of all female cancers. Approximately 90% of deaths from cervical cancer occurred in low- and middle-income countries". Despite the high mortality rate from cervical cancer globally, the trend could be reduced through a comprehensive approach that includes prevention, early diagnosis, effective screening and treatment programmes. In Cameroon, the prevalence of cervical cancer is 24% among women of reproductive age. An estimated 1,993 new cases are recorded annually in Cameroon with 1676 deaths. Despite this precarious situation, the uptake in cervical cancer screening service remains poor and stands at 19.6% in Cameroon. It is against this background that this paper evaluates the uptake of cervical cancer among women aged 25-65 years in the Kumbo West Health District (KWHD). Specifically, this study assesses the knowledge of women in this health district on cervical cancer and determines factors that affect the uptake of cervical cancer screening services. Methods: This study is a cross-sectional study in the KWHD involving 253 consented women between the ages 25 to 65 years. The principal research instrument was a three-part questionnaire designed to collect information on socio-demographic profile, cervical cancer knowledge and associated factors for uptake in cervical cancer screening. Data was entered in MS Excel and analysed using Excel. Results were presented in tables and figures. Results: Our study reveals that a majority of the participants (74.70%) had heard of cervical cancer and 43.48% had undergone cervical cancer screening. Again, 24.51% and 29.25% of the participants respectively could not identify any risk factor and symptom of cervical cancer. Conclusion: The study revealed that the uptake of cervical cancer screening in KWHD is higher than the national uptake. The level of awareness on the risk factors and symptoms of cervical cancer is low, posing a need to put more emphasis on educating and creating awareness of cervical cancer among communities on risk factors, prevention measures and signs and symptoms in all the health areas of the KWHD.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Camarões , Estudos Transversais , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
19.
Stomatologiia (Mosk) ; 98(4): 44-47, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31513148

RESUMO

The aim of the study is to implement the national project created within the framework of the state task of the Ministry of Education and Science of the Russian Federation 'Development of the program of screening of cancer and precancerous diseases of the oral mucosa and red border of the lips'. For its approbation and implementation, national research groups have been created at the bases of the Department of Therapeutic Dentistry of the Moscow State Medical and Dental University, the Tula regional dental clinic, City dental clinic in Noyabrsk City (Yamal-Nenets autonomous district), which in the period from 2015 to the first half of 2018 studied the epidemiology of cancer and precancer of the oral mucosa and the vermilion among 217 806 people aged 18-92 years. Over three and a half years, the effectiveness of the research team increased by 8.45 times. The results of the study confirmed the low oncological alertness of dentists. Educational working program for dentists training 'Screening of diagnostics of precancerous diseases and cancer of the oral mucosa - AFS-D Set' was developed by coordinators of the project and implemented for training of 574 dentists within continuous medical education programs.


Assuntos
Detecção Precoce de Câncer , Neoplasias Bucais , Lesões Pré-Cancerosas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , Moscou , Mucosa Bucal , Neoplasias Bucais/diagnóstico , Lesões Pré-Cancerosas/diagnóstico , Federação Russa , Adulto Jovem
20.
Pneumologie ; 73(10): 573-577, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31537020

RESUMO

Substantial new data on early detection of lung cancer with low-dose CT has become available since the last joint statement of the German Roentgenological Society and the German Respiratory Society was published in 2011. The German S3 guideline on lung cancer was revised in 2018 and now contains a weak recommendation towards early detection of lung cancer with low-dose CT in a quality-assured early detection program. These new developments required a repositioning of the involved professional societies. This present joint statement describes main features of a quality-assured program for early detection of lung cancer with low-dose CT in Germany.


Assuntos
Detecção Precoce de Câncer , Neoplasias Pulmonares/diagnóstico por imagem , Proteção Radiológica/métodos , Proteção Radiológica/normas , Tomografia Computadorizada por Raios X/normas , Alemanha , Humanos , Guias de Prática Clínica como Assunto , Radiografia , Sociedades Médicas
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