Assuntos
Acessibilidade aos Serviços de Saúde , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde , American Cancer Society , Empatia , Promoção da Saúde , Humanos , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Neoplasias/terapia , Enfermeiras e Enfermeiros/provisão & distribuição , Pennsylvania , Autocuidado , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
Early in the 21st century, control of cancer is considered a major public health issue. Research advances are rapidly unraveling molecular genetic changes, which are the basis of human cancer. These advances are changing the way primary care providers will practice in the future. New genetic screening tools, early detection tests, and cancer prevention intervention will become routinely used in primary care.
Assuntos
Pesquisa Biomédica/tendências , Oncologia/tendências , Neoplasias/terapia , Padrões de Prática Médica/tendências , Atenção Primária à Saúde/tendências , Previsões , Humanos , Programas de Rastreamento/tendências , Qualidade da Assistência à Saúde , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: The poor prognosis reported for patients with high-grade glial neoplasms indicates a need for the development of multimodality therapeutic approaches. The addition of chemotherapy has contributed variably to increased survival. The objective of the current study (Southwest Oncology Group [SWOG] 9016) was to determine whether concurrent radiotherapy and chemotherapy with the combination of carmustine and cisplatin could be given safely in a cooperative group setting. Additional objectives included the estimation of response rate, the rate of disease stabilization, and the probability of 1-year survival. METHODS: SWOG 9016 study included 59 eligible patients with grade III or IV astrocytoma who received radiotherapy concurrently with carmustine/cisplatin chemotherapy. Patients were required to have either measurable or evaluable disease. The therapeutic endpoints were comprised of complete response (CR), partial response (PR), or progressive disease (PD). RESULTS: Six patients achieved a CR (CR rate of 10%; 95% confidence interval [95% CI], 4-21%), 4 achieved a PR (PR rate of 7%; 95% CI, 2-16%), and 2 patients (3%) experienced an unconfirmed response. Twenty-four patients (41%; 95% CI, 28-54%) had stable disease and 10 patients (17%) demonstrated PD. The overall disease stabilization rate (CR + PR + stable disease, excluding unconfirmed response) was 58% (95% CI, 44-70%). CONCLUSIONS: Despite the presence of a cohort of long-term survivors, the results of the current study do not appear to support the additional study or routine use of concurrent cisplatin and carmustine.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Carmustina/administração & dosagem , Cisplatino/administração & dosagem , Glioma/tratamento farmacológico , Glioma/radioterapia , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/patologia , Carmustina/efeitos adversos , Cisplatino/efeitos adversos , Terapia Combinada , Feminino , Glioma/mortalidade , Glioma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Radioterapia Conformacional/métodos , Sudoeste dos Estados Unidos , Análise de Sobrevida , Resultado do TratamentoRESUMO
Each year, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screening rates for US adults. In 2006, there were no updates to ACS guidelines for early cancer detection. In this issue of the journal, we describe criteria for successful screening, discuss recent evidence and policy changes that have implications for cancer screening, summarize the ACS guidelines and describe guidelines reviews that are underway, and provide an update of the most recent data pertaining to participation rates in cancer screening from the Centers for Disease Control and Prevention's (CDC's) Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS).
Assuntos
Neoplasias/diagnóstico , Adolescente , Adulto , American Cancer Society , Sistema de Vigilância de Fator de Risco Comportamental , Neoplasias da Mama/diagnóstico , Neoplasias Colorretais/diagnóstico , Neoplasias do Endométrio/diagnóstico , Etnicidade , Feminino , Guias como Assunto , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias/etnologia , Padrões de Prática Médica , Neoplasias da Próstata/diagnóstico , Grupos Raciais , Fatores de Risco , Estados Unidos , Neoplasias do Colo do Útero/diagnósticoRESUMO
In 1998, the American Cancer Society (ACS) set a challenge goal for the nation to reduce cancer incidence by 25% over the period between 1992 and 2015. This report examines the trends in cancer incidence between 1992 and 2004. Trends were calculated using data on incident malignant cancer cases from the Surveillance, Epidemiology, and End Results (SEER) Registry. Delay-adjusted incidence trends for all cancer sites; all cancer sites without prostate cancer included; all cancer sites stratified by gender, age, and race; and for 20 selected cancer sites are presented. Over the first half of the ACS challenge period, overall cancer incidence rates have declined by about 0.6% per year. The greatest overall declines were observed among men and among those aged 65 years and older. The pace of incidence reduction over the first half of the ACS challenge period was only half that necessary to put us on target to achieve the 25% cancer incidence reduction goal in 2015. New understandings of preventable factors are needed, and new efforts are also needed to better act on our current knowledge about how we can prevent cancer, especially by continuing to reduce tobacco use and beginning to reverse the epidemic of obesity.
Assuntos
American Cancer Society , Neoplasias/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Obesidade/epidemiologia , Grupos Raciais , Fatores de Risco , Programa de SEER , Distribuição por Sexo , Fumar/epidemiologia , Taxa de Sobrevida/tendênciasRESUMO
Each January, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screening rates for US adults. In 2005, there were no updates to ACS guidelines. In this issue of the journal, we summarize the guidelines, discuss recent evidence and policy changes that have implications for cancer screening, and provide an update of the most recent data pertaining to participation rates in cancer screening by age, sex, and insurance status from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System.
Assuntos
Neoplasias/diagnóstico , Sociedades Médicas , Adulto , Fatores Etários , Idoso , Feminino , Política de Saúde , Humanos , Masculino , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Estados UnidosRESUMO
Each January, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screening rates for US adults. In 2004, there were no updates to ACS guidelines. In this article, we summarize the current guidelines, discuss recent evidence and policy changes that have implications for cancer screening, and provide an update of the most recent data pertaining to participation rates in cancer screening by age, gender, and insurance status from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System.
Assuntos
Programas de Rastreamento , Neoplasias/prevenção & controle , Adulto , Idoso , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Fatores de Risco , Estados UnidosRESUMO
Each January, the American Cancer Society (ACS) publishes a summary of existing recommendations for early cancer detection, including updates, and/or emerging issues that are relevant to screening for cancer. In 2002, the ACS assembled expert groups to update guidelines for cervical cancer screening and breast cancer screening, and to evaluate new technology for colorectal cancer screening. In November 2002, updated guidelines for cervical cancer screening were published in this journal, and breast cancer screening guidelines will be updated in 2003. In this issue, there is a report of a workshop held to review emerging technology for colorectal cancer screening that resulted in a modification of current previous recommendations for fecal occult blood tests, and revised recommendations for the "cancer-related check-up" in which clinical encounters provide case-finding and health-counseling opportunities. Finally, we provide an update of the most recent data pertaining to participation rates in cancer screening by age, gender, and ethnicity from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS).
Assuntos
Programas de Rastreamento/normas , Neoplasias/diagnóstico , Pólipos Adenomatosos/diagnóstico , Pólipos Adenomatosos/epidemiologia , Adolescente , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Criança , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias do Endométrio/diagnóstico , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias da Próstata/diagnóstico , Medição de Risco , Neoplasias do Colo do Útero/diagnósticoRESUMO
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical neoplasia and cancer, based on recommendations from a formal review and recent workshop, is presented. The new screening recommendations address when to begin screening, when screening may be discontinued, whether to screen women who have had a hysterectomy, appropriate screening intervals, and new screening technologies, including liquid-based cytology and HPV DNA testing.
Assuntos
Programas de Rastreamento/normas , Displasia do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Idoso , DNA Viral/isolamento & purificação , Feminino , Humanos , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Estados Unidos/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/virologiaRESUMO
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical neoplasia and cancer, based on recommendations from a formal review and recent workshop, is presented. The new screening recommendations address when to begin screening, when screening may be discontinued, whether to screen women who have had a hysterectomy, appropriate screening intervals, and new screening technologies, including liquid-based cytology and HPV DNA testing.
RESUMO
Each year the American Cancer Society publishes a summary of existing recommendations for early cancer detection, including updates, and/or emerging issues that are relevant to screening for cancer. In last year's article, the guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers were updated, as was the narrative pertaining to testing for early lung cancer detection. Although none of the ACS's guidelines were updated in 2001, work is proceeding on an update of screening recommendations for breast and cervical cancer and an update of these guidelines will be announced in the January/February 2003 issue of CA. As in previous issues, we review recommendations for the "cancer-related check-up," in which clinical encounters provide case-finding and health counseling opportunities. Finally, we provide an update of the most recent data pertaining to participation rates in cancer screening by age, gender, and ethnicity from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS) and National Health Interview Survey (NHIS).
Assuntos
Neoplasias/prevenção & controle , Neoplasias da Mama/prevenção & controle , Colonoscopia/normas , Neoplasias Colorretais/prevenção & controle , Neoplasias do Endométrio/prevenção & controle , Feminino , Humanos , Neoplasias Pulmonares/prevenção & controle , Masculino , Mamografia/normas , Sangue Oculto , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/prevenção & controle , Sigmoidoscopia/normas , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal/normasRESUMO
In 2003, the American Cancer Society updated its guidelines for early detection of breast cancer based on recommendations from a formal review of evidence and a recent workshop. The new screening recommendations address screening mammography, physical examination, screening older women and women with comorbid conditions, screening women at high risk, and new screening technologies.