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PubMedDate not supplied

Skin cancer prevention and early detection practices in a sample of rural women.

BACKGROUND: The incidence of skin cancer in the United States is rapidly increasing, and current estimates suggest that about one in five persons will be diagnosed with skin cancer in their lifetime. However, comparatively little is still known about the prevention and early detection behaviors of healthy individuals. This study presents information on prevention and early detection practices for a sample of non-Hispanic rural white women. METHOD: Interviews were conducted with 1,295 women age 20 or older who were patients in six public health departments and one primary-care clinic serving a low-income population, all located in rural western North Carolina. RESULTS: Both prevention and early detection behaviors were found to be infrequent in this population. Low knowledge of skin cancer, younger and older ages, and low education characterized women least likely to practice prevention. Low knowledge, younger age, and low education characterized women least likely to practice early detection. Perceived barriers to cancer screening including cost, lack of symptoms, and denial also were predictive of a low likelihood of both prevention and early detection behavior. Fatalism and fear of the stigma associated with cancer also were predictive of lower participation in selected early detection behaviors. A summary general barriers score was significantly associated with all prevention and early detection behaviors examined in the study. CONCLUSIONS: The results indicate a need for skin cancer education among this population.

Adult↗
PubMed2000

Discriminant analysis models for early detection of glaucomatous optic disc changes.

AIM: To evaluate and compare four different mathematical formulas for the early detection of morphometric optic nerve head changes in chronic open angle glaucoma. METHODS: The optic nerve heads of 161 patients with perimetrically defined glaucomatous optic nerve damage and of 194 normal subjects were examined by confocal laser scanning tomography. Using four formulas of linear discriminant analysis and the optic cup shape measure as the single optic disc variable, the predictive power of each of these methods was examined to differentiate between the normal eyes and the glaucoma eyes. RESULTS: The highest predictive power had an optic disc sector based formula, in particular in eyes with medium and large optic discs. This optic disc sector based formula was the one with the best agreement with the other formulas examined. It achieved a better predictability than any single optic disc variable evaluated. CONCLUSIONS: Combining quantitative optic disc variables by discriminant analysis functions, the predictive power of semiautomatic quantitative optic nerve head evaluation can be improved by providing the ophthalmologist with a diagnostic score for the detection of glaucomatous optic nerve damage. Because of the pattern of glaucomatous neuroretinal rim loss, an optic disc sector based discriminant formula may have a higher diagnostic precision than other formulas in detecting early glaucomatous damage.

Adult↗
PubMed1986

Early detection of amatoxins in human mushroom poisoning.

Amatoxins were detected radioimmunologically as early as 90-120 min after ingestion in the gastric fluid and urine of a 15-year-old boy who tried to commit suicide by ingestion of wild mushrooms. This early detection of amatoxins in the urine is proof of rapid absorption from the intestinal tract and subsequent excretion by the kidneys in man.

Adolescent↗
PubMed1991

Early detection of breast cancer: mammography.

Detection of early breast cancer utilizing mammography can be accomplished through more frequent and earlier use of the test as well as exploring techniques to improve sensitivity and specificity. Efforts at educating primary care physicians about the role of mammography as well as training technologists and radiologists in performing optimum examinations and correctly interpreting them is of prime importance. The use of computers may aid in increasing the sensitivity of the examinations and may also provide improved feature analysis for the radiologist, thus enhancing the separation of benign and malignant disease. New technologies also show promise to improve the accuracy of mammography. Direct digital mammography and digital enhancement of standard mammograms are actively being investigated. The use of MRI and specifically 31P spectroscopy shows initial promise to increase the specificity of mammography. Several clinical trials are also under way to assess a possible niche which fine needle aspiration biopsy (FNAB) may occupy in the quest for early breast cancer detection. Any future collaborative work between Japan and Western countries should take into account the potential of these new methods for improving the sensitivity and specificity of mammography.

Biopsy, Needle↗
PubMed1996

Early detection of familial ovarian cancer.

When ovarian cancer is detected at an early stage, prognosis is good, which has led to discussion of a screening programme. The aim of this study was to identify and examine women at high risk of familial ovarian cancer, and to evaluate the inclusion criteria and the diagnostic methods for early detection of ovarian cancer. We report the first round screening findings in a prospective study of 180 women (mean age 43.4 years) considered to be at high risk of ovarian cancer based on family history. They were subjected to gynaecological examination with transvaginal ultrasound (TVU), CA125 and breast examination. Of these, 13 women with oestrogen receptor positive breast cancer had therapeutic oophorectomy and the ovaries were histologically examined. Among 180 women examined, nine ovarian cancers (among them two found at oophorectomy because of breast cancer) (mean age 49.0 years), seven benign tumours of the ovary (mean age 48.1 years), one cancer of the cervix, and four breast cancers were diagnosed. The prevalence of ovarian cancers (5%) was significantly more than in any previous series. TVU as a diagnostic method proved useful and detected 7/9 cancers, whereas CA125 was elevated in 4/9 cancers. To our knowledge, this is the first programme which has successfully delineated a high risk group and prospectively demonstrated their high prevalence of ovarian cancer. Possible biases are discussed.

Adult↗
PubMed1984

Utilization of primary health care workers for early detection of oral cancer and precancer cases in Sri Lanka.

Oral cancer presents a serious public health problem in south-east Asian countries. In Sri Lanka and India 35-40% of all cancers are reported to be oral cancers, which are curable if detected in the early stages. The idea that, in developing countries, one of the few practical approaches to early detection of these cases could be through the utilization of primary health care workers was tested in a field study carried out in Sri Lanka. In a control area the subjects with oral lesions were identified by medical/dental officers. In the study, 34 primary health care workers were able, alongside their routine duties, to examine the oral cavity of 28 295 subjects during a period of 52 weeks; 1220 subjects were detected with lesions needing re-examination. The performance of these primary health care workers was very satisfactory in terms of the number of cases detected and the accuracy of their diagnoses, which were verified by re-examination at a specially designated referral centre. The clinical diagnoses of the three categories of lesions detected were as follows: stage 1 lesions for observation (homogeneous or ulcerated leukoplakia), stage 2 lesions for investigation (speckled leukoplakia, erythroplakia, or submucous fibrosis), and stage 3 lesions for treatment (cancer). There was 89% correspondence between the stage 1-3 diagnoses by the health workers and the clinical diagnoses made at the referral centre. However, compliance by patients was low because only 50% of the cases detected in the field attended the referral centre. The cost-effectiveness of this approach to cancer control has been demonstrated.

Adult↗
PubMed2000

African-American men and intention to adhere to recommended follow-up for an abnormal prostate cancer early detection examination result.

OBJECTIVES: To assess the intention of African-American men to have the recommended follow-up in the event of an abnormal prostate cancer early detection examination and to identify the variables that help to explain adherence intention. METHODS: In the spring of 1995, we selected a random sample of 548 African-American men who were patients at the University of Chicago Health Service. The sample included men who were 40 to 70 years of age, did not have a personal history of prostate cancer, and had a working telephone number. A total of 413 men who completed the telephone survey received an invitation to consider undergoing a prostate cancer early detection examination. The survey provided data on personal background characteristics, knowledge, attitudes, and beliefs related to prostate cancer and early detection. Respondents were asked whether they would choose to have the recommended follow-up in the event of an abnormal early detection examination result. Univariate and multivariate analyses of intention to have follow-up were performed. RESULTS: An intention to have the recommended follow-up was reported by 77% of the survey respondents. The results of multivariate analyses revealed that the intention to have the follow-up was positively associated with education beyond high school (odds ratio [OR] 1.9); perceived self-efficacy related to prostate cancer screening (OR 2.1); the belief that prostate cancer can be cured (OR 3.3); the belief that prostate cancer screening should be done in the absence of prostate problems (OR 2.3); and physician support for prostate cancer screening (OR 2.1). CONCLUSIONS: African-American men who have a high school education or less may be at risk of nonadherence to recommended follow-up. Adherence also may be low among men who do not have favorable views of early detection or do not perceive strong physician support for early detection. Research is needed to determine whether intention and other factors predict actual adherence to follow-up in this population group.

Adult↗
PubMed1995

[Early detection of prostate cancer-results of a prostate specific antigen-based detection program at a "multiphasic screening"].

Determination was made of serum PSA in the early detection of prostate cancer in a population of 1,227 men aged 55 years or older who visited a "human dock". "Human dock" is a unique health examination facility open to public in Japan. Recommendation for biopsy was made based solely on this parameter when its value exceeded 2.0 ng/ml in IMx immunoenzymetric assay (Dinabot Co.). Of these, 162 (13.2%) had elevated values. The proportion of males with serum PSA greater than 4.0 ng/ml was only 3.6%. Of the 109 males who underwent ultrasound guided biopsies, 17 cancers were detected, the cancer detection rate thus being 1.4%. Most of these cases (82.4%) were clinically localized cancers. Eight patients with cancer had serum PSA levels below 4.0 ng/ml including 6 less than 3.0 ng/ml. Radical prostatectomy was conducted on 14 patients. All had histologic features of clinically significant cancer and 64.3% were pathologically confined. Oriental elderly males appear to have lower serum PSA than western counterparts. The optimal cutoff of serum PSA for early detection should be examined further in oriental male populations. Differences in the incidence of prostate cancer between ethnic groups may have been overestimated in previous studies owing in part to unawareness by the physician and general public. Though the application of PSA for early detection will likely disclose greater numbers of prostate cancers in Japan, whether early detection reduces mortality by minimizing risk of death from cancer remains a point to be clarified.

Aged↗
PubMed2006

Early detection of the first episode of schizophrenia and suicidal behavior.

OBJECTIVE: The suicide rate in schizophrenia is high, with the risk being highest early in the course. The rate of suicide attempts before treatment onset is also high and is often the event leading up to first treatment contact. A previous report showed that the duration of untreated psychosis can be reduced through an early detection program, and that the reduction was associated with lower symptom levels at treatment initiation. Treatment programs that bring first-episode patients into treatment at lower symptom levels can have the potential to reduce risk for suicide attempts. METHOD: The authors examined consecutive patients with nonorganic, nonaffective psychosis who sought initial treatment at psychiatric treatment units in four catchment areas: two that had an early detection program and two that did not. RESULTS: The rate of severe suicidality (plans or attempts) was significantly higher in subjects from communities without the early detection program relative to those from early detection communities, even after adjustments for known predictors of suicidality. CONCLUSION: Early detection programs that bring patients into treatment at lower symptom levels may reduce suicidality risk at first treatment contact.

Adult↗
PubMed1995

The early detection of and screening for melanoma. International status.

Cutaneous melanoma is an increasingly common public health problem in industrialized nations. In theory, education and early detection should decrease melanoma morbidity and mortality, because the lesion is external and visible, risk factors are known, and thin tumors are associated with a high 5-year survival rate. The efficacy of early detection and screening programs, however, remains untested by randomized trials. Some early data are available from melanoma prevention and control efforts that have begun in many nations over the past decade. Textbook definitions of cancer screening are particularly challenging when applied to skin cancer control. Although some propose that there are rigid differences among screening, education, and early detection of skin cancer, the visible nature of this cancer makes early detection through education and screening inextricably intertwined. This article discusses the intermediate measures of education and screening within the context of the American Academy of Dermatology programs. Over the next few decades, screening and education for melanoma and other skin cancer will receive increasing worldwide attention. Multiple strategies will be required to combat increasing incidence and mortality rates. Screening and educational programs have been implemented worldwide, but data on their effects are only just being collected. Future collaborative work in melanoma/skin cancer prevention, education, and early detection holds promise as a way to decrease mortality and save lives.

Australia↗
PubMed2006

Early detection of left ventricular diastolic dysfunction in Chagas' disease.

BACKGROUND: Chagas' disease may cause left ventricular diastolic dysfunction and its early detection in asymptomatic patients would allow to stratify the risk and to optimize medical treatment. The aim of this study is to investigate if transmitral Doppler flow can detect early abnormalities of the diastolic left ventricular function in patients during the indeterminate phase of Chagas' disease, in which the electrocardiogram (ECG), chest x-ray and 2-D echocardiogram (2D-echo) are normal. METHODS: a group of 54 patients with Chagas' disease was studied and compared to a control group of 27 subjects of similar age. All were assessed with an ECG, chest X-ray, 2-D echo, and transmitral Doppler flow. RESULTS: both groups had similar values in the 2D-echo. In patients with Chagas' disease, the transmitral Doppler showed a higher peak A velocity (control group: 0.44 m/sec, Chagas group: 0.55 m/sec, p = 0.001), a lower E/A ratio (control group: 1.45, Chagas group: 1.22, p < 0.05), and a lengthening of the deceleration time of early diastolic filling (control: 138.7 +/- 26.8 msec, Chagas group: 167.9 +/- 34.6 msec, p = 001), thus revealing an early disorder of the diastolic left ventricular function in patients with Chagas' disease. CONCLUSION: in patients with Chagas' disease who are in the indeterminate phase, transmitral Doppler flow allowed to identify early abnormalities of the left ventricular diastolic function, which provide useful clinical information for prognostic stratification and treatment.

Adult↗
PubMed1993

[Therapeutic consequences of early detection of locoregional recurrences in breast cancer].

The value of follow-up investigations depends on the therapeutic consequences of early detection of recurrences and metastatic disease. After breast conservation early detection of recurrent disease by physical and apparative examinations has to be aimed for due to a possible curation by salvage surgery. Also in recurrences of the chest wall a great deal of local controls can be achieved when detected early and at smaller sizes. While axillary recurrences can be controlled by surgery and radiation therapy the prognosis is poor in the case of a supraclavicular and retrosternal lymph node involvement. Diagnostic and therapeutic options will be discussed for these five types of recurrences.

Breast Neoplasms↗
PubMed1999

Adherence by African American men to prostate cancer education and early detection.

BACKGROUND: This study was designed to identify factors that predict adherence by African American men to prostate cancer education and early detection. METHODS: In the spring of 1995, the authors identified 548 African American men who were patients at the University Health Services of the University of Chicago, were ages 40-70 years, and did not have a personal history of prostate cancer. Baseline telephone survey data were collected from 413 men (75%). Participants were randomly assigned to either a minimal or an enhanced intervention group. Men in the former group were mailed a letter and a reminder that invited them to a urology clinic for prostate cancer education and early detection. Men in the enhanced intervention group were sent the same correspondence and were also given print material and telephone contacts, which were tailored to each recipient. RESULTS: Adherence was significantly higher (OR = 2.6, CI: 1.7-3.9) in the enhanced intervention group than in the minimal intervention group (51% and 29%, respectively). Men who were age 50 years or older (OR = 1.7, CI: 1.1-2.8), were married (OR = 1.8, CI: 1.2-2.9), believed that prostate cancer early detection examination should be performed in the absence of symptoms (OR = 2.3, CI: 1.3-4.0), and self-reported an intention to have an early detection examination (OR = 1.9, CI: 1.2-2.9) were also more likely to adhere. CONCLUSIONS: A tailored behavioral intervention can influence adherence to prostate cancer early detection among African American men. Individual background and cognitive and psychosocial characteristics may also affect behavior. Future studies should assess the impact of this type of intervention on cognitive and psychologic correlates of decision-making and behavior along the continuum of prostate cancer care. [See editorial on pages 1-2, this issue.]

Adult↗
PubMed2000

[PSA-based early detection of prostate cancer].

Prevention of prostate cancer up to now is not possible, advanced stages of prostate cancer are not curable. About 13 000 men a year die of prostate cancer in Germany. PSA-based screening has been shown to be effective in detecting prostate cancer at an early, potentially curable stage; however, this tumor marker is limited by appreciable false-positive and false-negative results. Several PSA-related indexes may improve the power of PSA in early detection: As PSA density, age-adjusted PSA, and percent free PSA. These indexes can improve positive predictive value of PSA-testing, but are not able to differentiate carcinoma from benign hyperplasia on an individual basis. Men presenting for early detection have to be informed about possible overtreatment before undergoing biopsy to further investigate increased PSA above 4.0 ng/ml or suspect findings in digital rectal examination.

Biomarkers, Tumor↗
PubMed2005

Simultaneous detection of hepatitis C virus (HCV) core antigen and anti-HCV antibodies improves the early detection of HCV infection.

To evaluate whether a new enzyme immunoassay developed for the simultaneous detection of hepatitis C virus (HCV) core antigen (Ag) and anti-HCV antibodies (anti-HCV Ab) (Monolisa HCV Ag/Ab ULTRA; Bio-Rad) could improve the early detection of HCV infection, we compared its sensitivity to that of anti-HCV, HCV core Ag, and HCV RNA assays. The populations studied included 12 blood donor samples positive for HCV RNA and HCV core Ag but negative for anti-HCV antibodies and 23 hemodialysis patients who developed anti-HCV Ab (seroconversion) during the follow-up. From these 23 individuals, 83 samples sequentially collected prior to seroconversion and 108 samples collected after seroconversion were tested. Six of 12 blood donations were positive by the HCV Ag/Ab assay. In the hemodialysis cohort, the 24 HCV RNA-negative samples were negative by the HCV Ag/Ab assay and 23 of the 59 HCV RNA-positive samples (39%) were positive. The HCV Ag/Ab assay detected HCV infection on average 21.6 days before the most sensitive antibody assay. The HCV Ag/Ab assay did not detect HCV infection as early as the HCV RNA assay (mean delay, 30.3 days) or HCV Ag assay (mean delays, 27.9, and 16.3 days by the HCV core Ag quantification assay and the HCV Ag blood screening assay, respectively). This new assay provides a notable improvement for the early detection of HCV infection during the so-called window period compared with anti-HCV Ab assays and could be a useful alternative to HCV RNA detection or HCV core Ag assays for diagnosis or blood screening when nucleic acid technologies or HCV core Ag detection are not implemented.

Blood Donors↗
PubMed2002

The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer.

The purpose of this Committee Opinion is to define the role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer. Currently, it appears that the best way to detect early ovarian cancer is for both the patient and her clinician to have a high index of suspicion of the diagnosis in the symptomatic woman. In evaluating symptoms, physicians should perform a physical examination, including a pelvic examination. In premenopausal women with symptoms, a CA 125 measurement has not been shown to be useful in most circumstances. In postmenopausal women with a pelvic mass, a CA 125 measurement may be helpful in predicting a higher likelihood of a malignant tumor than a benign tumor, which may be useful in making consultation or referral decisions or both. A woman with a suspicious or persistent complex adnexal mass requires surgical evaluation by a physician trained to appropriately stage and debulk ovarian cancer. Data suggest that currently available screening tests do not appear to be beneficial for screening low-risk, asymptomatic women. An annual gynecologic examination with an annual pelvic examination is recommended for preventive health care.

Female↗
PubMed2003

The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer.

The purpose of this Committee Opinion is to define the role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer. Currently, it appears that the best way to detect early ovarian cancer is for both the patient and her clinician to have a high index of suspicion of the diagnosis in the symptomatic woman. In evaluating symptoms, physicians should perform a physical examination, including a pelvic examination. In pre-menopausal women with symptoms, a CA 125 measurement has not been shown to be useful in most circumstances. In postmenopausal women with a pelvic mass, a CA 125 measurement may be helpful in predicting a higher likelihood of a malignant tumor than a benign tumor, which may be useful in making consultation or referral decisions or both. A woman with a suspicious or persistent complex adnexal mass requires surgical evaluation by a physician trained to appropriately stage and debulk ovarian cancer. Data suggest that currently available screening tests do not appear to be beneficial for screening low-risk, asymptomatic women. An annual gynecologic examination with an annual pelvic examination is recommended for preventive health care.

Carcinoembryonic Antigen↗
PubMed2002

ACOG Committee Opinion: number 280, December 2002. The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer.

The purpose of this Committee Opinion is to define the role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer. Currently, it appears that the best way to detect early ovarian cancer is for both the patient and her clinician to have a high index of suspicion of the diagnosis in the symptomatic woman. In evaluating symptoms, physicians should perform a physical examination, including a pelvic examination. In premenopausal women with symptoms, a CA 125 measurement has not been shown to be useful in most circumstances. In postmenopausal women with a pelvic mass, a CA 125 measurement may be helpful in predicting a higher likelihood of a malignant tumor than a benign tumor, which may be useful in making consultation or referral decisions or both. A woman with a suspicious or persistent complex adnexal mass requires surgical evaluation by a physician trained to appropriately stage and debulk ovarian cancer. Data suggest that currently available screening tests do not appear to be beneficial for screening low-risk, asymptomatic women. An annual gynecologic examination with an annual pelvic examination is recommended for preventive health care.

CA-125 Antigen↗