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PubMed2000

[The result of mass screening of 1997 for prostatic cancer in Isesaki City].

PURPOSE: Screening by only prostate specific antigen (PSA) for prostate cancer was started since PSA had been added to mass screening as one of check lists in 1997 in Isesaki city, Gunma pref. We expected PSA screening to be introduced into other areas. We therefore studied how to perform a screening procedure for prostate cancer as well as discussed our result of the screening conducted lately. MATERIALS AND METHODS: 1,382 out of 1,423 Isesaki citizens who took mass screening aged 40 to 64 were chosen. Regardless of age, men with a serum PSA level equal or larger than 4.1 ng/ml (Tandem R) were selected for second screening since we determined it was a cut-off level for further check-up. Of those men, 38 were requested for second screening and actually only 24 took it. All these men took PSA check-up again, furthermore 23 took transrectal examination (TRE) and/or transrectal ultra sonography (TRUS) except for one of them. The next screening was requested for sixteen of them. Prostate biopsy was conducted for all of them. RESULTS: More old men took screening and were diagnosed prostate cancer. The findings derived from such diagnosis showed one of them aged 50 to 59 and six of them aged 60 to 64 had the cancer. Moreover, four out of twenty with PSA level ranging 4.1 to 10.0 ng/ml and all of three with PSA level over 20.0 ng/ml had the cancer. Five out of sixteen with a positive sign for further PSA check-ups had the cancer. All the three suspect of the cancer by TURS and DRE had prostate cancer. Two of seven with PSA negative showed suspicion of prostate cancer and had the cancer. No neo-adjuvant and total prostatectomy was conducted for four with 4.0 to 10.0ng/ml diagnosed T2N0 M0. One of them with PSA equal or over 20.0 ng/ml was diagnosed T3N0M0. After hormone therapy its PSA decreased to that equal or under 0.5 ng/ml. Total prostatectomy was conducted for it. CONCLUSION: It is not proved that only PSA mass screening for prostatic cancer contributes to detect early cancer and better prognosis cure case. For the proof, it will be nessary that PSA mass screening is examined more people in the wide area. We conclude men aged 65 to 69 also should take PSA check-up based on epidemiological feature of prostatic cancer.

Adult↗
PubMed1994

[Psychological test as a mass-screening system for depression].

A mass-screening system for depression is aimed at calculation of the prevalence rate, or at mental health checks in employees. But with the recent increased interest in mental health and QOL, depression has become an important issue at every stage of the life cycle. In this paper, we review psychological screening tests for child, adult and aged from the viewpoint of life cycle. Some tests, especially for children and the aged need further tests regarding reliability and validity. What is clarified and which approach in mental health is indicated by the screening test must be further examined. Further development of screening tests, appropriate to each life cycle, is needed.

Depression↗
PubMed1997

Prostate-specific antigen levels from a mass screening program using highly sensitive RIA kits.

BACKGROUND: This study was designed to evaluate the distribution of prostate-specific antigen (PSA) levels of men in a mass screening program for prostatic disease. METHODS: A total of 763 men over 40 years of age underwent mass screening for prostatic disease in a Japanese prefecture using the highly sensitive Eiken kit and the Hybritech (Tandem-R) kit. The screening tests consisted of serum PSA determination, digital rectal examination, a questionnaire on symptoms, evaluation of prostate volume, and determination of the obesity rate. RESULTS: Serum PSA levels of all subjects were measured with both kits. The correlation between the values obtained by the Eiken kit and those of the Tandem-R kit was high (r = 0.990), but the values of the former were slightly higher than those of the latter. Serum PSA weakly correlated with age, however, when estimated within decade age brackets, the levels of PSA showed significant differences among only 1 pair of groups stratified by age. In contrast, the levels of PSA showed significant differences among 9 pairs of groups stratified by prostate volume. CONCLUSION: A highly sensitive assay kit is useful to evaluate both the distribution of PSA levels and the relationship of PSA values to age and prostate volume of men in mass screening programs for prostatic disease, since approximately 40% of the subjects who underwent the present mass screening showed PSA values under 1.0 ng/mL, which have been the the lower limit of detection of many PSA kits.

Adult↗
PubMed1994

[Mass screening for prostate cancer at a local town--five-year results and screening system].

The results of a mass screening examination for prostate cancer conducted from 1989 to 1993 at a local town, Kawagoe-cho, in Mie Prefecture were evaluated. Among the 216 examinees, 4 were found to have prostate cancer. The most accurate examination was the prostate specific antigen (PSA), which was followed by digital examination and transrectal ultrasound. The applicants for the prostate cancer screening accounted for only 8% of the Kawagoe-cho male residents over 40 years old. An educational campaign of prostate disease in the area must be started to increase the number of applicants. We concluded that the most effective modality for the screening program was a combination of PSA and digital examination in the field study, and transrectal ultrasound accompanied by systemic biopsy results in the second tool for screening.

Adult↗
PubMed1993

Effect of mass screening for breast cancer from the aspect of psychosocial assessment of the quality of life.

To assess the quality of life (QOL) in patients with breast cancer receiving mass screening, a collaborative matched case-control study was conducted in nine hospitals throughout Japan. A total of 122 patients detected by mass screening (study group) and 226 patients found in out-patient clinics (control group) were assessed psychosocially on the basis of questionnaire information. The incidence of patients with early stage breast cancer was significantly higher in the study group than in the control group (P < 0.05). Chest wall pain was observed in 35.2% of the study group and in 46.5% of the control group (P < 0.05). Although control patients were more optimistic than study group patients, disturbed daily life and anxiety about recurrence were a little more frequent in the former group than in the latter. In particular, shoulder stiffness was frequently seen in the control group (P < 0.05). Early detection and information do not create anxiety in mass screening patients (P < 0.01). We should recommend mass screening to patients to detect early stage breast cancer and provide better QOL.

Activities of Daily Living↗
PubMed2004

[Usefulness of low-dose single-slice CT (SSCT) for mass screening to detect various thoracic diseases including lung cancer].

This study assessed the usefulness of SSCT for mass screening retrospectively in 8885 subjects (6781 men, 2104 women) who had received mass screening to detect thoracic disease by using SSCT from 1999 to 2003. In the 8885, 119 (1.3%) lesions were detected as active thoracic disease. These 119 lesions comprised 39 neoplasms and 80 instances of non-neoplastic disease. Of those with neoplastic lesions, 25 had lung cancer (adenocarcinomas, 20; Squamous, 3; carcinoids, 2), 7 had mediastinal tumors and 7, others. Non-neoplastic cases comprised 39 of COPD (pulmonary emphysema), 17 of pulmonary tuberculosis, 8 of non-tuberculous mycobacteriosis and 16 others. Surgical treatment was performed in 46 cases: 25 of lung cancer, 14 of non-cancerous neoplasms, 3 of pulmonary sequestration and 4 others. In the lung cancer cases, the post-surgical staging was I or II (stage I, 20; stage II, 5). Low-attenuation areas (LAA) were seen on multiple CT slices in 2.2% of all subjects (195). These 195 cases had no respiratory symptoms such as exertional dyspnea, But 39 of them had an FEV1.0% (FEV1.0/FVC) of less than 70%. All 39 had a history of smoking, We suggested that SSCT screening is a useful method of mass screening to detect thoracic neoplastic lesions as well as non-neoplastic lesions.

Adult↗
PubMed1987

Mobile unit for use in mass screening for breast cancer.

Since 1977, mass screening for breast cancer has been carried out in Miyagi prefecture, Japan. The main activities involve itinerant screening in the communities and group screening at the workplaces. The first step in this screening is the physical examination; the second step, for women with suspicious findings, is examination by mammography and ultrasonography, in a specially equipped mobile unit. The number of subjects screened over a seven-year period ending in March, 1984, was 94,953. Mammography was performed on 4,485 subjects (4.7 per cent) Breast cancer was detected in 116 subjects (0.12 per cent). Since 1980, 2,292 high risk subjects have undergone mammography as the first step screening. The detection rate (0.35 per cent) for this group was higher than for the general subjects examined. Therefore, mammography performed in a mobile unit is a suitable approach for the detecting and diagnosing of breast cancer.

Breast Neoplasms↗
PubMed1987

[Cost-benefit effect of mass screening for prostatic disease on national economy].

A survey was made to determine how much mass screening for prostatic cancer (PC) and benign prostatic hypertrophy (BPH) would benefit the nation economically. Presently in Japan, approximately 20,000 people are suffering from PC, approximately 0.2% of the male population over the age of 55. Approximately 37 billion yen is spent annually to treat them with current medical care. This amounts to approximately 0.3% of the annual national medical fee for all diseases and approximately 4% for malignant neoplasms. However, if all adult males participated in a mass screening program for prostatic cancer once every two years, a program already established by us, eradication of PC may be theoretically possible at the cost of approximately 31 billion yen per year. Mass screening for prostatic cancer will thus contribute highly to both the reduction of the national medical costs and the decrease of deaths from cancer. The nation also spends heavily on BPH. There is an urgent need to recognize that BPH is a heavy burden on the national economy, and to consider a proper counterplan.

Aged↗
PubMedDate not supplied

Nipple discharge cytology in mass screening for breast cancer.

Since 1977 mass screening for breast cancer has been conducted in Miyagi Prefecture, Japan; inspection, palpation and cytologic examination of any nipple discharge are part of the initial screening procedures. Among 149,681 subjects examined, 404 cancer cases and 63 papilloma cases were detected. The nipple discharges from 20,537 women were examined cytologically; of the 61 cancer cases, the smears were positive in 18 cases, suspicious in 7, negative with atypical findings in 12 and negative in 24. Ten of the cancer cases were detected exclusively by the cytologic examination of a nipple discharge. In eight of these ten cancer cases, there was no other initial evidence of the primary tumor. The cytologic diagnosis of discharges without blood from 28 cancer cases was positive or suspicious in 10 cases and negative in 18. Thirty-seven of the papilloma cases were initially detected only by the cytologic examination of a nipple discharge; neither physical examination nor mammography showed any abnormal findings.

Adult↗
PubMed1989

[Mass screening of neonates for histidinemia].

The authors report on newborn mass-screening for histidinemia by Guthrie bacterium inhibition assay. 51,618 newborns were screened and 805 cases with more than 5 mg% histidine blood level were found. A second test, urocanic acid thin-layer chromatography was done from these samples. According to these tests no histidinemic patient was detected. It is worth mentioning that blood histidine level exceeded 20 mg% in 55 cases from 805 newborns. Considering our screening results, the low incidence and the relatively good prognosis of the disease, a mass-screening in Hungary is not necessary.

Histidine↗
PubMed2004

Mass screening of prostate cancer in Changchun City of China.

OBJECTIVES: Mass screening of prostate cancer in China had not been studied until now. To clarify the incidence of prostate cancer among the population of aged men in Changchun City of China, we performed a mass screening program for prostate cancer using prostate specific antigen (PSA). METHODS: Men aged more than 50 years were examined by PSA, with a cut-off values 4.1 ng/ml. Subjects, whose serum PSA concentration was more than 4.1 ng/ml, were recommended to secondary examination of transrectal ultrasound-guided systematic six-sextant biopsy examination (TRUS-guided biopsy). RESULTS: Between April 1998 and December 2000, in the urban area of Changchun City 4218 men over 50 years old were screened. As 190 men were found to have elevated PSA and 116 men underwent a TRUS-guided biopsy of the prostate, of whom 29 men were found to have cancer. In all, the age-adjusted PSA positive rate was 4.80%, cancer detection rate was 0.74%. The age-adjusted cancer detection rate was 0.78%. After adjusted for secondary examination rate, the cancer detection rate reached 1.28%. The cases of stage B with limited cancer within the prostate gland, accounted for 62% of 29 cancer cases. Stage B was much more detected (accounted for 60%) in the PSA range of 4.1-10.0 ng/ml. Stage C and D were much more detected (accounted for 85.71%) in the PSA range over 10.1 ng/ml, with a significant difference by Fisher exact test (P < 0.05). A significant correlation of age-adjusted PSA positive rate and age-adjusted cancer detection rate adjusted by secondary examination rate was showed in six groups of Community and Army, Factory, Corporation, Post and Telecom Office, Government and Academy, and University and Technical School (r = 0.898, P < 0.01). Both of the age-adjusted PSA positive rate and age-adjusted cancer detect rate of "Universities and Technical Schools" were significantly higher than that of "Factories" (chi2 test P < 0.05). CONCLUSIONS: The prevalence of prostate cancer was not so low in Chinese people as expected. For 50 years or older men, cancer detection rate was 0.74%, The age-adjusted cancer detect rate was 0.78%. Much more early stage cancer could be detected in the screening using serum PSA. For the different company the detection rate of prostate cancer varied each other among the groups. Age-adjusted cancer detection rate in "Universities and Technical Schools" were significantly higher than in "Factories", suggesting environment factor or diet might be associated with the prostate cancer.

Age Factors↗
PubMed1996

Usefulness of ultrasonography combined with conventional physical examination in mass screening for breast cancer: a retrospective study of Yamanashi Health Care Center results from 1989 to 1994.

We retrospectively analyzed the records for 34,474 women who participated in mass screening for breast cancer by physical examination with or without ultrasonography (US) at Yamanashi Health Care Center between April, 1989 and March, 1994 to evaluate the usefulness of US in mass screening. In one group (15,935 women) conventional physical examination with inspection and palpation alone had been performed, and in another (18,539 women) both conventional physical and US examinations were performed. Breast cancer was detected in 27 of the women (0.08% of the total group screened), 22 of whom were in the group examined by US; moreover, 16 of these 22 women had early breast cancer, which was a non-palpable tumor in 13. Half of the 22 women were examinees under the age of 50 years. Of the 22 tumors detected in the groups examined by US, 16 (73%) were early breast cancer. The overall detection of early breast cancer (0.09%) in the US group was significantly higher than that (0.01%) in the group examined by conventional methods (P < 0.05). Of the tumors detected in the US group, 59.1% were non-palpable. These results suggest that early and non-palpable breast cancer can be detected using US, and the incidence of detection of such tumors in women under the age 50 years is increased in mass screening including US examination. This examination is effective in mass screening for breast cancer, especially for early and non-palpable breast cancer tumors.

Adult↗
PubMedDate not supplied

Effectiveness of mass screening for endometrial cancer.

OBJECTIVE: To investigate the effectiveness of mass screening for endometrial cancer using Endocyte (Laboratoire CCD, Paris, France) endometrial smears. STUDY DESIGN: The study subjects were consecutive patients with documented endometrial cancer diagnosed between January 1, 1989, and December 31, 1997, at 22 hospitals in Japan. One hundred twenty-six cases were detected by mass screening and 1,069 diagnosed in outpatient clinics. We compared the stage of cancer at diagnosis and survival rate of patients in the two groups. RESULTS: Early stage was significantly more frequent in the screening group (P < .001); stage I comprised 88.1% of the screening group as compared with 65.3% of the outpatient group. Well-differentiated adenocarcinoma was significantly more frequent in the screening group (P < .01); grade 1 constituted 74.7% of the screening group as compared with 61.0% of the outpatient group. The five-year survival rate was significantly higher in the screening group than in the outpatient group (94.0% vs. 84.3%, P = .041). The crude hazard ratio (HR) of dying of endometrial cancer for the screening group as compared to the outpatient group was .47 (95% CI .22-.99, P = .048). HR became .96 (95% CI .45-2.08, P = .925) after adjustment for age, study area and cancer stage. CONCLUSION: The results suggest that an endometrial cancer screening program would lead to early detection and improved survival among women with endometrial cancer.

Adult↗
PubMed2005

Projected color slides as a method for mass screening test for color vision deficiency (a preliminary study).

This article compared the efficiency of the mass screening test with projected color slides in detecting color-blindness with the authentic classic method of Ishihara. The study was conducted in a randomly selected lecture room with 104 students aged between 19-25 years (median 21). Using Ishihara projected slides, performed mass screening test. Re-testing was done individually with printed Ishihara plates. Six male and one female with color-blindness were detected. The frequency of color-blindness was 13.6% among males, with a total incidence of 6.7%. The results of two testing methods were compared statistically. Sensitivities and specificities of both tests were 100%. Using projected slides of Ishihara plates instead of the authentic method is an effective and timesaving method for detecting color-blindness. This method can be suggested as a mass-screening test and might be beneficial in detecting color-blindness in large populations such as students, soldiers, and so on.

Adult↗
PubMed1992

[A study on the mass screening system for prostatic diseases].

Between 1984 and 1990, a mass screening for prostatic diseases was carried out on men over 55 years old in cities, towns and villages in Toyama Prefecture, Japan. The total number of subjects examined in the primary study was 1,232, which was 17.7% of the males over 55 years old in these areas. The primary study consisted of inquiry concerning urination, digital examination of the prostate, transabdominal ultrasonography, and determination of tumor markers. A secondary study was indicated for 100 subjects (8.9%) suspected to have prostatic cancer and 169 (15%) suspected to have benign prostatic hypertrophy, but only 92 (35%) of them were actually examined. Prostatic cancer was histologically diagnosed in 3 subjects (0.3%), and benign prostatic hypertrophy was established in 56 subjects (4.5%), who were referred to urologists. Though a high percentage of the population was covered by the primary study the percentage of subjects who received the secondary study among those in whom it was indicated was low. This probably was a reason for the low detection rate of prostatic cancer. An improved system is considered to be needed to increase the efficiency of mass screening for prostatic diseases.

Humans↗
PubMed1996

Mass screening for neuroblastoma: quo vadis? A 9-year experience from the Pediatric Oncology Study Group of the Kyushu area in Japan.

Since 1985, a nationwide program of mass screening for neuroblastoma has been available for 6-month-old infants throughout Japan. From 1985 to 1993, the authors studied 285 patients with neuroblastoma among their regional population of 15 million. There was an increase in the total number of patients per year in comparison to the previous 6-year period (1979 to 1984). However, no significant difference was noted in the number of patients older than 1 year or in the incidence of advanced-stage (stages III and IV) unscreened cases. The majority of neuroblastomas in the screened group showed favorable biological factors, even in the advanced stages. However, there was a small group with histologically and/or biologically unfavorable factors; five of 115 had amplified N-myc oncogene, four of 74 showed unfavorable Shimada histological findings, and three of 33 had an unfavorable DNA ploidy pattern. One case from this group with unfavorable factors died of the tumor. 3) Thirty-eight cases were negative at the time of mass screening, but later presented with neuroblastoma. Most of them were diagnosed between 1 and 3 years of age, and 30 of the 38 cases (78.9%) were advanced stage with unfavorable prognostic factors. Thus, the authors conclude that mass screening at 6 months can detect a selected population of infants with neuroblastoma; some of the tumors may represent subclinical masses destined for spontaneous regression. However, some tumors with unfavorable factors have been detected by mass screening before progression and/or dissemination. Infants in this group are considered to benefit most from early diagnosis and treatment.

Adolescent↗
PubMed1991

The study of the mass screening of persons without symptoms and of the screening of outpatients with gastrointestinal complaints or icterus for pancreatic cancer in Japan, using CA19-9 and elastase-1 or ultrasonography.

To investigate the possibility of detecting carcinomas of the pancreas at an early stage by mass screening of persons without symptoms or by screening the outpatients with gastrointestinal complaints or jaundice, we performed a multicentral study of the mass screening of 10,162 persons at five local areas and of the outpatient screening of 4506 at 17 hospitals for pancreatic cancer in Japan for two years from 1984 to 1985, using serum CA19-9 and elastase-1 determinations or ultrasonography. Mass screening of 10,162 persons over 40 years old found only four (0.04%) cases of pancreatic cancer, including one case that was curatively treated. According to the screening of 4506 outpatients with gastrointestinal complaints or icterus, 85 (1.9%) patients were found to have pancreatic cancer. Of these 85 patients, 28 could undergo curative treatment. In addition to them, 73 (1.6%) patients with other digestive organ cancer were found. Our results suggest that the mass screening of persons without symptoms is not worthwhile in the early detection of pancreatic cancer, but outpatient screening is useful for detecting curative cancers of the pancreas.

Adult↗