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PubMed1984

A neonatal mass-screening for congenital adrenal hyperplasia in Japan.

A pilot neonatal mass-screening for congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) was performed in the western region of Shizuoka Prefecture, Japan, using a simplified radioimmunoassay method for 'Disc-17-hydroxyprogesterone (17-OHP) determination. The results obtained during a 30-month period indicated that 3 infants out of the 34314 neonates examined were proved to have 21-OHD, and the incidence of homozygotes and heterozygotes were estimated to be 1:11438 and 1:54, respectively. At the time of recall, the concentrations of plasma 17-OHP and 21-deoxycortisol and their urine metabolites as well as plasma sodium levels were quite applicable to diagnosis, while the clinical signs that may be manifest in 21-OHD were of little value in this connection. Prematurity and perinatal complications of neonates tended to give false-positive results, being secondary to the function of the residual foetal adrenal cortex and non-specific stimulatory effects of various stresses. Despite several technical and practical problems to be solved, the present study demonstrated the importance and validity of a neonatal mass-screening program for CAH.

17-alpha-Hydroxyprogesterone↗
PubMed1993

Imaging of neuroblastoma in patients identified by mass screening using urinary catecholamine metabolites.

Between April 1983 and August 1991, mass screening in Chiba Prefecture found 25 infants to be positive for neuroblastoma based on elevated urinary levels of catecholamine metabolites. Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy (BS), and 67Ga scintigraphy (GS) detected neuroblastomas in 12 of the 25 infants. The primary site of tumor was the mediastinum in 1 patient, the adrenal gland in 7, retroperitoneum in 3, and pelvis in 1. To determine the accuracy of each imaging technique, the percent sensitivity (SE), percent specificity (SP), and percent accuracy (AC) were determined for each technique from surgical findings and a follow-up study. MRI showed the highest diagnostic accuracy (100% for SE, SP, and AC), followed by CT (100%, 92%, 96%), US (82%, 92%, 88%), BS (58%, 100%, 80%), and GS (42%, 85%, 64%) in that order. MRI is most suitable for the imaging of individuals judged to be positive in the mass screening for neuroblastoma because of the advantages of visualization of the spread of tumor and the relationship of tumor to the great blood vessels, important determinants of resectability and therapy.

Adrenal Gland Neoplasms↗
PubMed1992

[Significance of prostatic specific antigen in the mass screening for prostate cancer].

The significance of prostatic specific antigen (PSA) was investigated in the subjects examined by the mass screening for prostate cancer from 1985 to 1990. All subjects was examined by digital rectal examination (DRE) and with prostatic acid phosphatase (PAP) and the subjects in whom prostate cancer (Pca) was suspected from abnormal DRE and/or elevated PAP were recommended to receive the secondary screening to confirm the presence of Pca. PSA was measured by radioimmunoassay using Ball-Elsa-PSA-kit. 1,600 serum samples were obtained from our serum bank. The relationship among PSA, prostate size estimated by DRE and age was investigated. PSA was increased with age and the prostate size, PSA being more closely related with the latter. Therefore, we estimated that PSA has an ability to detect benign prostatic hypertrophy (BPH) in the mass screening. This estimation should be confirmed by using an ultrasound tomography because the prostate size obtained by DRE is inaccurate as compared with that obtained by ultrasound tomography. The cut off level of PSA was determined by control which was composed from the subjects with normal size prostate and one with BPH. When the cut off level was 8.6 ng/ml, the sensitivity, specificity and efficiency as Pca marker was 73.9%, 97.4% and 97.1%, respectively. PSA was more than 8.6 ng/ml in all of Pca with elevated PAP. PSA was expected to improve the Pca detection rate in our mass screening system.

Aged↗
PubMed1985

Significance of a gastric mass screening survey.

We analyzed the rate of occurrence of gastric cancer in a population of 39,250 by mass screening survey. In 0.123% of the total subjects gastric cancer was detected, 0.064% was at early stage and 0.059% at an advanced stage. The incidence of gastric cancer in the newly examined persons was 0.17%, 0.08% was at early stage and 0.09% at advanced stage. Of the frequently examined persons 0.07% was found to have gastric cancer, 0.043% at early stage and 0.027% at an advanced stage. The rate of occurrence of early gastric cancer was significantly higher than that of advanced gastric cancer within a 1 1/2 year interval of screening. From these results, gastric mass screening survey is considered to be effective in detecting asymptomatic gastric cancer in the "newly examined persons," and also to be beneficial in detecting "early" gastric cancer at intervals of 1 1/2 years of screening.

Adult↗
PubMed1987

Effects of the mass screening of neuroblastoma in Sapporo City.

One hundred sixty-seven cases of neuroblastoma in the Registry of Childhood Malignancies in Hokkaido Prefecture from 1969 to 1984 were studied, using the age at diagnosis, the clinical stage at diagnosis, and the survival rate to assess the influence of the mass screening of neuroblastoma performed in Sapporo City since 1981. In Sapporo City, the capital of Hokkaido Prefecture, the condition of the three parameters improved significantly after the institution of mass screening (e.g., the 48-month survival rate improved--from 21.3% to 87.5%). In Hokkaido Prefecture (Sapporo City excluded), however, where the mass screening had not yet been performed, no significant change was observed in any of the three parameters (48-month survival rate changed only from 21.1% to 28.1%). Consequently, the improvement in Sapporo City was thought to be attributable to the effects of the mass screening.

Age Factors↗
PubMed2002

Effectiveness of mass screening for the prognosis of prostate cancer patients in Japanese communities.

BACKGROUND: A study was conducted to investigate the effectiveness of mass screening (MS) for prostate cancer in Japanese communities using the long-term follow-up results. METHODS: Subjects were 279 patients with prostate cancer detected by MS in Gunma prefecture (MS group) and 624 patients with prostate cancer who did not undergo screening (non-MS group). From the follow-up data, the prognoses were compared between the groups. RESULTS: The ratio of patients with Stage II cancer was higher for the MS group (59.1%) when compared to non-MS group (25.3%). As a whole, the prognosis of the MS group was more favorable than that of the non-MS group for relative survival rate. Prognosis was especially favorable for patients with Stage III prostate cancer in mass screening group considering the effect of lead-time bias. CONCLUSIONS: Early detection and longer survival of the patients with prostate cancer detected by mass screening suggested the effectiveness of prostate cancer screening.

Age Factors↗
PubMed2001

A computer simulation model for cost-effectiveness analysis of mass screening for Type 2 diabetes mellitus.

The cost-effectiveness analysis of mass screening for Type 2 diabetes mellitus (DM) was performed to elucidate whether, who and how often it should be conducted in Taiwan. A series of Markov process was developed to model the disease natural history of Type 2 DM. A hypothetical cohort with 30,000 residents aged over 30 years in Taiwan was randomly assigned to three arms of screening regimes, biennial, five-yearly and the control group. A Monte Carlo computer simulation was performed to calculate effectiveness of two screening regimes compared with the control group. Direct costs and utilities were incorporated to each corresponding state to calculate the incremental costs per life-years gained and per quality-adjusted life-years (QALYs) for biennial and five-yearly screening regimes. The incremental costs for biennial screening regime were estimated at $26,750 per life-year gained, and $17,833 per QALY. The corresponding figures for five-yearly screening regime were $10,531 per life-year gained and $17,113 per QALY. The incremental costs per life-year gained and per QALY increase with age, ranging from $17,238 for aged 30-39 years to $54,700 for aged over 70 years and from $9193 to 36,467, respectively. In conclusion, mass screening for Type 2 DM, especially in younger subjects, with 5-year inter-screening interval is cost-effective in Taiwan.

Computer Simulation↗
PubMed1985

[Current problems in mass screening for breast cancer].

As the trend in the incidences of morbidity and mortality from breast cancer in Japan has been going up in recent years, mass screening for breast cancer is being undertaken on a nationwide scale. In Tokushima prefecture, 111,571 women (49,319 in actual number) were subjected to mass screening with physical examination from 1970-1984. In 116 including 26 cases of so-called "interval cancer", breast cancer was detected. Those with cancer detected by screening were in the earlier stage of the disease as compared to those diagnosed through regular medical care at our out-patient clinic during the same period. In the breast cancers detected by screening, the classifications of tumor size and lymph node involvement were not significantly different among the initial screening cases, subsequent screening cases and interval cases. The detection rate was 0.08% of total examinees, having 0.13% in the initial screening and 0.04% in the subsequent screening. The cancer was detectable mostly in patients aged over 60 and there were few cases in the younger generation. Repeat examinees accounted for 55.8% with an annual increase, but the proportion of initial examinees remained unchanged. Women in their 30s and 40s accounted for about 64.2% of all examinees. The results suggest that procedures such as inspection and palpation are useful for early detection of breast cancer among Japanese women. It is important to emphasize the following items for further improvement in our program, older women should be encouraged to actively participate in the screening, and percentage of initial examinees should be increased. Furthermore, the current objectives of mass screening for breast cancer are: to determine an appropriate screening survey method, to organize an adequate follow-up system for women with abnormal findings, and to educate the examinees in breast self-examination.

Adult↗
PubMed1990

[Mass screening for uterine cancer during the last 10 years--its present situation and problems].

In Omagari city and five towns, 37,793 women were subjected to mass screening of uterine carcinoma from 1979 to 1988. The detection rate of uterine carcinoma was 0.058%. Initial screening rate was 41% 10 years ago, but in 1988, it was decreased to 18%. The peak age of the mass screening was 50-54 years old, but the carcinoma and dysplasia high degree were detected mostly in patients aged 60 years old or more. And the constitution of the age of mass screening in this study was inadequate for the screening of endometrial carcinoma. It is important to emphasize that older women (aged 60 or above) and nullipara should be encouraged to actively participate in the screening of cervical and endometrial carcinoma.

Adult↗
PubMed1995

A Comparison of Mass Screening for Breast Cancer Using Mammography and Physical Examination Alone in Japan.

To compare the sensivity of breast cancer screening methods by conventional physical examination and film mammography, a trial of mass screening for breast cancer using mammography was principally carried out in asymptomatic women over 50 years of age in Tokushima Prefecture. In this trial craniocaudal and mediolateral oblique imagings of the breast using two-view film mammography and physical examination, using inspection and palpation of the breasts were performed independently. Breast cancer was detected in 8 of a total of 950 examinees by mammography alone, and no cases of breast cancer were detected by physical examination. The detection rate of breast cancer was 0.84%, that is 7 times higher than that(0.12%) obtained by conventional mass screening using physical examination alone. The detection rate of increased especially in the sixth and seventh decades of life. The stage of the detected breast cancer was stage 0 (Tis) in 5 cases and stage T, with a tumor size of 1.0 cm or less, in 3 cases. All 8 cases were in the early stage, and they underwent breast conservation therapy. Based on these results, it is recommended to employ mammography in breast cancer screening for asymptomatic women aged over 50 years. We consider mammography alone may be sufficient for mass screening for breast cancer in these subjects.

Journal Article↗
PubMed1987

Mass screening for colorectal cancer--the Philadelphia experience.

On May 18, 1985, the Philadelphia Division of the American Cancer Society and WCAU-TV entered into a jointly-sponsored colorectal health day to do mass screening throughout the greater Philadelphia area. This was preceded by a week-long series of television awareness programs, and an organization based on having individual hospital coordinators for those hospitals participating. A total of 46 hospitals in Pennsylvania alone participated in this project, and over 16,000 people were screened in a single day. 410 patients had positive stools for occult blood on site, and 359 were positive on take-home 3-packs. Rectal pathology was diagnosed initially in 502 patients. 13 colorectal cancers and 38 polyps have been diagnosed directly as a result of this screen. Total cost to the Cancer Society was $13,300, meaning each diagnosed cancer cost $1,023 and each cancer or polyp cost $266 in actual funds expended for the screen. This overwhelming response by the public to such a mass screening effort indicates the potential for such programs for colorectal cancer, and the techniques employed in planning, implementing, and following up on data retrieval are discussed. This mass screening effort should serve as a model for future projects, and emphasize the importance not only of interrelationships with the media, but also liaison efforts with a network of area hospitals and individual hospital coordinators.

Colorectal Neoplasms↗
PubMed2000

[Breast cancer mass screening in the Province of Liege. Results after 8 years].

Breast cancer mass screening by mobile units started in 1992 in the Province of Liège (Belgium). This project is developed for rural areas and interests all women between 40-69 years old not regularly X-rayed in traditional breast cancer diagnosis centers. Despite lots of efforts population participation is low (25%). Nevertheless, the experiment results are encouraging: in a series of 31,443 women, 213 cancers were diagnosed, corresponding to a rate of 6.9/1000, 75% of which are of good prognosis. After an 8 years experiment, it is hoped that the population concerned becomes more sensitive to this mass screening project and one should expect a better collaboration with the other actors in the field of breast diseases diagnosis.

Adult↗
PubMed1977

Cervical cancer. Mass screening, incidence and mortality in Finland.

Since mass screenings were started in Finland, the incidence of cervical cancer has dropped by about 50 per cent. In the age groups 25-60 the decrease has been two thirds. Moreover, there has been a similar decrease in mortality in the younger age groups, in particular. All risk groups are not covered by the screening program, however. Cervical carcinoma is still a socio-medical and clinical problem particularly among elderly women.

Adult↗
PubMed2004

Mass screening of 12,027 elderly men for prostate carcinoma by measuring serum prostate specific antigen.

BACKGROUND: The incidence of prostate carcinoma (Pca) has been increasing in China. We detected Pca in elderly men in Changchun, north China and the significance of prostate specific antigen (PSA) in mass screening and clinical staging of Pca. METHODS: Serum PSA from 12,027 men over 50 years old from Changchun was analyzed. In case of serum PSA greater than 4.0 ng/ml, the patient was suspected of potentially suffering from Pca, and transrectal six-point puncture prostate biopsies were performed under ultrasound guidance. Pathological examinations were performed on the biopsy tissue, and ABCD and TNM clinical stagings were used in accordance with international standards. Correlations between serum PSA level and clinical stage were analyzed. RESULTS: PSA was greater than 4.0 ng/ml in 813 patients (6.8% of the 12,027 men). Transrectal six-point prostate puncture biopsies guided by ultrasound were performed in 273 patients (33.6% of the 813 patients who were tested positive in the initial mass screening). Of these 273 patients, 69 cases of Pca (25.3% of 273) were confirmed by biopsy in the second screening, with an overall detection rate for Pca of 0.57% (69/12,027). The total number of patients in stages A, B, T1, or T2 was 57.9%, and over 20% of them suffered from late stage Pca with lymph node and bone metastasis. An obvious positive correlation was observed between ABCD staging, TNM staging, and serum PSA level. CONCLUSIONS: Serum PSA level is not only the golden standard for mass screening of Pca, but also the predictor for clinical stage of Pca. PSA testing revealed asymptomatic Pca cases in early, middle, and later stages in the elderly, suggesting that mass screening is of paramount importance.

Aged↗
PubMed1993

An evaluation of mass screening using fecal occult blood test for colorectal cancer in Japan: a case-control study.

There is as yet no firm evidence showing that mass screening for colorectal cancer using fecal occult blood tests (FOBTs) reduces the mortality from this cancer. Therefore we evaluated the effectiveness of the screening by a case-control study in Miyagi Prefecture, Japan. The study included as case subjects 28 individuals who had died from colorectal cancer and had had an opportunity to participate in the mass screening before the date of diagnosis as colorectal cancer, and 3 controls for each case subject randomly selected from residents who were alive on the date of death of case subjects and matched by sex, age (within 3 years) and living area using residential files. For each set, i.e., a case subject and 3 controls, screening histories before the date of the diagnosis of the case as colorectal cancer were examined. Both the case subjects and the controls who had participated in the screening at least once within 3 years before the date of diagnosis of the case were classified as "screened." The 28 case subjects consisted of 12 males and 16 females (average age: 60.8 years). The odds ratio of death from colorectal cancer for the screened versus the non-screened persons was 0.24 (95% confidence interval = 0.08-0.76) by the Mantel-Haenszel method. The present study suggests that mass screening using FOBTs for colorectal cancer significantly reduces the mortality from this cancer epidemiologically.

Aged↗
PubMed1986

Evaluation of the efficacy of mass screening for uterine cancer in Japan.

To evaluate epidemiologically the efficacy of mass screening for uterine cancer, we compared the changes in the age-adjusted death rates from cancer of the uterus from 1969-1972 to 1973-1977 between the high coverage-rate areas and the control areas. The main results were: the decrease in the average age-adjusted death rate from cancer of the uterus was greater in the overall high coverage-rate (20% and over) areas (33.4%) than in the control areas (26.9%), but this difference was not statistically significant, when the high coverage-rate areas were limited to those where the uterine cancer death rate in 1969-1972 was greater than 90% of the average rate of all Japan, the decrease in the average age-adjusted death rate from cancer of the uterus was also greater in these high coverage-rate areas (68.1%) than in the control areas (44.2%) and this difference was statistically significant (P less than 0.01), when the high coverage-rate areas were limited to municipalities with a population size larger than 5,000, similar trends were observed. These results suggested that if mass screening for uterine cancer is widely conducted in areas with relatively high mortality rate from uterine cancer, it may be possible to reduce the mortality from this cancer at the community level.

Adult↗
PubMed1977

Mass screening in Sweden for cancer of the uterine cervix. Results and epidemiologic effect.

The mass screening program in Sweden for cancer of the uterine cervix, which was started in 1964, is now almost nation-wide. Approximately a quarter of a million women are screened every year. The attendance varies between 55 and 90%. Approximately two per cent of the screened female population is invited to further examination or treatment. The yield through the mass screening program varies between 3.5 and 10 positive cases per 1000 examined women. The incidence of cancer of cervix is decreasing. This is most evident in those counties, which have been carrying out the screening program for about ten years. The stage distribution in cancer of the cervix has not been changed by the screening program. Mortality in cancer of the cervix is unchanged. There has been an enormous increase in the number of diagnosis of cancer in situ of the cervix, which is a difficult practical problem.

Adolescent↗