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PubMed1998

[Mass screening for prostate cancer--how to eliminate clinically insignificant cancer].

The ultimate aim of the mass screening program for prostate cancer is to decrease prostate cancer mortality, which can be demonstrated only in a well-designed and well-controlled trial comparing screened and unscreened populations. However, no trials have been performed to demonstrate the effect of this program. Some reports claimed that such a program includes the high possibility of detecting clinically insignificant cancer, for example, latent cancer. In this paper, early cancer detection and treatment in mass screening program are discussed.

Humans↗
PubMed2001

A case-control study for evaluating the efficacy of mass screening program for lung cancer in Miyagi Prefecture, Japan.

BACKGROUND: In Miyagi Prefecture, Japan, a mass screening program for lung cancer has been conducted since 1982 (miniature chest X-ray for all screenees and sputum cytology for those with a smoking index > or = 600) [smoking index 600 = 30 pack years, the average number of cigarettes smoked per day multiplied by the number of years of regular smoking]. Over 1500 lung carcinomas, including 250 roentgenographically occult lung tumors, were detected and treated up to 1999. In the current study, a nested case-control study was conducted in the population that was screened in 1989 to evaluate the efficacy of the screening program for lung cancer. METHODS: To reduce self-selection bias, the source population was defined as screenees with negative results in 1989 (284,226 individuals). In the population, 474 individuals died of lung carcinoma during 1992-1994. After exclusion, 328 patients who died of primary lung carcinoma at between ages 40 years and 79 years were defined as the cases. Six controls were supposed to be selected in the source population for each case and matched by gender, year of birth, municipality, and smoking habits. Controls who had died or moved before the matched case was diagnosed were excluded. Finally, 328 cases and 1886 controls were selected. Screening histories were compared, and odds ratios were calculated using conditional logistic regression analysis. RESULTS: Within the 12 months before diagnosis, 241 of 328 cases (73.5%) had attended the screening compared with 1557 of 1886 controls (82.6%). The smoking-adjusted odds ratio was 0.54 (95% confidence interval, 0.41-0.73). CONCLUSIONS: The mass screening program for lung cancer in Miyagi Prefecture was capable of reducing by 46% the risk of death from carcinoma of the lung.

Adult↗
PubMed1990

Prevalence of genital human papillomavirus infections in a mass-screened Finnish female population aged 20-65 years.

The results of the nationwide, population-based cervical cancer screening programme (organized by the Finnish Cancer Society since early 1960s) were analysed to establish the prevalence figures (and their changes) for genital human papillomavirus (HPV) infections in an unselected Finnish female population (aged between 20 and 65 years) screened in Kuopio Province between 1981 and 1989. During the study period 82,393 women were invited on a regular basis for the mass-screening, and also 4131 women in a risk group. Of these, a total of 63,115 and 3249 women attended, resulting in the attendance rates of 76.6% and 78.6%, respectively. As a result of the screening, a total of 509 (0.80%) of the 63,115 smears were diagnosed as having the cytological changes consistent with HPV infection in the mass screening. The corresponding figures in the risk group screening were 58/3249 (1.78%). There was a sharply increasing trend in the prevalence of genital HPV infections from 1981 through 1987, from 0.04% to 1.76% (ie a 44-fold increase in 7 years) which, surprisingly, then declined to 1.43% in 1988 and 1.04% in 1989. Based on a random sample of 2084 routine (non-mass-screening) Pap smears (out of (28,861) collected from the files of our laboratory, the prevalence of HPV infections was stratified by age groups. The highest prevalence (6.1%) was observed in women aged between 20 and 29 years, followed by 2.2% in those aged 30-39 years. Using the figures of the relative risk (RR) of HPV infections by age, an estimation was made to assess the prevalence of clinical HPV infections in the Finnish female population in general.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Results of a colpocytologic mass screening and in-patient casework: comparison by age groups.

This paper reports the results of cervico-vaginal examinations performed on the women (7,098) resident in the municipality of Bollate (mass screening) and the women (1,416) hospitalized in the Gynecologic ward in the same period (in-patients). Age distribution, prevalence of initial and invasive forms, and prevalence according to age groups have been considered. The results are: 1) any kind of lesion is more frequent among in-patient than mass-screening subjects; 2) the prevalence of benign displasia, incipient, in situ and invasive carcinoma per age group, considered per quinquennium, shows a three-phase trend, both in mass screening and in-patient cases; 3) the time of evolution is different for cervicocarcinoma in the different age groups of incipience. Periodic checks are a useful means of precocious diagnosis of cervicocarcinoma; the frequency of checks should vary according to patient age.

Adult↗
PubMed1993

[Examination of serum prostate specific antigen (PSA) in the mass screening for prostatic diseases].

While it is widely recognized that elevated prostate specific antigen (PSA) correlates with the presence of prostate cancer, little data exist on the use of PSA as the initial test in the mass screening for prostate diseases. Thus, digital rectal examination, transrectal ultrasonography of the prostate as well as measurements of serum PSA were performed in a series of 647 men 55 years old or older who participated in the mass screening. We found 7 patients with prostatic cancer (1.1%) and 53 with benign prostatic hypertrophy faced with the necessity of the therapy (8.2%). The PSA values of 6 cancer patients exceeded 3.6 ng/ml and that of one cancer patient was 2.6 ng/ml. While 587 subjects were judged to be without clinical evidence of prostate cancer and benign prostatic hypertrophy, 564 of them has PSA values under 2.6 ng/ml. The proportion of those who were free from prostatic diseases and had a PSA value of 2.6 ng/ml or more was only 3.4% of all participants. Since the proportion of the subjects falsely screened at a relatively lower cut-off point of PSA was quite low, the measurement of serum PSA is suggested to be useful as the initial test in the mass screening for prostatic diseases.

Aged↗
PubMed1999

A new mass screening method for methylmercury poisoning using mercury-volatilizing bacteria from Minamata Bay.

A simplified mass screening method for methylmercury exposure was developed using methylmercury-volatilizing bacteria from Minamata Bay. Some bacteria can transform methylmercury into mercury vapor. Most mercury in the hair is methylmercury, which is readily extracted with HCl solution. Black spots are formed on X-ray film due to the reduction of Ag(+) emulsion with mercury vapor produced by methylmercury-volatilizing bacteria. By exploiting these characteristics, a screening method was developed, whereby the fur of rats injected with methylmercury chloride formed clear black spots on X-ray film, whereas the fur of rats injected with saline did not. Subsequently, 50 human hair samples were examined using this mass screening method. The method identified people who had high mercury concentration, over 20 microg/g. A few thousand hair samples may be screened in a day using this method because it is rapid, simple, and economical. This method, therefore, enables screening of persons with methylmercury poisoning in mercury-polluted areas.

Animals↗
PubMed2003

Neuroblastoma detected by mass screening: the Tumor Board's role in its treatment.

Japan has a nationwide mass-screening program for neuroblastoma in 6-month-old infants. Neuroblastoma can regress spontaneously, and some institutions observe selected cases. We evaluated the management of screened neuroblastoma at our hospital since 1997 when an observation program was introduced. Criteria for the observation program were stage-I, stage-II, or stage-IVs tumors, urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels <40 microg/mg creatinine, tumor <5 cm in diameter, no invasion to the intraspinal canal or great vessels, and parental consent to participate. Patients who did not meet observation criteria underwent surgery or mild chemotherapy according to the location of the tumor. If patients met observation criteria after chemotherapy, surgical intervention was no longer performed. Thirty-six patients attended our hospital for screened neuroblastoma from 1997 to 2002. Thirty-three patients who were managed at our hospital participated in this study. Ten subjects met observation criteria. Tumors regressed in 7 patients (mean follow-up period 36.3 months) with corresponding decreases in VMA and HVA levels (group A). Three underwent surgery (group B) because of increasing VMA and HVA levels, increase in tumor size, or guardian's request. Twenty-three subjects did not meet observation criteria. Four patients underwent primary surgery (group C), and 19 patients had chemotherapy initially. Fourteen patients met observation criteria after chemotherapy and two are still having chemotherapy (group D). Three patients required surgery due to insufficient regression of their tumors (group E). Fourteen subjects in group D had marked decreases in VMA and HVA levels and tumor size (mean follow-up period 29.1 months), and tumors were not detected using imaging techniques in 8 patients. Histological examination of all resected specimens during the study period showed favorable histology and no N-myc amplification. There was no evidence of unfavorable prognosis in any of the 33 subjects, although 1 patient who underwent primary surgery had a vanishing kidney 1 year later and 1 patient had multiple bony metastases after complete resection of tumor, which was treated by chemotherapy. Until the real significance of mass screening for neuroblastoma as a public health measure is confirmed, observation with careful follow-up should be adopted more extensively because it has a favorable outcome in many cases, and is associated with minimal therapeutic complications.

Adrenal Gland Neoplasms↗
PubMed1995

PSA assay of dried blood samples from the ear lobe on a filter paper with special reference to prostatic mass screening.

To eliminate complicated procedures for taking blood samples in the field work for prostatic mass screening, we developed a method for PSA testing using blood samples taken from the ear lobe and dried on a filter paper. The stability, the diagnostic efficacy, and the cost-benefit effect of the method were confirmed in hospitalized patients, as well as in subjects from our mass screening program.

Blood Specimen Collection↗
PubMed1991

Mass screening for rectal neoplasm in Jiashan County, China.

Jiashan county is a rural area in China with very high incidence and mortality rates of colorectal cancer. From 1980 to 1984, we conducted a mass screening for rectal neoplasm in the 11 people's communes in this county. Of the 72,879 individuals who were eligible for screening, 60,496 participated, representing an overall participation rate of 83.0%. Both the fecal occult blood (OB) test and rectoscopy were performed on 47,560 of the participants, and rectoscopy only was performed on the remaining 12,936 individuals. From the mass screening, 15 rectal cancers, 3 carcinoids, 899 polyps, 98 ulcers, and 7 inflammatory tumors were detected, a total of 1022 cases. Eight of the 15 detected cases of rectal cancer were in Dukes' stage A. We did not find any evidence for an association between schistosomiasis and colorectal cancer. Results from the OB test were found to have a negative correlation with results from rectoscopy (odds ratio = 0.8, 95% CI = 0.6, 1.1). The OB test had a high false positive rate of 32.7%, and a poor positive predictive value of 3.5%. Both its positive and negative predictive powers were below 1.0, in other words, its positive likelihood ratio was below 1.0 and negative likelihood ratio was above 1.0, indicating that the OB test is not informative and has a poor predictive accuracy for rectal neoplasm. In addition, there were a number of practical problems concerning the use of the OB test for mass screening in the rural community.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

An international survey of attitudes of medical geneticists toward mass screening and access to results.

A survey on mass screening was sent to 1,053 medical geneticists in 18 nations, of whom 677 responded. Three theoretical screening situations were proposed, screening in the workplace for genetic susceptibility to work-related disease, carrier screening for cystic fibrosis, and presymptomatic testing for Huntington disease. Of the respondents, 72 percent thought screening in the workplace should be voluntary, and 81 percent said employers should have no access without the worker's consent, including 22 percent who believed that employers should have no access at all. There was strong consensus in all but one nation that insurance companies should have no access to test results without the worker's consent, and strong consensus in two countries that they should have no access at all. Most (82 percent) believed that screening for cystic fibrosis should be applied to the entire population, but 18 percent believed that it should be applied primarily to Caucasians. In all, 66 percent of respondents believed that individuals at risk for Huntington disease should be told their test results only if they say that they wish to know, recognizing a "right not to know" whether they will develop the disease in later life. Twelve percent thought that spouses should have access to test results if they asked, and 26 percent thought that spouses should be informed of results even if they did not ask. Geneticists in all nations were vividly aware of the potential damage from third party access to results, especially access by insurance companies. They had little sympathy with insurers' needs to assess actuarially accurate premiums.

Attitude of Health Personnel↗
PubMed2003

Evaluation of a mass screening program for lysinuric protein intolerance in the northern part of Japan.

Lysinuric protein intolerance (LPI:MIM 222700) is an autosomal recessive disease characterized by defective transport of the dibasic amino acids. We recently reported a local cluster of LPI in the northern part of Japan (Koizumi et al., 2000). Mutational analysis of the LPI patients in this local cluster revealed they were exclusively homozygous for the R410X mutation. The effectiveness of early intervention with citrulline therapy (200 mg/kg per day) and protein restriction (1.5 g/kg per day) was confirmed in these patients. Mass screening was conducted in 4,568 newborn babies between 1999 and 2002, which was estimated to cover 100% of almost all newborns delivered in the screened area. Forty heterozygous newborns were found (0.88%), leading to an estimated incidence of LPI of 1:51,984. The number of people that required screening to detect one case was 51,984, and the cost for mass screening was 30 cents/person (a total of dollars 15,600). This is comparable to, or even less than, the cost of currently screened diseases in Japan. Therefore, we conclude that a mass screening program for LPI can be introduced effectively and economically into an area where an LPI cluster is located as the result of a founder mutation.

Adolescent↗
PubMed2006

The reasons of general practitioners for promoting colorectal cancer mass screening in France.

Implementation of colorectal cancer (CRC) mass screening is a public health priority. Obtaining the involvement of general practitioners (GPs) is crucial for ensuring participation by the general public. This study elicited GPs' reasons for promoting CRC screening. The method used was discrete choice modeling. Questionnaires with a set of pairs of hypothetical screening scenarios were sent to 700 GPs. Factors influencing GPs' screening practice were found to be: the effectiveness of the screening program, the proportion of false negatives and false positives, and their remuneration. Hence improving screening test sensitivity and setting up specific remuneration for conducting screening would help to increase GPs' participation in CRC screening in France.

Adult↗
PubMed1995

Neuroblastoma mass screening: the arguments for and against.

Neuroblastoma is the second commonest malignancy in childhood. The prognosis of the disease is largely dependent on the extension of the tumour at diagnosis. For disseminated disease the survival rate is very low. The question as to whether mass screening in infants can improve the prognosis of the disease was first addressed in Japan more than 20 years ago. Since then, more than 7 million children have been screened in Japan and over 650 cases of neuroblastoma have been detected. However, the available data are compromised by an inadequate cancer registry and conclude that screening at 6 months of age seems to double the incidence of neuroblastoma. This result has been verified by a Canadian study conducted from 1989 to 1994 in the province of Quebec. The incidence of neuroblastoma appeared to have tripled, and there was no decrease in the rate of advanced disease. Mass screening pilot studies have also been conducted in the U.K., France, Austria, Australia, U.S.A., Italy, Norway and Germany. Analysis of the results shows that neuroblastoma screening before the age of 6 months is feasible, but no significant reduction in mortality could be shown until now. Moreover, most of the cases diagnosed by screening have favourable biological markers. Only a few with unfavourable parameters, such as amplification of proto-oncogene MYCN, diploidy and/or del 1p36 could be detected. A screening programme that includes 1.25-2 million screened and unscreened children at 1 year of age monitored by an almost complete national cancer registry should show whether mass screening for early detection of neuroblastoma is worthwhile.

Biomarkers, Tumor↗
PubMed1997

[Mass screening of colorectal cancer by general practitioners in France: what is the real target population?].

OBJECTIVES: People at high risk of colorectal cancer, due to familial or personal history, or to specific symptoms, are considered not to be concerned by mass screening by Haemoccult test. The aim of this study was to investigate people aged 50 to 74 with high risk of colorectal cancer among general practitioners' practices in the department of Calvados (France). METHODS: A random sample of 200 general practitioners were asked to systematically fill out a questionnaire on Haemoccult II proposal for 50-74 year-old patients for a whole week. RESULTS: Participation rate of general practitioners was 58.5%. According to our findings, 13% of 50-74 years patients are considered not be concerned by mass screening, due to familial or personal history, or to specific symptoms. CONCLUSIONS: Colorectal cancer screening protocol have to be fit to level of risk of colorectal cancer. Involvement of general practitioners in colorectal cancer mass screening allows identification of high risk people who can then be managed with a more suitable screening protocol.

Aged↗
PubMed2003

Clinical usefulness of iodine-123-MIBG scintigraphy for patients with neuroblastoma detected by a mass screening survey.

UNLABELLED: The purpose of this study was to evaluate the usefulness in a clinical setting of iodine-123-metaiodobenzylguanidine (123I-MIBG) scintigraphy, planar and single photon emission computed tomography (SPECT) images, in patients with neuroblastoma as detected by a mass screening survey. METHODS: 123I-MIBG planar whole body images, and regional SPECT images of patients with neuroblastoma in 51 studies were reviewed. They were all detected by a mass screening survey performed in the 6th month after birth using vanil mandelic acid (VMA), and homovanillic acid (HVA) and the neuroblastoma had been confirmed by surgery. Scintigraphy was performed 24 hours after injection of 111 MBq of 123I-MIBG. We assessed the accuracy of the planar whole body images in order to demonstrate the extent of the lesion and the correlation between the degree and extent of the lesions of 123I-MIBG accumulation and clinical staging with tumor markers, such as urinary VMA, urinary HVA, serum neuron specific enolase (NSE) and serum lactate dehydrogenase (LDH). Additionally, we evaluated SPECT how useful supplemental SPECT might be in a clinical setting as compared with planar whole body images. RESULTS: 123I-MIBG planar whole body images revealed all 33 (100%) primary lesions, 4 of the 5 cases (80%) with liver metastasis, 3 of the 13 (23%) with lymph nodes metastasis and 1 of 3 (33%) with bone marrow infiltration. The extent and degree of accumulation correlated with the values of urinary VMA, urinary HVA and serum NSE. SPECT images helped to understand the positional relation in all cases and provided useful additional information for clinical staging in 7 cases. CONCLUSION: 123I-MIBG scintigraphy with planar and SPECT images is useful for evaluating patients with neuroblastoma, following detection by a mass screening survey.

3-Iodobenzylguanidine↗