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PubMedDate not supplied

Mass screening for neuroblastoma in Japan.

The present status of the neuroblastoma mass screening program in Japan, the first national trial in the world, is evaluated. This program, now in its fifth year, was conducted in cooperation with the infants' mothers, local health centers, screening centers, and selected hospitals. From the onset of the program in Kyoto in 1973 to the end of 1989, 337 cases were detected and analyzed. Most cases were detected at early stages and 97% are expected to be cured. Several social, technical, and clinical problems remain unresolved.

Abdominal Neoplasms↗

PubMed1988

[Mass screening or early detection of cancer of the prostate by echography].

Mass screening of prostatic cancer by transrectal ultrasonography would result in between 600 and 2,500 negative biopsies for one positive biopsy, depending on the quality of the ultrasonographic image obtained. It is clear that such a procedure is not profitable. Early detection of prostatic cancer is profitable in a male population over the age of 50 with benign prostatic enlargement. For one positive biopsy, there would be 7 to 25 negative biopsies. In our opinion, a 4 to 16% yield justifies endorectal ultrasonography to look for a malignant prostatic tumor and is fully justified in men scheduled to undergo surgery on an adenoma of the prostate.

Adenocarcinoma↗

PubMed1992

[Biochemical diagnosis and mass screening for hereditary amino acid disorders].

During the past 50 years, the development of both organic and analytical chemistry has greatly contributed to the discovery of new hereditary amino acid disorders. As a result, more than 80 new amino acid disorders have been discovered. More recently, the development of protein chemistry has made it easily to investigate the biochemical basis of these disorders. In this paper we present the status of biochemical diagnosis as well as mass-screening for amino acid disorders. The result of neonatal mass-screening for 4 amino acid disorders (PKU, MSUD, homocystinuria and histidinemia) from 1977 to 1990 revealed that the incidence of PKU is extremely rare in Japan when compared to European Countries, and the incidence of MSUD and homocystinuria are also less common in Japan. On the other hand, the incidence of histidinemia is higher in Japan than in Europe, however, a follow up study of more than 1,500 patients showed almost all cases developed normally without any dietary treatment.

Adolescent↗

PubMed1986

[The statistical evaluation of the female breast cancer detected by mass screening in Hokkaido].

In Hokkaido, 113, 612 women were subjected to mass screening of breast cancer from 1973 to 1983. Out of them, 74, 285 (56.3%) were examined once and the remainder twice or more: 4,798 (4.2%) were advised to receive further precise examinations and 99.8% of them underwent the second examination. Breast cancer was detected in 377, in which 291 (77.2%) were detected by the first examination and 33 (3.8%) were so-called "interval cancer" with the mean interval of 19.3 months. The detection rate was 0.3%. Histologically non-invasive cancer was seen in 26 (6.9% of 377). Despite a recent significant increase in detection rate of the earlier stage of breast cancer, the present study showed no evidence of a decrease in advanced cancer. The prognosis of the patients who had curable operation revealed 86.9% in 5 year survival rate and 40% in 10 year survival rate.

Breast Neoplasms↗

PubMed1991

[Detection of early prostatic cancer in mass screening program].

Since 1975 up to 1988, we have performed a mass screening program (MS) for prostatic diseases using transrectal ultrasonography (TRS) in the primary study. In our study, 42 cases of prostatic cancer (0.6%) was detected among 6,674 examinees. Out of 42 cases of cancer, 24 (57.1%) were diagnosed as early prostatic cancer (Stage A 1, Stage B 23). The detection rate of cancer in MS and the ratio of early stage of cancer among them were higher than those in the outpatient clinic of our department. Diagnostic accuracy of TRS, palpation and tumor markers in MS were studied respectively through our series of MS. TRS was useful for MS especially in low false negative rate. On the other hand, palpation was characteristic in low false positive rate. Prostatic specific antigen (PSA) among tumor markers was effective to detect early prostatic cancer. However, there were some problems about distinguishing early prostatic cancer from BPH, because of the high false positive rate.

Aged↗

PubMed1976

[Suitability of the Weidemann test for galactose in mass screening (author's transl)].

With slight practical modification, especially in the preparation of blood samples on filter paper in place of liquid blood samples, it was possible to adapt the determination of galactose dehydrogenase (Weidemann, G. (1971), this Journal 9,527) to mass screening. The technique is described, and the first results are briefly discussed and compared with those obtained over the years in our screening program with proven the Guthrie test (1): The dehydrogenase test is much quicker and shows a higher substrate specificity than the Guthrie test (duration 2 hours compared with 44 hours; false positive results of 16.87 mmol/l galactose or higher 1:42231 compared with 1:3519). It is, however, less sensitive (16.87 mmol/l compared with 1.69 mmol/l galactose), so that a combination of both tests would seem appropriate for the mass screening of new borns.

Alcohol Oxidoreductases↗

PubMed1999

What factors determine whether individuals found to have hypercholesterolaemia at mass screening accept advice to visit their physician.

OBJECTIVE: This study aims to identify the determinants of compliance with the recommendation to visit a physician for advice which was given to individuals whose cholesterolemia was > 6.2 mmol/l at mass screening for risk factors of cardiovascular diseases. METHODS: Data were collected from 1144 adults found to be hypercholesterolemic during a screening programme in 54 work sites and 29 public areas and contacted by phone two to six months later. Based on the Health Belief Model, perceived seriousness, perceived self-efficacy, and cues to action were measured. Potential determinants of compliance to the recommendation were examined using multivariate analyses. RESULTS: Mean compliance was 58.6%. For the perceived seriousness dimension of the Health Belief Model, personal history of CVD or risk factors, and prior awareness of cholesterol levels were important determinants. Those already treated for hypercholesterolemia comply twice as much as those who were aware and untreated. Among cues to action, higher cholesterol levels and hypertension are associated with greater compliance; however, smokers were less likely to comply. The dimension of perceived self-efficacy, as measured by ease of access to health services and prior success in eating habit modification, is also associated with compliance to the recommendation. Compliance increases significantly with age. For those previously aware of their elevated cholesterol level, variables representing perceived self-efficacy were no longer determinants. For those previously unaware of their elevated cholesterol level, variables representing CVD perceived threat do not influence compliance. CONCLUSION: The Health Belief Model appears to be an appropriate framework to the determinants of compliance with the recommendation to visit a doctor during mass screening.

Adult↗

PubMed1990

Problems of mass screening for neuroblastoma: analysis of false-negative cases.

The Japanese mass screening (MS) system for neuroblastoma at 6 months of age has resulted in the earlier diagnosis of the tumor with excellent therapeutic results. However, some problems are involved in the present MS system. We present six false-negative cases, ages ranging from 1 year 11 months to 3 years 11 months. Neuroblastoma cell taken from four of these patients were studied biologically. These patients had advanced disease (one was stage III; five were stage IV). Three of the patients have died and one is terminally ill despite undergoing surgery combined with intensive chemotherapy. Cytogenetic analysis performed in three cases showed that all the cases had diploid chromosome mode associated with 1P-, double minutes (DMs), or marker chromosomes. N-myc oncogene analysis, performed in four cases, showed amplification in two; one patient had diploid chromosomes, but the other was not examined cytogenetically. These findings were strikingly different biologically from those of cases found by MS. The majority of neuroblastomas detected by MS were found to be triploid tumors without N-myc amplification. These findings suggest that the main reason for the false-negative results in the patients we examined is that they were tumor-free or the tumors were so small in size that they were unable to produce urinary vanillylmandelic acid and or homovanillic acid levels high enough to be detected at the time of MS. Therefore, we conclude that MS at 6 months of age is too early to detect neuroblastoma with a diploid chromosome mode and/or amplified N-myc oncogene. We propose that MS at the age of 1 year 6 months would be more effective to pick up these cases, because treatment strategies depend on the different biological characteristics of tumor cells.

Adrenal Gland Neoplasms↗

PubMed1992

[Cost of a mass screening program for colorectal cancer using the occult blood test].

The Cancer Registry of Burgundy, France, set up a controlled study involving 91,000 people aged 45 to 74 to ascertain the cost-effectiveness of mass screening for colorectal cancer with the Hemoccult test. The aim of this study was to estimate the cost of the first part of the screening campaign, which took place in 1988 and 1989. The overall cost of the campaign was 2,275,589 FF. The cost for the GPs' instruction course was 3.9 percent and the press campaign, 8.4 percent of total costs. The cost related to the distribution or prescription of tests by the GPs was 60.3 percent of the total cost of the campaign. The average cost per test was 39.8 FF when it was distributed by the GPs. The average cost per test was 116.4 FF when bought individually in drugstores or pharmacies. The average cost per test was 70.1 FF when mailing was used. The average cost per test for the analysis was 12.7 FF that is to say 13.7 percent of the total cost. The cost of scientific follow-up and analysis was 13.8 percent. The cost for one person completing the test averaged 92.7 FF. The preliminary results of the cost-effectiveness analysis make it possible to estimate the cost of the mass screening campaign for colorectal cancer. Better cost/effectiveness ratios have already been made according to these results.

Aged↗

PubMed1976

Effect of a mass screening program on the risk of cervical cancer.

In Finland, the organized mass screening program for the early detection of cervical cancer covers, with few exceptions, all women between the ages of 30 and 55 every fifth year. On the basis of material originating from the Finnish Cancer Registry it was estimated that the probability for a woman aged 30-59 to experience frankly invasive cervical cancer was 0.010 before the screening program, and 0.002 after the first screening. The corresponding probability estimate was 0.022 for pre-invasive lesions subjected to operative treatment. On the assumption that the same relationship applies beyond this age group it was estimated that from 28-39% of the pre-invasive cases progress to invasive cervical cancer, and that 21% of the frankly invasive cases are preceded by a pre-invasive stage of shorter duration than the time period between the screenings, or have no preclinical stage.

Adult↗

PubMed1990

Colorectal cancer: implications of mass screening for public health.

The faecal occult blood test (FOBT) for colorectal cancer has a place in clinical practice in case finding, and, perhaps, in screening high-risk groups, but is it a worthwhile screening test when applied to the general population? This question is important and topical: there is increasing interest in Australia in screening by FOBT, but such a programme would be neither free of risk, nor inexpensive. We argue that there is not yet satisfactory evidence that screening by FOBT reduces mortality from colorectal cancer. There is no quicker way of learning whether FOBT saves lives than to wait for the results of the major overseas trials, the first of which should become available in the next three to five years. Until this evidence becomes available, Australia should not proceed with mass screening for colorectal cancer by FOBT. Sporadic and haphazard screening should be discouraged. What we can, and should, do now is find out more about the attitudes and behaviour of consumers and providers of screening by FOBT, the infrastructure that would be required to promote and sustain an effective mass screening programme, the total costs of colorectal cancer screening, and the performance in representative populations of new screening technologies.

Australia↗

PubMed2000

Analysis of loss of heterozygosity at 16p12-p13 (familial neuroblastoma locus) in 470 neuroblastomas including both sporadic and mass screening tumors.

BACKGROUND: Neuroblastoma (NBL) in children usually occurs in a sporadic form. However, it rarely occurs in families. Recently, the familial neuroblastoma (FNB) locus has been mapped to 16p12-p13 by linkage analysis. PROCEDURE: Here we show the result of loss of heterozygosity in the region spanning 16p12-p13 (D16S406-D16S409, 46 cM) in 470 NBLs including both sporadic and mass screening cases. RESULTS: Allelic loss was found in 61(13%) tumors. Deletion of 16p was associated with mass screening tumor (P = 0.035) and <1 year of age at diagnosis (P = 0.048). We found two commonly deleted regions: the sizes of the region were approximately 2 cM and approximately 6 cM. CONCLUSIONS: Our data suggested that allelic loss of 16p was common in favorable NBLs, and there may be at least two candidate loci within the region of FNB.

Child↗

PubMed1994

[Mass-screening for ovarian cancer by transvaginal ultrasonography--study on ultrasonographic findings].

Mass-screening for ovarian cancer by means of transvaginal ultrasonography has been performed in Aomori Prefecture since 1989. To select appropriate candidates to receive the second screening, the findings in 614 ultrasonic pictures of pelvic tumors over 30mm recorded on a VTR were studied. The results were as follows: 1) At the first screening, the rate of solid tumors was similar in each age group, but that of mixed tumors was higher in the thirties. 2) When ultrasonic findings at the first screening with that of the second screening were compared, (1) Twenty to thirty per cent of all tumors detected in the first screening had disappeared or had become under 30mm in size at the second screening. (2) About 20% of solid tumors detected in the first screening were not ovarian tumors (uterine myomas or others) in the second screening, regardless of the tumor size. (3) The rate which decided the course of therapy or follow up at the time of the second screening was not related to the ultrasonic findings for tumors smaller than 50mm. At the present time, classification of transvaginal ultrasonic findings is insufficient, and so it is difficult to use it to select appropriate candidates to receive the second screening. But the ultrasonic findings are very important in deciding on the course of therapy and follow up.

Adult↗

PubMed1975

Evaluation of mortality data for cervical cancer with special reference to mass screening programs, Denmark, 1961-1971.

During the years 1961-1971, a total of 3696 women died in Denmark from cervical cancer. The annual mortality per 1000 was 0.23 and was constant in this period. The mortality was 0.30 in the Capital where a mass screening program has existed since 1968; in the Provinces, where screening was negligible, the rate was 0.21; the time trend was also constant. The mortality was low in youth, reaching a level of 0.30 around 45 years. Single women had the lowest mortality; among married women it was double, among widows 2-4 times higher, among divorcees 4 times. Within the marital groups, the Capital had higher or the same rates as the Provinces, except for divorcees in the Provinces who had higher rates. The lowest socioeconomic groups had the highest death rates at young ages. The effects of a total vs. an age-specific case-finding program have been estimated under three circumstances, namely that mass screening could reduce the cervical cancer mortality by 10%, by 50%, or by 100%. The impact on the public's health has been evaluated by relating the hypothetically prevented cervical cancer deaths to all cancer deaths and to deaths from all causes. The general population was subdivided by age, marital status and residence and ranked according to cervical cancer mortality. These data were used to design programs which would minimize the number of examinees and maximize the number of prvented deaths.

Adult↗

PubMed2002

[Newborn mass screening for congenital hypothyroidism in Gdańsk region].

Newborn mass screening for congenital hypothyroidism was introduced in the Gdańsk region in 1993. During the period 1993-2001 180708 newborns were screened. The prevalence of congenital hypothyroidism was 1:4203. The prevalence of transient hyperthyrotropinemia before implementation of the program of universal salt iodization was 0.016%, after that 0.003%.The request rate for repeated samples was 0.47% before and 0.24% after salt iodization.

English Abstract↗

PubMed1995

Age-related profile of neuroblastoma: a comparison of tumors detected by mass-screening with those detected clinically.

Infants with neuroblastoma are known to have a favorable prognosis compared to those over 1 year of age. However, there is little biological information about the age-related heterogeneity of neuroblastoma. We evaluated the biological profile comparing cases detected by mass screening with those detected clinically. A total of 238 patients with neuroblastoma were classified into four groups according to their age at diagnosis. Patients in group A were 0-5 months of age (n = 31). Patients in group B were detected clinically and were 6-11 months of age (n = 25). Patients in group C were 6-11 months of age and were detected by mass-screening (n = 97). Patients in group D were more than 12 months of age (n = 85). The age-related heterogeneity was evaluated by Kaplan-Meier survival analysis, several clinical markers (neuron specific enolase, ferritin, vanillylmandelic acid and homovanillic acid) at diagnosis, tumor Ha-ras p21 expression and tumor N-myc amplification. Infant neuroblastoma had unique features in comparison to neuroblastoma diagnosed over 12 months of age. Clinical outcome of the patients in groups A and C was quite favorable. Even patients with stage III or IV disease in group A had a favorable prognosis. However, stage IVs disease in group A was not necessarily associated with a good prognosis and the early death after diagnosis was also characteristic. The biological profile of tumors in group C was similar to that in group A but different from the profile in groups B and D. Tumors in group B had a biological profile intermediate between groups A and D.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMedDate not supplied

Does earlier detection of lung cancer on mass screening improve outcome in younger and middle-age patients?

In order to demonstrate clinicopathological features, especially in relation to the detection of lung cancer in younger (<40 years) and middle-aged patients, a total of 850 patients with lung cancer were analyzed with reference to their basis for detection. Asymptomatic patients in their forties and fifties diagnosed on mass screening had higher prevalence rate of surgically resectable disease and better three-year survival compared with patients who required medical attention because of symptoms. Our results suggest that mass screening for patients under the age of 50 years does not change the outcome, however, patients in the age group 50-59 years receive some benefit in our screening system.

Adenocarcinoma↗

PubMed2001

Biological aspects of neuroblastomas identified by mass screening in Quebec.

BACKGROUND: Neuroblastoma has several characteristics that suggest that preclinical diagnosis might improve outcome. Therefore, the Quebec Neuroblastoma Screening Project was undertaken from 1989 to 1994 to examine infants at 3 weeks and 6 months by measuring urinary catecholamine metabolites. PROCEDURE: Over the 5-yr period, 45 tumors were detected by screening, 20 were identified clinically prior to the third week, and 64 were identified clinically at a later time. We analyzed available tumors for Shimada histopathology, tumor ploidy, MYCN copy number and serum ferritin. RESULTS: Of the tumors detected by screening, only 2 of 45 tested had unfavorable histology, 2 of 45 had diploid or tetraploid DNA content, 0 of 43 had MYCN amplification, and 4 of 44 had elevated serum ferritin. All of these patients are alive and well. The 20 patients detected prior to the 3-week screen had similar biological characteristics. In contrast, of the patients detected clinically after 3 weeks of age, 19 of 51 testedhad unfavorable histology, 25 of 66 had diploid or tetraploid tumors, 12 of 56 had MYCN amplification, and 14 of 54 had elevated ferritin. CONCLUSIONS: The difference between the screened and clinically detected cases was highly significant for each biological variable. Preliminary data on other biological variables, such as neurotrophin expression and allelic loss on 1 p in these patients are consistent with the above findings. These data suggest that mass screening for neuroblastoma at or before 6 months of age detects almost exclusively tumors that have favorable biological characteristics, many of which might have regressed spontaneously. Thus, continued mass screening for neuroblastoma at 6 months is unlikely to accomplish its intended goal, and should probably be discontinued.

Age Factors↗