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PubMed2005

Infrared thermography to mass-screen suspected SARS patients with fever.

Fever greater than 38 degrees C is a cardinal sign of patients with the severe acute respiratory syndromes (SARS). To reduce the risk of nosocomial cross infections, screening all patients and visitors who visit hospitals and clinics for fever at the entrance of every hospital building has become a standard protocol in Taiwan during the SARS epidemic from mid-April to mid-June 2003. We used a digital infrared thermal imaging (DITI) system (Telesis Spectrum 9000 MB) to conduct mass screening of patients and visitors who entered the hospital to identify those with fever. The DITI system has two components: a sensor head and a PC imaging workstation. The sensor head is an optic-mechanical device which consists of imagining optics for focusing the infrared source information on the infrared detector. The infrared images are further converted into electrical signals, which are then processed for real-time display on the monitor. During the period from April 13 to May 12 2003, 72,327 outpatients and visitors entered Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan. A total of 305 febrile patients (0.42%) was detected by infrared thermography. Among them, three probable SARS patients were identified after thorough studies including contact history, laboratory tests and radiology examinations. The findings suggests that infrared thermography was an effective and reliable tool ideal for mass-screening patients with fever in the initial phase of screening for SARS patients at a busy hospital which sees approximately 3,000 outpatients every weekday during the SARS epidemic.

Cross Infection↗
PubMed1981

[A result of mass-screening for uterine cervical cancer in Hyogo prefecture (author's transl)].

A result of mass-screening for uterine cervical cancer conducted by Hyogo Cancer Hospital performed using mobilunit from 1965 to 1978 was analyzed and presented in this paper. The total number of women taking our initial screening examination was 188, 183.5% women screened or 9,447 were transferred for the further accurate examination. The rate of participants for this 2nd examination was 93.8% on the average. In this initial screening examination, a result of cytological examination on Papanicolaou's classification was as follows; 94.87% for class I and II, 4.81% for class III, and 0.21% for class IV and V. In the 2nd examination, the rate of the negative, suspected positive were 70.6%, 22.5% and 6.9% respectively. 759 cervical cancers were detected in our screening. The detecting rate of cervical cancer was 0.4% among initially screened women and 8.6% among women who appeared for the accurate examination. As the detecting rate among women for the 2nd examination became higher year by year (20% increase during recent 3 years), the accuracy of our screening methodology appeared to be improving. The incidence rate of cervical cancer in our screening was classified as stage 0; 49.0%, Ia; 36.4%, Ib; 9.1%, II; 3.9% an III; 1.6%. The most of detected cancer was occupied by cancer in situ and early invasive cancer. Annual review showed there is a gradual and steady increase in incidence rate to stage 0 in our screening.

Female↗
PubMed2000

Pulmonary tuberculosis in Norwegian patients. The role of reactivation, re-infection and primary infection assessed by previous mass screening data and restriction fragment length polymorphism analysis.

SETTING: Norwegian patients with pulmonary tuberculosis notified to the National Tuberculosis Register in 1975, 1985 and 1995. OBJECTIVE: To assess the proportion of cases attributable to endogenous reactivation, exogenous re-infection and primary infection. DESIGN: We reviewed patients notified with sputum smear and/or culture confirmed pulmonary tuberculosis in 1975 (50% random sample, 95 cases), 1985 (133 cases) and 1995 (70 cases). Information on previous chest X-ray, tuberculin and BCG status was collected from mass screening data files. Strains from 54 patients in 1995 were analysed by IS6110 restriction fragment length polymorphism (RFLP) typing and compared with culture-positive patients notified between 1994 and 1997. RESULTS: Most patients had previously had tuberculosis (65% in 1975, 53% in 1985 and 61% in 1995), either notified with tuberculosis or with X-ray findings indicating previous tuberculosis. Another 10% had a prior infection, but normal X-rays. No previous tuberculosis infection or disease was found in 10% in 1975, 19% in 1985, and 16% in 1995. Of 54 patients with RFLP results, three were caused by laboratory contamination. Of the remaining 51, eight (16%) belonged to a cluster. Among 45 patients with results of both RFLP typing and mass screening, 37 (82.2%) were probably caused by reactivation, six (13.3%) by re-infection and two (4.4%) by primary infection. CONCLUSION: Pulmonary tuberculosis in Norwegian patients can mainly be attributed to reactivation, predominantly in persons with previous changes on chest X-ray.

Adolescent↗
PubMed1991

Epidemiological study of oral leukoplakia based on mass screening for oral mucosal diseases in a selected Japanese population.

The purpose of this study was 1) to show the epidemiological status of oral leukoplakia in a selected population of 3131 Japanese (504 women, 2627 men, aged 18-63 yr, mean age 35.9 yr), and 2) to estimate of the validity of the diagnosis of oral leukoplakia by general practitioners. Seventy-seven individuals were detected as having leukoplakia, a prevalence of 2.5%; 2.7% and 1.0% for men and women, respectively, a difference that is statistically significant (P less than 0.001). The percentage of smokers was 75.3% for patients with leukoplakia and 47.8% for individuals detected as not having leukoplakia, a difference which is statistically significant (P less than 0.001). Of 77 leukoplakia patients, 37 cases (48.1%) received a clinically confirmed diagnosis and 27 patients were diagnosed in further examination as having leukoplakia. These results can also be expressed by a positive predictive value of 0.73 and a false positive ratio of 0.27 for the diagnosis of leukoplakia in the primary mass screening by general practitioners. The results of this study suggest that in order to carry out an efficient oral health program in Japan, the objects for mass screening for leukoplakia might be better limited to men over 30 and women over 40 yr of age.

Adolescent↗
PubMed1993

[Evaluation of mass screening for colorectal cancer with 'sequential fecal occult blood test' in an asymptomatic population. Multicenter GI Research Group of Beijing Area of PLA].

In order to search for a reasonable screening method for colorectal cancer in accordance with the situations in China, we designed the sequential fecal occult blood test' (CFOBTS-->IFOBT-->colonoscopy) and compared with chemical fecal occult blood test (CFOBT) and immuno-fecal occult blood test (IFOBT). On the basis of our findings, SFOBT is not only sensitive, easy to perform but also economical as compared with CFOBT & IFOBT. By using the program of SFOBT, we carried out a mass screening of an asymptomatic population of 102,800 people, covering five provinces in northern China. The results are as follows: (1) The incidence of colorectal cancer in northern China was about 24.31/10(5); (2) 52% of colorectal cancer cases detected through the screening were classified as Dukes stages A or B, whereas only 36.83% are those clinically diagnosed (P < 0.05); (3) The incidence of colorectal cancer increased with age, the high-risk age group peak at 60-69 years; (4) 84% of cancer & 62.23% of adenomas were detected in sigmoid colon or rectum; (5) The incidence of colon tumour was significantly increased in subjects with family history of colon tumour as compared with those without; (6) Diet habits of different nationalities may not be related to the morbidity of colorectal cancer. In conclusion, mass screening for early detection of colorectal cancer following SFOBT program is suitable for the situations in China.

Adenoma↗
PubMed2005

Clinical onset and prognosis of Asian children with organic acidemias, as detected by analysis of urinary organic acids using GC/MS, instead of mass screening.

Organic acidemias (OAs) have been detected worldwide in symptomatic patients using gas chromatography mass spectrometry. We diagnosed 188 Asian cases of OAs by analysis of urinary organic acids and investigated their clinical onset and outcome. Methylmalonic acidemia (MMA) was most common (74 cases), followed by propionic acidemia (23 cases), ornitine transcarbamylase deficiency (22 cases), and multiple carboxylase deficiency (15 cases). For these 188 patients, onset was most frequent in the neonatal period or early infancy. Approximately 30% of the patients had a family history of similar symptoms or diseases. Although the outcome of OA patients varied, patients with early onset generally had poor outcomes despite early detection. Of the 45 MMA patients whose clinical data were available, 25 were clinically vitamin B12-responsive, while the remaining 20 were non-responsive. A favorable outcome was obtained in 7 of the 25 B12-responsive patients, and in only 3 of the 20 B12-nonresponsive patients. It was suggested that even in B12-responsive MMA cases, earlier detection and B12 therapy were needed to improve the prognosis. We concluded that detection of such patients at the presymptomatic stages using newborn mass screening is essential for prognosis improvement with OAs.

Adolescent↗
PubMed1975

Mass screening of newborn Swedish infants for alpha antitrypsin deficiency.

During the first year of mass screening for alpha1 antitrypsin deficiency, 108,000 newborn Swedish infants were examined. The screening method and criteria used for selecting infants with alpha1 antitrypsin deficiency were reliable. The Pi Z phenotype occurred at a rate of one per 1,433 infants, and the PiZ allele frequency was .026. The Pi- allele was found in one Pi Z and one Pi S infant. The Pi- allele frequency probably was below .001.

Alleles↗
PubMed1984

[Mass screening for colorectal cancer by occult blood testing under restricted diet].

We conducted a mass screening survey for colorectal cancer by the combination of fecal occult blood tests under a restricted diet and a medical questionnaire in 7,392 healthy volunteers. Further diagnostic work-up was needed in 1,934 (26.2%) individuals. Of these, 1,409 (72.9%) showed occult blood in at least one slide, 245 (12.7%) had symptoms and 306 (15.8%) had a positive family history. Proctosigmoidoscopy, barium enema and flexible colonoscopy were performed in 1,251, 779 and 95 persons, respectively. Colorectal cancers were detected in 10 individuals (0.14%); 5 of these were in the early stage.

Adult↗
PubMed2002

Stephen L. Gans overseas lecture. Mass screening for neuroblastoma in Japan: lessons learned and future directions.

BACKGROUND/PURPOSE: Since 1985, a nationwide mass screening program (MS) for neuroblastoma has been conducted for 6-month-old infants throughout Japan, resulting in the detection of more than 1,900 cases of neuroblastoma. The outcome of these patients has been excellent: more than 97% of them are alive. Yet, several reports suggest that the number of advanced-stage neuroblastoma patients over 1 year of age has not changed substantially. The current report focuses on the 15-year experience with MS of the Kyushu Pediatric Oncology Study Group. METHODS: The clinical and biological features of neuroblastoms detected (n = 320) and not detected by MS (n = 245) were compared. Regional and national statistics for neuroblastoma before and after 1985 were analyzed using standard epidemiologic measures for the occurrence of disease. RESULTS: The majority of the MS-positive cases were biologically favorable and had an excellent outcome. In contrast, the majority of non-MS patients in whom neuroblastoma later developed had advanced-stage, unfavorable-prognosis tumors. The overall mortality rate of neuroblastoma in the Kyushu area was not improved by MS. CONCLUSIONS: The optimal time for screening is the point at which neuroblastomas regressing spontaneously can no longer be detected, but more aggressive disease can be found. A birth cohort study could determine the optimal timing for a second screening. Identification of other new prognostic factors may be required.

Adrenal Gland Neoplasms↗
PubMed1981

[Enzyme immunoassay of TSH in dried blood, its application to mass-screening of primary hypothyroidism (author's transl)].

Enzyme immunoassay (EIA) for Thyroid Stimulating Hormone (TSH) has been developed. A principle of the assay was the competitive method and used a double antibody solid phase technique. TSH-horse radish peroxidase (HRP) conjugate and TSH-beta-D-galactosidase (beta-Gal) conjugate were used, and a fluorometry was introduced for measuring the activity of the enzyme. The substrates for determining the enzyme activities were 4-methylumbelliferyl-beta-D-galactoside for beta-Gal, and 3-p(hydroxyphenyl)-propionic acid for HRP. A polyacetal bead coated with a purified double antibody was used for the separation of Bound and Free. With the assay methods, TSH in two of 3mm discs of dried blood on filter paper was measurable. The whole process was completed within 24 hours. TSH standards containing 0.05 microU/tube showed 80 approximately 90% of B/Bo, and the containing 0.25 microU/tube showed about 50% of B/Bo. As a routine method for mass screening of primary congenital hypothyroidism, the EIA method using TSH-beta-Gal was adopted. A variation resulting from day to day experiments was 4.7 approximately 9.4% at B/Bo during a seven day trial. From April of 1980, 12357 samples of newborn blood on filter paper were measured, and a distribution of the value of TSH in dried blood was almost the same as that obtained by RIA. Three cases of cogenital hypothyroidism were detected, and about 0.15% of the total samples showed a TSH concentration higher than 20 microU/ml of whole blood. All the samples were determined by RIA too, and the TSH values obtained from the EIA method were compared to that obtained from the RIA method. The correlation of both EIA and RIA methods was analyzed. Although there were slight discrepancies between EIA and RIA, the samples having high TSH values with the RIA method were all detected by the EIA method. Therefore, the EIA method will be usable as a tool for the mass-screening for the detection of primary congenital hypothyroidism.

Congenital Hypothyroidism↗
PubMed1989

A long-term follow-up study of patients with gastric cancer detected by mass screening.

This report is based on 1,139 patients with gastric cancer (GC) detected by mass screening conducted by the Center for Adult Diseases, Osaka during 1961-1985. Early GC totalled 527 patients and advanced GC totalled 612 patients. In 859 patients curative resection was performed. Their vital status was traced yearly and six patients were lost to follow-up. Relative survival rates of screening-detected GC patients were 69-70% and almost constant after 5 years from operation/diagnosis. The survival curve in which only death from GC was counted as a death was almost equal to the relative survival curve in its shape and value. The hazard rates of screening detected GC patients decreased rapidly within 7 years and remained low after 7 years. It was confirmed by this long-term follow-up study that about two thirds of GC patients detected by screening were successfully cured of their disease.

Adult↗
PubMed1995

Diagnostic significance of prostate specific antigen and the development of a mass screening system for prostate cancer.

PURPOSE: The significance of prostate specific antigen (PSA) in the mass screening for prostate cancer was investigated. MATERIALS AND METHODS: A total of 4,375 PSA, digital rectal and transrectal ultrasonographic examinations was performed on 3,526 subjects. RESULTS: Among the 3 modalities, PSA had the highest sensitivity (80.4%) and positive predictive value (45.1%). We established age-specific reference PSA ranges for normal Japanese men, and demonstrated the significance of PSA density and PSA velocity. CONCLUSIONS: The significance of PSA as a prostate cancer screening modality should be evaluated across multiple age ranges and in combination with previous PSA data and/or prostate volume.

Adult↗
PubMed1980

Mass screening in colorectal cancer.

The results in a continuing study, using the Haemoccult slides for mass screening in colorectal cancer in asymptomatic individuals in Central Queensland, are presented. They are compared with those in a review of the incidence of the same disease treated during the years 1972 to 1976 in the same area. A discussion is undertaken to determine whether the slides test will improve the five-year survival rates in this district.

Colonic Neoplasms↗
PubMed1986

[Mass screening for cervix cancer under the law of health for the elderly in Fukuoka Prefecture].

Mass screening for cancer of the uterine cervix was performed mainly in a screening car or by a gynecological practitioner in Fukuoka Prefecture. In 1983, 114,000 women were screened for cervix cancer, and 102 cervix cancers were detected. Cytology activity index was 110. To reduce deaths from cervix cancer, 400,000 women should be screened by cytology. Detection of cancer in the population with abnormal cytology was not satisfactory in some departments. The gynecologists in these departments should be trained for colposcopic practice. The training of cytotechnologists is also necessary for the elimination of false negative cytology. These trainings are now being done under the law of health for the elderly.

Aged↗
PubMed1993

An infant with bilateral adrenal neuroblastoma found by mass-screening: report of a case.

A male infant with bilateral adrenal neuroblastoma found by mass-screening is herein reported. The patient presented with almost equal-sized tumors, each remaining confined to the respective adrenal gland without crossing the midline. No other tumorous lesion was evident. The two adrenal tumors had similar histologic features and appeared to have grown concurrently. Such simultaneous occurrence of primary adrenal neuroblastoma is unusual, and appears to reflect the multicentric origin of this tumor.

Adrenal Gland Neoplasms↗
PubMed1985

VMA mass screening program of neuroblastoma for infants in Nagoya City, Japan.

In Nagoya City, Japan, VMA mass screening for detection of neuroblastoma has been performed since 1977. Filter paper strips wetted with urine are mailed to a central laboratory. Positive tests are followed up by more definitive testing. Of the 20,053 urine samples of 6-month-old infants tested, January 1977 to March 1983, five asymptomatic infants with neuroblastoma have been discovered. All have been treated and are alive as of January 1984.

Child, Preschool↗