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PubMed1986

Mass screening for colorectal cancer by testing fecal occult blood.

The validity of screening for colorectal cancer by testing for occult blood on 2 successive days was evaluated over a 2-year period beginning April 1980 by testing 9449 individuals without symptoms. The Shionogi slide (Shionogi Pharmaceutical Co., Osaka, Japan), a commercial guaiac-impregnated slide with moderate sensitivity, was used for screening subjects under dietary restriction. Of the 1401 persons (14.8%) who had a positive reaction for occult blood, 858 (61.2%) received further diagnostic examinations, and 265 of them proved to have one or more abnormalities of the gastrointestinal tract. Colorectal cancer was detected in 11 persons and polyps in 91 persons. Eight of the cancers were in an early stage. This screening method was found to be suitable for large-scale mass screening, and appears to have high diagnostic value.

Adult↗
PubMed1992

[Clinical assessment of patients with microscopic hematuria pointed out by mass screening examination].

We clinically examined 445 patients with positive urine occult blood test found by mass screening examination. Among them, 41 cases had the history of macroscopic hematuria. Urological abnormalities were observed in 169 (41.8%) of the patients with microscopic hematuria, and in 22 (53.7%) of those with a history of macroscopic hematuria. Genitourinary neoplasms were found less frequently in the patients with microscopic hematuria (1.2%) than in those with macroscopic hematuria (22%). We couldn't find a correlation between the degree of hematuria and the severity of the underlying diseases. Hematuria is often thought to appear intermittently, and urinalyses of the patients with so-called significant disease may not be found at the first visit.

Adult↗
PubMed1984

[Studies on mass screening for gastric cancer in remote areas of Kochi Prefecture].

Between Jan., 1975 and Jan., 1983, mass screening for gastric cancer by (vehicles) equipped with X-ray apparatus was carried out on 58,103 inhabitants over 40 years old (15.4% of the inhabitants) in Kochi Prefecture. As a result, 9,193 (12.2%) were suspected of being affected by gastroduodenal diseases. 87 of these were diagnosed as gastric cancer by endoscopic examination. Therefore, the frequency of the revelation of the gastric cancer was 0.15%. Gastric cancer was diagnosed histologically as early gastric cancer in 44.5% of the 87 patients.

Adult↗
PubMed1992

Views of a general population on mass screening for colorectal cancer: the Burgundy Study.

BACKGROUND: The success of a screening program depends on a number of factors, including the validity of the test, its efficacy, its feasibility, and the rate of compliance. Thus, it is important to determine the factors influencing compliance to the screening test in order to obtain a high participation rate. METHODS: A mass screening campaign for colorectal cancer using the Hemoccult test was conducted in Burgundy, France. One year later, a questionnaire was mailed to a random sample of the population to assess the views of the general public (870 persons who had not completed the Hemoccult test, 750 persons who had a negative test, and 100 persons who had a positive test). The compliance rate of this survey was 32.2% among persons who had not completed the screening test, 88.2% among persons with a negative result, and 98.0% among persons with a positive result. RESULTS: The main reason for not participating was not wanting to know more about their health status (34.3%). Of the factors credited with encouraging persons to perform the test, the most important ones were the practitioner's explanations (55.7%) and the leaflet sent by mail (42.5%). The impact of the media campaign was weak. A small portion of the population (4.3%) said that they were very anxious while waiting for the results. Among persons with a positive screening test, only 1.2% regretted having taken it. Among those who took the test, 94.2% said they were ready to do it again; and among those who did not take it, 36.7% would accept it at a second screening. CONCLUSIONS: The data suggest that overall the Hemoccult is well accepted, that the campaign did not upset the population, and that it is worthwhile at the second screening to include those who did not participate in the first screening test.

Aged↗
PubMed2006

Relationship between aortic calcification and stroke in a mass screening program using a mobile helical computed tomography unit.

BACKGROUND: It is reported that there is a significant relationship between the calcification of the aortic arch detected by chest X-ray examination and stroke. However, the relationship between stroke and aortic calcification (AoC) detected during a mass screening using a mobile helical computed tomography (CT) unit remains unknown. METHODS AND RESULTS: The study population consisted of 2,618 subjects (1,345 men, and 1,273 women; mean age, 52.9+/-13.8 years) who participated in a mass CT screening for lung cancer and tuberculosis. In the present study, 28 subjects (18 men, and 10 women; mean age, 65.9+/-13.5 years) had a past history of cerebral infarction. There were no subjects with a past history of intracerebral or subarachnoid hemorrhage. The frequency of AoC was significantly higher in the infarction group who were older than 50 years of age. In logistic regression analysis, the AoC was a stronger contributor of infarction than sex, age, and risk factors. Furthermore, the odds ratio of AoC for subjects with a past history of infarction increased as the number of calcified segments increased, and these values were 1.82 (95% confidence interval (CI) 1.06-3.15) in men, and 2.53 (95% CI 1.12-5.75) in women. CONCLUSIONS: These results suggest that detection of AoC during mass chest screening using a mobile helical CT unit is an effective way to evaluate the risk of cerebral infarction.

Adolescent↗
PubMed1992

[Mass screening for detection of infants with hearing impairment. II. Screening items and risk factors of hearing impairment].

Validity of the items included in a questionnaire for mass screening for hearing impairment of infants and the risk factors for hearing impairment of 4-month-old infants were studied. Qualitative differences in the questionnaire items were found that would be related to decisions regarding need for thorough examination or followup of a case. The combined use of the risk factors and the questionnaire for 4-month-old infants may considerably reduce the number of false positive cases. A case whose number of negative items was three or less and who had at least one risk factor at 4 months of age was shown to have a high risk of auditory impairment. The cut-off point for the followup screening questionnaires at 7- and 10-month old infants was determined to be at three or less and four or more items.

Hearing Disorders↗
PubMed1988

Chromosome findings and prognosis in 15 patients with neuroblastoma found by VMA mass screening.

We performed chromosome analysis of 15 neuroblastomas found by mass screening using a vanillymandelic acid spot test. We found near triploid chromosome abnormalities, ranging from 60 to 77 chromosomes, in the tumor cells from 14 patients, and hyperdiploidy with the mode of 50 in cells from one. A structural abnormality was observed in only one patient. We did not find a marker chromosome 1, homogeneously staining region, or double minutes, which have been previously reported in advanced neuroblastomas or in cell lines. All of our patients were completely free of disease 4 to 32 months after diagnosis. We consider that patients with hyperdiploidy or near triploidy are different from those with marker chromosome 1, homogeneously staining region, or double minutes and may constitute a subgroup with a good prognosis in childhood neuroblastoma.

Adrenal Gland Neoplasms↗
PubMed2003

Neuroblastoma mass screening in late infancy: insights into the biology of neuroblastic tumors.

PURPOSE: Neuroblastoma screening in early infancy has detected predominantly "favorable" tumors. We postponed screening to an age between 7 and 12 months to test whether this shift of screening age might influence the detection rate of genetically/clinically unfavorable tumors. PATIENTS AND METHODS: In a 10-year period, 313,860 infants were screened by analysis of urine catecholamines. When a neuroblastoma was diagnosed, at least two different areas from every tumor were analyzed for genetic features (MYCN amplification, 1p status, ploidy). Furthermore, neuroblastoma incidence and mortality of the screened group and the cohort of 572,483 children not participating in the screening program were compared. RESULTS: Forty-six neuroblastomas were detected by mass screening. In 17 tumors (37%) at least one of the biologic features was "unfavorable." In 10 of 17 patients, one or more of these alterations were only focally present (tumor heterogeneity). In the screened cohort, neuroblastoma incidence was significantly higher when compared with unscreened children (18.2 v 11.2/100,000 births), while there was a trend towards lower incidence of stage 4 over 1 year (2.2 v 3.8). Mortality was not significantly different (0.96 v 1.57). CONCLUSION: In contrast to other neuroblastoma screening programs, more than one-third of patients were found with unfavorable genetic markers in our study. The high proportion of focal alterations suggests that biologically young neuroblastomas may consist of genetically favorable and unfavorable parts/areas/clones. We conclude that at least one-third of neuroblastomas detected by screening in late infancy are anticipated cases. This, however, does not result in significantly reduced mortality.

Austria↗
PubMed2004

Mass screening for coeliac disease using antihuman transglutaminase antibody assay.

AIMS: To determine coeliac disease prevalence by an anti-transglutaminase antibody assay in a large paediatric population; to evaluate acceptance of the screening programme, dietary compliance, and long term health effects. METHODS: Cross-sectional survey of 3188 schoolchildren (aged 6-12) and prospective follow up of diagnosed cases. Main outcome measures were: prevalence of coeliac disease defined by intestinal biopsy or positivity to both human tissue transglutaminase and anti-endomysium antibodies in HLA DQ2-8 positive subjects; percentage of children whose families accepted screening; dietary compliance as defined by negativity for anti-transglutaminase antibodies; and presence of clinical or laboratory abnormalities at 24 month follow up. RESULTS: The families of 3188/3665 children gave their consent (87%). Thirty biopsy proven coeliacs were identified (prevalence 1:106). Three other children testing positive for both coeliac related autoantibodies and HLA DQ2-8 but refusing biopsy were considered as having coeliac disease (prevalence 1:96). Of 33 cases, 12 had coeliac related symptoms. The 30 biopsy proven coeliacs followed a gluten-free diet. Of 28 subjects completing 18-24 months follow up, 20 (71.4%) were negative for anti-transglutaminase antibodies, while eight were slightly positive; symptoms resolved in all 12 symptomatic children. CONCLUSIONS: Prevalence of coeliac disease is high in Italian schoolchildren. Two thirds of cases were asymptomatic. Acceptance of the programme was good, as was dietary compliance. Given the high prevalence and possible complications of untreated coeliac disease, the availability of a valid screening method, and evidence of willingness to comply with dietary treatment population mass screening deserves careful consideration.

Antibodies↗
PubMed1980

[Critical analysis of the 2-hour test in mass screenings for the early detection of diabetes].

Out of 500 random trial subjects, taken for a mass-screening for early detection of diabetes mellitus, the Authors tried a correlation between the reliability of the "two-hour test" and the 2 h OGTT. The latter method provides more reliable results, allowing us to diagnose a high percentage of cases which is not possible if the simple two-hour test were used. Research of glycosuria in the course of OGTT did not show any real reliability, whereas it did prove useful in the preliminary phase of our research in order to distinguish the subjects for whom a deeper investigation would be advisable.

Diabetes Mellitus↗
PubMed1994

A trial to discriminate spontaneous regression from non-regression cases during mass screening for neuroblastoma.

We tried to discriminate between cases of spontaneous regression and non-regression during mass screening for neuroblastoma, taking advantage of differences in respect to the urinary homoranillic acid/vanillyl mandelic acid (HVA/VMA) ratio and the original tumor site among true positive, false negative and natural occurrence cases. After classifying them into a total of six groups depending on the two factors, ratio: < 1, 1-2 or > or = 2 and tumor site: adrenal or extra-adrenal in origin, we calculated the mathematical probability of a given true positive case being one of spontaneous regression. A tumor of extra-adrenal origin was likely to regress spontaneously, especially one with an HVA/VMA ratio < 1 or > or = 2 (82.2-100%). A tumor of adrenal origin with an HVA/VMA ratio < 1 seemed unlikely to regress spontaneously (0-4%). The present method, employing simple preoperative information, would be useful in future for the selection of true positive cases which should be observed without treatment.

Adrenal Gland Neoplasms↗
PubMed1990

[Left high R wave amplitude and blood pressure levels before and after 5 minutes' rest in a mass screening program].

In order to evaluate the implication of blood pressures measured without 5 minutes' rest in mass screening programs, blood pressures were measured before and after 5 minutes' rest on 820 subjects in a rural community, aged 35 to 65 years and not receiving hypertensive treatment. Although the systolic blood pressure showed a significant drop of an average of 3 mmHg among males and 4 mmHg among females after rest, 23.3% of 820 subjects had higher systolic blood pressure reading after rest than before. The relationship between left high R (LHR) in electrocardiograms and blood pressure (BP) before and after rest was studied. The presence of LHR was significantly related to BP both before and after rest among males, but more strongly associated to BP before rest. The relationship of the difference between BP before and after rest to the prevalence of LHR was analyzed by multiple logistic method. A significantly higher prevalence of LHR with greater difference between systolic BP before and after rest was observed among males, even with age and systolic BP level after rest taken into account. These findings suggest the potential significance of blood pressure readings before 5 minutes' rest which may be a response to mental stress of having the initial blood pressure reading taken by the observer. It would seem worthy to obtain blood pressure before rest as well as after rest in detecting blood pressure abnormalities.

Adult↗
PubMed1996

Cervical neoplasia in pap smears: risk of cervical intra-epithelial neoplasia (CIN) after negative or no prior smears in a population without a mass screening programme.

BACKGROUND: The aim of this study was to examine, in a population not submitted to mass screening, the risk of cancer and cervical intra-epithelial neoplasia (CIN) in Pap smears from women without previously reported positive smears. METHODS: In a logistic regression model consisting of 58,271 smears from 40,536 Norwegian women the risk of cytologically indicated CIN was studied according to age and time elapsed since last smear. RESULTS: The risk of CIN was highest in smears from women with no previously registered smears and in smears taken after an interval of > or = 5 years. Odds ratio for CIN I-II adjusted for age was highest in first time smears and in smears taken after an interval of 5 years. Odds ratio for CIN III was highest in first registered smears. No difference in risk of CIN III was found in smears taken within one year or 2-3 years after the last smear. The increased risk of CIN III in first smears was most pronounced in postmenopausal women ( > 50 years). Nine of 16 cases with cytological indication of cancer were found in women having a smear taken for the first time. All cases with malignancy in smears were > 50 years. CONCLUSIONS: The risk of cytologically diagnosed premalignant cervical conditions increases with time since the previous smear, but more than 5 years have to elapse before the risk is comparable with that in first smears taken. Postmenopausal women without previous smears run the highest risk of serious cervical premalignancies and cancer.

Adolescent↗
PubMed1975

Mass-screening of a female population for detection of early carcinoma of the breast.

In 1969-1970 a breast mass-screening was undertaken in Gävle, with thermography and questionnaire. Mammary radiography and clinical examination of subjects with abnormal screening reports and of a group of normal subjects were performed. In spite of having achieved early detection of malignant tumours in many cases with a preponderance of carcinoma cases in the abnormal group, thermography was found to have considerable drawbacks as a screening method.

Adult↗
PubMed1987

Colorectal carcinoma and Haemoccult. A study of its value in mass screening using meta-analysis.

Meta-analysis has been performed on the world literature relating to Haemoccult screening for colorectal cancer. The analysis indicated a sensitivity of about 50%, specificity of about 97%, positive predictive value of 4.3% and negative predictive value of 99.85%. These figures assume a prevalence of colorectal cancer in the population of 0.3%. A model calculation using these figures together with some additional realistic assumptions suggests no reduction in mortality compared to an unscreened population. It is concluded that many questions about faecal occult blood screening remain and that uncontrolled mass population screening is not justified at this stage.

Adenoma↗
PubMed1988

Effects of the mass screenings for neuroblastoma in Japan. A study of 68 cases.

Sixty-eight cases of neuroblastoma detected during mass screening being performed by 11 local self-governing bodies of Japan were studied concerning age, clinical stage, and survival rate. Their average ages at the first screening, at the beginning of thorough examination, and at the start of therapy were 215.7, 245.6, and 264.7 days, respectively. This screening, which is aimed at the 6-month-old infants is considered to be acceptable, on the grounds that the majority of the cases (95.6%) were asymptomatic at the time of thorough examination, that for most of the cases (98.5%) the initiation of therapy was at under 1 year of age, and that their 60-month survival rate was 87.5%. However, there seems to be room for discussion of the best age at which subjects should be screened, because the 68 cases included some patients already with advanced stages at the time of thorough examination, and because "false negative cases" were identified besides the 68 positive cases.

Age Factors↗
PubMedDate not supplied

Asymptomatic extrahepatic portal obstruction without portal hypertensive findings detected in ultrasonic mass screening.

BACKGROUND/AIMS: We report three adult cases of extrahepatic portal obstruction (EHPO) detected by ultrasonic (US) mass screening. MATERIAL AND METHODS: All these cases were asymptomatic with no abnormalities on hematological or biochemical tests. Only indocynanine green clearance test revealed a slight abnormality. By imaging modalities, the portal trunk could not be visualized and cavernous transformation could be visualized. RESULTS: There were no findings of portal hypertension, such as splenomegaly, esophageal varices and hepatofugal collaterals, in any of these cases. CONCLUSIONS: As many EHPOs without symptoms can be detected on US mass survey, US is considered to be the best modality for screening for this disease.

Adult↗