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PubMed1987

Mass screening for cervical cancer in Ostfold county of Norway 1959-77.

In 1959, the Norwegian Cancer Society started a research project in Ostfold county to assess the effect of a mass screening program for cervical cancer. The program comprised 5 screening rounds during the period 1959-77. At each screening a clinical gynecological examination was performed in addition to the cytological test. A total of 45,960 women aged 25-59 years at the first screening were invited to participate. The follow-up, which was based on the data base of the Cancer Registry of Norway, lasted until December 31, 1982. For the follow-up period as a whole, the observed incidence and mortality were reduced to 78% and 83% of the expected values, respectively. Through the initial phase of the program there was a cumulation of patients with early-stage disease, while the incidence of advanced disease and mortality were reduced. In the later part of the follow-up period, a decrease in incidence of early and advanced disease as well as in mortality was observed. Women not participating in the screening program had a significantly higher risk of cervical carcinoma than the reference population, and a less favorable stage distribution as well. Among participants in the screening program, the reduction of risk was dependent upon the number of previous negative smears. Women with 5 previous negative smears had a risk of disease which was only 18% of that expected. Problems concerning choice of reference population, migration, attendance rates, sensitivity and specificity of the cytological tests and intervals between screenings are discussed. Also, the probable conversion rates of pre-cancerous lesions to cancer and the health hazards involved in possible over-treatment of pre-cancerous cases which otherwise would have regressed, are considered. A dynamic model is suggested. In order to achieve a reduction of mortality in the short term, the efforts of the program should initially be concentrated on older women. To achieve a reduction of incidence in the long run, younger women should gradually be included. Finally, special efforts should be made to increase attendance rates among high-risk women.

Adult↗
PubMed2003

First year of mass screening for prostatic cancer in Yaizu city.

Three thousand one hundred and twenty men out of the target population of 22,195 men underwent PSA (prostatic specific antigen) determinations as the mass screening test for CAP (prostatic cancer). Three hundred and sixty men showed high (> or = 4.0 ng/ml) PSA values and proceeded to the secondary examinations. Prostatic biopsies were done on two hundred and twelve men, 35 % (74) of them had CAP. The detection rate was 2.4 % of the total examinees.

Age Factors↗
PubMed1995

Newborn mass screening and molecular genetics of phenylketonuria in east Asia.

Phenylketonuria (PKU) is an autosomal recessive disorder caused by a deficiency of hepatic phenylalanine hydroxylase (PAH), and is performed with newborn mass screening. PKU causes irreversible mental retardation that can be prevented by a strict low-phenylalanine diet. More than 100 different mutations have been identified world wide and it has been revealed that PKU is a highly heterogeneous disorder. Here, we describe the progress of the molecular genetics of PKU in East Asia. Approximately 60% of all PKU alleles in East Asians have been characterized with 10 PKU mutations. Two major PKU mutations, R413P and IVS4nt-1, may have originated in different populations, spreading in prehistoric times through the Asian continent due to the founder effect, genetic drift, and bottleneck effect. We found different mutations in Caucasians and East Asians, thus PKU mutations have occurred after ethnic divergence between Caucasians and East Asians. Furthermore, PKU genotype and in vitro PAH activity in expression analysis correlates to the clinical and biochemical phenotypes in East Asians. The molecular defects at the PAH gene regulate the in vivo PAH activities and clinical manifestations.

Alleles↗
PubMed1986

Common oral lesions found during a mass screening examination.

The first detailed study of common oral connective tissue and mucosal lesions in US adults is reported. More than 10% of the 23,616 white Americans who participated in a mass screening examination had at least one oral lesion. The 30 most common lesions, which represented more than 93% of all reported lesions, are ranked according to gender-specific prevalence rates. Leukoplakia was the most common mucosal lesion. Oral carcinoma ranked 24th overall. Data from this study are compared with data from other studies dealing with the prevalence of oral lesions.

Adolescent↗
PubMed2003

[The analysis of the sensitivity and the specificity of the mass screening system of BSE].

Since the first infected case of BSE(Bovine Spongiform Encephalopathy) was identified in September, 2001 in Japan, Japanese people have been deeply concerned about safety of meat despite a mass screening system established by Japanese government. In the system all the cows for food must be examined with ELISA as screening and additionally with more accurate tests such as western blot etc. if the screened result is positive. To investigate the accuracy of the system, we calculated the number of false negatives and positives using computer simulation. Consequently, the sensitivity analysis towards ELISA showed that even if Japanese cattle were in a low risk group, a few of them are likely to be misdiagnosed as "negative" in spite of true BSE under the current screening system. Also we indicated how to improve the current system to get less false negatives. We believe the analysis of this study can contribute to risk communication with people to minimize the fear or irrationality caused by BSE epidemic.

Animals↗
PubMed1998

[A child case of idiopathic membranous glomerulonephritis associated with isolated anti-nuclear antibody detected by urine mass-screening of school children].

A 12-year-old boy was referred to our hospital because of persistent hematuria with proteinuria. He was found to have urine abnormalities by a school mass-screening and visited a hospital, where a routine examination revealed proteinuria of 190 mg/d/, hematuria of 2+ and anti-nuclear antibody (ANA) of 1: 320 with a speckled pattern. The other laboratory findings, including anti-DNA antibody were unremarkable. Hypocomplementemia was not seen. Although he had no disabilities and manifestations suggesting systemic lupus erythematosus, urine abnormalities persisted. Percutaneous renal biopsy findings demonstrated stage II diffuse membranous glomerulonephritis (MGN). Neither anti-hepatitis B virus antigens and antibodies nor hepatitis C virus antibody were detected in his sera. Thus, the diagnosis of idiopathic MGN was made. Initiation of a 6-month course of alternate-day prednisolone (an initial dosage at 30 mg) combined with an anti-thrombocyte agent resulted in gradual subsidence of the urine abnormalities and ANA titer. Although pathogenesis of his MGN remains speculative, possible activation of autoimmunities, which led to ANA positivity, might be responsible.

Antibodies, Antinuclear↗
PubMed1975

Follow-up of mass screening for coronary risk factors in 1817 adults.

The prevalence of coronary risk factors was assessed in 1,817 asymptomatic adults in Long Beach, California, at the beginning and end of a 10-11 month interval. The risk factors evaluated were hypercholesterolemia, hypertriglyceridemia, hypertension, smoking, hyperglycemia, and marked obesity. The results of the tests were sent to the participants and to their physicians. An educational program aimed at reducing coronary risk factors was offered to the first 1,250 persons screened. Eight hundred and seventy-two of those 1,250 allocated to the education group returned for a second screening. The prevalence of 0, 1, 2, 3, 4, 5, or 6 coronary risk factors did not change significantly between the two screens in either the total group of 1,817 adults or in the 872 adults in the educational program. The Long Beach Heart Association mass screening program for coronary risk factors was ineffective in reducing the number of coronary risk factors.

Adult↗
PubMed1978

Polystyrene tube immunoradiometric assay for human alpha1-fetoprotein, and its use for mass screening.

We describe a two-site immunoradiometric assay for human alpha1-fetoprotein, with use of antibody-coated polystyrene tubes as solid phase. The sensitivity, precision, and simplicity of this system make it eminently suitable for mass-screening purposes. We currently use it for neonatal detection of hereditary tyrosinemia in the Province of Quebec; measurements are made on blood spotted and dried on paper. This system could be well suited for other mass surveys, such as prenatal screenings for fetal abnormalities.

Amino Acid Metabolism, Inborn Errors↗
PubMed1987

Transmission of human T cell lymphotropic virus type I by blood transfusion before and after mass screening of sera from seropositive donors.

The human T cell lymphotropic virus type I (HTLV-I) is transmitted by blood transfusions that contain cell components as one of the virus transmission modes. We carried out mass screening of sera from seropositive donors by a gelatin particle agglutination test to prevent the spread of HTLV-I by transfusion. Seroconversion rates were compared before and after screening. The results show a remarkable decrease in the rate of infection from 53.6 to 0.9%. Therefore, it is certain that screening by the agglutination method prevents the spread of HTLV-I transmission in blood transfusions.

Antibodies, Viral↗
PubMed2002

Outcome of infants with neuroblastoma detected by mass screening and surgically treated in Shiga Prefecture, Japan: what is the role of surgery?

To investigate retrospectively the clinical and biological features that influence the outcome of infants with neuroblastoma (NB) detected by mass screening (NBMS), and to construct surgical strategies to deal with NBMS, 20 infants diagnosed as having either NB or ganglioneuroblastoma (GNB) between 1986 and 1998 were enrolled in a study. They comprised 15 boys and 5 girls ranging in age from 7 to 14 months. The following factors were analyzed by multivariate analysis: age, stage according to the Japanese staging system at the time of diagnosis, site of the primary tumor, histologic findings, preoperative urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels, VMA/HVA ratio, lactate dehydrogenase, neuron-specific enolase, Shimada's histologic classification, amplification of the N- myc oncogene by Southern blot analysis, nuclear content, and chromosomal abnormality. The 2-year survival was 95.0% (19/20). The site of the primary tumor was the adrenal gland in 12 cases, retroperitoneum in 6, and retrothoracic space in 2. Four infants had stage I, 6 stage II, 3 stage III, 3 stage IVB, and 4 stage IV disease. Complete resection was achieved in all cases except for 1 retroperitoneal GNB. Histologic examination showed that 8 patients had NB. Of the 12 GNBs, 8 were poorly-differentiated and 1 was well-differentiated. Only 1 of the 14 examined tumors showed amplification of N- myc (20 copies). The infant with N- myc-positive NB (stage II) died 23 months after surgery in spite of aggressive postoperative chemotherapy. Multivariate analysis revealed the plasma NSE level to be a significant predictor of survival (p < 0.0143). This suggests that N- myc amplification and plasma NSE level could be closely related to the survival of infants with NBMS. The N- myc-positive NB case implies that even in locoregional NB detected by NBMS, surgical excision should play a central role in the diagnosis of its oncogenic characteristics and indicate any subsequent therapy.

Adrenal Gland Neoplasms↗
PubMed1975

Mass screenings for cervical cancer in Finland 1963-71. Organization, extent, and epidemiological implications.

In Finland, up to 100,000 smears are taken annually from Finnish women, who number more than 2 millions, in conjunction with the mass screening programme organized by the Cancer Society of Finland. About 400,000 smears were taken during the period 1963-71; the detection rates per 10(5) were found to be 69 for invasive cancer, 6 for microinvasive carcinoma, 168 for carcinoma in situ, 127 for dysplasia of high degree. Those previously married, and those experiencing bleeding on sexual intercourse, formed high risk groups (relative risk 2 and 6) whereas those previously electro-coagulated had a relative risk of 0.13 only. Probably no changes will occur in the time trends of mortality rates as a result of the screening. The incidence of invasive carcinomas was found to be decreasing by time, although the increase in carconoma in situ cases exceeded this decline.

Adult↗
PubMed1988

[Two cases of renal cancer detected by ultrasonic scan during mass screening and subsequent MRI].

Reported herein are the cases of two woman, aged 47 and 69, respectively, who were each found to have a right renal carcinoma, both carcinomas discovered incidentally by an abdominal ultrasonic scan during a mass screening, with no other signs or symptoms of renal cancer being indicated. Following clinical diagnostic verification, using X-ray CT, and an MRI, radical nephrectomies were performed. In each instance, the pathohistological diagnosis was renal cell carcinoma, pT2N0M0V0. The clinical imagings, including the MRI, are presented, and the diagnostic techniques used in this imaging and the screening modality in cases of asymptomatic renal cancer are discussed.

Aged↗
PubMed1991

[A mass screening of the prostatic diseases and serum prostate specific antigen].

We examined the values of prostate specific antigen (PSA) with a RIA kit (Pros Check PSA) and an EIA kit (Market F PA), measuring prostate weights of 125 participants in a mass screening of the prostatic diseases. A mild positive correlation (r = 0.467) between values of PSA (RIA) and prostate weights was found in the participants in whom the prostate cancer was not detected. Since serum PSA levels measured by RIA of 45 normal subjects were 1.8 +/- 1.5 ng/ml (Mean +/- S.D), the upper limit of the normal range was set at 6.3 ng/ml. The participants whose PSA levels exceeded this upper normal range and also whose prostate weights were under 30 g were found in 11 of the 122 subjects (9%). On the contrary, the abnormal values (EIA) were found in only two subjects (one, a prostate cancer and the other, a benign prostate hypertrophy). We, further, examined the PSA values (EIA) in 415 subjects in whom the prostate cancer was detected in 5 (1.2%). The abnormal values were found in 8 (4 prostate cancer, 3 benign prostate hypertrophy and one without prostatic disease). As the false positive rate was very low, the use of PSA is recommended in the first screening of the check up program of the prostatic disease.

Aged↗
PubMed1997

Mass screening for neuroblastoma and mortality in birth cohorts.

Mortality resulting from neuroblastoma in birth cohorts in both Sapporo City and the whole of Japan was investigated to evaluate the effects of a high-performance liquid chromatography (HPLC) mass screening program, targeting on 6 month-old infants. In Sapporo City, the non-HPLC screened cohort showed no reduction in mortality at 4 years of age compared with the pre-screening cohort. However, the HPLC screened cohort showed a reduction of 69% in mortality compared with the pre-screening cohort. On a nation-wide scale, there was a significant decline in mortality for the non-HPLC screened cohort compared with the pre-screening cohort; for the HPLC screened cohort for 1989-1991, there was also a reduction in mortality for children younger than 2 years of age. The incidence of neuroblastoma at 1-4 years of age in the HPLC cohort in Sapporo City was about half that in the pre-screening cohort, along with and probably because of an increasing incidence among infants in the same cohort. Our findings suggest that HPLC screening may detect some poor-prognosis neuroblastoma cases at early stages, thus providing for more favorable therapy.

Adolescent↗
PubMed1995

Characteristics of participants and non-participants in annual mass screening for oral cancer in 60-year-old residents of Tokoname city, Japan.

Three thousand one hundred and twenty three 60-year-old residents of Tokoname city, Japan, were eligible to take part in an ongoing annual mass screening programme for oral cancer and precancer during the years 1986-1990. All received a mailed questionnaire to ascertain details of their personal circumstances, lifestyle factors and medical history. One thousand six hundred and sixty eight (53 per cent) responded and of these, 347 plus an additional 89 non responders, totalling 14 per cent of the sample, subsequently attended for screening. Those screened were significantly more likely than non participants to have taken part in other general health or cancer screening, to report past histories of diseases or conditions with severe subjective symptoms and to have access to the screening facility on foot, by bicycle or by car. There were no significant differences between the groups in their smoking habits or alcohol consumption. Ways of improving compliance in screening are considered and in particular, the need for further strengthening the complementary public education programme to increase its effectiveness is highlighted.

Alcohol Drinking↗
PubMed1996

[Mass screening of colorectal cancer: where are we up to?].

Considering the present state of knowledge on the question, only the strategy of screening for intestinal tumours at the asymptomatic stage would seem capable of reducing such a problem as colorectal cancer. Detection of occult blood in stool is currently being evaluated through a mass screening test. Methods used to obtain a high participation rate are now well-defined. In France, to achieve this goal, the test must be proposed by GPs and then mailed to those who do not consult GPs. Four case-control studies and one randomized study conducted among volunteers suggest the efficacy of screening with faecal occult blood testing to reduce mortality from colorectal cancer but they do not indicate effectiveness within a population. Four population-based studies have been set up in Europe (Denmark, England, Sweden and France). Results will be available within one to three years. They should lead to a national screening strategy.

Aged↗
PubMed1989

[Mass screening and prognosis of sequelae of closed cranio-cerebral trauma in children].

A prognostic method is offered in order to improve the dispensary supervision system for children after closed head trauma. For this purpose, a program of mass screening was specially designed and applied for long-term follow-up in child population in the framework of yearly medical checkups. This provided the information on 210 patients' pretrauma state. The patients were divided into groups according to severity of the posttrauma disorders of the following 2 years that allowed regarding any index in relation to its prognostic value. Computer data processing yielded prognostic criteria for the course of sequelae of the closed head injury.

Adolescent↗
PubMed1996

[Criteria of mass screening for cancer].

Evidence of the positive outcome of cancer screening (favorable effects higher than harmful effects) should be obtained before being acquired by the whole populations. The purpose of this article is to report the criterions necessary to the development of mass screening: knowledge of cancer, qualities of screening test, evidence of efficacy and efficiency, organizational aspects.

Cost-Benefit Analysis↗