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PubMedDate not supplied

[Program of early detection of breast cancer in Castilla-la-Mancha. Preliminary data of the first 5 months of performance. Regional Group on the Evaluation of the Program of Early Detection of Breast Cancer].

BACKGROUND: A Breast Cancer Screening Programme managed by the Regional Ministry of Health in Castilla-La Mancha (Spain) was started in November 1992 in two districts. The purpose of this study is to describe the short-term results after five months of running. METHODS DESIGN: descriptive, cross-sectional study. SETTING: female population of Talavera de la Reina and Cuenca cities, from November 1992 to the end of March 1993. PARTICIPANTS: 10.050 healthy women between 45-64 years old, who were invited, by personal letter, to attend a mammography unit. RESULTS: 6.503 women accepted the screening invitation (participation rate of 65%) without differences between both districts. The personal letter was the main information source to women, and the presence of beliefs, attitudes and favorable experiences were the main reasons to accept the screening. The rescreening was needed by 4% of women, and finally, 67 women (1.1%) were classified "positive". The programme cost for every women into the screening was 4.067 ptas. CONCLUSION: According to these results, is it feasible as economically as from the point of view of the organization, to extend the programme in Castilla-La Mancha.

Breast Neoplasms↗
PubMed2026

Liquid biopsy for early detection of pancreatic ductal adenocarcinoma.

There is no clinically relevant blood-based assay for the detection of early-stage pancreatic ductal adenocarcinoma (PDAC), a solid malignancy characterized by poor outcomes. Here we developed, validated and tested a blood-based microRNA (miRNA) assay (which included hsa-miR-142-3p, hsa-miR-30c-5p, hsa-miR-335-5p, hsa-miR-340-5p, hsa-miR-200b-3p, hsa-miR-1260b, hsa-miR-145-3p, hsa-miR-145-5p, hsa-miR-429 and hsa-miR-200a-3p) and a composite score, PANXEON (PANcreatic cancer eXosome Early detectiON), that integrates the miRNA signature with carbohydrate antigen 19-9 for the detection of early-stage PDAC. We conducted an international, multicenter, observational, prospective biomarker study that involved 1,785 individuals with and without PDAC from four countries. The miRNA signature achieved an area under the receiver operating characteristic curve of 88.6% in the testing cohort, with a sensitivity of 83.8% for early-stage PDAC, while showing minimal cross-reactivity with other gastrointestinal cancers. In a cohort of 19 individuals, the miRNA signature levels decreased during neoadjuvant chemotherapy and after surgery and increased before disease recurrence. When combined with carbohydrate antigen 19-9 levels, this blood assay demonstrated a sensitivity of 86.8% for stage I-II PDAC, false-positive rates of 3.2% in low-risk controls and 15.6% in high-risk controls in the testing cohort. PANXEON demonstrates potential for detecting high-grade dysplasia in individuals with high-risk pancreatic cysts (64.3%). Collectively, we present a composite biomarker that may complement existing strategies for the detection of early-stage PDAC and warrants further large-scale prospective studies. ClinicalTrials.gov registration: NCT06388967 .

Journal Article↗
PubMed2004

Community trends in the early detection of breast cancer in Wisconsin, 1980-1998.

BACKGROUND: Early detection of breast cancer is an important public health goal. Rates of early detection have increased over the past several decades, contributing to recent declines in mortality. Despite these overall trends, however, some populations have experienced less progress than others. METHODS: The rates of early detection, measured as the percentage of breast cancers diagnosed as breast carcinoma in situ, were calculated using data from Wisconsin's population-based tumor registry from 1980 to 1998. Trends in breast cancer (percent diagnosed in situ) were examined over time by socioeconomic characteristics of ZIP code of residence, using census data. RESULTS: The percentage of breast cancer cases that were breast carcinoma in situ was more than five times greater in the later period (1994-1998) (13.9%), compared with the early period (1980-1984) (2.6%). In the middle period (1987-1991), breast cancer was diagnosed as breast carcinoma in situ about one-third less frequently among women in areas with the lowest urbanization, median family income, and percent educated beyond high school, compared with communities with the highest levels of these variables. Recently disparities in early detection rates by community income and education indicators declined slightly, whereas disparities in percent of breast carcinoma in situ by urbanization did not. CONCLUSIONS: Communities with lower levels of income, education, and urbanization lagged in the early detection of breast cancer during the 1980s and, despite some progress during the 1990s, continue to be underserved. Women in these communities should be targeted for interventions to improve the early detection of breast cancer.

Breast Neoplasms↗
PubMed1988

[Early detection of developmental disorders: the need for a new perspective].

Early detection of abnormality in young children (aged 0-7) in the Netherlands is to be organized on two levels. First, regional cooperation between child-health professionals and institutions will be stimulated in order to form a nationwide network of 'multidisciplinary teams', with the task of coordinating early detection in a specific area. These teams are to advise parents and professionals in those cases where a child's development is suspected of being 'at risk'. The second part of the program is a campaign to promote the idea of early detection among the population. The aim is to develop the 'signalizing' and diagnostic abilities of parents, teachers and child-health professionals through education and training. The subject of early detection seemed and still seems to be a focus of different interests, and of conflicts of competence between different groups and schools of professionals and different institutions. In this article some of the main conflicting issues are discussed. One of the important problems concerning early detection is the question of defining normality and abnormality. It is concluded that in the case of early detection of both somatic and psychosomatic disorder there can be no such thing as an absolute scientific rationality, as is often suggested. Theoretical frameworks underlying methods of early detection are influenced by social, cultural and historical factors, and thus form a social construction. Finally a protocol-approach is being suggested, a method that might clear some of the problems concerning the content and organizational procedures of the Dutch system for early detection.

Child↗
PubMed1993

[Screening examination for prostate cancer. Early detection and mass screening].

The significance of symptoms, digital rectal examination (DRE), transrectal ultrasonography (TRUS) and prostatic specific antigen (PSA) as aids in the early detection of prostate cancer was investigated. In number of studies, sensitivity of DRE is lower than that of TRUS but specificity of DRE is adversely higher than that of TRUS. PSA was an excellent means to observe clinical course of prostate cancer patients but have proven to be insensitive and nonspecific to detect early stage prostate cancer. There is certainly no single test that can be applied reliable to detect the presence of prostate cancer at present. The use of three screening modalities must be recommended to improve the detection rate. Mass screening program in Gunma Prefecture has been being studied since 1981. In this paper, we demonstrated that this screening program is successful to detect early prostate cancer with high detection rate (0.8%), improves the survival rates comparing to those of patients detected by outpatient clinics and the tests applied in this program prove relatively high specificity and sensitivity. To prove the significance of mass screening program, pilot studies in well executed randomized prospective protocols are urgently needed. To achieve this purpose, it is necessary to organize a cooperative study group since approximate 50,000 to 100,000 subjects should be examined in this protocol.

Aged↗
PubMed1998

Image analysis combined with visual cytology in the early detection of recurrent bladder carcinoma.

BACKGROUND: Early detection of recurrent transitional cell carcinoma of the bladder (TCC) is important to permit early treatment, which produces maximal preservation of the bladder and maximum survival. METHODS: This retrospective cohort study attempted to determine the period of time over which urinary DNA image analysis combined with visual cytology is useful in the early detection of recurrent TCC of the bladder. The authors believe this study is unique in that it measured the effectiveness of this test (image analysis plus visual cytology combined) at varying times before clinical diagnosis of recurrence was made. The cohort was comprised of 175 urologic patients from urologic practices across the U.S. Data, collected between January 1991 and February 1994, included cystoscopy, biopsy, DNA image analysis, and visual cytologic reports. RESULTS: Sixty patients in the cohort were found to have active TCC whereas 115 patients had a history of, but no active, disease during the follow-up period. As expected, the sensitivity and specificity of DNA image analysis in combination with visual cytology, and DNA image analysis alone, were greatest when urinary samples were obtained close to the time of diagnosis. In general, the longer the interval from the combined tests to the time of diagnosis, the lower the sensitivity. The combined tests had predictive value up to 3 months prior to clinical diagnosis when any detectable cytologic abnormality was considered positive. At the optimal cutoff points as determined from receiver operating characteristic curves, sensitivity increased when DNA image analysis was supplemented with visual cytology. CONCLUSIONS: The combination of DNA image analysis and visual cytology provides a better method for the early detection of recurrent TCC than DNA image analysis alone. This test potentially may be useful in providing information regarding bladder tumor recurrence up to 3 months prior to clinical evidence of disease.

Adult↗
PubMed1994

Early detection of cancer. Psychologic and social dimensions.

Major strides in early detection research can be attributed to social and behavioral research. Social scientists have been involved in research determining the epidemiologic basis of and the cost-effectiveness of screening for asymptomatic disease. The availability of well accepted screening tests has been a barrier to early detection research, especially in the area of men's health. Early detection research has focused on the individual and system levels. Theoretical models are being adapted for early detection from smoking research and are a strength of current work. These models explain why people participate in early detection and how behavior change can occur. In studying system barriers to early detection, intervention efforts have been focused in the community and in the medical care delivery system. Methodologic issues are beginning to emerge, including measuring of program outcomes, and the appropriate research designs for community studies. Except for immigrant populations, initial screening rates are high, and the periodicity of screening becomes the outcome of choice. Some of these problems are the direct result of the success of research and public education efforts to increase cancer screening. The following are priorities for the next decade: theory driven research on behavior change and on interventions; the social determinants of physicians' participation in screening; process evaluation to relate community efforts to outcomes; and reductions in the stage at which cancer is diagnosed as an outcome measure.

Adult↗
PubMed1983

[Efforts for early detection of lung cancer].

The 3rd survey of "The Lung Cancer Early Detection Project" inaugurated in 1972, was conducted by Naruke team during the period from 1978 to 1980 on 1, 632, 157 test subjects collected from 60 institutions throughout Japan. Cases of detected lung cancer were classified in two groups as Prevalence case and Incidence case and discussed in the report. As the result, X-ray examination was effective to detect early peripheral lung cancer, and for high risk group X-ray examination combined with sputum cytology test indicated the highest detection rate for early hilar lung cancer. Our recent directions for the nation-wide mass screening of lung cancer consist of four methods: 1. Utilization of local self-governmental mass screening. 2. Mass screening conducted by general practitioners at local clinics. 3. Active cooperation of general practitioners with local self-government. 4. Public participation in the Lung Project. We should continue our efforts to solve these problems.

Adult↗
PubMed2005

Effect of an early detection programme on duration of untreated psychosis: part of the Scandinavian TIPS study.

BACKGROUND: It is unclear whether an early detection programme increases or decreases the number of patients with a long duration of untreated psychosis (DUP), and whether these differ from other patients with a long DUP. AIMS: To investigate whether the number and characteristics of patients with a long DUP in the early detection programme differ from those with a long DUP in the non-early detection programme. METHOD: We compared the number and characteristics of patients with a DUP > or =2 years in an early detection area and a non-early detection area. RESULTS: The early detection programme recruited slightly fewer patients with a long DUP than the non-early detection programme. The patients in the early detection programme had lower PANSS scores, but more frequently had a deteriorating course of premorbid social functioning. CONCLUSIONS: An early detection programme does not seem to drain a pool of previously undetected patients with a long DUP. The patients in the early detection programme seem to have a lower symptom level at baseline and to have had a deteriorating premorbid social course.

Adolescent↗
PubMed2005

Early detection and curative treatment of early-stage hepatocellular carcinoma.

The method for early detection of hepatocellular carcinoma (HCC) has been well-established in Japan by means of regularly screening patients at risk for developing HCC by using imaging and tumor markers. An important issue is the accurate characterization of nodular lesions found in cirrhotic livers. This problem has been addressed by development of imaging modalities such as ultrasonography angiography with intra-arterial injection of CO2, computed tomography during hepatic arteriography, and computed tomography during arterial portography. It is most important to differentiate the typical hemodynamic patterns of low-grade dysplastic nodule including arterial hypovascularity with preserved portal perfusion from those of HCC characterized by arterial hypervascularity with decreased portal perfusion. At present, these findings are easily obtained by contrast-enhanced phase-invasion harmonic imaging, which is a noninvasive ultrasound technology. Radiofrequency ablation is an efficient technique to curatively treat early-stage HCC. The 5-year survival rate of RFA at our institution is 76%. Although local recurrence rate after curative RFA is as low as 6.2%, the intrahepatic distant metastasis is as high as 85% at 5 years. The prevention of intrahepatic distant recurrence by maintenance interferon therapy is thus very important. The 5-year survival rate and first, second, and third recurrence rates after curative RFA in patients who had maintenance interferon therapy were much better than those in patients who did not receive interferon therapy after curative RFA. In conclusion, recent progress in screening, diagnostic, and therapeutic strategy for early-stage HCC has improved the prognosis of patients with HCC. Furthermore, advances of prognostic staging system, such as Japan Integrated Staging score, facilitate the management of HCC.

Antineoplastic Agents↗
PubMedDate not supplied

Rural women's perception of breast cancer and its early-detection measures in Ibadan, Nigeria.

Breast cancer is the leading cause of cancer death in women in many parts of the world and is the most common cancer in women in Nigeria. However, it lends itself to early detection and, subsequently, early treatment, if women use early-detection measures. It is pertinent to study rural women's perception of breast cancer and its early-detection measures because their perception would influence their use of early-detection measures of breast cancer. This is a descriptive study that assessed rural women's perception of breast cancer. Data from 2 rural health districts in Ibadan, Oyo state of Nigeria, were collected through a structured questionnaire. Four hundred seven women were randomly selected for the study. Results showed that 66.2% of the respondents considered that breast cancer is more severe than other forms of cancer. Respondents' perception of risk of developing breast cancer was low, as 64.8% rated themselves 1, on a scale of 1 to 9 (where 1 = does not perceive herself to have cancer; 9 = very much perceives herself to have cancer). Respondents' perceived cause of breast cancer included "putting money in brassiere" and attack from the enemy, among others. None of the respondents identified early detection as an advantage of breast self-examination. Swelling was the most acknowledged early-warning sign. Findings of this study indicate that there is a need for an interventional study to enhance the awareness of breast cancer and its early-detection measures among the rural population to influence early detection of breast cancer and subsequently reduce morbidity and mortality among them.

Adult↗
PubMed2003

Early detection of radiation-induced structural changes in rat trabecular bone.

OBJECTIVE: Early detection of bone changes following radiotherapy is very important. The aim of this study is to establish a radiographic image analysis method for early detection of radiation-induced trabecular bone changes. METHODS: Thirty-five Wistar rats were used for the experimental model of trabecular bone changes, which were induced by X-ray irradiation with 30 Gy to develop simulated osteomyelitis. Standardized 2.2 x direct magnification radiography was performed immediately prior to X-ray irradiation and once a week for 4 weeks following irradiation. The latent X-ray images were scanned using a computed radiography (CR) system. Mathematical morphological processing was then applied to the CR image data, which allowed the bone trabecular pattern features to be extracted as skeletal binary images. The sensitivity and specificity for detecting early trabecular bone changes in CR images and in skeletal binary images were evaluated. Quantitative analyses with quantum level value (QL value), skeletal pixel percentage (SKP) and star volume analysis (skeletal volume (Vsk), skeletal space volume (Vsp)) were performed. Histopathological examination was also conducted for confirmation of physical changes in the bone. RESULTS: Visual observation of the skeletal binary images provided a higher sensitivity than the CR images. In the quantitative analysis, SKP, Vsk and Vsp values provided higher sensitivity than QL values. CONCLUSION: The results of the present study suggest that a combined radiographic image analysis method using CR, mathematical morphological processing, SKP, Vsk and Vsp can be useful for the early detection of radiation-induced trabecular bone changes.

Analysis of Variance↗
PubMed1996

Improving the early detection of malignant melanoma.

The early detection of cutaneous melanoma is known to be associated with reduced mortality. In order to improve early detection of suspicious skin lesions a Pigmented Lesion Clinic (PLC) was set up at Mount Vernon Hospital in January 1993. Its aims were to provide a rapid method of expert assessment and treatment for malignant skin tumours as well as reassurance for patients with benign lesions. In the first 2 years, 1779 new patients were seen and 674 lesions excised, of which 18% were malignant. Comparison of the Breslow thicknesses of melanomas diagnosed via the PLC revealed a significant shift towards thinner early tumours when compared with the two previous years (chi 2 = 12.8, P < 0.01) and during the same time period via normal routes of referral (chi 2 = 8.68, P < 0.02). The running of such a service and its hidden benefits are discussed.

England↗
PubMed2006

Tumor characteristics and detection method in the MRISC screening program for the early detection of hereditary breast cancer.

In the MRISC study, women with an inherited risk for breast cancer were screened by a 6-month clinical breast examination (CBE) and yearly MRI and mammography. We found that the MRISC screening scheme could facilitate early breast cancer diagnosis and that MRI was a more sensitive screening method than mammography, but less specific. In the current study we investigated the contribution of MRI in the early detection of breast cancer in relation to tumor characteristics. From November 1999 to October 2003, 1909 women were included and 50 breast cancers were detected, of which 45 were evaluable and included in the current study. We compared the characteristics of tumors detected by MRI-only with those of all other (non-palpable) screen-detected tumors. Further, we compared the sensitivity of mammography and MRI within subgroups according to different tumor characteristics. Twenty-two (49%) of the 45 breast cancers were detected by MRI and not visible at mammography, of which 20 (44%) were also not palpable (MRI-only detected tumors). MRI-only detected tumors were more often node-negative than other screen-detected cancers (94 vs. 59%; P=0.02) and tended to be more often <or=1 cm (58 vs. 31%; P=0.11). MRI was more sensitive than mammography for a wide spectrum of invasive tumor characteristics i.e., size, nodal status, histology, grade and ER status. Half of the breast cancers detected in this study were visible by MRI only and these tumors were smaller and significantly more often node-negative than other screen-detected tumors, suggesting that MRI makes an important contribution to the early detection of hereditary breast cancer.

Breast Neoplasms↗
PubMed1996

Early detection and intervention in schizophrenia: research.

The data supporting early detection and intervention are preliminary but suggestive enough to warrant further research. Overall, we need to focus greater attention on the early course of schizophrenia, including defining and describing early course, detecting cases early at onset or in the prodrome, testing whether early detection and treatment enhances treatment response and prognosis, and predicting at-risk cases early in the prodromal phase. Designs to address these questions are presented, and relevant issues are discussed, including study aims and hypotheses, definitions and measures of early phases and caseness, detection (and early detection), treatment interventions, dependent and independent variables, and ethical issues. The technical challenges of this research are substantial, but the potential gains for our understanding of schizophrenia and treatment make the effort compelling.

Biomarkers↗
PubMedDate not supplied

[Best practice guidelines for the early detection of Autistic Spectrum Disorders (I)].

INTRODUCTION: The interest in early detection of Autism Spectrum Disorders (ASD) lies in the accumulated evidence of the fact that an early customized intervention for children with an ASD and their families leads to an improvement of the child's prognosis in most cases. OBJECTIVE: To establish criteria and procedures for early identification of children at risk of ASD and to facilitate full diagnostic assessment and prompt referral leading to adequate support. Early detection of ASD is extremely important, since early specific individualized treatment for the child and his or her family leads to long-term improvement in many children' prognosis. DEVELOPMENT: Firstly, a critical appraisal of the situation of early detection of ASD in Spain is made after reviewing the scarce bibliography available on current screening and diagnostic practices in the country. Data generated by questionnaires received from 646 Spanish families is also taken into account. Secondly, the Study Group of the Instituto de Salud Carlos III recommends the screening and early diagnosis process to be followed, describing the necessary steps, the public services involved and the available screening and diagnostic tools. CONCLUSIONS: The Study Group draws the main conclusions regarding the situation of ASD early detection in Spain, and makes a consensus proposal for the detection procedures, including routine developmental surveillance and identification of children at risk for ASD by using sensitive and specific assessment tools.

Child↗
PubMed2006

Early detection of prostate cancer. What do we tell our patients?

INTRODUCTION: Early detection of prostate cancer is possible; overdetection of early disease that may never surface clinically during a lifetime is likely. On the other hand, early detection measures will detect life-threatening disease of which some maybe amenable to cure, while otherwise it would kill the patient. Proof of effectiveness of early detection is unavailable. Those who decide to be screened and those who decide not to be screened take risks that are difficult to balance against each other. How do we deal with this situation? What do we tell our patients? DISCUSSION: Ongoing randomized studies are likely to produce definitive answers on the question of whether screening will save men from prostate cancer deaths within a few years. The trials will also provide answers to the optimal way of screening and to the question of how to avoid overdiagnosis and treatment. In the meantime, however, men who are considering to undergo testing have a difficult decision to make. Our profession is obliged to provide assistance. The information provided unfortunately at this time cannot be the simple message: if you undergo testing your cancer will be detected early and be curable, so you will resolve the problem. It is necessary to stress the potential benefits and also the downside of testing. Elements of such information are provided in this article. Benefits may include the reassurance resulting from a normal test result, the early diagnosis of aggressive and still-curable cancer, and the avoidance of the consequences of advanced prostate cancer such as the occurrence of metastatic disease. The downside includes the possibility of missing prostate cancer and providing a false reassurance, the fact that screening may lead to unnecessary anxiety and medical tests when no cancer is present, and the fact that it may detect slow-growing cancer that may never cause any symptoms or shorten lifespan. All treatments have side effects to which men will be exposed, even those who do not have life-threatening cancer. In addition, there is no certainty that treatment will be successful. CONCLUSION: In the present situation, it is important to emphasize to patients that capabilities are being developed to identify those prostate cancers that may not cause any harm and to exclude them from immediate treatment. This recent development is a very important aspect for those who consider to be tested outside ongoing trials.

Age Factors↗
PubMedDate not supplied

Controversies in the early detection of prostate cancer.

Fundamental issues about early detection of prostate cancer are unresolved. There is controversy over the need for early detection of prostate cancer, based on a relatively small number of lifeyears lost to prostate cancer when compared with other types of cancers. Earlier detection of prostate cancer is possible with PSA-driven strategies based on evidence that there is an interval of probably several years when the PSA is abnormal but the prostate cancer is still in the curative state. Earlier detection may only be advisable in men with risk for premature death from prostate cancer, i.e., younger men. Immediate problems in early detection of prostate cancer include, 1) An apparent indiscriminate use of PSA in all age groups; 2) Probable over treatment in some older patients; and 3) Morbidity from currently available therapies. Physician education about the use of PSA can be accomplished now. More precise characterization of the morbidity of treatment is needed; efforts to improve the quality of surgery, radiation therapy, or alternative treatments are warranted. A marvelous opportunity and challenge are presented in a disease that will become an increasingly important health care issue in our society.

Humans↗