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PubMed1985

[Reevaluation of recalled infants by neonatal mass screening for congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Diagnostic value of pregnanetriolone in a single urine specimen using glass capillary gas chromatography].

To establish a detailed reevaluation system for infants who were recalled by a neonatal mass screening for congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, pregnanetriol (PT) and pregnanetriolone (PTL) in a single urine specimen combined with plasma 17 alpha-hydroxyprogesterone (17-OHP) and 21-deoxycortisol (21-DOF) were determined by a simple method using glass capillary gas chromatography. A pilot study of neonatal mass screening for CAH with a determination of "disc 17-OHP" value in dried blood on filter paper was carried out in Western Shizuoka Prefecture. During the study period (32 months), 37472 neonates were determined by mass screening, and 362 neonates proved to be abnormal candidates who needed further evaluations. From out of these candidates, 262 neonates responded with recall and were studied. Amongst these 262 neonates, 241 neonates visited directly our outpatient clinic at Hamamatsu University Hospital. The reevaluation conducted at our clinic included a physical examination, detailed family history, measurement of serum electrolytes, disc 17-OHP, plasma 17-OHP and 21-DOF values, and PT and PTL in a single urine specimen. Consequently, 3 neonates appeared to be patients with CAH. Two of them were the salt-losing type and the other was the simple virilizing type. The rest of the candidates who received reevaluation were finally decided to be healthy neonates, indicating false positivity by mass screening. Compared to the candidates who showed false positivity in the mass screening, the CAH patients had an apparently high urinary PT and PTL titer of ten or one hundred fold. Additionally, despite corticosteroid treatment in one case, significantly elevated levels of PT and PTL were detected. To assay PTL was a more reliable parameter for the detection of CAH and for following up the candidates because PTL was not detectable in 63.3% of the false positive cases, suggesting that PTL was less likely to indicate false positive cases. PTL was detected at more than 0.01 microgram/ml urine in 19.4% of false positive cases, however, no case showed further elevation of PTL during the follow up period. In all false positive cases, PTL was not detectable until the age of six months. Despite problems to be resolved, determination of urinary PTL titer is valuable for the detection of CAH patients. In addition, urinary PTL could be a good parameter for the further follow up of false positive cases in neonatal mass screening.

17-alpha-Hydroxyprogesterone↗
PubMed1995

Participants' characteristics in a French colorectal cancer mass screening campaign.

BACKGROUND: Participation by the target population is clearly a key element in the success of mass screening programs for colorectal cancer. In France, involvement of general practitioners in test distribution is essential to reach a satisfactory participation rate, but other forms of recruitment also have to be organized. The aim of this study was to determine the influence of demographic characteristics such as sex, age, and place of residence on the participation rate in a French mass screening according to different recruitment methods. METHODS: The Hemoccult IIR test was proposed in three consecutive ways: spontaneously by general practitioners and occupational doctors during appointments (phase 1), by postal invitation (phase 2), and finally by direct mailing of the test (phase 3). The target population consisted of 11,947 people between 45 and 74 years of age, living in a district of the French county of Calvados, between March 1991 and April 1993. RESULTS: The overall participation rate was 51.3%. Forty-nine percent of all the tests were done during phase 1, 31% during phase 2, and 20% during phase 3. The overall participation rate varied essentially according to the place of residence, from 65.5% in urban areas and 48.9% in intermediate areas to 27.7% in rural areas. The overall participation rate was also higher for females (57%) than for males (45%) and for those 60 years and older (53.9%) than for those below this age (49.2%). The proportion of tests done during phase 1 was lowest among the youngest and the oldest age groups (37.5% in the 45- to 49-year class and 45.2% in the 70- to 74-year class) and among people living in the rural environment (respectively 55.3%, 45.5%, and 35.9% in urban, intermediate, and rural areas). CONCLUSIONS: This study shows that place of residence strongly influences the global participation rate in mass screening for colorectal cancer in France, whereas sex and age have little influence. Recruitment methods complementary to distribution by general practitioners must be organized, especially for the youngest and oldest age groups (45-49 years and 70-74 years) and above all for people living in rural areas. The social, cultural, and psychological reasons for these differences remain to be investigated, with the aim of adapting mass screening strategies to the different population groups.

Aged↗
PubMed2006

[Longitudinal analysis of factors associated with participation in community-based mass screening for the frail elderly in need of care].

PURPOSE: To examine factors associated with participation in a community based comprehensive health check to screen frail elderly before they become in need of long-term care. METHODS: All residents aged 70 years and over living in Kusatsu, Gumma prefecture were surveyed for their sociodemographics, and physical, mental and social functioning through in-person interview in the years 2001 and 2003. In the following years--in 2002 and 2004, respectively--mass screenings were conducted to detect early signs of need for care among the elderly. Using the baseline interview information as explanatory variables, we performed multiple logistic regression analysis in order to examine the social determinants of participation in the mass-screening. RESULTS: For the first mass-screening, having high blood pressure and poor subjective health decreased the likelihood of attending the screening by 34% and 65% respectively. In contrast, one point increases in IADL, mobility and social-role score increased the probability of attendance by 27%, 26% and 26% respectively. After the screening was re-conducted, the factors influencing attendance appeared to have changed. With a third mass-screening, while the IADL and mobility score still had significant effects, elderly having excellent subjective health were less likely to go by some 48%. It was also found that not having visual impairment had a significantly positive effect on attendance. CONCLUSION: If local government conducts community-based mass screening aiming to screen the frail elderly in need of care, it is likely that there are high risk elderly among the non-participants. It is very important to follow up those non-participants using an attendance roll and provide appropriate advice. It is also worth discussing mass screening that focuses more on health promotion than on "screening" itself.

Activities of Daily Living↗
PubMed1991

Mass screening in Japan increased the detection of infants with neuroblastoma without a decrease in cases in older children.

Analysis of data from the Kanto-Ko-Shin-Etsu Branch of the Japan Children's Cancer Registry revealed that mass screening for neuroblastoma increased the detection of cases in infants younger than 1 year from about 25% before screening to about 50%, and the percentage of neuroblastomas among all pediatric cancers almost doubled, from approximately 10% to 19.3%. However, when the cases found on screening were subtracted, the numbers after the onset of mass screening were similar to those before screening. It is likely that neuroblastoma mass screening has identified a unique type of tumor, which may not be recognized without mass screening, rather than that it has contributed to the earlier diagnosis of tumors in older children.

Age Factors↗
PubMed1992

[Mass-screening for ovarian cancer by means of transvaginal ultrasonography].

Since April, 1989 in Aomori Prefecture, mass-screening for ovarian cancer by means of transvaginal ultrasonography has been performed in a mass-screening car at the same time mass-screening for uterine cervical cancer. Subjects for this screening were self referred asymptomatic women 30 years of age or older. Real time ultrasonography was performed with a 5-MHz endovaginal transducer 5 sections for scanning were established by means of a transvaginal probe and all ultrasonic pictures obtained were recorded with an 8mm VTR. For women with abnormal ultrasonic findings, such as an ovary (tumor) over 30mm in size and massive ascites, a second screening or accurate examination was performed by retransvaginal ultrasonography, CT-scan, MRI and a combination assay of tumor markers. The results were as follows: The time required for the first screening, including bimanual examination, collection of Pap smear and ultrasonic examination, was about 60-70 seconds. The total number of screened women was 15,282, and 838 (5.5%) of them needed to receive the follow-up examinations. Laparotomy has been done for 48 women to date and 2 women were found to have premalignant and malignant ovarian tumors.

Adult↗
PubMed2004

Uterine body cancer mass screening at Tokai University Hospital.

A total of 1,512 women participated in mass screenings for uterine body cancer (UBC) from 1998 to 2003 at Tokai University Hospital. Their rate in the examinees of uterine cervical cancer (UCC) mass screenings was 4.7%. Among the 1,512 examinees, endometrial cytological abnormalities (class III or higher) were found in 17 (1.1%) cases. As a result, UBC was detected in two patients (0.13%). One case was diagnosed as class V, adenocarcinoma, and she underwent hysterectomy. In another case, adenocarcinoma was found to be associated with atypical endometrial hyperplasia in hysterectomy specimens. For the remaining 15 cases diagnosed as class III, the cytological abnormalities disappeared after a follow-up except for 3 patients who were not followed at Tokai University Hospital. In a comparison of the examinees with or without genital bleeding, the cytological abnormalities were more frequently detected in the former group; 4.2% (6/142) vs. 0.6% (5/819) (p < 0.05). We recommend examinees aged 40 years or higher with a complaint of genital bleeding to participate in UBC mass screening for detection of endometrial adenocarcinoma at early stages.

Adenocarcinoma↗
PubMed1990

[A case-control study of risk factors of breast cancer detected by mass screening].

A case-control study has been performed to elucidate the risk factors of women with a breast cancer that was detected by mass screening. Studied were the cases of fifty-two women with a primary breast cancer that had been detected by mass screening from 1978 to 1989. Age-matched mass screening controls and hospital controls were randomly selected at the rate of two controls for each case. Risk factors investigated were the age at menarche, the age at marriage, the number of pregnancies, the number of full-term pregnancies, the age at first delivery, the status of lactation, the age at menopause, the family history of breast cancer, benign breast disease, exogenous hormonal agents, and obesity. In comparing the mass screening subjects with the controls, a significant odds ratio (OR) was shown in no lactation (OR = 2.67, p = 0.02) and the history of a previous benign disease (OR = 2.56, p = 0.03). No lactation (OR = 2.29, p = 0.02) was significant when compared with the hospital controls. Furthermore, early menopause and an early age at first delivery seemed to act as a protective factor against breast cancer.

Adolescent↗
PubMed2006

Results for 79 patients with neuroblastoma detected through mass screening at 6 months of age in a single institute.

BACKGROUND: In Japan, mass screening for neuroblastoma has been performed at 6 months of age to improve the prognosis of this condition for more than 20 years. In recent years, most neuroblastomas detected by mass screening were considered to have favorable biological features and sometimes tend to regress spontaneously. METHODS: The authors established non-treated observation criteria in 1997 and criteria for observation of residual tumor after first-line chemotherapy in 1999, and have made an effort to reduce the intensity of medical treatment for neuroblastoma. The authors examined outcomes of 79 patients who were found in the Shizuoka neuroblastoma mass screening at 6 months of age and who received medical treatment or underwent observation in Shizuoka Children's Hospital, Shizuoka, Japan, between December 1981 and December 2004. RESULTS: A total of 77 patients survived but the remaining two patients died from complications of medical treatment. None of the patients died due to progression of neuroblastoma. In the cases, non-treated observation was performed in 17. Of those, 12 patients are now under non-treated observation. Of their tumors, two have disappeared, nine have become smaller and another one has not change in size. Observation of residual tumor after first-line chemotherapy was performed in 15 cases, and three disappeared and the other 12 cases became smaller. Medical treatment-related complications were observed in 20 of 67 patients who received medical treatment, and 18 of the 20 patients were seen before establishing non-treated observation criteria. CONCLUSION: Non-treated observation and observation of residual tumor after first-line chemotherapy were useful to reduce medical treatment-related complications.

Adrenal Gland Neoplasms↗
PubMed1997

Risk factors of end-stage renal disease and serum creatinine in a community-based mass screening.

This study evaluated risk factors for end-stage renal disease (ESRD) and the prognostic significance of serum creatinine levels in a community-based mass screening. We used the registries of both community-based mass screening and chronic dialysis programs. In 1983, a total of 107,192 subjects over 18 years of age (51,122 men and 56,070 women) participated in a mass-screening program in Okinawa, Japan. Among them, serum creatinine data were available for 14,609 participants (5,613 men and 8,996 women). During 10 years of follow-up, we identified 60 dialysis patients (29 men and 31 women) among this group. Logistic regression analysis on the risk of ESRD was performed to determine the significance of serum creatinine levels in comparison with other clinical variables. The adjusted odds ratio (95% confidence interval) was 5.31 (3.39 to 8.32) in men and 3.92 (2.88 to 5.34) in women when compared to baseline serum creatinine levels of less than 1.0 mg/dl in women and 1.2 mg/dl in men. Diastolic blood pressure was not a significant predictor of ESRD. Results demonstrated the prognostic significance of serum creatinine in a community-based mass screening. Gender difference in the incidence of ESRD was explained, at least partly, by differences between clinical predictors and baseline serum creatinine levels.

Adolescent↗
PubMed1995

The effect of mass screening on incidence and mortality of squamous and adenocarcinoma of cervix uteri.

OBJECTIVE: To describe the efficacy of the Finnish mass screening program for cervical squamous carcinoma and adenocarcinoma, as reflected by changes of incidence and mortality rate. METHODS: Cervical cancer incidence and mortality data were obtained from the Finnish Cancer Registry. Data were available from the year 1953, when the registry was established. The nationwide mass screening program in Finland was started in the mid-1960s. A centralized organization administers this program. Women age 30-60 years are notified for screening every 5 years. RESULTS: The mean incidence of cervical carcinoma in the early 1960s was 15.4 per 10(5) woman-years. In 1991, it was only 2.7 per 10(5) woman-years. The mortality rate has decreased in the same proportion since the mass screening program. In the early 1960s, the mortality was 6.6 and in 1991 1.4 per 10(5) woman-years. However, the decrease of the incidence is seen almost exclusively in squamous cell carcinomas. The mortality caused by adenocarcinoma has decreased in screened birth cohorts, but the incidence rate has remained the same. CONCLUSIONS: The Finnish mass screening program has been effective and its continuation is of utmost importance. In the future more attention should be given to glandular cell atypias in cervical smears. Thus, it might be possible to decrease the incidence of cervical adenocarcinoma.

Adenocarcinoma↗
PubMed1993

[The development of mass-screening method for benzodiazepines by radioimmunoassay].

For the mass-screening of benzodiazepines in urine, radioimmunoassays (RIAs) for two benzophenones (metabolites of the drugs) were established, and an animal experiment was carried out to verify their usefulness. Immunogens were prepared by condensing 2-hemisuccinyl derivatives of 2-amino-5-chlorobenzophenone (A-CBP) or 2-amino-5-nitrobenzophenone (A-NBP) to bovine serum albumin (BSA). Antisera were produced in rabbits by immunization with the individual antigens. Two kinds of RIA were established separately for A-CBP and A-NBP using each antiserum, and their sensitivities were 150 pg/tube and 30 pg/tube, respectively. The antisera had broad cross-reactivity with many chlorbenzophenone and nitrobenzophenone derivatives, respectively. Diazepam or nitrazepam was administered to rats, and the total amounts of each in urine (benzodiazepines plus their metabolites such as benzophenones) were determined relative to time using the RIAs after acid hydrolysis of the specimen. The benzophenones were positive in urine even 9 h after administration, whereas diazepam was undetectable using a RIA against diazepam. The characterization of the antisera and the results of the animal experiments indicate that these RIAs will be very useful for mass-screening of benzodiazepines.

Animals↗
PubMed1995

Mass screening and age-specific incidence of neuroblastoma in Saitama Prefecture, Japan.

PURPOSE: To provide the population-based incidence rate of neuroblastoma and to determine the effect of mass screening on the annual age-specific incidence of the tumor in Saitama Prefecture, Japan, from 1981 to 1992. METHODS: Data on screened infants and patients detected by the screening were obtained from the records of the Prefectural Screening Center. Data on neuroblastomas in this area were obtained from the Children's Cancer Registry of the Saitama Prefectural Government (Prefectural Registry) and from the Japan Children's Cancer Registry (National Registry). Population data were obtained from the Prefectural Census. Mass screening for 6-month-old infants was performed by qualitative assessment of urinary vanillylmandelic acid (VMA) from June 1981 to September 1989 and by quantitative measurement of VMA/creatinine (Cre) and homovanillic acid (HVA)/Cre from October 1989 to December 1992. RESULTS: Between 1981 and 1992, 199 cases of neuroblastoma, which include 74 cases detected by mass screening, were identified in Saitama Prefecture. The incidence rate for children under 15 years of age increased from 6.4/10(6) to 20.1/10(6), that for children 0 to 4 years of age increased from 17.0/10(6) to 64.1/10(6), and that for infants under 1 year of age increased from 27.9/10(6) to 260.4/10(6) during these 12 years. No significant reduction in the incidence rate was observed for children over 1 year of age. CONCLUSION: The incidence rate for children under 15 years of age increased with mass screening. The rate for infants was sharply increased, with no corresponding decrease in the rate for children at older ages. These data suggest that there is a subset of neuroblastoma that can be detected by mass screening at 6 months of age but would not be diagnosed later clinically.

Adolescent↗
PubMed1984

[Mass screening program for cancer].

Since Japan, a national cancer control program has been initiated in 1957. The fundamental principles were set up in 1965. Under these principles, the Ministry of Health and Welfare granted financial support for stomach and uterine cancer mass screening programs, which were conducted by the local governments. At that time, the number of examinees was limited; 990,000 persons for stomach cancer screening program and 127,000 persons for uterine cancer screening program in 1966. However, it increased rapidly year after year and reached to 4,350,000 examinees for the stomach cancer and 2,656,000 examinees for the uterine cancer In 1983, the Health Promotion Act for the Aged was enacted. The Act prescribes the local municipalities to conduct stomach and uterine cancer mass screening programs for their inhabitants. This report describes a historical review of the development of the mass screening programs, especially on the objection objection against the programs in 1967-69 and in 1978-79, and on the reaction to those objection. The definition of mass screening programs and the future of mass screening are discussed.

Female↗
PubMed2001

Maturation of mass-screened localized adrenal neuroblastoma.

BACKGROUND/PURPOSE: In infants, neuroblastoma has been known to spontaneously differentiate into a benign ganglioneuroma. Although several investigators have compared mass-screened with unscreened, disseminated with localized, and adrenal with retroperitoneal neuroblastoma, there are very few cross-comparisons of the above parameters. Herein, the authors report the maturation of mass-screened, localized adrenal neuroblastoma. METHODS: Fifty-one mass-screened adrenal neuroblastomas were divided into 2 groups. In infants less than 1 year of age (Group A), 45 neuroblastomas were resected, whereas 6 neuroblastomas were resected after observation in 1- to 4-year-old children (group B). Histopathology of the tumors in the 2 groups was compared. Data were analyzed by X(2) test, and P <.05 was considered significant. RESULTS: According to the International Neuroblastoma Pathological Classification, 41 of 45 tumors of group A were "differentiating neuroblastoma" and 4 of 6 tumors of group B were "maturing ganglioneuroma." Maturation toward ganglioneuroblastoma was observed in 16 neuroblastomas of group A (36%) and 6 neuroblastomas of group B (100%). In group A, 58% had low mitosis karyorrhexis index (MKI); all patients in group B had low MKI. CONCLUSIONS: If left untreated, maturation of mass-screened, localized adrenal neuroblastomas is a common phenomenon. These children do not need to undergo early operation.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Mass screening for neuroblastoma by HPLC and by non-HPLC: a review.

There have been a number of contradictory views concerning the efficacy of mass screening for neuroblastoma. Three Japanese and one cohort study from Quebec, and three Japanese cross-sectional studies were reviewed. The four cohort studies revealed that mass screening using high performance liquid chromatography (HPLC) reduced the incidence of this disease by about half in children aged from 1 to 4 years while little reduction was noted in screening utilizing non-HPLC methods. There is a large difference in the efficacy of mass screening depending on the method used. In the three cross-sectional studies, there was no discrimination between screened and unscreened cases, or between subjects screened by HPLC and non-HPLC methods. The percentage of children in the cross-sectional studies screened by HPLC was low. Cross-sectional studies seem inappropriate in assessing the effectiveness of current HPLC mass screening.

Brain Neoplasms↗
PubMed1992

Clinicopathological features of advanced gastric cancer detected by periodic mass screening.

We have attempted to clarify the clinicopathologic features of advanced gastric cancers that were detected in periodic mass screening by comparing them with those of cancers detected by an initial mass screening. The macroscopic type of the cancers detected by periodic mass screening included Borrmann's type 3 in 47% of cases but was an unclassifiable type because of its resemblance to early cancer in gross appearance in another 47% of cases. The predominant histologic type of the cancers was found to be poorly differentiated adenocarcinoma with scirrhous growth. From these results, advanced gastric cancers that resemble early cancers of the depressed type, in gross morphology, and which are histologically diagnosed as poorly differentiated scirrhous carcinoma, are assumed to be rapidly growing tumors. Therefore, some of the cases that have these characteristics may, in fact, represent early-phase scirrhous carcinoma, diffuse carcinoma classified as Borrmann's type 4, of the stomach.

Adenocarcinoma↗
PubMedDate not supplied

Evaluation of effectiveness of mass screening for colorectal cancer.

As the first step in the epidemiological evaluation of the effectiveness of mass screening for colorectal cancer, we compared clinicopathological features and survival rates of patients with cancer detected by mass screening (screened group) with those for patients treated in our outpatient clinic in the same period (outpatient group). The screened group consisted of 53 patients with colorectal cancer detected by 2-day or 3-day screening for fecal occult blood by guaiac slides. Their background factors were comparable to those of 120 patients of the outpatient group in regard to age, sex ratio, location of cancer, and histological type of cancer. In the screened group, 90% of patients had no complaints, and positive occult blood tests led to the detection of cancers. More than 60% of the patients had Dukes' A and B1 early cancers while only about 30% had advanced cancers. In the outpatient group, nearly 90% of patients were symptomatic, most commonly from rectal bleeding. Early-stage cancers made up only 20%, and large, advanced-stage cancers accounted for 80%. The 5-year survival rate of the screened group was 91.5%, being significantly higher than the 60% survival rate for the outpatient group. It is anticipated that mass screening for colorectal cancer by guaiac fecal occult blood testing will significantly reduce the mortality due to this neoplasm.

Aged↗
PubMed1983

[Studies on the appropriated interval of mass screening for cervical cancer].

In order to study the appropriate interval for cervical cancer screening, we investigated mainly the screening history of 1,086 cervical squamous cancer cases detected by mass screening. 1) The cancer detection rate (CDR) for the 2-year successively screened group who were class I in the first screening was 0.051% and all cases were carcinoma in situ (CIS). In the 2-year interval screened group, detection rates for CIS, microinvasive cancer and stage 1b cancer were 0.053%, 0.035% and 0.018%. But there is no significant difference in CDR between the 2-year successively screened group and 2-year interval screened group (p less than 0.05). 2) In the 2-year successively screened group who were class II in the first screening, the CIS and microinvasive cancer detection rates were 0.044% and 0.022%. There is no significant difference in CDR between class I group and class II group. In the group who were class I in the first screening, we detected most cases in the stage 0 and a few cases in the stage Ia and Ib by mass screening at 2-year intervals. If the detection of a few cases in stage Ib is permitted, we can enforce mass screening for cervical squamous cancer at 2-year interval and it is considered that class II group can be screened at same interval as class I group.

Female↗