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Journal of Medical Screening

David S Wald, Nicholas J Wald
Objective To integrate child-parent screening and cascade testing into a single pathway-child-parent cascade screening (CPCS), for the identification of familial hypercholesterolaemia in the population and to estimate the number of new familial hypercholesterolaemia cases identified per child screened and the associated costs. Methods We applied the results from the published MRC Child-Parent Screening Study to 10,000 children, together with cascade testing first degree relatives of parents with a familial hypercholesterolaemia mutation identified by child-parent screening...
October 14, 2018: Journal of Medical Screening
Jeremy P Brown, Kate Wooldrage, Ines Kralj-Hans, Suzanne Wright, Amanda J Cross, Wendy S Atkin
Objective To investigate the outcomes of biennial guaiac faecal occult blood test (gFOBT) screening after once-only flexible sigmoidoscopy (FS) screening. Methods Between 1994 and 1999, as part of the UK FS Screening Trial (UKFSST), adults aged 55-64 were randomly allocated to an intervention group (offered FS screening) or a control group (not contacted). From 2006, a subset of UKFSST participants (20,895/44,041 intervention group; 41,497/87,149 control group) were invited to biennial gFOBT screening by the English Bowel Cancer Screening Programme...
October 3, 2018: Journal of Medical Screening
Alejandra Castañon, Matejka Rebolj, Peter Sasieni
Objective It often takes considerable time for sufficient evidence to accumulate to support implementation of new methods in routine screening. Where national screening programmes are already effective, switching to a more sensitive screening test may not be a priority. Although risk associated with overly rapid implementation exists, postponement is also associated with a (to date unquantified) missed opportunity to prevent deaths. This risk tends not to be addressed where effective screening methods are already in use...
October 3, 2018: Journal of Medical Screening
Na Young Sung, Jae Kwan Jun, Youn Nam Kim, Inkyung Jung, Sohee Park, Gyu Ri Kim, Chung Mo Nam
Objective In evaluating the efficacy of cancer screening programmes, sojourn time (duration of the preclinical detectable phase) and sensitivity of the screening test are the two key parameters. Studies suggest that in breast cancer screening, both parameters may vary depending on age at the time of screening, but few studies have examined other cancers. We expanded an existing probability model for periodic screening by performing simultaneous estimation of age group-dependent and sensitivity at preclinical onset time, and tested the expanded model using data from the Korean National Colorectal Cancer Screening Programme...
September 27, 2018: Journal of Medical Screening
Geralyn Lambert-Messerlian, Glenn E Palomaki
Objective To quantify changes in the proportion of women aged 35 and older choosing serum screening for Down's syndrome over time and the effect on false positive and detection rates. Methods From Rhode Island hospital-based laboratory prenatal screening records (2013-2017) we extracted the test performed (Integrated, Combined, Quadruple), maternal age, and Down's syndrome risk; documented observed changes in maternal age distributions and false positive rates, and modelled the impact of varying proportions of older women choosing screening on each test's performance using the 2015 United States birth cohort as baseline...
September 25, 2018: Journal of Medical Screening
Samantha L Quaife, Jo Waller, Christian von Wagner, Charlotte Vrinten
Objective Some degree of general worry about cancer may facilitate screening participation, but specific worries about the potential consequences (e.g. treatment, death) may act as deterrents. No studies have examined these associations in the same sample. We assessed associations between general versus specific cancer worries and cancer screening participation. Methods In 2016, a population-based cross-sectional survey of adults living in England was carried out. This paper reports analyses of a subsample (n = 1694)...
September 24, 2018: Journal of Medical Screening
Yvonne Daniel, Joan Henthorn
Objective Beta thalassaemias are a group of hereditary red cell disorders resulting in a reduced or absent production of the main adult haemoglobin, adult haemoglobin. In England, the NHS Sickle Cell & Thalassaemia Screening Programme recommends reporting newborn beta thalassaemia disease as an incidental finding when detected whilst screening for sickle cell disease. The current action value to initiate further investigations is 1.5% adult haemoglobin, using high-performance liquid chromatography or capillary electrophoresis...
September 24, 2018: Journal of Medical Screening
Carlo Senore, Cesare Hassan, Daniele Regge, Eva Pagano, Gabriella Iussich, Loredana Correale, Nereo Segnan
Objective Several European countries are implementing organized colorectal cancer (CRC) screening programmes using faecal immunochemical test (FIT) and/or flexible sigmoidoscopy (FS), but the cost-effectiveness of these programmes is not yet available. We aimed to assess cost-effectiveness, based on data from the established Piedmont screening programme. Methods Using the Piedmont programme data, a Markov model was constructed comparing three strategies in a simulated cohort of 100,000 subjects: single FS, biennial FIT, or sequential strategy (FS + FIT offered to FS non-responders)...
September 4, 2018: Journal of Medical Screening
Nicholas J Wald Editor, Robert Old
No abstract text is available yet for this article.
August 16, 2018: Journal of Medical Screening
Martin J Yaffe, Nicole Mittmann, Oguzhan Alagoz, Amy Trentham-Dietz, Anna Na Tosteson, Natasha K Stout
Objectives Incidence-based mortality quantifies the distribution of cancer deaths and life-years lost, according to age at detection. We investigated the temporal distribution of the disease burden, and the effect of starting and stopping ages and interval between screening mammography examinations, on incidence-based mortality. Methods Incidence-based mortality was estimated using an established breast cancer simulation model, adapted and validated to simulate breast cancer incidence, screening performance, and delivery of therapies in Canada...
July 26, 2018: Journal of Medical Screening
Jonathan P Bestwick, Wayne J Huttly, Nicholas J Wald
Objective To assess whether the accuracy of risk estimation in antenatal screening for trisomy 18 using the Combined test can be improved by revising the truncation limits of two serum markers. Methods In an audit of data from 420 trisomy 18 and 573,754 unaffected singleton pregnancies screened at the Wolfson Institute of Preventive Medicine, London (March 2003 to June 2017), the accuracy of risk estimation was assessed by inspection of a validation plot (the median predicted late first trimester Combined test risk plotted against observed prevalence within categories of predicted risk estimates)...
July 26, 2018: Journal of Medical Screening
Nora Eisemann, Annika Waldmann, Bernd Holleczek, Alexander Katalinic
Objective The main purpose of skin cancer screening is melanoma mortality reduction. Before the implementation of nationwide German skin cancer screening, the pilot project SCREEN was conducted in Schleswig-Holstein in 2003-2004. We aimed to determine whether the pilot project had achieved a mortality reduction. Methods Using an incidence-based approach (patients with both melanoma diagnosis and death in 2003-2008), we compared the observed melanoma mortality of the SCREEN cohort to the melanoma mortality expected without screening in the general population of Saarland...
September 2018: Journal of Medical Screening
Joonas Miettinen, Nea Malila, Matti Hakama, Janne Pitkäniemi
Objectives In colorectal cancer screening, randomized clinical trials have shown a 16% mean reduction in colorectal cancer mortality, but the Finnish randomized health services study showed no effect. We quantified spillover (the total indirect effect caused by the programme on the non-invited) and corrected the effectiveness estimate of the Finnish programme. Methods We retrieved from the Finnish Cancer Registry data on all non-invited colorectal cancer patients diagnosed in 1999-2013 in municipalities that adopted screening ( n = 18,948)...
September 2018: Journal of Medical Screening
Paul F Pinsky, Christina R Bellinger, David P Miller
Objectives Low-dose computed tomography lung cancer screening has been shown to reduce lung cancer mortality but has a high false-positive rate. The precision medicine approach to low-dose computed tomography screening assesses subjects' benefits versus harms based on their personal lung cancer risk, where harms include false-positive screens and resultant invasive procedures. We assess the relationship between lung cancer risk and the rate of false-positive LDCT screens. Methods The National Lung Screening Trial randomized high-risk subjects to three annual screens with low-dose computed tomography or chest radiographs...
June 2018: Journal of Medical Screening
Gisela Lg Menezes, Gonneke Ao Winter-Warnars, Eva L Koekenbier, Emma J Groen, Helena M Verkooijen, Ruud M Pijnappel
Objectives To investigate the risk of malignancy following stereotactic breast biopsy of calcifications classified as Breast Imaging Reporting and Data System (BI-RADS) 3, 4, and 5. Methods The study included women with pure calcifications (not associated with masses or architectural distortions) who underwent stereotactic breast biopsy at the Dutch Cancer Institute between January 2011 and October 2013. Suspicious calcifications (Breast Imaging Reporting and Data System 3, 4, or 5) detected on mammography were biopsied...
June 2018: Journal of Medical Screening
Phu-Quoc Lê, Alina Ferster, Laurence Dedeken, Christiane Vermylen, Anna Vanderfaeillie, Laurence Rozen, Catherine Heijmans, Sophie Huybrechts, Christine Devalck, Frédéric Cotton, Olivier Ketelslegers, Marie-Françoise Dresse, Jean-François Fils, Béatrice Gulbis
Objectives To compare the outcomes of sickle cell disease patients diagnosed through neonatal screening with those who were not. Methods In an observational multicenter study in Belgium, 167 screened and 93 unscreened sickle cell disease patients were analyzed for a total of 1116 and 958 patient-years of follow-up, respectively. Both groups were compared with propensity score analysis, with patients matched on three covariates (gender, genotype, and central Africa origin). Bonferroni correction was applied for all comparisons...
June 2018: Journal of Medical Screening
Louise E Johns, Anthony J Swerdlow, Susan M Moss
Objectives To evaluate the effectiveness of the NHS breast screening programme (NHSBSP) on breast cancer mortality in England and Wales and to compare findings with a cohort analysis of the same underlying population. Methods A nested case-control study within a cohort of 959,738 women in England and Wales aged 49-64 who were eligible for routine NHSBSP screening during 1991-2005. Cases who died from breast cancer in 1991-2005 were matched to controls without breast cancer at the case diagnosis date and alive when the case died...
June 2018: Journal of Medical Screening
Apostolos Tsiachristas, Matthew Gittins, Henry Kitchener, Alastair Gray
Objective To assess the cost-effectiveness of strategies to increase cervical cancer screening uptake at first invitation (STRATEGIC trial). Methods We performed an economic analysis alongside the STRATEGIC trial, comparing each of seven novel interventions for improving cervical screening uptake with control general practices in Greater Manchester and Grampian (United Kingdom). A template was developed to measure the intervention costs. Trial estimates of screening uptake were combined with data from the literature to estimate healthcare costs of each intervention...
June 2018: Journal of Medical Screening
Amanda J Chorley, Yasemin Hirst, Charlotte Vrinten, Christian von Wagner, Jane Wardle, Jo Waller
Objectives In examining informed choice in cancer screening, we investigated public awareness that some screening programmes aim to prevent cancer, while others seek to detect cancer at an early stage. Methods A population-based survey of adults aged 50-70 in England (n = 1433), including data on demographic characteristics and screening experience. Participants were asked to select the main purpose of cervical, breast, and colorectal cancer screening (both faecal occult blood testing and flexible sigmoidoscopy)...
June 2018: Journal of Medical Screening
H Kitchener, M Gittins, M Cruickshank, C Moseley, S Fletcher, R Albrow, A Gray, L Brabin, D Torgerson, E J Crosbie, A Sargent, C Roberts
Objectives To measure the feasibility and effectiveness of interventions to increase cervical screening uptake amongst young women. Methods A two-phase cluster randomized trial conducted in general practices in the NHS Cervical Screening Programme. In Phase 1, women in practices randomized to intervention due for their first invitation to cervical screening received a pre-invitation leaflet and, separately, access to online booking. In Phase 2, non-attenders at six months were randomized to one of: vaginal self-sample kits sent unrequested or offered; timed appointments; nurse navigator; or the choice between nurse navigator or self-sample kits...
June 2018: Journal of Medical Screening
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