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Annual Screening (annual + screening)
Selected AbstractsRenal cell carcinoma in dialysis patients: A single center experienceINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2006YASUYUKI KOJIMA Aim: Renal cell carcinoma (RCC) is a life-threatening complication of end-stage renal disease with an unclear pathogenesis. We evaluated RCC developing in patients undergoing dialysis. Methods: In 2624 patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at our hospital between July 1993 and March 2004, we performed annual screening for RCC using abdominal computed tomography and ultrasonography. Patients diagnosed with RCC underwent radical nephrectomy as well as clinical and pathologic evaluation. Results: RCC was detected in 44 patients (1.68%; 31 males and 13 females). The age of RCC patients was 55.5 ± 11.1 years. Dialysis duration before RCC diagnosis was 11.2 ± 7.2 years. Most RCC were early stage and low stage by TNM classification, 43 patients had N0M0 RCC, whereas one had N1M0. Tumor size was 2.9 ± 1.9 cm. The predominant histological type of RCC was common or conventional cell-type carcinoma (clear cell carcinoma and granular cell carcinoma). Of patients, 5(11.4%) had bilateral RCC, and satellite tumor lesions in RCC were detected in 13 (29.5%). In 36 patients (81.8%) RCC was accompanied by acquired cystic disease of the kidney. These patients had longer dialysis durations (P = 0.01) and smaller tumors (P = 0.048). RCC metastasized postoperatively in 4 patients (9.1%), while one (2.3%) died of cancer. Conclusions: Our dialysis patients showed a higher incidence of RCC than the general population. Prognosis was favorable because tumors were detected by screening when they were small. Therefore, periodical screening for RCC seems very important in dialysis patients. [source] Infrequency of Sexually Transmitted Disease Screening Among Sexually Experienced U.S. Female AdolescentsPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 6 2004Lynne C. Fiscus CONTEXT: Since 1993, the Centers for Disease Control and Prevention and professional medical organizations have recommended that all sexually experienced female adolescents receive annual screening for Chlamydia trachomatis. Whether adolescents receive this care is largely unknown. METHODS: Reports of receipt of testing or treatment for a sexually transmitted disease (STD) in the past year, as well as sites of care, were obtained from 3,987 sexually experienced females in grades 7,12 who participated in Wave 1 of the National Longitudinal Study of Adolescent Health, conducted in 1995. Logistic regression was used to determine predictors of reporting care. RESULTS: Eighteen percent of all participants reported having received STD services in the past year. Of those who reported having had a routine physical examination in the past year, 22% reported receipt of STD services. The proportion reporting STD care increased linearly with age from 9% of 12,13-year-olds to 25% of those 19 or older. In adjusted analyses, the odds of reporting testing or treatment were elevated among participants who had had a physical examination in the past year (odds ratio, 2.1), those with Medicaid or Medicare insurance (1.9), black women (1.5) and older adolescents (1.2). Adolescents most often reported having received STD care at a community health center (44%) or a private physician's office (31%). CONCLUSIONS: Continued inadequate screening may contribute to persisting high prevalence of chlamydia infection among adolescents. Future research is needed to determine whether the proportions of adolescents receiving recommended STD screening have increased over time. [source] The cost-effectiveness of cervical screening in Australia: what is the impact of screening at different intervals or over a different age range?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2008Rob Anderson Abstract Objective: To estimate the cost-effectiveness of altering the currently recommended interval and age range for cervical screening of Australian women. Methods: The cost and effectiveness estimates of alternative screening strategies were generated using an established decision model. This model incorporated a Markov model (of the natural history of cervical cancer and pre-cancerous lesions) and decision trees which: ,mapped' the various pathways to cervical cancer screening; the follow-up of abnormal Pap test results; and the management of confirmed lesions. The model simulated a hypothetical large cohort of Australian women from age 15 to age 85 and calculated the accumulated costs and life-years under each screening strategy. Results: Our model estimated that moving from the current two-yearly screening strategy to annual screening (over the same age range) would cost $379,300 per additional life-year saved. Moving from the current strategy to three-yearly screening would yield $117,100 of savings per life-year lost (costs and effects both discounted at 5% per year), with a relatively modest (<5%) reduction in the total number of life-years saved by the program. Conclusions: Although moving to annual screening would save some additional lives, it is not a cost-effective strategy. Consideration should be given to increasing the recommended interval for cervical screening. However, the net value of any such shift to less effective (e.g. less frequent) and less costly screening strategies will require better evidence about the cost-effectiveness of strategies that encourage non-screeners or irregular screeners to have a Pap test more regularly. [source] The pattern of breast cancer screening utilization and its consequencesCANCER, Issue 1 2002James Michaelson Ph.D. Abstract BACKGROUND The objective of this study was to describe the pattern of screening utilization and its consequences in terms of tumor size and time of tumor appearance of invasive breast carcinoma among a population of women who were examined at a large service screening/diagnostic program over the last decade. METHODS Utilization of mammography was assessed from a population of 59,899 women who received 196,891 mammograms at the Massachusetts General Hospital Breast Imaging Division from January 1, 1990 to March 1, 1999, among which 604 invasive breast tumors were found. Two hundred six invasive, clinically detected tumors also were seen during this period among women who had no record of a previous mammogram. Additional information was available on screening of women from March 1, 1999 to June 1, 2001. RESULTS Fifty percent of the women who used screening did not begin until the age of 50 years, although 25% of the invasive breast tumors were found in women age < 50 years. Relatively few of the women who used screening returned promptly for their annual examinations; by 1.5 years, only 50% had returned. Approximately 25% of the invasive breast tumors were found in women for whom there was no record of a previous screening mammogram, and these tumors were larger (median, 15 mm) than the screen-detected tumors (median, 10 mm). Approximately 30% of the 604 invasive breast tumors in the screening population were found on nonmammographic grounds, and they also were larger (median, 15 mm) than the screen-detected tumors (median, 10 mm). However, only 3% of these 604 tumors were found by nonmammographic criteria within 6 months of the previous negative examination, and only 12% were found within 1 year. By back calculating the likely size of each of these tumors at the time of the negative mammogram, it could be seen that most tumors probably emerged as larger, palpable masses not because they were missed at the previous negative mammogram, because most were too small then to have been detected, but because too much time had been allowed to pass. CONCLUSIONS Far too many women did not comply with the American Cancer Society recommendation of prompt annual screening from the age of 40 years. Consequently, almost 50% of the invasive tumors emerged as larger and, thus, potentially more lethal, palpable masses. Cancer 2002;94:37,43. © 2002 American Cancer Society. [source] | ||||||||||