Skip header and navigation

Refine By

12 records – page 1 of 2.

An audit of the cervical cancer screening histories of 246 women with carcinoma.

https://arctichealth.org/en/permalink/ahliterature127411
Source
J Low Genit Tract Dis. 2012 Jul;16(3):263-70
Publication Type
Article
Date
Jul-2012
Author
Máire A Duggan
Jill Nation
Author Affiliation
Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada. duggan@ucalgary.ca
Source
J Low Genit Tract Dis. 2012 Jul;16(3):263-70
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alberta
Benchmarking
Cohort Studies
Colposcopy - standards - trends
Confidence Intervals
Cytodiagnosis - standards - trends
Databases, Factual
Early Detection of Cancer - standards - trends
Female
Gynecological Examination - standards - trends
Health Knowledge, Attitudes, Practice
Humans
Mass Screening - standards - trends
Medical Audit
Middle Aged
Needs Assessment
Patient Compliance - statistics & numerical data
Retrospective Studies
Risk assessment
Sensitivity and specificity
Time Factors
Uterine Cervical Dysplasia - pathology - prevention & control
Uterine Cervical Neoplasms - pathology - prevention & control
Vaginal Smears - standards - trends
Abstract
Women with cervical carcinoma and residing in the Calgary Health Region between 1996 and 2001 were audited to characterize factors in the opportunistic cervical cancer screening pathway contributing to screening failures.
The cohort consisted of 246 women. Information on their Pap tests and colposcopic/gynecologic examinations was obtained from the files of Calgary Laboratory Services and their colposcopic/cancer center treatment charts. Screening failure factors were defined, and frequencies were calculated.
Screening failure factors were as follows: (1) 41 (16.7%) were not screened, that is, no Pap test screening; (2) 29 (11.8%) were underscreened, that is, no Pap test within 12 months of diagnosis; (3) 28 (13.7%) were undersampled, that is, the Pap test result was negative; (4) 34 (13.8%) had no referral for a colposcopy/gynecology examination, and/or it was delayed for more than 3 months; (5) 18 (13.2%) had delayed referral for examination of an atypical glandular cell-high-grade squamous intraepithelial lesion and higher Pap test for more than 3 months; and (6) 73 (55.3%) were underdiagnosed, that is, the diagnosis in colposcopy examination was less than malignant. Underreported Pap tests and delayed Pap test reporting could not be fully investigated, but limited evidence suggested that underreporting contributed to some failures.
Factors other than recruitment to cytological screening need targeted improvement if the region's cervical cancer prevention program is to be more effective.
PubMed ID
22297213 View in PubMed
Less detail

Can the Gail model be useful in American Indian and Alaska Native populations?

https://arctichealth.org/en/permalink/ahliterature3904
Source
Cancer. 2004 Mar 1;100(5):906-12
Publication Type
Article
Date
Mar-1-2004
Author
Judith Salmon Kaur
Marilyn A Roubidoux
Jeff Sloan
Paul Novotny
Author Affiliation
College of Medicine, The Mayo Clinic, Rochester, Minnesota 55905, USA. kaur.judith@mayo.edu
Source
Cancer. 2004 Mar 1;100(5):906-12
Date
Mar-1-2004
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Alaska - epidemiology
Arizona - epidemiology
Attitude to Health - ethnology
Breast Neoplasms - ethnology - prevention & control
Female
Humans
Incidence
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Mass Screening - standards - trends
Middle Aged
Models, Theoretical
Registries
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk assessment
Rural Population
South Dakota - epidemiology
Urban Population
Abstract
BACKGROUND: Very little is known about breast carcinoma risk factors for American Indian/Alaska Native (AI/AN) women undergoing screening. The Gail model has been a useful tool for predicting the risk of breast carcinoma in several populations. It has not been applied systematically to AI/AN women. METHODS: The current study was a retrospective review of 1458 screening mammograms performed for AI/AN women. The authors applied the Gail model to estimate both absolute risk and relative risk for breast carcinoma for AI/AN women screened in South Dakota, Arizona, and Alaska. RESULTS: The mean age of the women was 52.4 years. The onset of menses was not significantly different than expected. The average age at first birth was 20 years, very few women were nulliparous, and few women were age > 30 years at first live birth. The proportion of women reporting a first- or second-degree relative with breast carcinoma was similar to the proportion in the general population. The results of the model indicated an overall average relative risk that ranged from 1.42 to 2.69 compared with white American women, depending on the model assumptions used. Using a modified Gail model and calculating an imputed absolute risk, the expected incidence of breast carcinoma in this population increased to rates of 170-180 per 100,000 in the next 10 years, a significant increase over the Surveillance, Epidemiology and End Results-derived incidence rates from 1988 to 1992 of 31.6 per 100,000 for AI women in New Mexico and 78.9 per 100,000 for AN women. CONCLUSIONS: The model indicated a likelihood of increasing rates of breast carcinoma in the study population. The data obtained were useful in generating preliminary estimates of breast carcinoma risk in the study population, for which no prospective population survey has been completed. The inherent weaknesses in the current retrospective study indicated the need for a large-scale prospective data collection to confirm these exploratory findings.
PubMed ID
14983484 View in PubMed
Less detail

Detection of prostate cancer: the impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC).

https://arctichealth.org/en/permalink/ahliterature17131
Source
Can J Urol. 2005 Feb;12 Suppl 1:2-6; discussion 92-3
Publication Type
Article
Date
Feb-2005
Author
Fritz H Schröder
Author Affiliation
Erasmus MC, Rotterdam, The Netherlands.
Source
Can J Urol. 2005 Feb;12 Suppl 1:2-6; discussion 92-3
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Comparative Study
Europe - epidemiology
Humans
Incidence
Male
Mass Screening - standards - trends
Middle Aged
Neoplasm Staging
Prognosis
Prostate-Specific Antigen - blood
Prostatic Neoplasms - diagnosis - epidemiology
Randomized Controlled Trials
Risk assessment
Survival Rate
Time Factors
Abstract
The European Randomized Study of Screening for Prostate Cancer (ERSPC) is a large, randomized controlled trial of screening versus control, conducted in eight European countries (Belgium, Finland, France, Italy, the Netherlands, Spain, Sweden, and Switzerland). This article focuses on important aspects relating to recent findings from the ERSPC about two topics: first, leadtime and overdiagnosis, and second, prostate-specific antigen (PSA) as a test for repeated screening. The ERSPC together with the prostate cancer arm of the Prostate, Lung, Colon and Ovary (PLCO) screening trial of the National Cancer Institute in the United States are set to show or exclude an effect of screening on prostate cancer mortality. Both studies are progressing according to plan. Definitive endpoint-related data can be expected between 2005 and 2010 depending on the difference in prostate cancer mortality that may be shown between the screening and control arms. The ERSPC will allow a risk-to-benefit analysis including parameters of quality of life and cost. Overdiagnosis with present prostate cancer screening regimens is high. This amount of overdiagnosis is likely to be unacceptable for most healthcare policy makers and providers. Addressing overdiagnosis will be a major research task for urologists for the years to come. Present screening needs to be more "selective" for cases that have aggressive patterns and are likely to lead to clinical diagnosis of prostate cancer and/or death. The test characteristics of prostate-specific antigen (PSA) change after one use. The positive relation between PSA levels and positive predictive value (PPV) and detection rates in first screening rounds are lost. This may be compatible with the observation that tumor volumes in second round screening are smaller, and larger tumors are harvested. Tumor volume becomes a negative predictor in round 2, indicating that a large proportion of elevated PSA values are caused by benign prostatic hyperplasia (BPH) rather than by prostate cancer. While the outcome of the ongoing randomized studies is uncertain, screening tests cannot be refused to men who are well-informed and accept to take the risk of experiencing more harm than benefit as a result of a positive screening test result.
PubMed ID
15780157 View in PubMed
Less detail

Osteoporosis screening for men: are family physicians following the guidelines?

https://arctichealth.org/en/permalink/ahliterature155699
Source
Can Fam Physician. 2008 Aug;54(8):1140-1141, 1141.e1-5
Publication Type
Article
Date
Aug-2008
Author
Natalie Cheng
Michael E Green
Author Affiliation
Enhanced Rural Skills, Queen's University in Kingston, Ontario, Canada.
Source
Can Fam Physician. 2008 Aug;54(8):1140-1141, 1141.e1-5
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Academic Medical Centers
Age Distribution
Aged
Aged, 80 and over
Attitude of Health Personnel
Bone Density - physiology
Cross-Sectional Studies
Family Practice - standards
Guideline Adherence - statistics & numerical data
Humans
Incidence
Male
Mass Screening - standards - trends
Ontario
Osteoporosis - diagnosis - epidemiology
Physicians, Family - statistics & numerical data
Practice Guidelines as Topic
Retrospective Studies
Risk assessment
Sensitivity and specificity
Abstract
To determine rates of screening for osteoporosis among men older than 65 years and to find out whether family physicians are following the recommendations of the Osteoporosis Society of Canada's 2002 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada.
Chart audit.
The Family Medicine Centre at Hotel Dieu Hospital in Kingston, Ont.
All male patients at the Family Medicine Centre older than 65 years for a total of 565 patients associated with 20 different physicians' practices.
Rates of screening with bone mineral density (BMD) scans for osteoporosis, results of BMD testing, and associations between results of BMD testing and age.
Of the 565 patients reviewed, 108 (19.1% of the study population) had received BMD testing. Rates of screening ranged from 0% to 38% in the 20 practices. Among 105 patients tested (reports for 3 patients were not retrievable), 15 (14.3%) were found to have osteoporosis, 43 (41.0%) to have osteopenia, and 47 (44.8%) to have normal BMD results. No significant association was found between BMD results and age. Screening rates were higher among men older than 75 years than among men aged 65 to 75 and peaked among those 85 to 89 years old.
On average, only about 20% of male patients older than 65 years had been screened for osteoporosis, so most of these men were not being screened by BMD testing as recommended in the guidelines. Considering the relatively high rates of osteoporosis and osteopenia found in this study and the known morbidity and mortality associated with osteoporotic fractures in this population, higher rates of BMD screening and more widespread treatment of osteoporosis could prevent many fractures among these patients. Family physicians need to become more aware of the risk factors indicating screening, and barriers to screening and treatment of osteoporosis in men need to be identified and addressed.
Notes
Cites: Best Pract Res Clin Rheumatol. 2001 Jul;15(3):415-2711485338
Cites: Arch Intern Med. 2002 Oct 28;162(19):2217-2212390065
Cites: CMAJ. 2002 Nov 12;167(10 Suppl):S1-3412427685
Cites: Am Fam Physician. 2003 Apr 1;67(7):1521-612722852
Cites: CMAJ. 2000 Oct 31;163(9):1139-4311079058
Cites: Osteoporos Int. 2000;11(8):680-711095171
Cites: Can Fam Physician. 2000 Nov;46:2228-3511143582
Cites: JAMA. 2001 Feb 14;285(6):785-9511176917
Cites: Rheum Dis Clin North Am. 2001 Feb;27(1):19-4711285995
Cites: Can Fam Physician. 2003 Apr;49:405-7, 412-412729232
Cites: Can Fam Physician. 2003 Apr;49:462-812729242
Cites: Maturitas. 2004 Jul 15;48(3):225-3315207888
Cites: Arch Intern Med. 1991 Oct;151(10):2026-321929691
Cites: Osteoporos Int. 1992 Nov;2(6):285-91421796
Cites: Osteoporos Int. 1994 Nov;4(6):368-817696835
Cites: Can J Surg. 1996 Apr;39(2):105-118769920
Cites: CMAJ. 1996 Oct 1;155(7):921-38837540
Cites: J Bone Miner Res. 1998 Dec;13(12):1915-239844110
Cites: Osteoporos Int. 1999;10(1):73-810501783
Cites: Osteoporos Int. 2005 Aug;16(8):953-6215928798
Cites: Osteoporos Int. 2005 Sep;16(9):1079-8515586267
Cites: Clin Cornerstone. 2006;8 Suppl 3:S7-1317046428
Cites: CMAJ. 2007 Jan 30;176(3):345-817261833
Comment In: Can Fam Physician. 2008 Nov;54(11):1524; author reply 1524-519005115
PubMed ID
18697977 View in PubMed
Less detail

Population-based study of prostate-specific antigen testing and prostate cancer detection in clinical practice in northern Sweden.

https://arctichealth.org/en/permalink/ahliterature18409
Source
Scand J Urol Nephrol. 2003;37(3):210-2
Publication Type
Article
Date
2003
Author
Björn Pilebro
Robert Johansson
Lena Damber
Jan-Erik Damber
Pär Stattin
Author Affiliation
Department of Urology, Umeå University Hospital, Sweden.
Source
Scand J Urol Nephrol. 2003;37(3):210-2
Date
2003
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Clinical Medicine - standards - trends
Comparative Study
Humans
Incidence
Male
Mass Screening - standards - trends
Middle Aged
Neoplasm Staging
Pilot Projects
Prostate-Specific Antigen - blood
Prostatic Neoplasms - diagnosis - epidemiology
Registries
Research Support, Non-U.S. Gov't
Risk assessment
Sensitivity and specificity
Survival Analysis
Sweden - epidemiology
Abstract
OBJECTIVE: The pattern of prostate-specific antigen (PSA) testing in clinical practice is largely unknown; it may be used either in asymptomatic men or in the work-up of men with urinary or other symptoms. The aim of this study was to investigate the pattern of PSA testing in clinical practice for men diagnosed with stage T1c prostate cancer in a region with no formal screening programme. MATERIAL AND METHODS: Using the Primary Prostate Cancer Register for Northern Sweden, all cases of stage T1c prostate cancer diagnosed between 1992 and 1999 in the city of Umeå were identified. The cause of PSA testing was assessed by examining the medical records. Men were categorized as asymptomatic, having lower urinary tract symptoms (LUTS) or having symptoms other than LUTS. Prospective registration of the cause of PSA testing in the entire region of Northern Sweden started in 2000. RESULTS: We found that in Umeå only 32/213 (15%) cases diagnosed with T1c prostate cancer were asymptomatic at the time of PSA testing, 55% of men had a PSA test as part of a work-up for LUTS and 30% had other symptoms. In 2000, 126 cases of stage T1c prostate cancer were diagnosed in the entire region and 20/126 (16%) of these men were asymptomatic. CONCLUSIONS: PSA testing was mostly used as a tool in the work-up of symptomatic patients in Umeå and also in the region of Northern Sweden. Further studies in other populations are needed.
PubMed ID
12775278 View in PubMed
Less detail
Source
Duodecim. 1997;113(6):532-6; author reply 536-9
Publication Type
Article
Date
1997
Author
E. Saksela
Author Affiliation
Haartman Institute, Department of Pathology, Helsinki University, Helsinki, Finland.
Source
Duodecim. 1997;113(6):532-6; author reply 536-9
Date
1997
Language
Finnish
Publication Type
Article
Keywords
Aged
Ethics, Medical
Finland
Humans
Male
Mass Screening - standards - trends
Middle Aged
Prostate-Specific Antigen - analysis
Prostatic Neoplasms - diagnosis
Sensitivity and specificity
PubMed ID
11370075 View in PubMed
Less detail
Source
Can Fam Physician. 2009 Apr;55(4):352
Publication Type
Article
Date
Apr-2009
Author
Val E Ginzburg
Source
Can Fam Physician. 2009 Apr;55(4):352
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Canada
Colonic Neoplasms - prevention & control
Colonoscopy - economics - statistics & numerical data
Cost Savings
Family Practice - standards - trends
Health Care Costs
Humans
Mass Screening - standards - trends
Occult Blood
Physician's Practice Patterns
Professional Practice Location
Rural Health Services - standards - trends
United States
Notes
Cites: Ann Intern Med. 2002 Jul 16;137(2):132-4112118972
Cites: Can Fam Physician. 2009 Feb;55(2):170-519221080
Comment On: Can Fam Physician. 2009 Feb;55(2):170-519221080
PubMed ID
19366940 View in PubMed
Less detail

Significant improvement in breast cancer survival through population-based mammography screening.

https://arctichealth.org/en/permalink/ahliterature182528
Source
Breast. 2003 Oct;12(5):308-13
Publication Type
Article
Date
Oct-2003
Author
Pekka J Klemi
Ilmo Parvinen
Liisa Pylkkänen
Lea Kauhava
Pirjo Immonen-Räihä
Osmo Räsänen
Hans Helenius
Author Affiliation
Department of Pathology, Turku University Hospital, FIN-20520 Turku, Finland. pekka.klemi@tyks.fi
Source
Breast. 2003 Oct;12(5):308-13
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - diagnosis - mortality
Confidence Intervals
Female
Finland
Humans
Mammography - utilization
Mass Screening - standards - trends
Middle Aged
Neoplasm Staging
Population Surveillance
Predictive value of tests
Probability
Prognosis
Proportional Hazards Models
Risk assessment
Survival Analysis
Abstract
The purpose of this study was to evaluate the effect of population-based mammography screening on survival. A total of 176 908 screening examinations were performed in 36 000 women aged 40-74 during the years 1987-1997. Screen-detected and interval primary invasive breast cancers (n=685, screened) were more often smaller (P
Notes
Comment In: Breast. 2003 Oct;12(5):299-30114659143
PubMed ID
14659145 View in PubMed
Less detail

12 records – page 1 of 2.