Academic literature on the topic 'Population-Based screening program'
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Journal articles on the topic "Population-Based screening program":
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Pashayan, Nora. "Abstract IA011: Implementation of population-based precision cancer screening programs." Cancer Prevention Research 16, no. 1_Supplement (January 1, 2023): IA011. http://dx.doi.org/10.1158/1940-6215.precprev22-ia011.
Abstract:
Abstract To date, evidence from modeling studies indicates that precision early detection approaches could potentially improve the benefit-harm balance and the cost-effectiveness of cancer screening programs. A precision program involves risk assessment of all individuals in the population, stratification of the population into several risk groups and tailoring early detection and prevention recommendations to each risk group. Implementing precision program raises number of questions at each stage. It is important not only to generate evidence on the individual ‘jigsaw’ pieces of the program, but also to bring the pieces together in a complex adaptive system, while considering the healthcare organizational readiness for change, the economic and social context. Citation Format: Nora Pashayan. Implementation of population-based precision cancer screening programs. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr IA011.
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Lin, J. Y. "Information System of Nationwide Population-Based Cancer Screening in Taiwan." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 209s. http://dx.doi.org/10.1200/jgo.18.84500.
Abstract:
Background: Pap smear screening was the first nation-wide population-based organized screening since 1999 in Taiwan. After that, nationwide screening programs for breast cancer, colorectal cancer, and oral cancer have been launched since 2004. The national online information system was built for the infrastructure, monitoring, delivery, evaluation, and management of health care services in our nationwide screening program. Aim: To develop a comprehensive health information system for cancer screening to assist health professionals in processing screening with quality assurance and evaluation. Methods: A Web-based solution combining data gathering and processing capabilities was developed. Application design in a server was based on the ASP, HTML, DHTML, Java Script, Java Applet technology and SQL-SERVER relational database. Web-based software programs were developed to facilitate the structure, process, and outcome for screening. Individual screening data were transferred to centralized databases via the Internet. The client-users now include 25 health bureaus, 369 health centers and over 6500 clinics or hospitals. Results: The Taiwanese cancer screening system incorporates nationwide breast cancer screening with mammography, colorectal cancer with fecal immunochemical test, oral cancer with visual inspection. The key performance index for screening including screening rate, positive rate, referral rate, positive predictive rate, detection rate, and interval cancer rate were provided in the system. The system allows for the flow of information among different health services and country areas to monitor participants in the whole process screening. It has an alert system to prevent delayed referral for cases in need of diagnosis and treatment. A total of 2.27 million women aged 45-69 years have attended biennial mammography screening program at least once between 2004 and 2014. More than 4.6 million subjects with the exposure of betel quid and/or cigarette have attended the biennial oral cancer screening. Around 3.8 million subjects aged 50-74 years have attended the biennial FIT screening. Information on organized features appertaining to screening, diagnosis, and outcomes after long-term follow up were collected for the systematic evaluation. The proposed health information system for cancer screening is centered on modules that would allow for the computerization, process, update of screen data, and link with other registry data (e.g., population registry, cancer registry, and mortality). Conclusion: A nation-wide information system for breast cancer, colorectal cancer, and oral cancer screening was successfully developed to support health professionals and health decision makers for planning, delivery, management, and evaluation in population-based cancer screening program.
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Szynglarewicz, B., D. Blaszczyk, A. Maciejczyk, P. Kasprzak, and R. Matkowski. "676. Quality assessment of population-based mammographic screening program." European Journal of Surgical Oncology (EJSO) 42, no. 9 (September 2016): S189. http://dx.doi.org/10.1016/j.ejso.2016.06.352.
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Redman, Sally, and Alexandra Barratt. "Towards a population-based screening program for cervical cancer." Australian Journal of Public Health 19, no. 2 (February 12, 2010): 115–17. http://dx.doi.org/10.1111/j.1753-6405.1995.tb00356.x.
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Buchberger, Wolfgang, Sabine Geiger-Gritsch, Rudolf Knapp, Kurt Gautsch, and Willi Oberaigner. "Combined screening with mammography and ultrasound in a population-based screening program." European Journal of Radiology 101 (April 2018): 24–29. http://dx.doi.org/10.1016/j.ejrad.2018.01.022.
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Hsu, C. "Screen-Round–Based Risk Strategies for Population-Based Mammography Screening." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 205s. http://dx.doi.org/10.1200/jgo.18.82800.
Abstract:
Background: The widespread use of organized screening strategies of mammography screening at population level stood a chance of reducing the threat to women's life from breast cancer. However, such a population-wide strategy is often faced with the questions like “How many rounds of mammography screening are require before detecting cancer in question?” and “Can the attendee be classified the low risk after several negative screening rounds?” In addition to the concerns on resource allocation for the purpose of planning an efficient population-based screening program, the recent emergence in precision medicine also makes it attractive for considering such a risk-based decision on breast cancer prevention under the context of mass screening. Aim: To quantify number of screen rounds required for detecting an asymptomatic cancer in question and dispensing with further invitation to screen. Methods: By applying a series of Bayesian negative–binomial family–based stochastic process models taking sensitivity and specificity into account, we elucidated the aforementioned issues based on the empirical data on population-based breast cancer screening program in Finland with international collaboration. The Finnish nationwide biennial mammographic screening program was implemented and targeted to women aged 50-59 years since 1988. The panel data on the regular invitation of eligible population by Pirkanmaa screening center excluding the women who had been diagnosed by breast cancer before their first invitation were enrolled in this study. Results: Based on the estimated results, we are able to determine the rounds of screens required before detecting an asymptomatic breast cancer according to the risk profile determined by age and the performance of screening tool. Based on the empirical data, an average of 2.77 (95% CI, 2.61-2.91) screen rounds will be required to detect an asymptomatic breast cancer cases. A woman may not be invited after a series of negative findings of 8 rounds of screen. Considering the sensitivity of 83% (95% CI, 61%–95%), the required screen rounds become 2.81 (95% CI, 2.65-2.94). The screening rounds required for the young (<55 years) and the old (≥55 years) age group, the corresponding figures was 2.81 (95% CI, 2.55-3.11) and 2.76 (95% CI, 2.43-3.05). Conclusion: We quantified the screen round, 2.77 on average, required to detect an asymptomatic breast cancer and 8 rounds of screen to dispense with further invitation based on the risk and the performance of screening tool. The findings may aid in risk-based interscreening interval determination but also provide information on resources required by different screening policies with target population with different risk levels.
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Grega, Tomáš, Ondřej Májek, Ondřej Ngo, Norbert Král, Bohumil Seifert, Ladislav Dušek, Miroslav Zavoral, and Štěpán Suchánek. "Current principles of colorectal cancer screening – from opportunistic screening to a population-based screening program." Gastroenterologie a hepatologie 70, no. 5 (October 25, 2016): 383–92. http://dx.doi.org/10.14735/amgh2016383.
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Hamers, F., N. Duport, and N. Beltzer. "Population-based organized cervical cancer screening pilot program in France." European Journal of Cancer 72 (February 2017): S158. http://dx.doi.org/10.1016/s0959-8049(17)30589-0.
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Cortesi, L., V. E. Chiuri, S. Ruscelli, V. Bellelli, R. Negri, I. Rashid, C. Cirilli, E. Gallo, and M. Federico. "Early assessment of a population-based breast cancer screening program." Journal of Clinical Oncology 23, no. 16_suppl (June 2005): 1018. http://dx.doi.org/10.1200/jco.2005.23.16_suppl.1018.
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Hamers, Françoise F., Nicolas Duport, and Nathalie Beltzer. "Population-based organized cervical cancer screening pilot program in France." European Journal of Cancer Prevention 27, no. 5 (September 2018): 486–92. http://dx.doi.org/10.1097/cej.0000000000000365.
Dissertations / Theses on the topic "Population-Based screening program":
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Koivogui, Akoi. "Mieux atteindre, cibler et caractériser les patients relevant du dépistage organisé du CCR en France : place des bases médico-administratives et des réseaux sociaux." Electronic Thesis or Diss., Paris 13, 2023. http://www.theses.fr/2023PA131041.
Abstract:
Toutes les conditions justifiant la mise en place d'une politique de dépistage sont remplies par le cancer colorectal (CCR) : il est fréquent (43 000 nouveaux cas en France chaque année), grave (on ne guérit actuellement qu'un cancer sur deux) et s'il est diagnostiqué au début, il est habituellement guéri. Ce cancer peut être prévenu par la détection et l'exérèse des adénomes qui le précèdent le plus souvent. Enfin, il existe une stratégie de dépistage reposant sur la recherche d'un saignement occulte dans les selles par un test réalisé tous les 2 ans. En France, le taux de participation aux campagnes de dépistage atteint rarement 50% dans la plupart des départements français. Nous cherchions à vérifier deux hypothèses : i)l'exploitation de plusieurs sources de données, notamment les bases de données médico-administratives et les registres de cancers, permettrait de mieux cibler et caractériser les personnes éligibles aux campagnes de dépistage en France, ce qui améliorerait considérablement le taux d'exclusion médicale ; ii) la promotion du dépistage à travers les réseaux sociaux permettrait d'atteindre les personnes non participant aux campagnes de dépistage, ce qui améliorerait considérable l'effectif de participants à une campagne de dépistage. Dans cette thèse, nous nous sommes fixés pour objectif de développer des approches pour mieux cibler, caractériser et atteindre les patients relevant du dépistage en France, en s'intéressant en particulier à l'apport de la réutilisation de données médico-administratives et l'usage de réseaux sociaux. Notre approche méthodologique a été de comparer d'abord les définitions internationales des populations cible du dépistage et la place des bases de données médico-administratives dans les méthodologies de ciblage des populations éligibles aux campagnes de dépistage à travers le monde. Une synthèse des différents profils de personnes atteintes d'une situations morbides pouvant justifier d'une exclusion médicale a été faite. La définition de la personne a été faite à l'aide de critères d'exclusion consensuels dans les programmes internationaux dans le de la transcrire en requête pour pouvoir exclure les personnes du dépistage à partir des données du Système national des données de santé (SNDS). A l'aide d'un module de géolocalisation et de sensibilisation sur le réseau social Facebook, nous avons analyser l'apport des réseaux sociaux comme sources supplémentaires de motivation des personnes à participer aux campagnes de DOCCR.Cette thèse met en évidence des stratégies et moyens d'exploitation de plusieurs sources de données pour une optimisation des campagnes de DOCCR en France. La thèse montre aussi que ces sources de données n'étaient pas encore exploitées en France dans le cadre du dépistage du cancer colorectal. Pour consolider la définition de la population éligible au DOCCR, l'intérêt du développement d'une méthode d'identification à partir des données de consommation de soins du SNDS a été largement argumenté dans cette thèse. Nous avons argumenté l'accès aux données du SNDS et le projet suit son cours en guise de perspective à la thèse. Nous envisageons aussi, la mise en place et l'évaluation à grande échelle d'une stratégie complémentaire d'optimisation des campagnes de DOCCR à travers les réseaux sociaux notamment Facebook car l'expérimentation n'avait ciblé que six communes d'un seul départementAll the conditions justifying the implementation of a screening policy are met by colorectal cancer (CRC): it is frequent (43,000 new cases in France each year), serious (only one in two CRC case is currently cured) and if diagnosed early, it is usually cured. This cancer can be prevented by the detection and excision of the adenomas which most often precede it. Finally, there is a screening strategy based on the search for occult bleeding in the stools by a test carried out every 2 years. In France, the participation rate in screening campaigns rarely reaches 50% in most French districts. We sought to verify two hypotheses in this research work: i) The use of several data sources, in particular medico-administrative databases and cancer registries, would make it possible to better target and define people eligible for screening campaigns in France, which would improve significantly the medical exclusion rates; ii) Promoting screening through social networks would make it possible to reach people who do not participate in screening campaigns, which would considerably improve the number of participants in a screening campaign.In this thesis, we aimed to develop approaches to better target, define and reach patients subject to screening in France, focusing in particular on the contribution of the reuse of medico-administrative data and the use of social networks.Our methodological approach was to first compare international definitions of screening target populations and the place of medico-administrative databases in methodologies for targeting populations eligible for screening campaigns around the world. A summary of the different profiles of people suffering from morbid situations that could justify medical exclusion was highlighted. The definition of the person was made using consensual exclusion criteria in international programs in order to translate it into a query to be able to exclude people from screening campaign using the data of the French medico-administrative database usually called ?SNDS? (?Système national des données de santé?). Using a geolocation and awareness module on the social network Facebook, we analyzed the contribution of social networks as additional sources of motivation for people to participate in colorectal cancer screening campaigns.This thesis highlights strategies and means for using several data sources for optimization of screening campaigns in France. The thesis also shows that these data sources were not yet used in France for colorectal cancer screening. To consolidate the definition of the campaign's eligible population, the interest in developing an identification method based on healthcare consumption data from SNDS has been widely argued in this thesis. We have argued for access to SNDS data, and the project is continuing as a perspective for the thesis. We are also considering the implementation and large-scale evaluation of a complementary strategy for optimizing screening campaigns through social networks, particularly Facebook, because the experiment only targeted six municipalities in a single district
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Gerald, Joe K. "Cost-effectiveness of a multi-stage school-based asthma case detection program in an urban school system." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2007. https://www.mhsl.uab.edu/dt/2009r/gerald.pdf.
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Kwok, Yick-ting Andy, and 郭奕廷. "How should a population-based screening programme for type 2 diabetes be implemented in Hong Kong?: from aneconomic perspective." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42994858.
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Kwok, Yick-ting Andy. "How should a population-based screening programme for type 2 diabetes be implemented in Hong Kong? from an economic perspective /." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994858.
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Hornby, Steven Thomas. "The performance of faecal and plasma biomarkers with a local population based bayesian prior risk model as a potential screening programme for oesophago-gastric cancer." Thesis, Exeter and Plymouth Peninsula Medical School, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.658030.
Abstract:
Oesophago-gastric cancer is a devastating disease associated with 5 year survival rate of 11 %. It frequently presents in the later stages of the disease when curative treatment is not possible, and there is currently no screening test available. 8ayes' theorem has been used in prenatal screening for trisomy 21 and pre-eclampsia, to derive a patient-specific risk of disease. This study aimed to determine if a screening process for oesophago-gastric cancer could be developed using a combination of biomarkers and a 8ayesian prior risk model. METHODS 53 patients with established oesophago-gastric cancer were recruited along with 275 control patients. A medical history was recorded from each patient and blood taken for measurement of Plasma M2-Pyruvate Kinase (M2-PK) and two cancer antigens (CA 19-9 and 72-4). The subjects then returned a faecal sample for analysis of Faecal M2-PK. A comprehensive literature search of the risk factors for oesophago-gastric cancer was used to inform a prior risk model. The biomarkers were then combined with the prior risk model and the screening performance assessed with receiver operator characteristic curves. RESULTS The median value of all the biomarkers was higher in the cancers than the controls. A combination of prior risk model and all 4 biomarkers provided the best test performance, although the improvement seen from the addition of the prior risk model was not statistically significant. For a fixed detection rate of 60% the false positive rate (FPR) was 4.9% and 22.5% respectively for gastric and oesophageal cancers. Despite the relatively low false positive rate for gastric cancer, the low estimated prevalence in the population means that the number of endoscopies required to detect 60% of cancers would likely prove practically preclusive. The test would require a FPR of 1.3% for both cancers in order to generate the equivalent extra number of endoscopies that have been seen with colorectal screening. CONCLUSION 8ayesian Prior risk models combined with biomarker measurement can in theory be used to screen for oesophago-gastric cancer. More work is required to identify better performing biomarkers and to refine the prior risk model in order to minimize the false positive rate.
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Silfverdal, Lena. "Cervical cancer prevention : studies on outcome of cervical screening and on management of abnormal cytology findings." Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-39862.
Abstract:
Background Screening by cytology has been highly effective in reducing the incidence and mortality from squamous invasive cervical cancer (ICC), but the effectiveness is less established regarding non-squamous ICC and regarding women above screening ages and below 30 years of age. Cervical cancer still occurs despite the presence of an organised screening programme. A substantial proportion of screened women with ICC are reported to have had previous abnormal cytology findings. The significance of negative cytology with limited evaluation is not quite determined, the most effective management of women with low-grade abnormalities is controversial, and evaluation of long-term effect of different treatment methods is limited. Aims To identify possible areas of improvements in the prevention of cervical cancer by evaluating the effectiveness of the Swedish cervical screening programme, and by exploring risk factors for ICC in the cytological screening histories and in the management of women with abnormal cytology findings. Methods The screening histories of all ICC cases in Sweden 1999-2001 (n=1230) and of five population-based control women per case were reviewed, using data from the Swedish Cancer Registry, the national population register, the Swedish national cervical screening quality register, histopathological reports and questionnaires to clinicians. The risk of cervical cancer according to screening histories 0.5-6.5 years before cancer diagnosis was estimated as odds ratios (ORs) in logistic regression models with 95% confidence interval (CI) (Paper I). Risk related to different cytological reports was assessed in women below 67 years of age with cytology (n=572, n=3569) in Paper II. The initial follow-up of women with abnormal or unsatisfactory cytology reports (n=159, n=258) was evaluated in Paper III, and further investigation and treatment of abnormalities (n=143 cases, n=176 controls) in Paper IV. Results The cancer cases were above screening ages (31%), had not been screened according to recommendations (33%), had negative cytology (23%), or had previous positive screening tests (13%). No screening within the recommended interval increased the risk of squamous (OR 2.97, 95% CI 2.51-3.50) as well as non-squamous cancer (OR 1.59, 95% CI 1.20-2.11), and increased the risk in all ages. Negative cytology with partially obscuring factors and unsatisfactory cytology increased the risk of subsequent early stage ICC. All cytological abnormalities increased the risk of ICC, and women with glandular atypia or atypia in cells of uncertain origin carried a particularly high risk (OR 11.69, 95% CI 7.02-19.46). After a low-grade squamous abnormal smear finding, further investigation with biopsy was more effective than repeated cytology (OR 0.46, 95% CI 0.24-0.89). Lack of biopsy increased the risk in women with both low-grade and high-grade squamous abnormalities. Neither repeat cytology, nor biopsy, decreased the risk in women with glandular atypia or atypia in cells of uncertain origin. Treatment decreased the risk, even when the biopsy before treatment was negative or showed low-grade atypia only. Ablative therapy was less effective than excision and laser conisation was the most effective therapy. Conclusions Improved adherence to screening recommendations and including older women at increased risk in the programme would have significant cancer preventive gains. Women with negative cytology with limited evaluation and with unsatisfactory cytology may need further evaluation. Assessment with biopsy should be recommended for women with low-grade as well as high-grade squamous abnormalities. The diagnosing of precancer lesions and the identification of women in need of treatment warrant improvements, in particular in cases of glandular or “other” atypia in cytology. Treatment techniques need further evaluation.
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Palència, Fernàndez Laia. "Socioeconomic inequalities in the use of health care services in Europe : the role of public coverage and population-based cancer screening programmes." Doctoral thesis, Universitat Pompeu Fabra, 2012. http://hdl.handle.net/10803/104154.
Abstract:
The aim of this thesis was to describe inequalities in the use of different health care services according to socioeconomic position (SEP) in Catalonia, Spain and Europe. In addition, we intended to assess whether the public coverage of the services, in particular dental health care, has an influence on the magnitude of inequalities in the use of such services. Finally, we aimed to determine the influence of population-based female cancer screening programmes on the prevalence of screening and on the extent of inequality. To accomplish these objectives four studies were carried out. The sources of information of the four studies were, respectively: several editions of the Catalan Health general practitioner (GP) services are equitable or manual classes use them to a greater extent. However, there are marked SEP inequalities in the use of outpatient specialist services, especially in dental care. Socioeconomic inequalities in use of dental care services exist throughout Europe, but they are larger in countries in which dental care is not covered at all by the public health care system than in countries in which dental care is partially covered. In Europe, socioeconomic inequalities in breast and cervical cancer screening are not found in countries with population-based screening programmes but they are found in those countries with only regional or pilot programmes and in those countries with opportunistic screening.L'objectiu d'aquesta tesi era descriure les desigualtats en l'ús de diferents serveis sanitaris segons la posició socioeconòmica a Catalunya, Espanya i a Europa. A més a més, es volia avaluar si la cobertura pública dels serveis, en particular la dels serveis dentals, infuencia la magnitud de les desigualtats socioeconòmiques en l'ús d'aquests serveis. Finalment, es va voler determinar la influència dels programes poblacionals de cribratge dels càncers de mama i cèrvix en la prevalença de cribratge i en la magnitud de les desigualtats. Per tal d'assolir aquests objectius es van dur a terme 4 estudis. Les fonts d'informació d'aquests estudis van ser, respectivament: diferents edicions de l'Enquesta de Salut de Catalunya (ESCA), diferents edicions de l'Enquesta Nacional de Salut d'Espanya (ENS), l'Enquesta de Salut, Envelliment i Jubilació a Europa (SHARE) 2006 i dades dels països europeus que van participar a l'Enquesta Mundial de la Salut de l'OMS l'any 2002. Els dos primers estudis eren estudis de tendències mentre que els dos últims van ser transversals. En tots els estudis les desigualtats socioeconòmiques es van mesurar mitjançant índexos relatius (RII) i absoluts (SII) de desigualtat. Els resultats d'aquests estudis mostren que a Catalunya i a Espanya els serveis d'atenció primària són equitatius o fins i tot les persones de classes manuals en presenten una major proporció d'ús. Tanmateix, hi ha marcades desigualtats en visites a l'especialista, en especial en les visites al dentista. Les desigualtats socioeconòmiques en la utilització dels serveis dentals existeixen a tota Europa, però són més grans en aquells països on l'atenció dental no està coberta pel sistema públic de salut que en aquells països on aquesta està parcialment coberta. A Europa, no es troben desigualtats socioeconòmiques en el cribratge dels càncers de mama i cèrvix en aquells països amb programes poblacionals de cribratge, però sí que es troben en aquells països amb programes pilot o regionals o amb només cribratge oportunista.
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"Population-based outcomes of a provincial prenatal screening program : examining impact, uptake, and ethics." Thesis, 2014. http://hdl.handle.net/10388/ETD-2014-06-1356.
Abstract:
The field of prenatal screening and diagnosis has developed rapidly over the past half-century, enabling possibilities for detecting anomalies in reproduction that were never before contemplated. A simple blood sample can aid in the identification of several conditions in the fetus early in the pregnancy. If a fetus is found to be affected by Down syndrome, anencephalus, spina bifida, or Edward's syndrome, a decision must then be made whether to continue or terminate the pregnancy. As prenatal screening becomes increasingly commonplace and part of routine maternal care, researchers are faced with the challenge of understanding its effects at the level of the population and monitoring trends over time. Greater uptake of prenatal screening, when followed by prenatal diagnosis and termination, has important implications for both congenital anomaly surveillance and infant and fetal mortality indicators. Research in Canada suggests that this practice has led to reductions in the congenital-anomaly specific infant mortality rate and increases in the stillbirth rate.(1, 2)
The current study is a population-based, epidemiological exploration of demographic predictors of maternal serum screening (MSS) and amniocentesis uptake, with special attention to variations in birth outcomes resulting from different patterns of use. To accomplish our objectives, multiple data sources (vital statistics, hospital and physician services, cytogenetic and MSS laboratory information) were compiled to create a comprehensive maternal-fetal-infant dataset. Data spanned a six-year period (2000-2005) and involved 93,171 pregnancies. A binary logistic regression analysis found that First Nations status, rural-urban health region of residence, maternal age group, and year of test all significantly predicted MSS use. Uptake was lower in women living in a rural health region, First Nations women, and those under 30 years of age. The study dataset identified ninety-four terminations of pregnancy following detection of a fetal anomaly (TOPFA), which led to a lower live birth prevalence of infants with Down syndrome, Trisomy 18, and anencephalus. While a significant increasing trend was observed for the overall infant mortality rate in Saskatchewan between 2001-2005, a clear trend in one direction or the other could not be seen in regards to infant deaths due to congenital anomaly.
First Nations status and maternal age were important predictors of both MSS and amniocentesis testing, and appeared to influence the decision to continue or terminate an affected pregnancy. The fact that First Nations women were less likely to screen (9.6% vs. 28.4%) and to have diagnostic follow-up testing (18.5% vs. 33.5%), meant that they were less likely to obtain a prenatal diagnosis when the fetus had a chromosomal anomaly compared to other women (8.3% vs. 27.0%). This resulted in a lower TOPFA rate compare to the rest of the population (0.64 vs. 1.34, per 1,000 pregnancies, respectively) and a smaller difference between the live birth prevalence and incidence of Down syndrome and Trisomy 18 for First Nations women.
Women under 30 years of age were much less likely to receive a prenatal diagnosis when a chromosomal anomaly was present (18.4% vs. 31.8%). While risk for a chromosomal anomaly is considerably lower for younger mothers, 53.5% of all pregnancies with chromosomal anomalies and 40.7% of DS pregnancies belonged to this group.
Consistent with other studies pregnancy termination rates following a prenatal congenital anomaly diagnosis are high (eg. 74.1% of prenatally diagnosed Down syndrome or Trisomy 18 cases), but these rates may be misleading in that they are based on women who chose to proceed to prenatal diagnosis. The fact that two-thirds (67.3%) of Saskatchewan women who received an increased-risk result declined amniocentesis, helps to put this finding into context.
Strong surveillance systems and reasonable access to research datasets will be an on-going challenge for the province of Saskatchewan and should be viewed as a priority. Pregnancies and congenital anomalies are two particularly challenging outcomes to study in the absence of perinatal and congenital anomaly surveillance systems. Still pregnancies that never reach term must be accounted for, in order to describe the true state of maternal-fetal-infant health and to study its determinants. While our study was able to identify some interesting trends and patterns, it is only a snapshot in time. Key to the production of useful surveillance and evaluation is timely information. The current system is not timely, nor is it user-friendly for researchers, health regions or governments. Data compilation for the current study was a gruelling and cumbersome process taking more than five years to complete. A provincial overhaul is warranted in both the mechanism by which researchers access data and in the handling of data. The Better Outcomes Registry & Network (BORN) in Ontario is an innovative perinatal and congenital anomaly surveillance system worthy of modelling.(3)
Academic papers in non-ethics' journals typically focus on the technical or programmatic aspects of screening and do not effectively alert the reader to the complex and profound moral dilemmas raised by the practice. A discussion of ethics was felt necessary to ensure a well-rounded portrayal of the issue, putting findings into context and helping to ensure their moral relevance did not remain hidden behind the scientific complexities. Here I lay out the themes of the major arguments in a descriptive manner, recognizing that volumes have been written on the ethics of both screening and abortion. A major ethical tension arising within the context of population based prenatal screening is the tension between community morality and the principle of respect for personal autonomy. Prenatal screening and selective termination have been framed as a purely private or medical matter, thereby deemphasizing the social context in which the practice has materialized and the importance of community values. I consider how a broader sociological perspective, one that takes into account the relevance of community values and limitations of the clinical encounter, could inform key practice and policy issues involving prenatal screening. It is my position that the community's voice must be invited to the conversation and public engagement processes should occur prior to any additional expansion in programming. I end with a look at how the community’s voice might be better heard on key issues, even those issues that at first glance seem to be the problems of individuals. As Rayna Rapp (2000) (4) poignantly observed, women today are 'moral pioneers' not by choice, but by necessity.
By elucidating the effects of prenatal screening and the extent of the practice of selective termination in the province, the true occurrence of important categories of congenital anomalies in our province can be observed. Without this knowledge it is very difficult to identify real increases or decreases in fetal and infant mortality over time as the etiologies are complex. Evidence suggests a large and increasing impact of TOPFA on population-based birth and mortality statistics nationally, whereas in Saskatchewan the effect appears to be less pronounced. Appreciation of the intervening effect of new reproductive technologies will be increasingly important to accurate surveillance, research, and evaluation as this field continues to expand.
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Bruce, A., G. Santorelli, J. Wright, J. Bradbury, Brendan T. Barrett, Marina Bloj, and T. A. Sheldon. "Prevalence of, and risk factors for, presenting visual impairment: findings from a vision screening programme based on UK NSC guidance in a multi-ethnic population." 2018. http://hdl.handle.net/10454/16380.
Abstract:
YesPurpose: To determine presenting visual acuity levels and explore the factors associated with failing vision screening in a multi-ethnic population of UK children aged 4–5 years. Methods: Visual acuity (VA) using the logMAR Crowded Test was measured in 16,541 children in a population-based vision screening programme. Referral for cycloplegic examination was based on national recommendations (>0.20logMAR in one or both eyes). Presenting visual impairment (PVI) was defined as VA >0.3logMAR in the better eye. Multivariable logistic regression was used to assess the association of ethnicity, maternal, and early-life factors with failing vision screening and PVI in participants of the Born in Bradford birth cohort. Results: In total, 2467/16,541 (15%) failed vision screening, 732 (4.4%) had PVI. Children of Pakistani (OR: 2.49; 95% CI: 1.74–3.60) and other ethnicities (OR: 2.00; 95% CI: 1.28–3.12) showed increased odds of PVI compared to white children. Children born to older mothers (OR: 1.63; 95% CI: 1.19–2.24) and of low birth weight (OR: 1.52; 95% CI: 1.00–2.34) also showed increased odds. Follow-up results were available for 1068 (43.3%) children, 993 (93%) were true positives; 932 (94%) of these had significant refractive error. Astigmatism (>1DC) (44%) was more common in children of Pakistani ethnicity and hypermetropia (>3.0DS) (27%) in white children (Fisher’s exact, p < 0.001). Conclusions: A high prevalence of PVI is reported. Failing vision screening and PVI were highly associated with ethnicity. The positive predictive value of the vision screening programme was good, with only 7% of children followed up confirmed as false positives.
National Institute for Health Research Post-Doctoral Fellowship Award (PDF-2013-06-050); The Born in Bradford study presents independent research commissioned by the National Institute for Health Research Collaboration for Applied Health Research and Care (NIHR CLAHRC) and the Programme Grants for Applied Research funding scheme (RP-PG-0407-10044).
Books on the topic "Population-Based screening program":
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Ali, Najef. Population based screening program for the prevention of ischaemic heart disease. Bradford, 1987.
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Scheuner, Maren T., Marcia Russell, Jane Peredo, Alison B. Hamilton, and Elizabeth M. Yano. Implementing Lynch Syndrome Screening in the Veterans Health Administration. Edited by David A. Chambers, Wynne E. Norton, and Cynthia A. Vinson. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190647421.003.0024.
Abstract:
Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Diagnosis of LS has important clinical implications for CRC patients and their family members. LS screening in tumor tissue is possible, and screen-positive cases are referred for diagnostic testing. This case study describes how implementation science informed a population-based LS screening program in the Veterans Health Administration (VHA), the largest integrated health care delivery system in the United States. Successful implementation strategies relied on the organizational structures and processes characteristic of integrated health care systems, including data warehousing methods that leverage the electronic health record, case management, and centralized technical assistance. Challenges to sustainability of the population-based program include low prevalence of LS among veterans, limited expertise, organizational changes, and the rapidly evolving field of precision oncology. LS screening is an exemplar case study for implementation science in integrated health care delivery systems.
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Kolko, David J., and Eric M. Vernberg. Assessment and Intervention with Children and Adolescents Who Misuse Fire. Oxford University Press, 2017. http://dx.doi.org/10.1093/med:psych/9780190261191.001.0001.
Abstract:
Children and adolescents in the general population and in clinical populations reveal surprisingly high rates of playing with fire or actual firesetting behavior. A single fire has the potential to cause a cascade of serious consequences to the child, family, and the community, some of which may continue forever. Yet, there is limited practical information and advice based on available empirical evidence to help programs or practitioners work effectively with children or adolescents who misuse fire, and their families. This book provides practical guidelines designed to facilitate the clinical assessment and treatment of youthful firesetting behavior based on nearly four decades of research and intervention experience with this population. The topics covered in this book address several important content areas. Initial chapters provide an overview of the significance of the problem, and some lessons learned based on case control, clinical trial, and real-world implementation projects. Recommendations for using screening and assessment measures that evaluate firesetting and general psychosocial issues are included. Several intervention methods are outlined for use with children, caregivers, and families. These methods encompass fire safety education materials and several cognitive-behavioral treatment skills-training procedures that focus on understanding of the fire, affect regulation and self-control, parenting practices, and home-based management programs. The book also includes suggestions to promote professional and program development which reflect on various educational, ethical, legal, collaborative, and community safety considerations. The book’s content is intended to help a diverse array of practitioners understand and target the context in which the misuse of fire occurs.
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Grant, Warren, and Martin Scott-Brown. Prevention of cancer. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0350.
Abstract:
In the UK, the four commonest cancers—lung cancer, breast cancer, colon cancer, and prostate cancer—result in around 62 000 deaths every year. Although deaths from cancer have fallen in the UK over the last 20 years, the UK still suffers from higher cancer death rates than many other countries in Western Europe. In 1999, the UK government produced a White Paper called Saving Lives: Our Healthier Nation that outlined a national target to reduce the death rate from cancer by at least 20% in people under 75 by 2010. The subsequent NHS Cancer Plan of 2000 designed a framework by which to achieve this target through effective prevention, screening, and treatment programmes as well as restructuring and developing new diagnostic and treatment facilities. But do we know enough about the biology of the development of cancer for government health policies alone to force dramatic changes in survival? The science behind the causes of cancer tells us that its origin lies in acquired or inherited genetic abnormalities. Inherited gene mutation syndromes and exposure to environmental mutagens cause cancer, largely through abnormalities in DNA repair mechanisms, leading to uncontrolled cell proliferation. Although screening those thought to be at highest risk, and regulating exposure to environmental carcinogens such as tobacco or ionizing radiation, have reduced, and will continue to reduce, cancer deaths, there are many other environmental factors that have been shown to increase the population risk of cancer. These will be outlined in this chapter. However, the available evidence is largely from retrospective and cross-sectional population-based studies and therefore limits the ability to apply this knowledge to the risk of the individual patient who may been seen in clinic. Although we may be able to put him or her into a high-, intermediate-, or low-risk category, the question ‘will I get cancer, doc?’ is one that we cannot answer with certainty. The NHS Cancer Plan of 2000, designed to reduce cancer deaths in this country and to bring UK treatment results in line with those other countries in Europe, focuses on preventing malignancy as part of its comprehensive cancer management strategy. It highlights that the rich are less likely to develop cancer, and will survive longer if they are diagnosed than those who live in poverty. This may reflect available treatment options, but is more likely to be related to the lifestyle of those with regular work, as they may be more health aware. The Cancer Plan, however, suggests that relieving poverty may be more labour intensive and less rewarding than encouraging positive risk-reducing behaviour in all members of the population. Eating well can reduce the risk of developing many cancers, particularly of the stomach and bowel. The Cancer Plan outlines the ‘Five-a-Day’ programme which was rolled out in 2002 and encouraged people to eat at least five portions of fruit and vegetables per day. Obese people are also at higher risk of cancers, in particular endometrial cancer. A good diet and regular exercise not only reduce obesity but are also independent risk-reducing factors. Alcohol misuse is thought to be a major risk factor in around 3% of all cancers, with the highest risk for cancers of the mouth and throat. As part of the Cancer Plan, the Department of Health promotes physical activity and general health programmes, as well as alcohol and smoking programmes, particularly in deprived areas. Focusing on these healthy lifestyle points can potentially reduce an individual lifetime risk of all cancers. However, our knowledge of the biology of four cancers in particular has led to the development of specific life-saving interventions. Outlined in this chapter are details regarding ongoing prevention strategies for carcinomas of the lung, the breast, the bowel, and the cervix.
Book chapters on the topic "Population-Based screening program":
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Mehdi, Itrat, Abdul Aziz Al Farsi, Bassim Al Bahrani, and Shadha S. Al-Raisi. "General Oncology Care in Oman." In Cancer in the Arab World, 175–93. Singapore: Springer Singapore, 2022. http://dx.doi.org/10.1007/978-981-16-7945-2_12.
Abstract:
AbstractThe Sultanate of Oman is located on the Arabian Peninsula and is part of Western Asia. Oman has a relatively young population. The economy is based on oil, agriculture, fishing, and overseas trading. Oman spends around 3% of its GDP on health care. Omani nationals have free access to public healthcare. Due to increased incomes and changing lifestyles, the rate of Non-Communicable Diseases (NCD) including cancer is rising. This is slowly saturating the system and increasing health care costs. Cancer is now the third leading cause of mortality. The age-adjusted annual incidence of cancer ranges from 70 to 110 per 100,000 population. Oman has an operational national NCD action plan. This multi-sectoral plan was launched in 2018 and focuses on the government approach in addressing NCDs including cancer, highlighting the prevention and control strategies. There is an integrated cancer care service, cancer registry, and cancer control program; under the auspices of the Directorate general of Non-communicable diseases—Ministry of Health. Oman has envisioned an ambitious long-term health care plan called “Health care Vision 2050”, which includes the development and progression of cancer care services as well. This plan has an emphasis on development, patient empowerment, public awareness, health education, integration and accessibility of services, screening, and early detection, public–private partnership, indulgence for NGOs, research, and capacity building.
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Skaane, Per. "Digital Mammography in European Population-Based Screening Programs." In Digital Mammography, 155–73. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-540-78450-0_10.
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Driedger, S. Michelle, Elizabeth J. Cooper, and Ryan Maier. "Balancing Shared Decision-Making with Population-Based Recommendations: A Policy Perspective of PSA Testing and Mammography Screening." In Democratizing Risk Governance, 247–70. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-24271-7_10.
Abstract:
AbstractPopulation-based screening programs invite otherwise healthy people who are not experiencing any symptoms to be screened for cancer. In the case of breast cancer, mammography screening programs are not intended for higher risk groups, such as women with family history of breast cancer or carriers of specific gene mutations, as these women would receive diagnostic mammograms. In the case of prostate cancer, there are no population-based screening programs available, but considerable access and use of opportunistic testing. Opportunistic testing refers to physicians routinely ordering a PSA test or men requesting it at time of annual appointments. Conversations between patients and their physicians about the benefits and harms of screening/testing are strongly encouraged to support shared decision-making. There are several issues that make this risk scenario contentious: cancer carries a cultural dimension as a ‘dread disease’; population-based screening programs focus on recommendations based on aggregated evidence, which may not align with individual physician and patient values and preferences; mantras that ‘early detection is your best protection’ make public acceptance of shifting guidelines based on periodic reviews of scientific evidence challenging; and while shared decision-making between physicians and patients is strongly encouraged, meaningfully achieving this in practice is difficult. Cross-cutting these tensions is a fundamental question about what role the public ought to play in cancer screening policy.
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McDougall, Jean A., Shoshana Adler Jaffe, Dolores D. Guest, V. Shane Pankratz, Charles L. Wiggins, Angela L. W. Meisner, and Andrew L. Sussman. "Financial Hardship, Food Insecurity, and Forgone Medical Care." In Advancing the Science of Cancer in Latinos, 125–39. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-14436-3_11.
Abstract:
AbstractFinancial hardship is increasingly understood as a serious threat to achieving cancer health equity. Food insecurity, defined as an inability to access enough healthy food because of a lack of money or other resources, is an extreme manifestation of financial hardship that occurs when patients shift money from their food budget to cover other expenses, including cancer treatment. Emerging evidence suggests that cancer-related financial hardship disproportionately impacts Latinos; however, the research on financial hardship, food insecurity, and access to medical care is limited. Results are presented from a cross-sectional survey comparing the prevalence of financial hardship and food insecurity among population-based Hispanic and non-Hispanic cancer survivors, and the relationship between ethnicity, food insecurity, and forgone medical care is examined. The substantially higher prevalence of food insecurity among Hispanic cancer survivors highlights the need for food insecurity screening and prevention programs in community oncology practice.
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Mønsted, Troels. "A Matter of Distance? A Qualitative Study of Data-Driven Early Lifestyle Assessment in Preventive Healthcare." In Quantifying Quality of Life, 467–81. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94212-0_19.
Abstract:
AbstractAn essential objective of preventive healthcare is to assess the lifestyle of citizens and identify those with health risk behaviors long time before they develop a lifestyle-related disease. In spite of lasting attempts to support preventive healthcare services in reaching individuals at risk through information campaigns, systematic health check programs, and more recently, data-driven approaches, citizens remain at a distance to the preventive healthcare services. The purpose of this chapter is to investigate the reasons for this distance between citizens and preventive care offers and the potential of quantified-self technologies for decreasing this. The analysis shows that while data-driven approaches to lifestyle assessment do assist preventive care services in screening a large population, they do not solve the fundamental challenge; that citizens are often challenged in relating to the risk assessment and in the consequences of their current behaviors on a long timescale. Based on these findings, two design implications are elicited to guide design of systems based on quantified-self to support early assessment and improvement of potentially unhealthy lifestyle, potentially improving health and quality of life in the long term.
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Peckham, Catherine S., and Stuart Logan. "Congenital Infections." In The Epidemiology Of Childhood Disorders, 153–72. Oxford University PressNew York, NY, 1994. http://dx.doi.org/10.1093/oso/9780195075168.003.0006.
Abstract:
Abstract Knowledge about the role of infections in pregnancy and the effects they may or may not have on the fetus and infant is of great practical importance for clinicians and policy makers. Accurate information is needed so that women exposed to specific infections can be informed about the implications of this exposure for their pregnancy and can then be offered the most appropriate management. In addition, decisions about the appropriateness of recommending the introduction of a screening program to detect a specific infection in pregnancy, with a view to treatment or the opportunity to offer termination of the pregnancy, must be based on sound epidemiologic information. This information should include data on the prevalence of the infection, the risk of maternal infant transmission, the consequences of congenital or perinatal infection on pregnancy outcome and subsequent disability, and the benefits of treatment. Unfortunately, information is often derived from anecdotal experience or based on clinic populations that do not reflect the population at risk (see Chapter 1). In addition, the relevant issues may be clouded by media attention that then prompts campaigns for screening programs based on opinion, rather than on sound analyses of their risks and benefits.
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Singh, Rani. "Maple Syrup Urine Disease." In Pediatric Nutrition In Chronic Diseases And Developmental Disorders, 267–70. Oxford University PressNew York, NY, 2005. http://dx.doi.org/10.1093/oso/9780195165647.003.0038.
Abstract:
Abstract Maple syrup urine disease (MSUD) is a heterogeneous genetic disorder resulting from over 50 known mutations that impair the mitochondrial branched-chain a-ketoacid dehydrogenase (BCKD) complex. The components of the BCKD complex include E1, a decarboxylase; E2, an acyl transferase; and E3, a lipomide dehydrogenase (dihydrolipoyl dehydrogenase). The defect in this multienzyme complex results in accumulation of the branched-chain amino acids (BCAAs) leucine, isoleucine, and valine and their respective a-ketoacids (BCKAs) in body fluids (Fig. 38–1). Maple syrup urine disease is inherited as an autosomal recessive trait. Its incidence varies with the population studied, from 1/760 in selective screening of an inbred Mennonite group to 1/290,000 in a New England newborn screening program. Molecular mutation analysis has not revealed a strong genotype-phenotype correlation to date. Numerous variant forms of MSUD resulting in a spectrum of BCKD insufficiency (3% to 40% normal) have been reported. The clinical outcome appears to be associated with the age at diagnosis, the degree of enzyme impairment, the time at which diet therapy is begun, and the degree of metabolic control. Five clinical and biochemical phenotypes have been reported and used based on clinical presentation and therapeutic responses to thiamin observed in patients.
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Galsworthy, Paul. "The principles of a national diabetic eye screening programme." In Diabetic Retinopathy: Screening to Treatment (Oxford Diabetes Library), 111–22. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198834458.003.0012.
Abstract:
Screening identifies apparently healthy people who may be at increased risk of a disease or condition, enabling earlier treatment or better-informed decisions. The NHS diabetic eye screening (DES) programme is one of the young person and adult NHS population screening programmes in the UK. The UK National Screening Committee (UK NSC), which makes independent, evidence-based recommendations to ministers in the four UK nations about the 11 population-based screening programmes. Public Health England (PHE)—Screening Quality Assurance Service (SQAS) ensures programmes are safe and effective by ensuring national standards are met.
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"Propagated Fish in Resource Management." In Propagated Fish in Resource Management, edited by DOUGLAS E. OLSON, BOB SPATEHOLTS, MIKE PAIYA, and DONALD E. CAMPTON. American Fisheries Society, 2004. http://dx.doi.org/10.47886/9781888569698.ch49.
Abstract:
<em>Abstract.</em>—Salmon hatcheries in the Pacific Northwest continue to produce fish for harvest, largely to fulfill a mitigation function. Fisheries management struggles with the need to integrate this harvest opportunity from hatcheries with wild fish conservation. Warm Springs National Fish Hatchery demonstrates a program that balances this need to help offset salmon losses, provide fisheries, and protect wild fish. The U.S. Fish and Wildlife Service and Confederated Tribes of the Warm Springs Reservation of Oregon initiated the hatchery program in 1978 with wild, native fish from the Warm Springs River. The goal is to cooperatively manage hatchery operations to balance harvest opportunities with protection of wild fish populations and their inherent genetic resources. The management objectives are (1) to produce spring Chinook salmon <em>Oncorhynchus tshawytscha </em>for harvest in tribal subsistence and sport fisheries, (2) to preserve the genetic characteristics of the native population both in the hatchery and in the naturally spawning component of the integrated population, (3) to manage impact on wild fish to levels which pose a minimum risk, and (4) to develop and implement a hatchery operations plan to achieve both the harvest and conservation goals for the Warm Springs River Chinook population. To determine if these objectives are met, data on harvest, escapement, recruitment, spawning success, fish health, survival, run timing, age and size at return, and juvenile production characteristics have been collected to monitor changes over time and to compare performance of wild and hatchery origin fish. These data have been cooperatively collected by the Confederated Tribes of the Warm Springs Reservation, Oregon Department of Fish and Wildlife, and U.S. Fish and Wildlife Service for more than 25 years. Every 5 years, a hatchery operation plan has been developed based on this monitoring. The following list of actions are identified in the 2002–2006 hatchery operations plan and are measures for protecting the natural population while operating the hatchery for harvest augmentation: (1) Mass marking and codedwire tagging of hatchery production for selective fisheries, broodstock management, and hatchery evaluations; (2) Selecting broodstock to mimic wild fish run timing; (3) Incorporating wild fish in the hatchery broodstock using a sliding scale; (4) Limiting the number of hatchery fish allowed to spawn naturally; (5) Operating an automated passage system for returning adults to reduce handling of wild fish; (6) Replacing the hatchery’s water intake structure to meet new screening criteria to protect juvenile fish; (7) Simulating environmental and biological factors in the hatchery environment to match natural production; (8) Managing fish health at the hatchery; (9) Assessing ecological interactions between wild and hatchery fish; and (10) Determining the reproductive success of hatchery fish spawning in the stream. The monitoring and management of Warm Springs National Fish Hatchery demonstrates a sustainable program, integrating the need for both harvest and wild fish conservation.
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Moumtzoglou, Anastasius, and Abraham Pouliakis. "Population Health Management and Cervical Cancer Screening Programs." In Advances in Healthcare Information Systems and Administration, 1–31. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-1724-5.ch001.
Abstract:
Population Health Management (PHM) aims to provide better health outcomes for preventing diseases, closing care gaps and providing more personalized care. Since the inception of the Pap test, cervical cancer (CxCa) decreased in countries applying screening programs, involving both prevention and treatment. In this chapter, we map a PHM roadmap to CxCa screening programs, examine the effect of supporting information technology systems, and propose a suitable architecture for implementation. Notwithstanding screening programs have a tight relation to PHM; the mapping reveals numerous interventions involving additional data sources, and timeless reconfiguration. Today, the use of open source platforms allows the implementation of IT systems supporting CxCa screening, when employed in a multitier web-based architecture.
Conference papers on the topic "Population-Based screening program":
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Berrocal-Almanza, LC, AM OConnell, MC Muzyamba, A. Mirza, M. Lalor, A. Lalvani, and D. Zenner. "S30 Is the new national ltbi screening program reaching the target population? a population-based cohort study." In British Thoracic Society Winter Meeting 2017, QEII Centre Broad Sanctuary Westminster London SW1P 3EE, 6 to 8 December 2017, Programme and Abstracts. BMJ Publishing Group Ltd and British Thoracic Society, 2017. http://dx.doi.org/10.1136/thoraxjnl-2017-210983.36.
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Daca Alvarez, M., D. Zaffalon, I. Portillo, L. Bujanda, I. Gil-Lasa, G. Ibañez Sanz, A. Herreros de Tejada, et al. "IMPACT OF FIT-BASED CRC POPULATION SCREENING PROGRAM ON THE MANAGEMENT OF PT1 COLORECTAL CANCER." In ESGE Days 2022. Georg Thieme Verlag KG, 2022. http://dx.doi.org/10.1055/s-0042-1744680.
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Keane, HJ, K. Elder, and GB Mann. "Abstract P4-02-02: Outcomes of diagnostic surgical biopsy in a population-based mammographic screening program." In Abstracts: 2018 San Antonio Breast Cancer Symposium; December 4-8, 2018; San Antonio, Texas. American Association for Cancer Research, 2019. http://dx.doi.org/10.1158/1538-7445.sabcs18-p4-02-02.
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Pesatori, E. V., S. M. Milluzzo, P. Cesaro, S. Piccirelli, F. Catino, A. Quadarella, N. Olivari, et al. "INCREMENTAL YIELD OF ARTIFICIAL INTELLIGENCE IN A FECAL OCCULT BLOOD TEST BASED ORGANIZED SCREENING POPULATION PROGRAM." In ESGE Days 2022. Georg Thieme Verlag KG, 2022. http://dx.doi.org/10.1055/s-0042-1745022.
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Eisen, A., J. Carroll, AM Chiarelli, M. Horgan, W. Meschino, L. Rabeneck, R. Shumak, and E. Warner. "Abstract P3-02-10: Implementation and uptake of a provincial, population-based, organized breast screening program for high risk women in Ontario: The Ontario breast screening program (OBSP) high risk program." In Abstracts: Thirty-Fifth Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 4‐8, 2012; San Antonio, TX. American Association for Cancer Research, 2012. http://dx.doi.org/10.1158/0008-5472.sabcs12-p3-02-10.
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Hartopo, Anggoro B., Effika N. Putri, Maria P. Inggriani, Jajah Fachiroh, and Fatwa S. T. Dewi. "Ischemic Electrocardiogram Patterns among Population of Universitas Gadjah Mada Health and Demographic Surveillance System Sleman: The Community-Based Learning and Community Service by Cardiology and Vascular Medicine Residency Program at Universitas Gadjah Mada." In 3rd International Conference on Community Engagement and Education for Sustainable Development. AIJR Publisher, 2023. http://dx.doi.org/10.21467/proceedings.151.6.
Abstract:
Screening for coronary heart disease in the community can be performed by a simple method, namely an electrocardiography (ECG) examination. However, the ECG-based screening program has not been routinely performed in the Indonesian population, probably due to a scarcity of human resources e to interpret the ECG results. The ECG pattern recognition needs prolonged training, completed during Cardiology and Vascular Medicine Residency Program. Most Cardiology and Vascular Medicine Residency Program activities are performed in teaching hospitals. The involvement of cardiology and vascular medicine residents' involvement in interpreting ischemic ECG pattern during populational survey is necessary to fulfill their national standard competence and perform community service during the residency education program. Therefore, besides clinical services in teaching hospitals, community services in the population must be implemented during the residency program. The Universitas Gadjah Mada Health and Demographic Surveillance System (HDSS) Sleman is a longitudinal and community-based surveillance by the Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada in Sleman Regency, Yogyakarta since 2014 to obtain data regarding community health status, including cardiovascular diseases. The study aimed to investigate the ischemic ECG abnormal pattern and the feasibility of integrating community-based learning and community service by UGM HDSS Sleman, Yogyakarta, Indonesia residents. The results showed that among 787 subjects of the HDSS Sleman population, the prevalence of ischemic ECG pattern was only minority (n=48, 6%) and mostly among females (10.2%). The ischemic ECG pattern was associated with cardiovascular risk factors: hypertension (12.3% vs. 5.5%, p=0.035) and obesity (10.1% vs. 5.2%, p=0.035). By interpreting ECG patterns, residents can directly implement education and consultation to promote the community's cardiovascular disease prevention programs. This study highlights the feasibility of integrating community-based learning and community service performed by cardiology and vascular medicine residents during the residency education program embedded in the residency program curriculum.
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Ozmen, V., S. Ozkan-Gurdal, A. Kayhan, N. Ozaydin, N. Cabioglu, B. Ozcinar, and E. Aribal. "Abstract P2-04-06: Successful results of a population-based organized mammography screening program in a developing country: The Turkish experience." In Abstracts: Thirty-Sixth Annual CTRC-AACR San Antonio Breast Cancer Symposium - Dec 10-14, 2013; San Antonio, TX. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/0008-5472.sabcs13-p2-04-06.
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Bustamante-Balén, M., M. García-Campos, N. Alonso, VL Zúñiga, C. Sanchez, L. Argüello, and V. Pons-Beltrán. "Effect of Applying the 2020 ESGE Post-Polypectomy Surveillance Guidelines on the Surveillance Recommendations: Study on A Population-Based CRC Screening Program." In ESGE Days 2021. Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1724307.
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Rodrigues, R., S. Geyl, J. Albouys, CR de Carvalho, M. Crespi, T. Tabouret, A. Taibi, et al. "EFFECT OF IMPLEMENTING A REGIONAL REFERRAL NETWORK ON SURGICAL REFERRAL RATE OF BENIGN POLYPS FOUND DURING A COLORECTAL CANCER SCREENING PROGRAM: A POPULATION-BASED STUDY." In ESGE Days. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1704372.
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Tumeh, Isabella Barros Rabelo Gontijo, Cristiane Decat Bergerot, Mizza Nery Rocha Jacinto, Isabella Ferreira Santos, Moisés de Sousa, Lorena Nascimento Manrique Mollina, Daniel Fernandes Barbosa, and Ruffo FreitasJunior. "EVALUATION OF AN E-HEALTH PROGRAM: RESULTS IN THE EMOTIONAL WELL-BEING OF BRAZILIAN PATIENTS WITH BREAST CANCER." In Brazilian Breast Cancer Symposium 2022. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s2024.
Abstract:
Objective: The use of e-Health-based technologies has been boosted with COVID-19. This study evaluated the effectiveness of a program developed specifically for women with advanced breast cancer, users of the Unified Health System, in the course of outpatient chemotherapy. Methods: An e-Health program, called Conforto, was developed by a Brazilian group. Patients were followed up on a virtual platform and received psychosocial support via telehealth. In this longitudinal study, female patients diagnosed with locally advanced and metastatic breast cancers (IIIb, IIIc, and IV) undergoing outpatient chemotherapy were recruited. Symptom burden was assessed weekly and the EQ-5D-3L monthly in conjunction with the Perceived General Health (PSG) scale over 6 months with a 2-month follow-up. Results: A total of 71 patients were recruited; 71.8% (n=51) participated for at least 3 months and 39.4% (n=28) participated for 6 months. At baseline, patients had a higher burden of anxiety, distress, and insomnia. The results showed improvement in anxiety (p<0.001), distress (p <0.001), insomnia (p=0.03), sadness (p<0.001), and inappetence (p=0.01). PSG was significantly altered while remaining at follow-up (p=0.006). Most patients (70%), despite not having shown a history of symptoms to the attending physician, spoke with them about the symptoms. Conclusion: To date, this is the first study with e-Health technology developed for Brazilian cancer patients. Routine screening in the virtual modality and telephone service aimed at promoting self-management promotes emotional well-being even in an economically vulnerable population. Although being exploratory data, the findings suggest the effectiveness and feasibility of a sustainable intervention for women with locally advanced and metastatic breast cancers. The results facilitate access to supportive care and thus equity. For better results, it is necessary to include other professionals in the remote monitoring.
Reports on the topic "Population-Based screening program":
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
Abstract:
Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie, and Gregory J. Dore. Population-level interventions to improve the health outcomes of people living with hepatitis B: an Evidence Check brokered by the Sax Institute for the NSW Ministry of Health, 2022. The Sax Institute, August 2022. http://dx.doi.org/10.57022/pxwj3682.
Abstract:
Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.
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McEntee, Alice, Sonia Hines, Joshua Trigg, Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A. Smith, Carlene Wilson, and Jacqueline Bowden. Tobacco cessation in CALD communities. The Sax Institute, June 2022. http://dx.doi.org/10.57022/sneg4189.
Abstract:
Background Australia is a multi-cultural society with increasing rates of people from culturally and linguistically diverse (CALD) backgrounds. On average, CALD groups have higher rates of tobacco use, lower participation in cancer screening programs, and poorer health outcomes than the general Australian population. Lower cancer screening and smoking cessation rates are due to differing cultural norms, health-related attitudes, and beliefs, and language barriers. Interventions can help address these potential barriers and increase tobacco cessation and cancer screening rates among CALD groups. Cancer Council NSW (CCNSW) aims to reduce the impact of cancer and improve cancer outcomes for priority populations including CALD communities. In line with this objective, CCNSW commissioned this rapid review of interventions implemented in Australia and comparable countries. Review questions This review aimed to address the following specific questions: Question 1 (Q1): What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Question 2 (Q2): What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? This review focused on Chinese-, Vietnamese- and Arabic-speaking people as they are the largest CALD groups in Australia and have high rates of tobacco use and poor screening adherence in NSW. Summary of methods An extensive search of peer-reviewed and grey literature published between January 2013-March 2022 identified 19 eligible studies for inclusion in the Q1 review and 49 studies for the Q2 review. The National Health and Medical Research Council (NHMRC) Levels of Evidence and Joanna Briggs Institute’s (JBI) Critical Appraisal Tools were used to assess the robustness and quality of the included studies, respectively. Key findings Findings are reported by components of an intervention overall and for each CALD group. By understanding the effectiveness of individual components, results will demonstrate key building blocks of an effective intervention. Question 1: What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Thirteen of the 19 studies were Level IV (L4) evidence, four were Level III (L3), one was Level II (L2), none were L1 (highest level of evidence) and one study’s evidence level was unable to be determined. The quality of included studies varied. Fifteen tobacco cessation intervention components were included, with most interventions involving at least three components (range 2-6). Written information (14 studies), and education sessions (10 studies) were the most common components included in an intervention. Eight of the 15 intervention components explored had promising evidence for use with Chinese-speaking participants (written information, education sessions, visual information, counselling, involving a family member or friend, nicotine replacement therapy, branded merchandise, and mobile messaging). Another two components (media campaign and telephone follow-up) had evidence aggregated across CALD groups (i.e., results for Chinese-speaking participants were combined with other CALD group(s)). No intervention component was deemed of sufficient evidence for use with Vietnamese-speaking participants and four intervention components had aggregated evidence (written information, education sessions, counselling, nicotine replacement therapy). Counselling was the only intervention component to have promising evidence for use with Arabic-speaking participants and one had mixed evidence (written information). Question 2: What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? Two of the 49 studies were Level I (L1) evidence, 13 L2, seven L3, 25 L4 and two studies’ level of evidence was unable to be determined. Eighteen intervention components were assessed with most interventions involving 3-4 components (range 1-6). Education sessions (32 studies), written information (23 studies) and patient navigation (10 studies) were the most common components. Seven of the 18 cancer screening intervention components had promising evidence to support their use with Vietnamese-speaking participants (education sessions, written information, patient navigation, visual information, peer/community health worker, counselling, and peer experience). The component, opportunity to be screened (e.g. mailed or handed a bowel screening test), had aggregated evidence regarding its use with Vietnamese-speaking participants. Seven intervention components (education session, written information, visual information, peer/community health worker, opportunity to be screened, counselling, and branded merchandise) also had promising evidence to support their use with Chinese-speaking participants whilst two components had mixed (patient navigation) or aggregated (media campaign) evidence. One intervention component for use with Arabic-speaking participants had promising evidence to support its use (opportunity to be screened) and eight intervention components had mixed or aggregated support (education sessions, written information, patient navigation, visual information, peer/community health worker, peer experience, media campaign, and anatomical models). Gaps in the evidence There were four noteworthy gaps in the evidence: 1. No systematic review was captured for Q1, and only two studies were randomised controlled trials. Much of the evidence is therefore based on lower level study designs, with risk of bias. 2. Many studies provided inadequate detail regarding their intervention design which impacts both the quality appraisal and how mixed finding results can be interpreted. 3. Several intervention components were found to have supportive evidence available only at the aggregate level. Further research is warranted to determine the interventions effectiveness with the individual CALD participant group only. 4. The evidence regarding the effectiveness of certain intervention components were either unknown (no studies) or insufficient (only one study) across CALD groups. This was the predominately the case for Arabic-speaking participants for both Q1 and Q2, and for Vietnamese-speaking participants for Q1. Further research is therefore warranted. Applicability Most of the intervention components included in this review are applicable for use in the Australian context, and NSW specifically. However, intervention components assessed as having insufficient, mixed, or no evidence require further research. Cancer screening and tobacco cessation interventions targeting Chinese-speaking participants were more common and therefore showed more evidence of effectiveness for the intervention components explored. There was support for cancer screening intervention components targeting Vietnamese-speaking participants but not for tobacco cessation interventions. There were few interventions implemented for Arabic-speaking participants that addressed tobacco cessation and screening adherence. Much of the evidence for Vietnamese and Arabic-speaking participants was further limited by studies co-recruiting multiple CALD groups and reporting aggregate results. Conclusion There is sound evidence for use of a range of intervention components to address tobacco cessation and cancer screening adherence among Chinese-speaking populations, and cancer screening adherence among Vietnamese-speaking populations. Evidence is lacking regarding the effectiveness of tobacco cessation interventions with Vietnamese- and Arabic-speaking participants, and cancer screening interventions for Arabic-speaking participants. More research is required to determine whether components considered effective for use in one CALD group are applicable to other CALD populations.
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Zimbabwe: RTI screening methods for women are not cost-effective. Population Council, 1999. http://dx.doi.org/10.31899/rh1999.1012.
Abstract:
Reproductive tract infections (RTIs) are common in Zimbabwe. Many RTIs increase the risk of human immunodeficiency virus (HIV) infection. In 1998, the Zimbabwe National Family Planning Council (ZNFPC) conducted an operations research study to assess the feasibility of adding RTI diagnosis and treatment to its menu of services. The study population consisted of 1,634 clients at three ZNFPC clinics. Each client was asked about lower abdominal pain, vaginal discharge, and other RTI symptoms; examined for clinical signs of RTIs; and given laboratory tests to confirm the accuracy of diagnosis based upon symptoms and signs. Findings detailed in this brief were that existing methods for screening RTIs among family planning clients are not cost-effective, laboratory tests are too costly, and syndromic case management often leads to missed infections and unnecessary treatment. Health programs should continue to emphasize preventive measures—changing individual behavior and promoting condom use.
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Reproductive tract infections: A guide for programme managers. Population Council, 2001. http://dx.doi.org/10.31899/rh2001.1026.
Abstract:
Reproductive tract infections (RTIs) including sexually transmitted infections represent a silent worldwide pandemic that adversely impacts the reproductive health (RH) of women and men. Various community- and hospital-based studies in India have provided insights into the magnitude of the problem. The International Conference on Population and Development (1994) emphasized integration of RH services to meet the needs of men and women especially with prevention and management of RTIs/STIs. The emergence of HIV and the identification of STIs as a risk factor for the spread of HIV have further lent a sense of urgency for a programmatic response to address this public health problem. Programmatic evidence from developing countries indicates that integration of RTI/STI prevention and management with existing health services is both feasible and cost effective. The National Population Policy 2000 also highlights the need for programs that include provision of RTI/STI and HIV/AIDS prevention, screening, and management in RH care settings. This report reviews global and regional experiences and provides strategic directions likely to be the most effective in addressing these problems in India.