Risultati per: Screening del cancro ai polmoni

In this issue of JAMA, Feng et al studied whether late-stage cancer (ie, stage III or stage IV cancer), rather than cancer-specific mortality, was an acceptable alternative end point in clinical trials of cancer screening. The authors analyzed 41 clinical trials conducted in Europe, North America, and Asia, combining the data overall and according to cancer type. They evaluated the association between incidence of stage III-IV cancer and cancer-specific mortality in and across the selected studies.

This meta-analysis of 41 randomized clinical trials of cancer screening compares cancer-specific mortality with stage III-IV cancer as end points.

This 2024 Recommendation Statement from the US Preventive Services Task Force recommends biennial screening mammography for women aged 40 to 74 years (B recommendation) and concludes that evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older (I statement) and of screening using ultrasonography or MRI in women with dense breasts on a negative mammogram (I statement).

This modeling study uses Cancer Intervention and Surveillance Modeling Network models and national data on breast cancer incidence, mammography performance, treatment effects, and other-cause mortality in US women without previous cancer diagnoses to estimate outcomes of various mammography screening strategies.

Objectives
Migrants from high HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV) endemicity regions have a great burden of these infections and related diseases in the host countries. This study aimed to assess the predictive capacity of the Test Rapide d’Orientation Diagnostique (TROD) Screen questionnaire for HIV, HBV and HCV infections among migrants arriving in France.

Design
An observational and multicentre study was conducted among migrants. A self-questionnaire on demographic characteristics, personal medical history and sexual behaviours was completed.

Setting
The study was conducted in the centres of the French Office for Immigration and Integration (OFII).

Participants
Convenience sampling was used to select and recruit adult migrants between January 2017 and March 2020.

Outcome measures
Participants were tested for HIV, HBV and HCV with rapid tests. For each infection, the test performance was assessed using receiver operating characteristics curves, using area under the curve (AUC) as a measure of accuracy.

Results
Among 21 133 regular migrants seen in OFII centres, 15 343 were included in the study. The participants’ mean age was 35.6 years (SD±11.1). The prevalence (95% CI) of HBV, HCV and HIV was 2.0% (1.8% to 2.2%), 0.3% (0.2% to 0.4%) and 0.3% (0.2% to 0.4%), respectively. Based on the sensitivity–specificity curve analysis, the cut-off points (95% CI) chosen for the risk score were: 2.5 (2.5 to 7.5) for HBV infection in men; 6.5 (0.5 to 6.5) for HBV infection in women; 9.5 (9.5 to 12.5) for HCV infection; and 10.5 (10.0 to 18.5) for HIV infection. Test performance was highest for HIV (AUC=82.15% (95% CI 74.54% to 87.99%)), followed by that for HBV in men (AUC=79.22%, (95% CI 76.18% to 82.26%)), for HBV in women (AUC=78.83 (95% CI 74.54% to 82.10%)) and that for HCV (AUC=75.95% (95% CI 68.58% to 83.32%)).

Conclusion
The TROD screen questionnaire showed good overall performance for predicting HIV, HBV and HCV infections among migrants in OFII centres. It could be used to optimise screening for these infections and to propose rapid screening tests to those who are at high risk.

Trial registration number
NCT02959684.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

This systematic review and meta-analysis examines evidence regarding screening pathways incorporating magnetic resonance imaging with targeted biopsy and assess their diagnostic value compared with prostate-specific antigen–based screening with systematic biopsy strategies.

This cross-sectional study describes national- and state-level breast, cervical, and colorectal cancer screening use of more than 16 million adults served by federally qualified health centers and estimates the percentages of underscreened individuals in the US general population served by these centers.

This cohort study examines the applicability of personalized colorectal cancer (CRC) screening with fecal-hemoglobin (f-Hb)-guided screening intervals to reduce the number of fecal immunological tests and colonoscopy, as well as determine if it demonstrates equivalent efficacy as universal biennial screening.

The goal of screening for breast cancer is to find it early, before it has spread to lymph nodes, to reduce breast cancer mortality and also to reduce the morbidity of treatment. The updated recommendations from the US Preventive Services Task Force (USPSTF), informed by a decision analysis and comparative effectiveness review, support biennial screening mammography for women aged 40 to 74 years (B recommendation) but conclude that current evidence is insufficient to assess the balance of benefits and harms in women 75 years and older (I statement). These recommendations expand the potential benefits of screening mammography, but they do not go far enough.

Although much progress has been made in delivering cancer screening in the US, particularly for breast, cervical, and colorectal cancer, implementation remains suboptimal, particularly for populations experiencing systemic marginalization and economic disadvantage. Efforts to improve cancer screening implementation and reduce inequities are critical for achieving the goals of a just, high-performing health care system in the US.