Risultati per: Indicazioni per gli screening oncologici

Objective
To examine the feasibility of implementing remote atrial fibrillation (AF) self-screening among older people supported by a remote central monitoring system.

Design
Process evaluation of the Mass AF randomised clinical trial (ACTRN12621000184875) with one-to-one semistructured interviews using interview guides underpinned by the Critical Realism approach and coded using the UK Medical Research Council Guidance of Process Evaluation Framework.

Setting and participants
Community-dwelling people aged ≥75 years from both genders (ratio 1:1) and urban/rural (ratio 2:1) in Australia.

Interventions
Participants were provided handheld single-lead electrocardiogram (ECG) devices and trained to self-record ECGs once daily on weekdays for at least 6 months. A remote central team notified participants and general practitioners (GPs) of AF.

Primary feasibility outcomes
The strengths, weaknesses, opportunities and threats (SWOT) analysis examined enablers (ie, strengths and opportunities) and barriers (ie, weaknesses and threats).

Results
Overall, 200 participants; 98.5% completed the 6-month programme, 96% reported being satisfied with screening and 48 were interviewed: mean age 79 years, 54% male and 71% urban. 11 GPs were interviewed: 55% female and 64% urban. Programme participants trusted the remote monitoring system that supported the screening programme and provided follow-up pathways where required. GPs saw opportunities to introduce this self-screening programme to at-risk patients and improve patients’ risk profiles. Programme participants reported that after being trained to use the device, they felt empowered to do self-screening and found it convenient. GPs saw empowerment could enhance the doctor–patient relationship. Participants and GPs valued screening in diagnosing AF that would otherwise be missed in usual care, but the uncertainty of effective screening duration could be a barrier.

Conclusions
This screening programme was feasible with the reinforcement of the underpinning enablers. Several implementation strategies were identified using SWOT analysis, including leveraging the opportunity for GPs to introduce this screening programme to at-risk patients.

Trial registration number
ACTRN12621000184875.

Objectives
The objectives are to investigate the status of knowledge, attitudes and practices (KAP) and to identify factors related to KAP towards breast and cervical cancer screening among rural Chinese women aged 40–65 years.

Design and setting
This cross-sectional study was conducted from July to September 2020 in rural areas of eastern China.

Participants
This study involved 301 rural women aged 40–65 years.

Variables and outcomes
The questionnaire included demographic information and the KAP related to breast and cervical cancer screening. Multivariate linear regression analysis was used for the multifactor analysis.

Results
A total of 301 rural women aged 40–65 years participated in the survey. The overall score of KAP was (62.41±11.24), and the scores of each KAP domain relating to screening for breast and cervical cancer among participants in rural areas were (1.82±0.97), (44.52±7.20) and (16.06±4.56), respectively. The following factors were significantly associated with the total KAP Score relating to breast and cervical cancer screening among rural women aged 40–65 years, explaining 35% of the variance (p

Introduction
Developmental dysplasia of the hip (DDH) includes a spectrum of clinical and imaging findings at birth or early infancy. The circumstances in which this condition is detected and managed may be heterogeneous in Brazil owing to its large territory and regional socio-economic differences. Mapping DDH perspectives in a country is fundamental for designing guidelines and strategies for public policy. This scoping review aims to map the available literature related to screening, diagnosis, treatment and outcomes of DDH in the Brazilian population to provide an overview of this condition and to describe regional variations in presentation and management across the country.

Methods and analysis
This study will follow the methods outlined in the Joanna Briggs Institute Reviewers manual for conducting a scoping review. Relevant publications will be first searched in PubMed/MEDLINE, Scientific Electronic Library Online, Web of Science, Scopus, “Biblioteca virtual em saúde” and “Biblioteca Digital Brasileira de Teses e Dissertacões” using search terms developed from a brief preliminary search of those databases. There were no language or date range limitations for study inclusion. Databases will be searched from their inception until February 2024. Titles and abstracts will be analysed by two or more independent reviewers to assess them against the inclusion criteria for the review. The search results and study inclusion process will be reported in full in the final version of the scoping review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flowchart. The resulting data will be recorded and organised to present the key information contained in all examined articles.

Ethics and dissemination
This review will include existing available studies and does not require a specific ethical review or approval. The final study will be submitted for presentation at conferences that focus on Brazilian healthcare and publication in peer-reviewed journals. This scoping review protocol was registered in the Open Science Framework. DOI registration (https://doi.org/10.17605/OSF.IO/V3AYH).

Both Cologuard Plus and Shield were approved in 2024.

In Reply Our study compared the end points of cancer-specific mortality and late-stage cancer in randomized clinical trials of cancer screening. Drs Kim and Gibbs write that the relationship between these could be affected by changes in cancer staging and treatment. We agree that this is true not only for our comparison of end points, but for cancer screening in general. For example, a screening test that is effective at reducing cancer mortality could become ineffective if new treatments decrease differences in survival between stages. For the cancer types in our study, Surveillance, Epidemiology, and End Results data generally show survival improvements over time across all stages.

To the Editor A recent study provided a robust analysis of the association between the reduction in stage III to IV cancer diagnoses and overall survival gains in historical cancer screening trials, and the accompanying Editorial added an important epidemiological perspective. However, the relationship between cancer stage at diagnosis and survival is not static. Data from the studies examined, many of which were initiated 30 to 40 years ago, are of questionable relevance in the modern era.

To the Editor A recent study offered valuable insights into the management and prognosis of advanced cancer. Nevertheless, we have several concerns about this article.

L’Istituto in una nota, ‘modesta riduzione dell’ospedalizzazione’

L’Iniziativa promossa da Lilt (Lega italiana per la lotta contro i tumori) mette a disposizione un numero verde per effettuare le visite negli ambulatori aderenti

A 14-day monitor detected more atrial fibrillation but did not affect hospitalization rates for stroke or hemorrhage.

Fino a oggi era fissata a 50 anni. Si parte nel 2025

Annals of Internal Medicine, Ahead of Print.

Annals of Internal Medicine, Ahead of Print.

In 2009, the first state dense breast legislation was passed in Connecticut, requiring that women who undergo mammography receive written notification of breast density. This advocacy-driven policy was intended to raise women’s awareness that dense breasts are a risk factor for breast cancer and can also obscure breast cancer on mammography. Since then, 37 states and the District of Colombia have followed with their own reporting laws, and beginning in September 2024, the US Food and Drug Administration will require breast density notification to be included in mammography reports for all patients and their referring clinicians.

This model-based comparative effectiveness analysis examines the long-term benefits and harms of digital breast tomosynthesis and supplemental breast magnetic resonance imaging screening by breast density using data on screening performance from the Breast Cancer Surveillance Consortium.

In a large observational study, women with false-positive results were less likely to return for future screening.