Risultati per: Indicazioni per gli screening oncologici

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.

Introduction
Cervical cancer remains a significant public health concern in Singapore, with current screening rates at 43%, well below the national target of 70%. In 2019, human papillomavirus (HPV) DNA testing was introduced into the national cervical cancer screening programme, but barriers to participation include embarrassment, privacy concerns and discomfort with clinician-sampled tests. Self-sampled HPV DNA testing offers a promising alternative by providing more privacy and convenience. This study aims to evaluate the impact of including self-sampled HPV DNA testing as an alternative to clinician-sampling on screening uptake, clinical outcomes and cost-effectiveness in primary care.

Methods and analysis
This pragmatic, open-label, two-arm randomised controlled trial employs a Zelen design. A total of 650 women aged 30–69 who are due for cervical cancer screening will be recruited from National Healthcare Group Polyclinics in Singapore. Participants will be randomly assigned to either the intervention arm (offering both self-sampling and clinician-sampling) or the usual care arm (clinician-sampling only). The primary outcome is the proportion of participants in each arm detected with high-risk HPV. Secondary outcomes include the proportion of participants in each arm who undergo cervical cancer screening (uptake), are referred for colposcopy and are detected with CIN 2/3 or cervical cancer, as well as cost-effectiveness. Acceptability and feasibility of self-sampling will be evaluated through post-screening questionnaires.

Ethics and dissemination
Ethical approval was granted by the National Healthcare Group Domain Specific Review Board. Study results will be disseminated through peer-reviewed journals, healthcare conferences and shared with policymakers to guide potential inclusion of self-sampling in Singapore’s national cervical cancer screening programme. Findings from this trial will provide crucial evidence for the potential inclusion of self-sampling in Singapore’s national cervical cancer screening programme, which could increase screening rates and improve public health outcomes.

Trial registration number
ClinicalTrials.gov: NCT06528184.

To the Editor A recent study about newborn screening using genome sequencing for early actionable conditions highlighted the potential of early detection for actionable genetic disorders. However, genomic sequencing is a “double-edged sword,” providing substantial benefits while introducing complex challenges related to technology, ethics, and privacy.

In Reply The comments from Dr Wu and colleagues regarding our recently published article highlight important technical, clinical, and ethical considerations in the use of genomic sequencing for newborn screening.

Comunità Sant’Egidio, ‘opportunità concreta per migliorare accesso alle cure’

Con un prelievo, in Italia colpisce 20.000 bambini e adolescenti

Concerti organizzati dall’Irccs e dal Conservatorio di Potenza

L’ìniziativa si è svolta l’8 marzo ad Ascoli Piceno e prosegue

Tra primi 5 al mondo in ricerca. Corso con Società oncologi Usa

Objectives
Adherence to routine annual eye evaluations for diabetes is frequently insufficient on a global scale. We evaluated the adherence to annual diabetic retinopathy screening (DRS) and recommended follow-up among Chinese patients with diabetes, and we also identified the associated risk variables.

Design
This was a cross-sectional and longitudinal study.

Setting
Patients with diabetes were inquired about their completion of DRS within the preceding year. All participants were required to complete the Compliance with Annual Diabetic Eye Exams Survey.

Participants
Participants with diabetes who initially sought eye examination from November 2021 to October 2023 at He Eye Specialist Hospital, Shenyang, China.

Outcome measures
Logistic regression analyses defined the risk factors associated with poor compliance with the annual DRS and recommended follow-up.

Results
There were 468 patients registered, with a mean age of 67.42±10.66 years. A total of 308 (65.8%) participants had DRS in the previous year. Rural residents (OR 1.704, 95% CI 1.019 to 2.850, p=0.042), vision-threatening diabetic retinopathy (VTDR) (OR 1.948, 95% CI 1.145 to 3.313, p=0.014), item 7 (over the past 4 weeks, I have felt blue, downhearted or depressed) (OR 0.624, 95% CI 0.401 to 0.971, p=0.037) and item 42 (I receive a reminder from my eye doctor’s office when it is time to schedule an exam) (OR 0.618, 95% CI 0.387 to 0.989, p=0.045) were associated with non-adherence to annual DRS. The compliance with DRS improved to 80.9% in the second year after health education and reminders of follow-up. VTDR (OR 3.063, 95% CI 1.852 to 5.066, p

Objectives
This study aims to identify the optimal lumbar vertebral level for CT-based assessments of trunk muscles in relation to physical function and muscle strength, and to establish a foundation for opportunistic CT screening for sarcopenia.

Design
A cross-sectional study was conducted between April 2022 and December 2022. Pearson’s correlation coefficients and multiple linear regression analyses were employed to estimate the correlation between CT parameters of trunk muscle with physical function and muscle strength.

Setting and participants
The study included community residents aged 50 years and older from Kunming, Yunnan Province, China, who were part of the SOY (Sarcopenia and Osteoporosis Study of Yunnan) cohort. A total of 615 participants were enrolled, comprising 424 men and 191 women. Among these, 31 individuals (20 men and 11 women) were diagnosed with sarcopenia.

Interventions
Each participant underwent lumbar CT scanning, the Short Physical Performance Battery (SPPB) and handgrip strength (HGS) assessment.

Primary outcome measures
A correlation analysis was conducted for both the general and sarcopenia groups, after adjusting for age and body mass index. Additionally, a gender-stratified analysis was performed.

Results
Muscle density and muscle area at all levels exhibited a moderate correlation with grip strength, with the correlation for muscle area being more pronounced (correlation β of muscle density =0.48–0.54, p value

Objectives
To explore husbands’ views on breast cancer screening, risk-based screening and their role in influencing their wives’ health-seeking behaviours.

Design
Qualitative focus group discussion (FGD) supplemented by quantitative data from a cohort study using a structured questionnaire.

Setting
This study was conducted in a community-based setting, with participants recruited online through non-profit organisations via social media and email.

Participants
Nineteen husbands of women without breast cancer history participated. The questionnaire data were completed by 3395 women with no breast cancer history.

Interventions
Not applicable.

Primary and secondary outcome measures
Not applicable.

Results
Six key themes emerged from FGDs regarding husbands’ attitudes towards women’s breast cancer screening practices: awareness, priorities, social support structures, fears, incentives and attitudes towards risk-based screening. These themes were supported by the questionnaire data, which also identified additional concerns not raised in FGDs, suggesting a gap in the husband’s awareness and limited health-related communication between spouses. While husbands expressed interest in their wives’ health and provided support in making screening appointments, their influence may be limited by these communication gaps. Most husbands were receptive to risk-based screening but raised concerns around the testing frequency and result interpretation.

Conclusions
This study highlights the need to actively engage husbands in breast cancer screening discussions and develop support strategies that enhance their involvement. Strengthening spousal communication on breast health may increase screening uptake among women.

Asp Ambito 9 a Jesi per prevenzione malattie neurodegenerative