Risultati per: Screening della retinopatia diabetica

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.

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.

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 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.

Use of MRI led to fewer biopsies and fewer diagnoses of clinically insignificant cancer.

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

New England Journal of Medicine, Volume 391, Issue 12, Page 1083-1095, September 26, 2024.

Background
With the potential to identify a vast number of rare diseases soon after birth, genomic newborn screening (gNBS) could facilitate earlier interventions and improve health outcomes. Designing a gNBS programme will involve balancing stakeholders’ opinions and addressing concerns. The views of medical students—future clinicians who would deliver gNBS—have not yet been explored.

Methods
We conducted a nationwide online survey of UK medical students via the REDCap platform. Perceptions of gNBS, including scope of testing and potential benefits and drawbacks, were explored using a mix of multiple-choice questions, Likert scales, visual analogue scales and free-text questions.

Results
In total, 116 medical students across 16 universities participated. Overall, 45% supported gNBS, with a positively skewed mean support score of 3.24 (SD 1.26, range: 1.0–5.0), and 55% felt it relevant to their future practice. Almost all agreed that infant-onset and childhood-onset diseases and conditions with effective treatments should be included. Most felt that earlier interventions and personalised care would be the most important benefit of gNBS. Other perceived benefits included earlier diagnoses, diagnosing more patients and enabling research for new treatments. However, several perceived challenges were highlighted: risk of genomic discrimination, incidental or uncertain findings, data security and breaching children’s future autonomy. Students expressed conflicting opinions on the psychological impact on families, but most were concerned about a lack of support due to current resource limitations in health services. Students frequently reported having insufficient knowledge to form an opinion, which may reflect gaps in genomics education at medical school and the current lack of evidence base for gNBS.

Conclusion
Although some support for gNBS was demonstrated, ethicolegal and social challenges were raised, emphasising a need for ongoing discussions about the implications of gNBS.

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States. Despite evidence that screening effectively reduces incidence and mortality, screening is suboptimal, especially in safety net healthcare systems and federally qualified health centers (FQHCs). Safety net healthcare systems represent 25% of U.S. hospitals and are defined as hospitals that organize and deliver a significant level of healthcare and other related services to individuals without insurance, receiving Medicaid, and other vulnerable patients.

New England Journal of Medicine, Ahead of Print.

Annals of Internal Medicine, Volume 177, Issue 9, Page 1294, September 2024.