Risultati per: Screening del cancro al seno nelle donne

Annals of Internal Medicine, Volume 175, Issue 12, Page JC140, December 2022.

Nearly a quarter of physicians do not believe that a patient’s life expectancy should be a metric for halting cancer screening, despite guidelines that recommend against routine cancer screening when life expectancy is less than 10 years. What’s more, less than half of physicians are convinced the overscreening is a major problem among older adults.

Annals of Internal Medicine, Ahead of Print.

Presentato il 5/o Rapporto di Cittadinanzattiva e Federfarma

This cohort study assesses the association of prostate-specific antigen screening with incidence of metastatic prostate cancer in the Veterans Health Administration (VHA) from 2005 to 2019.

This review examines the current FDA regulatory process for artificial intelligence products used in breast cancer screening and suggests system improvements.

Appello da 4 campionesse per praticarlo anche nella terza e quarta età

Incontro nella Asl 1 di Roma con medici, dirigenti, ricercatori

Circulation, Volume 146, Issue 22, Page 1730-1732, November 29, 2022.

In squadra con Atena Donna. “Voliamo lontano dalla violenza”

Dati studio Iss in spot trasmesso su Reti Rai

Introduction
Colonoscopy quality can vary depending on endoscopist-related factors. Quality indicators, such as adenoma detection rate (ADR), have been adopted to reduce variations in care. Several interventions aim to improve ADR, but these fall into several domains that have traditionally been difficult to compare. We will conduct a systematic review and network meta-analysis of randomised controlled trials evaluating the efficacies of interventions to improve colonoscopy quality and report our findings according to clinically relevant interventional domains.

Methods and analysis
We will search MEDLINE (Ovid), PubMed, EMBASE, CINAHL, Web of Science, Scopus and Evidence-Based Medicine from inception to September 2022. Four reviewers will screen for eligibility and abstract data in parallel, with two accordant entries establishing agreement and with any discrepancies resolved by consensus. The primary outcome will be ADR. Two authors will independently conduct risk of bias assessments. The analyses of the network will be conducted under a Bayesian random-effects model using Markov-chain Monte-Carlo simulation, with 10 000 burn-ins and 100 000 iterations. We will calculate the ORs and corresponding 95% credible intervals of network estimates with a consistency model. We will report the impact of specific interventions within each domain against standard colonoscopy. We will perform a Bayesian random-effects pairwise meta-analysis to assess heterogeneity based on the I2 statistic. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework for network meta-analyses.

Ethics and dissemination
Our study does not require research ethics approval given the lack of patient-specific data being collected. The results will be disseminated at national and international gastroenterology conferences and peer-reviewed journals.

PROSPERO registration number
CRD42021291814.

Iniziativa per il quarto anno, dal primo al 31 dicembre

Only 13% of patients who met all 2013 USPSTF screening eligibility criteria were screened.

Introduction
Cervical cancer (CC) causes thousands of deaths each year. Nearly 100% of cases are caused by oncogenic strains of human papillomavirus (HPV). In most industrialised countries, CC screening (CCS) is based on the detection of HPV infections. For many reasons including lower adherence to CCS, underserved women are more likely to develop CC, and die from it. We aim to demonstrate that the use of incentives could improve screening rates among this population.

Methods and analysis
Our cluster randomised, controlled trial will include 10 000 women aged 30–65 years eligible for CCS, living in deprived areas in four French departments, two mainlands and two overseas, and who did not perform physician-based HPV testing within the framework of the nationally organised screening programme. HPV self-sampling kit (HPVss) will be mailed to them. Two interventions are combined in a factorial analysis design ending in four arms: the possibility to receive or not a financial incentive of 20 and to send back the self-sampling by mail or to give it to a health professional, family doctor, gynaecologist, midwife or pharmacist. The main outcome is the proportion of women returning the HPVss, or doing a physician-based HPV or pap-smear test the year after receiving the HPVss. 12-month follow-up data will be collected through the French National Health Insurance database. We expect to increase the return rate of HPV self-samples by at least 10% (from 20% to 30%) compared with the postal return without economic incentive.

Ethics and dissemination
Ethics approval was first obtained on 2 April 2020, then on July 29 2022. The ethics committee classified the study as interventional with low risk, thus no formal consent is required for inclusion. The use of health insurance data was approved by the Commission Nationale Informatique et Libertés on 14 September 2021 (ref No 920276). An independent data security and monitoring committee was established. The main trial results will be submitted for publication in a peer-reviewed journal.

Trial registration number
NCT04312178.