Risultati per: Screening del cancro del colon-retto

Objective
This study evaluates the effectiveness of Taiwan’s nationwide oral cancer screening programme in reducing late-stage diagnosis, treatment delays and mortality.

Design
A retrospective cohort study was conducted.

Setting
The study utilized Nationally representative datasets, including the Cancer Registry, Oral Mucosal Screening and National Health Insurance databases in Taiwan.

Participants
The study included patients with oral cancer diagnosed between 1 January 2010 and 31 December 2013, with follow-up through 31 December 2018. The final analysis included 16 430 patients.

Intervention
The intervention was Taiwan’s nationwide oral cancer screening programme which provides visual inspection and palpation of the oral mucosa.

Primary outcome measures
The primary outcomes measured were late-stage diagnosis (stages III and IV), treatment delay (time from diagnosis to treatment >30 days) and all-cause mortality.

Results
Oral cancer screening was statistically significantly associated with a reduced likelihood of late-stage diagnosis (adjusted OR (AOR)=0.85, 95% CI 0.80 to 0.91, p

ERBB2-pathway activation, through amplification or activating mutations, represents a new target for colon cancer (CC) treatment. We compared molecular methods to the gold-standard for assessing ERBB2 status and determined the prognostic value of ERBB2 amplification, mutations, and expression using data from two phase III trials involving nearly 3,000 stage III CC patients.

Focus su tumori ereditari e immunità nei contesti oncologici

Prior studies have shown that individuals with fecal hemoglobin (f-Hb) concentrations just below the positivity cut-off have an increased colorectal cancer (CRC) risk compared to those with no or low f-Hb. Understanding the dose-response association between f-Hb in prior screening round and the detection of colorectal neoplasia is crucial for tailoring risk-based screening recommendations.

Introduction
Hepatitis B virus (HBV) affects 296 million people globally, causing 780 000 annual deaths. It has been estimated that 12–43 million individuals are co-infected with hepatitis D virus (HDV). In Spain, the prevalence of HBsAg in adults is 0.22%, with an anti-HDV prevalence of 7.7%, although not extensively documented since many HBsAg-positive cases are not tested for anti-HDV. The primary objective of this project is to optimise hepatitis D care by implementing a screening programme for anti-HDV in all HBsAg-positive individuals over a 1 year period in Catalonia. Secondary objectives include evaluating hepatitis D prevalence, establishing a digital registry for all anti-HDV positive cases, testing them for HDV-RNA in a centralised laboratory and offering linkage to care.

Methods and analysis
This prospective study will be performed in seven hospital centres in Catalonia, which attend to more than 95% of the adult population. Approximately, 9290 HBsAg-positive individuals are expected to be screened for anti-HDV in 1 year. All anti-HDV positive samples will be sent to a centralised laboratory for HDV-RNA quantification. All individuals testing positive for anti-HDV will be registered on an electronic platform and linked to care. The registry will collect data on demographics, infection stage, risk factors, disease awareness and previous diagnoses. No additional interventions will be conducted for those with adequate follow-up.

Ethics and dissemination
The Vall d’Hebron Hospital Ethics Committee (PR(AG)628/2023) and the Spanish Agency of Medicines and Medical Devices approved this study. These findings will be disseminated through peer-reviewed publications and conference presentations.

Trial registration study
Grant number: IN-ES-980–7058.

Via a studio con Italia.Biopsia liquida per nuovo approccio cura

Al via uno studio con l’Italia. La biopsia liquida per un nuovo approccio di cura

Objective
To understand what leads to the non-adherence to the cervical cancer screening (CCS) recommendations during a consultation.

Design
For this qualitative study, in-depth semistructured interviews were carried out with French healthcare professionals. An interview guide was developed and tested. It included the following themes: CCS recommendations, patients’ profiles, relationship with patients, emotional work, over-screening and under-screening. Interviews were carried out until data saturation (no new data, theoretical diversity reached). The grounded theory was used for data analysis.

Participants
Gynaecologists, midwives and general practitioners (GPs). The sample diversity was achieved using the following criteria: place of work, type of healthcare profession, type of patients, private-sector or hospital professional.

Setting
Interviews were conducted between July and December 2022 in six regions in France.

Results
In-depth semistructured interviews were carried out with 15 midwives, 24 GPs and 11 gynaecologists from six French regions. Their analysis highlighted that the following factors contributed to the non-adherence to the CCS recommendation: burden of caring for family members for some women, adhesion to the principle of yearly screening by healthcare professionals and patients, need of negotiating the respect of the CCS recommendations, use of emotions, and arbitration to prioritise what is needed for good health maintenance. The search for mutual emotional comfort led some healthcare professionals to adopt attitudes towards the CCS that avoid positioning conflicts, even if this means departing from the recommendations.

Conclusion
CCS can be correctly performed if healthcare professionals and patients agree on the need of actively taking care of their health, which is difficult for women from lower sociocultural backgrounds. During the one-to-one meeting with their patients, healthcare professionals may find difficult to apply the CCS recommendations, although they know and agree with them.

New England Journal of Medicine, Volume 391, Issue 20, Page 1877-1889, November 21, 2024.

New England Journal of Medicine, Volume 391, Issue 20, Page 1947-1948, November 21, 2024.

This randomized clinical trial evaluates the effects of Helicobacter pylori stool antigen assessment plus fecal immunochemical testing (FIT), vs FIT alone, on gastric cancer incidence and mortality among adults in Taiwan.

To the Editor We read with interest the recent study that compared the fecal immunochemical test (FIT) positivity threshold vs multitarget stool RNA (mt-sRNA) testing for colorectal cancer screening. However, we have concerns regarding the study methodology and the capability of FIT to fully replace the mt-sRNA panel.

In Reply Our study adjusted the FIT cutoff to yield the same overall positivity rate as reported for the mt-sRNA test (17%) to enhance comparability of diagnostic performance of both tests. Below we address each of the 3 points made by Drs Yang and Ma.