scholarly journals Public Health: Prevention

2021 ◽  
Author(s):  
Azmawati Mohammed Nawi
Keyword(s):  
Screening Programme ◽  
Screening Program ◽  
Risk Group ◽  
High Risk Group ◽  
Screening Tools ◽  
Prevention Strategies ◽  
Low Socioeconomic ◽  
Standard Guideline ◽  
Incidence And Mortality ◽  
Colorectal Cancer Prevention

Nowadays, colorectal cancer prevention strategies play an essential role in reducing the incidence and mortality of the cases. A well-designed and establishment of the clinical pathway of screening programme needed in all country. Types of screening tools used may vary between the country with the use of FOBT and colonoscopy. The standard guideline related to screening programme such as for high-risk group should be emphasized more as compared to the low-risk group. The uptake of screening for CRC should be highlighted more as the program have showed a significantly reduction of the cases and mortality. The barrier of CRC screening uptake mainly due to poor awareness, discomfort, low physician recommendation, low socioeconomic and improper screening programme. Therefore others prevention strategies beside screening program such as health education and interactive intervention strategies need to be empower.

Comparison of SCORE and Reynolds cardiovascular risk assessments in a cohort without cardiovascular disease

2013 ◽  
Vol 154 (43) ◽  
pp. 1709-1712 ◽  
Author(s):  
Csaba Móczár
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Screening Program ◽  
Risk Group ◽  
Scoring Systems ◽  
High Risk Group ◽  
Risk Assessments ◽  
Gender And Age ◽  
Medium Risk

Introduction: Cardiovascular risk assessment may help in the identification of symptom-free subjects with high cardiovascular risk. Aim: The author studied the correlation between SCORE and Reynolds risk assessment systems based on data from the cardiovascular risk screening program carried out in subjects without cardiovascular disease. Method: Data obtained from 4462 subjects (1977 men and 2485 women; mean age, 47,4 years) were analysed. The comparison was based on risk categories of the SCORE system. Results: There was a strong correlation between the two scoring systems in the low risk population (under <2% SCORE risk the Spearman rho = 1, p < 0.001). A weak correlation was found in the medium risk group (between 3–4% the Spearman rho = 0.59–0.49, p < 0.001 and between 10–14% the Spearman rho = 0.42, ns.) and a stronger correlation in the high risk group (>15% the Spearmen rho = 0.8, p = 0.017). When correlations were analysed in gender and age categories, the weakest correlation was detected in medium risk women over 40 years of age. In cases when the differences between the two scoring systems were significant, the hsCRP levels were significantly higher (4.1 vs. 5.67 mg/L, p < 0.001). Conclusions: Introduction of hsCRP into cardiovascular risk assessments can refine the risk status of symptom-free subjects, especially among intermediate risk middle-age women (two-step risk assessment). Orv. Hetil., 154 (43), 1709–1712.

scholarly journals Identification of a Novel Glycolysis-Related Signature to Predict the Prognosis of Patients with Breast Cancer

2021 ◽  
Author(s):  
Menglin He ◽  
Cheng Hu ◽  
Jian Deng ◽  
Hui Ji ◽  
Weiqian Tian
Keyword(s):  
Breast Cancer ◽  
Risk Score ◽  
Cox Regression ◽  
Risk Group ◽  
Gene Signature ◽  
High Risk Group ◽  
Low Risk ◽  
Cox Regression Analysis ◽  
Expression Levels ◽  
Incidence And Mortality

Abstract Background: Breast cancer (BC) is a kind of cancer with high incidence and mortality in female. Conventional clinical characteristics are far from accurate to predict individual outcomes. Therefore, we aimed to develop a novel signature to predict the survival of patients with BC. Methods: We analyzed the data of a training cohort from the TCGA database and a validation cohort from GEO database. After the applications of GSEA and Cox regression analyses, a glycolysis-related signature for predicting the survival of patients with BC was developed. The signature contains AK3, CACNA1H, IL13RA1, NUP43, PGK1, and SDC1. Then, we constructed a risk score formula to classify the patients into high and low-risk groups based on the expression levels of six-gene in patients. The receiver operating characteristic (ROC) curve and the Kaplan-Meier curve were used to assess the predicted capacity of the model. Next, a nomogram was developed to predict the outcomes of patients with risk score and clinical features in 1, 3, and 5 years. We further used Human Protein Atlas (HPA) database to validate the expressions of the six biomarkers in tumor and sample tissues.Results: We constructed a six-gene signature to predict the outcomes of patients with BC. The patients in high-risk group showed poor prognosis than that in low-risk group. The AUC values were 0.719 and 0.702, showing that the prediction performance of the signature is acceptable. Additionally, Cox regression analysis revealed that these biomarkers could independently predict the prognosis of BC patients without being affected by clinical factors. The expression levels of all six biomarkers in BC tissues were higher than that in normal tissues except AK3. Conclusion: We developed a six-gene signature to predict the prognosis of patients with BC. Our signature has been proved to have the ability to make an accurate and obvious prediction and might be used to expand the prediction methods in clinical.

Informed decision making (IDM) for prostate cancer (PCa) screening in a high-risk population.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 112-112 ◽  
Author(s):  
Puneet Dhillon ◽  
Petros Grivas ◽  
Paola Raska ◽  
Devon Hickman ◽  
Paul Elson ◽  
...  
Keyword(s):  
Decision Making ◽  
Family History ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
High Risk Population ◽  
Group Setting ◽  
Incidence And Mortality ◽  
Post Test

112 Background: PCa incidence and mortality in African Americans (AA) is higher than in Caucasians. Health-education programs and culturally appropriate outreach to high-risk groups in accordance with American Cancer Society IDM guidelines can reduce disparities. Data show that it is hard to provide comprehensive unbiased education about screening to patients (pts). This study aims to examine whether IDM guidelines in a large high risk group setting can improve knowledge on PCa and screening decision, and whether such education program is overall beneficial to pts. Methods: Pts were included in one-day outreach event and were given a 15-question pre and post- test focused on standard informative educational PowerPoint and then were offered screening (PSA + DRE). Components of IDM were reviewed during this educational intervention. Demographics and family history was collected and UCSF 10-year mortality index was assessed to help IDM. Pre- and post- test number of correct answers were compared (Wilcoxon signed rank); pts were surveyed on their opinion on the program. The decision regarding screening after the intervention was tracked as well as the % of PCa diagnosed. Pts were tracked via an established navigation system to ensure follow up care. Results: 106 pts were included in the current analysis. Median number of correct answers at pre and post test was 8 and 11 (p < 0.001). Overall, 86% responded that they wanted screening. Of those, 92% were AA and 21% had family history of PCa; 21 pts had PSA only, 60 had PSA + DRE. 13 pts (16%) had abnormal PSA per NCCN guidelines, 5 (8%) had abnormal DRE. 5 PCa were biopsy-diagnosed, 4 had abnormal DRE + PSA; 1 had only abnormal DRE. Overall, 82% pts favored IDM before screening, 18% would prefer screening without IDM. 75% of all pts found the information “very helpful” in decision-making (within a 5-point Likert scale). Conclusions: Our education-based IDM led to significant improvement in knowledge about PCa screening. Most pts preferred education prior to screening. Our approach paired with the use of navigation program is feasible and was positively received by a large high risk group. Project is ongoing with more pts and follow up, and further validation is pending. Clinical trial information: NCT02419846.

scholarly journals A Case of Colorectal Cancer during Pregnancy: A Brief Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Sepideh Khodaverdi ◽  
Ali Kord Valeshabad ◽  
Maryam Khodaverdi
Keyword(s):  
Colorectal Cancer ◽  
Transverse Colon ◽  
Screening Program ◽  
Risk Group ◽  
High Risk Group ◽  
Planned Pregnancy ◽  
Cancer In Pregnancy ◽  
Advanced Stages ◽  
Partial Colectomy ◽  
Emergent Cesarean Section

The incidence of colorectal cancer (CRC) during pregnancy is so rare. Herein we present a case of colorectal cancer that was missed by pregnancy all over the pregnancy period. The patient was a 37-year-old woman (gravid 4, para 2) referred with the complaints of vaginal discharge and suspicious rupture of membrane (ROM). The patient was pale and the initial physical examination revealed dilation of two fingers, effacement about 30%. She underwent emergent cesarean section which showed adhesions surrounding the uterus, the bladder, and the abdominal wall. Forty days postoperatively, the patient presented with abdominal pain in the left upper quadrant (LUQ). Imaging confirmed a mass in LUQ. Partial colectomy of transverse colon (20 cm) was performed. Postoperative histopathologic study revealed a 7 * 6 * 5 cm mass in transverse colon compatible to stage IIa of the Duck class (T3, N0, Mx). Adjuvant chemotherapy was applied and the patient showed improvements during 7 months followup after surgery. Colorectal cancer in pregnancy is associated with diagnostic and therapeutic challenges which mostly lead to late diagnosis in advanced stages and poor prognosis. A targeted program to improve the general population knowledge and the establishment of a national consultant and screening program particularly for women with a planned pregnancy in the high risk group might be beneficial.

scholarly journals Modeling in Colorectal Cancer Screening: Assessing External and Predictive Validity of MISCAN-Colon Microsimulation Model Using NORCCAP Trial Results

2018 ◽  
Vol 38 (8) ◽  
pp. 917-929 ◽  
Author(s):  
Maaike Buskermolen ◽  
Andrea Gini ◽  
Steffie K. Naber ◽  
Esther Toes-Zoutendijk ◽  
Harry J. de Koning ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Predictive Validity ◽  
Screening Program ◽  
Task Force ◽  
Controlled Trial ◽  
Crc Screening ◽  
Hazard Ratios ◽  
Incidence And Mortality ◽  
Colorectal Cancer Prevention ◽  
Microsimulation Models

Background. Microsimulation models are increasingly being used to inform colorectal cancer (CRC) screening recommendations. MISCAN-Colon is an example of such a model, used to inform the Dutch CRC screening program and US Preventive Services Task Force guidelines. Assessing the validity of these models is essential to provide transparency regarding their performance. In this study, we tested the external and predictive validity of MISCAN-Colon. Methods. We validated MISCAN-Colon using the Norwegian Colorectal Cancer Prevention (NORCCAP) trial, a randomized controlled trial that examined the effectiveness of once-only flexible sigmoidoscopy (FS) screening. We simulated the study population and design of the NORCCAP trial in MISCAN-Colon and compared 10- to 12-year model-predicted hazard ratios (HRs) for overall and distal CRC incidence and mortality to those observed. In addition, we compared the numbers of screen-detected neoplasia. Finally, we predicted the trial’s future results to allow for the assessment of predictive validity. Results. MISCAN-Colon predicted an HR for overall CRC incidence (0.85), distal CRC incidence (0.82), overall CRC mortality (0.68), and distal CRC mortality (0.62). These were within the limits of the 95% confidence intervals of the NORCCAP trial results. Similar results were observed for the number of screen-detected cancers. The model significantly underestimated the number of screen-detected adenomas. Model-predicted HRs for CRC incidence and mortality up to 15- to 17-year follow-up were 0.84 and 0.72, respectively. Conclusion. Although the underestimation of screen-detected adenomas requires further investigation, MISCAN-Colon is able to make a valid replication of the CRC incidence and mortality reduction of an FS screening trial, which suggests that it can be considered a useful tool to support decision making on CRC screening.

Risk factors of colorectal cancer after screening colonoscopy

2021 ◽  
Vol 8 ◽  
pp. 25-29
Author(s):  
Paulina Wieszczy ◽  
Michał F. Kamiński ◽  
Jarosław Reguła
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Screening Program ◽  
Risk Group ◽  
High Risk Group ◽  
High Grade Dysplasia ◽  
Screening Colonoscopy ◽  
High Grade ◽  
Screening Programs

In the era of populational screening programs for colorectal cancer, evaluation of their quality and efficacy becomes an important issue. One of the main criteria taken into account when assessing the quality of a screening program is related to the risk of colorectal cancer developing in the period between the screening colonoscopy and the control examination. The objective of this article consists in presenting the results of the doctoral research carried out by dr. Paulina Wieszcza, a beneficient of the Polpharma Scientific Foundation scholarship. The objective of the doctoral dissertation was to investigate and discuss the relationship between the definition of risk groups as well as the quality of the study and the risk of colorectal cancer developing after the screening colonoscopy. The risk of colorectal cancer developing following adenomas being removed during the screening colonoscopy procedure was assessed using data obtained from the Colorectal Cancer Screening Program and the National Cancer Registry databases. The quality of the study was assessed on the basis of literature evidence regarding the adenoma detection rates (ADR). A total of 236.089 patients were included in colorectal cancer risk analyses, with at least one adenoma being detected in a screening study in 17.7% of cases. Over the follow-up period (median of 7 years, maximum duration of 14 years), colorectal cancer was detected in 439 patients. It was demonstrated that when the high-risk group was defined as patients presenting with adenomas ≥ 20 mm in diameter or high grade dysplasia rather than patients with ≥ 3 adenomas or adenomas ≥10 mm in diameter with high grade dysplasia or villous component (current definition), the number of patients requiring intensive surveillance can be reduced by 74% without any impact on the risk in the low-risk group. The literature review revealed a total of three studies which clearly showed that the risk of colorectal cancer significantly decreased with the increase in the endoscopist’s ADR. Restricting the high-risk group to patients with adenomas ≥ 20 mm in diameter or high-grade dysplasia facilitates optimized care being delivered to patients with a significantly increased risk of colorectal cancer. Scientific evidence is available for the important role of endoscopist’s ADR as the key parameter of the quality of colonoscopic examination.

scholarly journals Vaccination against Pneumococcal Infections of High-Risk People: Pharmacoeconomic Aspects

2020 ◽  
Vol 18 (6) ◽  
pp. 39-44
Author(s):  
A. V. Rudakova ◽  
S. M. Kharit ◽  
Yu. V. Lobzin
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
High Risk ◽  
Time Horizon ◽  
Risk Group ◽  
Pneumococcal Infection ◽  
High Risk Group ◽  
Cost Effectiveness Ratio ◽  
Pneumococcal Infections ◽  
Incidence And Mortality

Relevance. Vaccination of people at high risk against pneumococcal infection with a 13-valent conjugate vaccine (PCV13) can significantly reduce the corresponding incidence and mortality.The aim of the work was to assess the pharmacoeconomic aspects of vaccination of 65 year olds with a high risk of pneumococcal infection.Material and methods. The analysis was carried out by the method of Markov modeling from the position of the health care system. The time horizon is 5 and 15 years. It was assumed that vaccination is carried out with 1 dose of PCV13 and 1 dose of polysaccharide pneumococcal vaccine (PPV23) after 8 weeks with revaccination with 1 dose of PPV23 after 5 years. The costs of treatment of pneumococcal infections were calculated on the basis of the Compulsory medical insurance rates for St. Petersburg in 2019. The costs of vaccination were calculated on the basis of the price of auctions for the purchase of PCV13 and PPV23 for 2019.Results. For 15 years, vaccination of 100 ths people from the high risk group will prevent 1.7 ths cases of community-acquired pneumonia, 1.4 ths cases of invasive pneumococcal infections, and 397 cases of pneumococcal infections deaths. The cost-effectiveness ratio with a 15-year horizon is 161.4 ths rubles/quality-adjusted life year gained (QALY). Even if the time horizon is reduced to 5 years, vaccination can be considered as an economically highly effective intervention (cost-effectiveness ratio –571.9 ths rubles/QALY). At the same time, in 5 years, 37.6% of the money spent on vaccination will be returned to the budget of the health care system, and in 15 years – 49.3%.Conclusion. Vaccination of citizens of the Russian Federation from a high-risk group against pneumococcal infection can be considered as a socially and economically highly effective intervention that provides a significant reduction in the incidence and mortality caused by it.

Acromegaly and Obstructive Sleep Apnea: Identifying the High-Risk Group

2019 ◽  
Author(s):  
Xiaojun Zhan ◽  
Chandala Chitguppi ◽  
Ethan Berman ◽  
Gurston Nyquist ◽  
Tomas Garzon-Muvdi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Obstructive Sleep
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