A population survey on mass screening program for gastric cancer. Part 2. Why don't they receive mass screening examination?

The attitude of non-examined residents to a mass screening program for gastric cancer has been surveyed by a self-administered questionnaire among 3660 residents in a small town near Kitakyushu City. Among 1159 subjects who had not received any type of examination during the past 3 years, the answers of 638 subjects who completed the questionnaire were analyzed in this study. Reasons for not being examined were classified into 4 types; "unnecessary", "rejected", "inconvenient" and "others". The most frequent reason for not taking part in the screening program was "inconvenient" which means that there were some difficulties for them to participate in the program even if they wanted to. This reason was followed by "unnecessary" and "rejected". "Inconvenient" was the main reason for not being examined among people in their forties and fifties and/or among those who have jobs. Among elderly people, "unnecessary" had the highest frequency. "Rejected" was the least important reason in all age groups. In each age group "rejected" was found more frequently among females than males. As the type of reason for not being examined was different among groups, it is essential to work out different countermeasures for each group in order to raise the participating rate.     

云南某县农村居民对国家免费孕前优生健康检查的认知研究

目的 调查云南省某县农村居民对国家免费孕前优先健康检查项目的认知,为在卫生、计生合并的新形势下更好地开展国家免费孕前优生健康检查服务提出相应建议。方法 采用自行设计的调查问卷,对当地583名农村居民进行面对面问卷调查,调查其对国家免费孕前优生健康检查项目的知晓情况、知晓的途径、意愿等。结果该县农村居民对国家免费孕前优生健康检查项目的知晓率为50%,不同年龄、距离县城远近不同的人群对国家免费孕前优生健康检查项目的知晓率差异有统计学意义(P<0.05),随着年龄增长,知晓率呈上升趋势,距离县城越远,知晓率越高。调查对象对项目的接受程度很高,93.7%的居民愿意接受检查。结论 当地只有一半的居民知晓国家免费孕前优生健康检查项目,不同年龄和乡镇的人群在知晓率上存在差异,应加大宣传力度,扩宽信息传播途径,提高人群的知晓率,从而提高对国家免费孕前优生健康检查服务的利用。     

我国城市地区人群癌症筛查需求调查分析

目的 了解未参加过城市癌症早诊早治项目及其他国家级癌症筛查项目的城市社区居民对癌症筛查服务的接受意愿及对服务模式细化需求,从筛查潜在服务需求方的角度探索癌症筛查工作可持续性的影响要素。方法 基于城市癌症早诊早治项目的16个省份现场,采用方便抽样对当地40～69岁居民开展问卷调查,内容包括筛查服务需求意向等。结果 最终完成合格访谈16 394份,调查对象年龄（53.8±8.0）岁,男性占44.6%。若不考虑费用等因素,4 831名（29.5%）居民对癌症筛查服务没有需求,常见原因包括要等身体出现异常后才行动（61.8%）、所在单位已提供类似体检（36.8%）、自己不先做风险评估而直接去做筛查（33.0%）等。10 795名（65.8%）居民对癌症筛查服务有需求,但对筛查机构类型选择倾向不同：43.7%希望提供筛查的机构是综合性医院,36.5%希望是肿瘤专科医院;居民对于机构级别选择也有差异：61.4%的居民希望提供筛查的机构级别越高越好,36.4%则认为机构达到一定级别即可。关于筛查流程,61.5%未接收过筛查的居民认同“先问卷评估阳性后再临床检查”的模式。结论 大多数居民对癌症筛查服务有需求且倾向筛查机构级别越高越好。应普及癌症筛查知识宣传,并合理引导居民对筛查机构类型及级别的选择期望,建议加强基层筛查能力建设,合理分流居民对筛查机构的选择意愿。     

大肠癌序贯筛检方案在人群中应用的前瞻性评估

目的 建立并验证大肠癌序贯筛检方案在我国人群中应用的效果。方法 以大肠癌高发区嘉善县１９８９年３０岁及以上者作为目标人群,采用随机分组空白对照研究设计,以免疫法粪便潜血试验结合个体危险度隶属度函数（ＡＤ值）为初筛手段,纤维肠为复筛的序贯筛检方案。结果 经筛检后筛检人群与对照人群的大肠癌８年累积发病率分别为３．９５‰（９５％ＣＩ为３．８１～４．１０）和４．０１‰（９５％ＣＩ为３．８６～４．１６）,两     

上海市社区居民大肠癌筛查分析

目的了解上海社区市民大肠癌筛查情况。方法对1000名符合筛查条件的居民由社区卫生服务中心使用《上海市社区居民大肠癌筛查危险度评估表》开展大肠癌患病风险评估,并进行大便隐血试验（FOBT）,对问卷结果和FOBT结果进行分析。结果 1000名居民中,女性560人,占总数56%;男性440人,占总数44%;评价高危险度的人占总样本的11.6%,其中男性55人,女性61人;FOBT检查为阳性的总样本的占2.8%;在这些人中患慢性疾病以及有一级亲属遗传史的比例明显高于普通人,男女差异无统计学意义,但患病可能性却与年龄呈现高相关;慢性便秘史、黏液血便史以及直系家庭癌症史与FOBT检验结果差异有统计学意义,OR值分别为4.38（95%CI：1.71-11.21,P〈0.05）,8.86（95%CI：2.37-32.96,P〈0.05）和4.89（95%CI：1.60-14.91,P〈0.05）。结论即使在危险评估中显示阴性的人群,仍有FOBT检查为阳性的可能性,大肠癌筛查工作中不能掉以轻心,同时对于检查为阴性的人群同样需要进行相关的预防和健康教育干预。     

Participation of regional inhabitants in cancer screening

As part of the strategic planning for increasing participation by community residents in cancer screening, a survey about life style and attitudes toward cancer screening was carried out in Samukawa town, Kanagawa Prefecture. Subjects were males 40 years old or over, and females 30 years old or over selected by random sampling from residents. Number of subjects was 1,916 (822 males, 1,094 females). Self administered anonymous questionnaires were sent and returned by mail. The response rate was 73%. The results were as follows: (1) The reported participation rates for cancer screening under "the Health and Medical Services Law for the Aged" did not reflect the actual participation rate of residents. (2) The major reason for not participation in screening was lack of interest in cancer prevention. (3) Socio-economic status of regular participants in screening was different from persons who did not participate. (4) Persons who did not participate in screening were more passive with regard to obtaining knowledge of cancer than regular participants. (5) Results of this study show that cancer prevention education at various levels such as by clinical offices, TV and radio programs, and newspapers may be effective. In order to increase participation in screening programs, health education that considers the life style characteristics of persons who do not participate in the screening programs is vitally important.     

Effects of news events on response to a breast cancer screening program.

An opportunity to examine the effects of significant, widely reported events on participation in a breast cancer screening program was presented when countrywide public attention was called to breast cancer by reports of the breast surgery of the wives of President and Vice President of United States. These events occurred in September and October 1974 while a breast cancer screening program was underway in the health Insurance Plan of Greater New York. The research design of this program permitted measurements to be made of the participation of the plan''s members in the screening before, during, and after these famous mastectomies and of the participants'' characteristics during different periods of the research program. In late 1974, when there was great mass media emphasis on breast cancer, participation rates in the breast cancer screening program increased significantly. In the study periods immediately following, however, participation rates declined to previous levels. The increase in Participation rates in late 1974 was fairly uniform among all demographic groups, whether classified by age, education, income, race, or religion. In addition to increases in the participation rate associated with the events of late 1974, there was also an increased tendency among women who were screened to respond readily to mailed invitations to appear for screenings. This increase insensitivity to efforts to win their participation was more pronounced among those groups that this study and other studies have shown are more likely to participate in preventive health programs and to respond more readily to request to participate.     

Effect on attendance at breast cancer screening of adding a self administered questionnaire to the usual invitation to breast screening in southern England

STUDY OBJECTIVE: The primary aim of the research described in this paper was to ascertain whether inclusion of a self administered questionnaire with the usual invitation to routine breast screening affected screening uptake. Secondary aims included establishing appropriate questionnaire distribution and collection methods within the framework of the National Health Service Breast Screening Programme and optimisation of questionnaire design. DESIGN: Randomised study. SETTING: Oxfordshire and West of London Breast Screening Units. PARTICIPANTS/METHODS: 6400 women invited for routine screening mammography were individually randomised to receive either the usual breast screening invitation alone, or to receive the usual invitation accompanied by a self administered questionnaire, to be returned at the time of screening. Participants were then followed up and attendance rates at screening were compared between groups. MAIN RESULTS: Screening attendance rates were similar in women who did and did not receive a questionnaire (71% in each group). Of those who were sent a questionnaire and attended for screening, 77% returned a completed questionnaire. Screening uptake was not affected by the way in which the questionnaire was returned or by whether or not personal details and signed permission for follow up were requested. CONCLUSIONS: The inclusion of a self administered questionnaire accompanying the invitation to breast screening did not adversely affect screening uptake. A high proportion of women completed the questionnaire.

 

     

Screening for sexually transmitted infections among economically disadvantaged youth in a national job training program.

PURPOSE: To evaluate results of screening for syphilis, gonorrhea, and chlamydia among youth in a federally funded job training program. METHODS: Data were evaluated from medical records of 12,881 randomly selected students in 54 U.S. job training centers during 1996. The intake medical evaluation includes serologic testing for syphilis. The policy was for females to receive a pelvic examination with gonorrhea and chlamydia testing and for males to be first screened with a urine leukocyte esterase (LE) assay, with follow-up gonorrhea and chlamydia testing for those with positive LE results. RESULTS: Adjusting for our sampling strategy, among females, an estimated 9.2% had a positive chlamydia test, 2.7% a positive gonorrhea test, and 0.4% had a positive syphilis test. Gonorrhea and chlamydia rates among females were highest in African-American followed by Native American students. Chlamydia infection was most common in younger women < or = 17 years of age. An estimated 0.1% of males had a positive syphilis test, and 4.8% of males a positive urine LE test. Of 103 LE-positive males tested for gonorrhea and chlamydia, only 27 (26%) had a positive test for one of these STDs. CONCLUSIONS: Our study supports routine screening of adolescents for gonorrhea and chlamydia, including those youth from socioeconomically disadvantaged backgrounds. Because individuals from such backgrounds may not regularly interact with traditional clinical health care systems, screening and treatment should be offered in alternative settings, such as the job training program described in this study.     

Prevalence of appropriate colorectal cancer screening and preferences for receiving screening advice among people attending outpatient clinics

Objective: To examine among people attending outpatient clinics aged 50–74 at average risk of colorectal cancer (CRC): 1) The proportion who report: a) faecal occult blood test (FOBT) within the past two years; and b) colonoscopy within the past five years, including the reasons for undergoing colonoscopy; 2) characteristics associated with under‐screening; 3) For those who are under‐screened, the proportion who are: a) willing to receive help and the acceptability of different methods of receiving help, and; b) unwilling to receive help and reasons for this. Methods: Cross‐sectional survey of 197 participants attending a major regional hospital in New South Wales, Australia. Multivariable logistic regression was used to determine correlates of under‐screening. Results: A total of 59% reported either FOBT in the past two years or colonoscopy in the past five years. Of those reporting colonoscopy in the past five years, 21% were potentially over‐screened. Males were more likely than females to be under‐screened. Of those under‐screened (41%), fewer than half were willing to receive screening advice. Conclusions and implications for public health: A significant proportion of people attending outpatient clinics are under‐screened for CRC, with some people also over‐screened. There is a need to explore strategies to overcome both under‐ and over‐screening.     

Mass screening for detection of infants with hearing impairment. I. Methods and process of the mass screening examination for hearing]

A mass screening program to detect infants with hearing impairment was conducted at the Sapporo Toyohira Health Center in Hokkaido. Between April 1988 and March 1990, 5,676 infants were screened by a questionnaire at the time of the 4-month health examination. Out of the 5,080 cases who could be followed, nine infants underwent thorough otolaryngological examinations, and among the nine infants three cases with hearing impairment were detected. The prevalence rate was, therefore, one case out of 1,693 infants. Although false positive cases amounted to about 5% of the initial infant population, true positive cases were confirmed out of the initially screened positive cases at 7 or 10 months of age through other questionnaires and through behavioral hearing tests using a bell. No false negative cases were found. Inclusion of this mass screening system in the routine child health program is recommended.     

Female employee participation in a worksite mammography screening program.

We conducted a survey of 1,184 women 35 years of age or older who were employees of a company in Los Angeles County, California, to determine why some women participated in a worksite mammography screening program whereas others did not. Of the 111 who accepted a mammogram, 90 responded to the survey; of the 1,073 who declined mammography, 620 responded. The women were predominantly white, were well educated, and had health insurance. Of the 111 women who received mammograms, one was diagnosed with carcinoma. Seventy-three percent of the respondents to the survey 40 years of age or older who declined mammograms had already fulfilled American Cancer Society (ACS) guidelines for mammography screening at the time of the program. Women who accepted a mammogram were more likely to have had at least one previous mammogram than were women who had not met ACS guidelines yet who declined screening. We conclude that many female employees who are white, are well educated, and have health insurance may not participate in a worksite mammography screening program because they have been screened elsewhere. Companies providing worksite mammography screening should target education to women who have not met ACS guidelines, especially those who have never had a mammogram.     

Infrequency of sexually transmitted disease screening among sexually experienced U.S. female adolescents

CONTEXT: Since 1993, the Centers for Disease Control and Prevention and professional medical organizations have recommended that all sexually experienced female adolescents receive annual screening for Chlamydia trachomatis. Whether adolescents receive this care is largely unknown. METHODS: Reports of receipt of testing or treatment for a sexually transmitted disease (STD) in the past year, as well as sites of care, were obtained from 3,987 sexually experienced females in grades 7-12 who participated in Wave 1 of the National Longitudinal Study of Adolescent Health, conducted in 1995. Logistic regression was used to determine predictors of reporting care. RESULTS: Eighteen percent of all participants reported having received STD services in the past year. Of those who reported having had a routine physical examination in the past year, 22% reported receipt of STD services. The proportion reporting STD care increased linearly with age from 9% of 12-13-year-olds to 25% of those 19 or older. In adjusted analyses, the odds of reporting testing or treatment were elevated among participants who had had a physical examination in the past year (odds ratio, 2.1), those with Medicaid or Medicare insurance (1.9), black women (1.5) and older adolescents (1.2). Adolescents most often reported having received STD care at a community health center (44%) or a private physician's office (31%). CONCLUSIONS: Continued inadequate screening may contribute to persisting high prevalence of chlamydia infection among adolescents. Future research is needed to determine whether the proportions of adolescents receiving recommended STD screening have increased over time.     

东营区≥45岁人群结直肠癌初筛结果分析及肠镜顺应性调查

目的 对东营区≥45岁常住居民进行结直肠癌筛查,并探讨初筛阳性者肠镜顺应性及其影响因素,为提高居民结直肠癌筛查工作提供科学依据。方法 采用方便抽样方法选择辖区内2个镇和3个街道的社区卫生服务中心作为结直肠癌筛查志愿者招募点招募≥45岁常住居民为研究对象开展结直肠癌筛查及问卷调查,对初筛阳性者进一步进行肠镜检查,采用描述性分析方法对居民结直肠筛查结果及肠镜顺应性进行分析,并对其影响因素进行单、多因素分析。结果 本研究共纳入1 201人进行分析,男662人,女539人,45~59岁372人,60~69岁495人,70~79岁334人。初筛阳性人数总计371例,其中危险因素初筛阳性154例,FOBT阳性298例,危险因素和FOBT阳性双阳性者81例,初筛阳性率为30.89%。男性（OR=3.177）、黏液血便史（OR=7.683）以及肠道息肉病史（OR=5.008）为结直肠癌初筛阳性的危险因素。371例初筛阳性者中121例完成结肠镜检查,结肠镜检查顺应率为32.61%。性别（OR=2.776）、年龄（OR=0.511、0.433）、婚姻状况（OR=4.267）、文化程度（OR=2.782、3.916）、医疗保险（OR=2.743）是结直肠癌初筛阳性者结肠镜检查顺应性的影响因素。结论 东营市东营区结直肠癌初筛阳性率较高,应加强对存在黏液血便史以及肠道息肉病史男性个体人群的结直肠癌筛查。居民结直肠镜检查顺应性较低,尤其是60岁及以上、非在婚、文化程度较低、无医保的女性个体,可特异性强化对该群体个体的健康教育,提高其结直肠镜顺应性。     

A survey on urinary incontinence among middle aged and older people

OBJECTIVE: Studies in Western countries have revealed that urinary incontinence, non-intentional loss of urine, is a common condition in aged populations, and even younger individuals may suffer from urinary incontinence. However, in Japan, the evidence for community residents on this topic is limited. The aim of this study was to estimate the prevalence of urinary incontinence among middle aged using a structured questionnaire and older people and to provide useful information including frequency, voided volume, relation to parity as a risk factor and persons to consult for this condition. METHODS: The study subjects consisted of 985 residents, 350 males (mean age 62.5 +/- 11.2 years)and 635 females (64.3 +/- 11.4), who participated in annual health check-ups and answered a self-reported questionnaire on urinary incontinence. The questionnaire included questions on frequency, voided volume, condition-specific QOL score, self-diagnostic item (above four from Scored International Consultation on Incontinence Questionnaire-Short Form Japanese version), person to consult for this condition and parity (only for females). RESULTS: The proportion of those with urinary incontinence was 11.4% in males and 34.5% in females, and the proportion increased with age (P for trend <0.01). In females, the proportion was high, even in their forties (30.4%). In this study, parity was associated with urinary incontinence: compared to females with no childbirth experience, those giving birth to 4 or more children showed an odds ratio of 4.26 (95% CI: 1.13-16.10). In females, an increase in frequency of urinary incontinence negatively affected the QOL. When asked who they would consult, the majority of males answered either a medical institution (54.2%) or family (34.0%). In females, 39.6% reported a medical institution, 22.6% reported family, 16.5% reported no one, 10.6% reported health nurses other than in medical institutions and 9.5% reported friends. CONCLUSIONS: The study results showed that urinary incontinence is a common condition in this population. Particularly, a large proportion of females suffer from this condition, even in their forties. The study also revealed that urinary incontinence might negatively affect the QOL and that there are some individuals who do not consult (or intend to consult) anyone about their problem. This information might be useful for planning health policy on the topic in the future.     

Gastric cancer screening programme in Japan: how to improve its implementation in the community.

STUDY OBJECTIVE--The aim was to investigate which factors in the operating procedure of the gastric cancer screening programme carried out by local Japanese municipalities affect the participation rate. DESIGN--This was a cross-sectional study. Data were mainly obtained by questionnaire completed by the person in charge of health in each municipal council. Information was sought on screening motivation, screening programme organisation, payment for the examination, the scheduling and filing system, and community manpower. Data on the participation levels were obtained from the health data service system published by the Ministry of Health and Welfare in 1991. SETTING--All of Japan's 3268 local municipalities were sent the questionnaire. Altogether 2795 municipalities responded (85.5% response rate). SUBJECTS--The local municipality was regarded as the study unit. The municipalities were classified into two groups--small municipalities, those with < 10,000 population aged 40 years and over, and large municipalities, those with > 10,000 population aged 40 years and over. MAIN RESULTS--The participation rate in the screening programme varied according to the municipality population size and age. Small municipalities had higher participation rates. The rate in people aged 60-69 years was highest and that in those aged 70+ years was lowest. The participation rate was positively associated with factors related to the operating procedure before (for example, giving information about screening), during (for example, assisting the screening staff), and after (setting up the relevant filing systems) the gastric examination. CONCLUSIONS--The results suggest that personal motivation, manpower in local residents' organisations, scheduling time for convenience, and a basic filing system for individual data, especially for people who have not participated in the programme for a few years, are important in increasing participation.     

中老年居民骨质疏松高危人群筛查方法研究

目的探索适合江苏省中老年居民骨质疏松高危人群的筛查方法。方法 2013年采用多阶段分层随机抽样方法,在江苏省内抽取40~69岁常住居民,利用国际骨质疏松基金会(IOF)1分钟风险评估调查问卷和桡骨远端超声骨密度检查,进行骨质疏松高危人群筛查。结果有效调查5 537人,有效率为98.8%。骨质疏松高危人群检出率:1分钟问卷风险评估法为44.0%,桡骨远端超声骨密度检查法为42.4%,差异有统计学意义(χ2=17.53,P0.001)。2种方法筛查结果一致性较差,Kappa系数及其95%可信区间为0.048(0.022~0.074)。随着年龄的增加,骨质疏松高危人群检出率呈上升趋势,且存在地区差异(P0.05)。结论 1分钟问卷风险评估和桡骨远端超声骨密度检查法均可作为社区中老年人群骨质疏松筛查工具,但一致性较差,实际工作中建议联合运用,以便互相补充和验证。     

2014-2019年北京城市癌症早诊早治项目人群肺癌筛查结果分析

目的分析2014—2019年北京城市癌症早诊早治项目肺癌筛查结果。方法基于国家城市癌症早诊早治项目,以北京市东城、西城、朝阳、海淀、丰台和石景山区的80个筛查项目实施街道为研究现场,采用整群抽样的方法,将街道/居委会所辖的88044名40~69岁北京市户籍居民纳入研究。对问卷初筛肺癌阳性的人群,采用低剂量螺旋CT(LDCT)进行筛查,同时每年通过主动和被动随访相结合的方式对募集的全部人群进行随访,获取其健康结局信息(确诊肺癌/未确诊肺癌)。计算不同特征人群经问卷初筛的肺癌高危率、LDCT筛查参与率、肺部阳性结节检出率、肺癌发病密度(率)、累积发病率以及早诊率;采用Cox比例回归模型计算不同筛查模式下肺癌发生的风险。结果88044名研究对象年龄为(57.4±7.4)岁,其中男性占38.76%(34128例)。问卷初筛肺癌高危率为23.14%,临床筛查参与率为52.26%,肺部阳性结节检出率为10.99%。平均随访3年后,40~69岁男性肺癌发病密度为172.82/10万人年,女性肺癌发病密度为133.52/10万人年;肺癌发生风险随年龄升高而上升(P_趋势<0.001)。问卷初筛阳性人群发病密度为259.22/10万人年;与问卷初筛阴性人群相比,问卷初筛阳性人群肺癌发病风险HR(95%CI)值为2.27(1.83~2.81)。接受LDCT筛查且被判定为阳性结节人群的肺癌发病密度为1825.03/10万人年,3年内的累积发病率为4615.38/10万;与结节阴性人群相比,结节阳性人群肺癌发病风险HR(95%CI)值为13.80(8.91~21.36)。接受LDCT筛查者三年内确诊肺癌的早诊率为70.21%,高于未接受临床筛查者确诊肺癌时的早期比例(45.45%,P=0.016)。结论北京城市癌症早诊早治项目肺癌临床筛查依从性较好;在高危人群中应用LDCT筛查肺癌,能够提高肺癌患者检出率和早诊率。     

Health education to increase screening for cervical cancer among Lumbee Indian women in North Carolina.

Although age-adjusted mortality rates from cancer among Native-Americans are generally lower than for the US population as a whole, cervical cancer mortality rates are higher. This report presents results from a National Cancer Institute-funded health education program conducted among the Lumbee tribe in North Carolina that was designed to increase the proportion of women, age 18 and older, who receive Pap smears to screen for cervical cancer. The Solomon Four Group research design was used for this project. Participants were selected at random from the enrollment records of the Lumbee tribe and data collection was carried out during face-to-face interviews. The health education program was provided one-on-one in women's homes by a trained lay health educator and included verbal, print and videotape information. A total of 979 women were enrolled in the study, and 125 were lost to follow-up between the pre-test and post-test. Women who received the education program were found to be more likely to have knowledge of the Pap smear and to report a Pap smear in the past year at the post-test than those in the control group, regardless of whether they received the pre-test interview, P < 0.05. Women most likely to respond to the education program were also likely to have reported that they receive an annual physical examination. Women with better knowledge of the Pap smear tended to have more education, higher income and greater identification with Native-American culture than those with less knowledge. We conclude that the health education program was associated with greater knowledge about cervical cancer prevention and higher proportions of Lumbee women obtaining Pap smears in the past year.     

Neonatal screening for prenatal alcohol exposure: Assessment of voluntary maternal participation in an open meconium screening program

Meconium fatty acid ethyl esters (FAEEs) are validated biomarkers of fetal alcohol exposure. Meconium FAEE testing can potentially be used as a screen by health-care professionals to identify neonates at-risk for Fetal Alcohol Spectrum Disorder, thereby permitting diagnostic follow-up of these children and early intervention in those who develop disabilities. The purpose of this study was to assess whether women would willingly partake in a screening program of this nature. This was determined by launching a pilot screening program for prenatal alcohol exposure in a high-risk obstetric unit previously shown to have a high prevalence of FAEE-positive meconium via anonymous meconium testing. The program involved voluntary testing of meconium for FAEEs and long-term developmental follow-up of positive cases through an existing public health program. The participation rate in the screening program was significantly lower than when testing was conducted anonymously (78% vs. 95%, respectively; p < 0.05), and the positivity rate was 3% in contrast to 30% observed under anonymous conditions (p < 0.001). These low rates suggest that the majority of mothers who consumed alcohol in pregnancy refused to participate. We conclude that despite the potential benefits of such screening programs, maternal unwillingness to consent, likely due to fear, embarrassment, and guilt, may limit the effectiveness of meconium testing for population-based open screening, highlighting the need for public education and social marketing efforts for such programs to be of benefit.