The Impact of Population-Based Screening Studies on Hemochromatosis Screening Practices

Objectives  

To determine if community population screening studies for hemochromatosis affected HFE genetic screening practices in non-study populations.     

Costs and outcomes of Lynch syndrome screening in the Australian colorectal cancer population

Background and Aim

Individuals with Lynch syndrome (LS) are at increased risk of LS‐related cancers including colorectal cancer (CRC). CRC tumor screening for mismatch repair (MMR) deficiency is recommended in Australia to identify LS, although its cost‐effectiveness has not been assessed. We aim to determine the cost‐effectiveness of screening individuals with CRC for LS at different age‐at‐diagnosis thresholds.

Methods

We developed a decision analysis model to estimate yield and costs of LS screening. Age‐specific probabilities of LS diagnosis were based on Australian data. Two CRC tumor screening pathways were assessed (MMR immunohistochemistry followed by MLH1 methylation (MLH1‐Pathway) or BRAF V600E testing (BRAF‐Pathway) if MLH1 expression was lost) for four age‐at‐diagnosis thresholds—screening < 50, screening < 60, screening < 70, and universal screening.

Results

Per 1000 CRC cases, screening < 50 identified 5.2 LS cases and cost $A7041 per case detected in the MLH1‐Pathway. Screening < 60 increased detection by 1.5 cases for an incremental cost of $A25 177 per additional case detected. Screening < 70 detected 1.6 additional cases at an incremental cost of $A40 278 per additional case detected. Compared with screening < 70, universal screening detected no additional LS cases but cost $A158 724 extra. The BRAF‐Pathway identified the same number of LS cases for higher costs.

Conclusions

The MLH1‐Pathway is more cost‐effective than BRAF‐Pathway for all age‐at‐diagnosis thresholds. MMR immunohistochemistry tumor screening in individuals diagnosed with CRC aged < 70 years resulted in higher LS case detection at a reasonable cost. Further research into the yield of LS screening in CRC patients ≥ 70 years is needed to determine if universal screening is justified.     

Screening for gestational diabetes mellitus: cost–utility of different screening strategies based on a woman’s individual risk of disease

Aims/hypothesis  

The cost-effectiveness of eight strategies for screening for gestational diabetes (including no screening) was estimated with respect to the level of individual patient risk.     

Improving the Follow-Up of Positive Hemoccult Screening Tests: An Electronic Intervention

BACKGROUND  

Four population-based studies of screening for CRC with fecal occult blood testing (FOBT) have shown that mortality can be significantly reduced. However, nearly half of all positive screening tests are not appropriately evaluated.     

Fever screening during the influenza (H1N1-2009) pandemic at Narita International Airport,Japan

Background  

Entry screening tends to start with a search for febrile international passengers, and infrared thermoscanners have been employed for fever screening in Japan. We aimed to retrospectively assess the feasibility of detecting influenza cases based on fever screening as a sole measure.     

Colon Capsule Endoscopy compared to Conventional Colonoscopy under routine screening conditions

Background  

Colonoscopy (CSPY) for colorectal cancer screening has several limitations. Colon Capsule Endoscopy (PillCam Colon, CCE) was compared to CSPY under routine screening conditions.     

Take the sex out of STI screening! Views of young women on implementing chlamydia screening in General Practice

Background  

Australia is developing a chlamydia screening program. This study aimed to determine the attitudes of young women to the introduction of chlamydia screening in Australian General Practice.     

Yield of Practice-Based Depression Screening In VA Primary Care Settings

Background  

Many patients who should be treated for depression are missed without effective routine screening in primary care (PC) settings. Yearly depression screening by PC staff is mandated in the VA, yet little is known about the expected yield from such screening when administered on a practice-wide basis.     

Plans to Stop Cancer Screening Tests Among Adults Who Recently Considered Screening

Objective  

We sought to estimate what proportion of adults plan to stop cancer screening tests among adults who recently considered screening and to explore factors associated with these screening plans.     

"Pee-in-a-Pot": acceptability and uptake of on-site chlamydia screening in a student population in the Republic of Ireland

Background  

The aim of the study was to explore the acceptability and uptake of on-campus screening using a youth friendly approach in two Third Level higher education institutions (HEIs). This study is part of wider research exploring the optimal setting for chlamydia screening in Ireland.     

Body Mass Index as a Predictor of Colorectal Neoplasia in Ethnically Diverse Screening Population

Background  

Recent guidelines from the American College of Gastroenterology for screening for colorectal cancer have included obesity as an important risk factor. The recommendation for screening obese people at earlier age was tempered by the need for more data regarding obesity and colorectal neoplasia.     

Depression and Anxiety Diagnoses Are Not Associated with Delayed Resolution of Abnormal Mammograms and Pap Tests Among Vulnerable Women

Background  

Delays in care after abnormal cancer screening contribute to disparities in cancer outcomes. Women with psychiatric disorders are less likely to receive cancer screening and may also have delays in diagnostic resolution after an abnormal screening test.     

Non-invasive Testing for <Emphasis Type="Italic">Helicobacter pylori</Emphasis> in Patients Hospitalized with Peptic Ulcer Hemorrhage: A Cost-Effectiveness Analysis

Purpose  

Guidelines recommend routine invasive screening for Helicobacter pylori in patients with peptic ulcer hemorrhage (PUH). However, compliance with screening remains suboptimal. The aim of this study was to determine if a simplified approach based on noninvasive screening is cost effective in PUH.     

Fecal Occult Blood Testing Beliefs and Practices of U.S. Primary Care Physicians: Serious Deviations from Evidence-Based Recommendations

Background  

Fecal occult blood testing (FOBT) is an important option for colorectal cancer screening that should be available in order to achieve high population screening coverage. However, results from a national survey of clinical practice in 1999–2000 indicated that many primary care physicians used inadequate methods to implement FOBT screening and follow-up.     

Quality Concerns with Routine Alcohol Screening in VA Clinical Settings

BACKGROUND  

Alcohol screening questionnaires have typically been validated when self- or researcher-administered. Little is known about the performance of alcohol screening questionnaires administered in clinical settings.     

Hepatitis B and Hepatocellular Carcinoma Screening Among Asian Americans: Survey of Safety Net Healthcare Providers

Background  

Physician patterns of screening for hepatitis B (HBV) and hepatocellular carcinoma (HCC) among Asian Americans are not well described.     

Presence and Correlates of Racial Disparities in Adherence to Colorectal Cancer Screening Guidelines

Objectives  

We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS).     

Atherosclerosis Screening by Noninvasive Imaging for Cardiovascular Prevention: A Systematic Review

BACKGROUND  

Noninvasive imaging of atherosclerosis is being increasingly used in clinical practice, with some experts recommending to screen all healthy adults for atherosclerosis and some jurisdictions mandating insurance coverage for atherosclerosis screening. Data on the impact of such screening have not been systematically synthesized.     

Colorectal Cancer Testing in the National Veterans Health Administration

Background  

Colorectal cancer (CRC) screening is a priority for the Veteran’s Health Administration (VHA). Optimizing fecal occult blood testing (FOBT) is integral to CRC screening in health care systems.     

Improving the Quality of Colorectal Cancer Screening: Assessment of Familial Risk

Background  

Accuracy of familial risk assessment by endoscopists in determining colonoscopic screening and surveillance intervals is unknown.