Screening tests and evidence

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  • Document introduction of content: Introduction, methodology and literature review; epidemiology of colorectal cancer; screening tests and evidence - Stool tests, occult blood, and DNA; screening tests and evidence - Endoscopy and CT colonography, cost-Effectiveness of CRC screening; cascades – Tooling up for screening, where to get help, useful web sites, guidelines and selected references.

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  • Harrison's Internal Medicine Chapter 4. Screening and Prevention of Disease Screening and Prevention of Disease: Introduction A primary goal of health care is to prevent disease or to detect it early enough that intervention will be more effective. Strategies for disease screening and prevention are driven by evidence that testing and intervention are practical and effective. Currently most screening tests are readily available and inexpensive. Examples include tests that are biochemical (e.g., cholesterol, glucose), physiologic (e.g., blood pressure, growth curves), radiologic (e.g.

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  • Screening is performed earlier and more frequently when there is a strong family history. Randomized, controlled trials have documented that fecal occult blood testing (FOBT) confers a 15 to 30% reduction in colon cancer mortality. Although randomized trials have not been performed for sigmoidoscopy or colonoscopy, well-designed case-control studies suggest similar or greater efficacy relative to FOBT. b In the future, Pap smear frequency may be influenced by HPV testing and the HPV vaccine.

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  • Since 1995, the WHO Regional Office for Europe has been committed to reducing the public health hazards associated with prisons and protecting and promoting health in prisons. Regional Office reports such as the 2007 Health in prisons: a WHO guide to the essentials in prison health have combined the latest research and analysis from experts in the field and have raised the profile of prison health issues.

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  • Methods of Measuring Health Benefits It is not practical to perform all possible screening procedures. For example, screening for laryngeal cancer in smokers is not currently recommended. It is necessary to examine the strength of evidence in favor of screening measures relative to the cost and risk of false-positive tests.

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  • People are motivated to use ART to have a genetically related child, and circumstances vary widely: couples in which one person is infertile; 4 lesbian couples; gay male couples; a couple in which one or both partners are transgender; single straight, queer and trans women and men; women undergoing chemotherapy; women who want to delay childbearing; and couples who want to use pre-implantation genetic diagnosis (PGD) to screen against disability or for sex.

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  • Cancer registries can play an important role in the evaluation and mon- itoring of screening programmes aimed at detecting pre-invasive condi- tions. Cancer registration data have been used in routine-data-based stud- ies to examine trends in disease rates in relation to screening frequencies within a population and to compare disease rates between different popu- lations with the coverage offered by their screening programmes (see Section 16.3.1).

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  • Document "Constipation: A global perspective" introduction of content: Cascades—a resource-sensitive approach, pathogenesis and risk factors, associated conditions and medication, diagnostic criteria for functional constipation, patient evaluation,... Invite you to consult.

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  • Investigators continue to evaluate screening technologies in meta-analyses, randomized clinical trials, and cervical cancer prevention programs. The new evidence adds support for the use of HPV DNA testing as the primary technology for cervical cancer screening, both in high-resource areas and in developing countries. 6–8 Despite this evidence, significant barriers to widespread use of HPV DNA testing stand in the way, both in high- and low-resource areas.

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  • Although the last decade has been marked by a major decline in the incidence of tuberculosis (TB) in the United States, TB remains an important diagnosis to consider among older individuals. The clinical presentation is often insidious and non-specific, as is the radiological presentation. The elderly account for a large proportion of TB cases discovered at autopsy, illustrating the difficulty of clinical diagnosis in this age group. The last decade has also seen changes in tuberculin skin testing (TST) strategies and in the treatment guidelines for latent TB.

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  • In many industrialized countries, an increasing proportion of tuberculosis patients are immigrants. Immigrants account for 50% of the incidence in the Netherlands (12). Control policies with regard to immigrant tuberculosis usually rely on chest x-ray screening and treatment of active tuberculosis. A supplemental approach, recommended by the Institute of Medicine (14), is to conduct tuberculin skin testing and to apply preventive treatment of latent infections.

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  • Screening for precancerous lesions can be done in several ways including, cervical cytology (Pap tests), visual inspection of the cervix with acetic acid [VIA] or testing for HPV DNA. Each of these methods has specific advantages, disadvantages and health systems requirements that countries should consider when planning screening programmes (See Annex 1).

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  • There is a large volume of good quality evidence indicating that appropriate screening helps the detection and treatment of alcohol problems (see Annex 2 for a list of alerts). This evidence has consistently shown that screening using the Alcohol Use Disorders Identification Test (AUDIT) is effective within primary care, A&E, pre- and antenatal settings.

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