S Ciatto

..Subjects with negative findings at cytology, colposcopy and HPV testing are at negligible risk of recurrence and might return safely to standard screening protocol...

..This article is a review and meta-analysis of studies reporting contralateral MRI in women with newly diagnosed invasive breast cancer...

..Special screening protocols (shorter rescreening interval, routine use of ultrasonography) might be suggested for these subjects in order to improve screening sensitivity and efficacy...

..To evaluate the role of computer aided detection (CAD) in improving the interpretation of screening mammograms..

..The aim of this study was to assess the validity of predictors of prostate biopsy outcome in order to improve their positive predictive value...

..To evaluate the sensitivity at transrectal ultrasonography (TRUS) for prostate cancer...

..To assess the predictive value for a positive biopsy of different indicators (rectal examination, transrectal ultrasonography, total PSA, PSA density)...

..23 in subjects excluded from invitation due to previous cancer or major illness (95%CI=0.8-1.5). A 66% excess incidence rate was observed in the screened subjects over a 9-year period, confirming previous estimates of overdiagnosis...

..To evaluate the sensitivity for breast cancer of different diagnostic tests performed in a consecutive series of women aged under 36 years...

..To assess double reading effectiveness in mammography screening...

..Although training may improve these results, simpler alternative reporting methods (systems), focused on clinical decision-making, should be explored...

..As inconsistency is probably due to erroneous perception of classification criteria, standard sets of reference images should be made available for training...

..To define the normal cut off of endometrial thickness as measured at transvaginal ultrasonography (TVUS) in order to define postmenopausal women without symptoms or with abnormal uterine bleeding (AUB) at risk of endometrial carcinoma (EC)...

..2%) of the benign biopsies while decreasing the sensitivity by 7.6% (1/13), and is thus suggested as a possible criterion for the indication of repeat random biopsy for persistent PSA elevation...

..100, 81.6 or 91.6%; spec.=22.8, 40.4, or 56.7%). Breast cancer patients under tamoxifen might be selected for further invasive assessment on the basis of AUB and endometrial thickness assessed at TVUS...

..9%. The use of CAD as a possible surrogate to conventional DOUBLE needs to be confirmed by further studies, which should include a cost-effective analysis...

..To evaluate the role of computer aided diagnosis (CAD) to improve screening mammograms interpretation...

..To asses the effectiveness of arbitration of discordant double readings in mammography screening...

..To compare the diagnostic accuracy of two commercial CAD systems (CADx and R2) and their impact as an aid to conventional reading of screening mammograms...

..Although length bias may have occurred (symptomatic MCBC had a shorter free interval from the first cancer), the present evidence supports the practice of active follow-up aimed at the early detection of asymptomatic MCBC...

..The present study, performed at the Centro per lo Studio e la Prevenzione Oncologica of Florence, using both FFDM and SFM, was aimed at estimating the impact of introducing the new FFDM technique on overall mammography costs...

..To assess PSA use in the general population and estimate biopsy rate subsequent to opportunistic screening...

..Prognosis following a second breast cancer in this cohort was generally good. However, large or node-positive second tumours, and shorter intervals between diagnoses were indicators of poorer survival...

..Due to expected variability, review methods need standardisation to improve screening quality. Our data support blinded review of IC in mammography screening...

..1% where combined imaging is included into the diagnostic pathway. This is largely due to needle biopsy identifying most cancers missed on single imaging thus negating the effect of additional imaging on overall sensitivity...

..7%) and a high positive predictive value (41.5%). Faecal Hb content is significantly higher for those lesions (cancer and high-risk adenomas) screening is aimed at detecting...

..The aim of this study was to evaluate the performance of a sample of Italian radiologists undergoing a proficiency test of screening mammography...

..99; 95% CI=0.69-1.37). This finding might suggest a screening effect, but might also be ascribed to an healthy screening effect, and cannot be assumed as a reliable evidence of screening efficacy...

..3%) cancers. The average recall rate was 14.2%, the majority of recalls (45 out of 64) occurring for lesions marked by CAD. CAD may help in detecting at most half of cancers missed at a single reading but detected by a second reader...

..7 to 2.6 cancer biopsies would have been delayed to avoid 10 benign biopsies. As this balance is not acceptable, F/T PSA has no role as a biopsy indicator and its clinical use is questionable...

..Studies of screening for other carcinomas may be considered of higher priority...

..The assumption that FOBT screening for CRC has to be based on a guaiac test should be reconsidered, and RPHA should be recommended as the standard FOBT for screening purposes...

..Further evaluation of Hemeselect cost-effectiveness and sensitivity is needed in order to assess the optimal threshold of positivity and screening frequency...

..To compare two immunochemical faecal occult blood tests based on reversed passive haemagglutination (RPHA) or latex agglutination (Hdia) in a population based screening setting...

..5%), and HOS (96.1%) specificity. No significant difference between tests is evident in the CSPO population as far as positive predictive values and sensitivity for cancer and adenomas are concerned.(ABSTRACT TRUNCATED AT 250 WORDS)..

..Increasing screening sensitivity might be achieved if the detection rate of advanced adenomas could be increased without unacceptable loss in specificity...

..7-1.8). None of the possible variable combinations was clinically useful: the highest PPV (83.3%) was obtained with a combination of suspicious DRE/TRUS, PSAD >0.20 and F/T <0.15, which nevertheless missed 20 of 52 cancers...

..Different strategies seem to have a greater impact on adenomas rather than on cancer detection rate. The study provides information when deciding screening protocols and to adapt them to local resources...

..To assess the validity of PSA doubling time (PSADT) as a predictor of prostate sextant biopsy outcome in patients with PSA levels in the 4-10 ng/mL range...

..Surveillance based on endometrial ultrasonography was poorly sensitive, but the favorable stage at diagnosis of screen-detected or interval endometrial cancers does not support a more aggressive screening approach...

..54; 95% CI, 0.3-0.9) and increased towards unity subsequently. Our results suggest that screening for CRC by biennial faecal occult blood testing can reduce mortality from the disease...

..PSA seems the ideal test to be used in prospective controlled studies aimed at demonstrating screening efficacy...

..We studied imaging, pathology and diagnostic aspects of false negative assessment (FNA) in women recalled for suspicious screening mammography...

..It is unknown whether, for palpable cancers, ultrasound-guided FNAB is more accurate than freehand FNAB, and practice varies between physicians, services and countries...

..At least in those settings where access to cytopathology may be difficult, screening by colposcopy should be considered as a possible alternative...

..96 and 0.97, respectively. The routine use of FNAC is recommended since it helps in the differential diagnosis of suspicious cases and may bypass surgical biopsy of positive cases not eligible for surgical treatment...

..Due to the rarity of misperceived abnormalities (true screening errors), manual or automated rescreening of negative smears would not be an effective procedure for quality control...

..Periodic CXR survey looks a very questionable policy as it does not seem to have any favourable impact on prognosis. Its routine use in breast cancer patients should thus be carefully reconsidered...

..They also suggest that testing women negative for high-risk HPV at longer interval and strictly following-up women who are HPV positive could be an effective strategy for cervical cancer screening...

..We examined the prognostic effect of detection of ipsilateral breast relapse (IBR) or contralateral breast cancer (CBC) in the asymptomatic relative to symptomatic phase...

..We conclude that rehydrated HO should be introduced as the standard test for screening in order to increase sensitivity for colorectal cancer and adenomas...

..Tape-recorded videocolposcopy tests are a good, simple, practical and inexpensive method for interobserver quality control of colposcopic performance...

..Thus thermography did not show any practical role as a breast cancer risk indicator. Possible biases affecting previous reports suggesting the use of thermography as a breast cancer risk indicator are discussed...

..Acceptable (< 40 = 5, 40-49 = 1.5, 50-59 = 0.75, > 59 = 0.3) and desirable (2.5, 0.75, 0.35, 0.15) age specific reference standards for B/M are proposed...

..The study confirms the higher risk of ipsilateral and contralateral cancer in LCIS patients and warns about the possible hazards of limited surgery in these cases...

..Different approaches and longer interval screening tests are discussed...

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..The policy of repeat smear was more cost-effective than immediate colposcopy. According to such results, the protocol of the Florence screening program has been modified since October 1996...

..The aim of the present study was to evaluate the frequency of opportunistic screening by PSA in the District of Florence in the general population...

..Hospital discharge records-based procedures for interval cancers assessment should be employed routinely in screening programs...

..Further decrease of molecular immunochemistry testing due to technological progress may allow HPV and p16 testing to become a cost effective procedure in the future...

..Detailed analysis of a single morphologic characteristic was found to be of limited diagnostic value, suggesting that operators do perceive abnormalities but cannot translate these findings into distinct morphologic categories...

..We evaluated the contribution of ultrasound (US) in detecting breast cancer in women with dense breasts and negative mammograms...

..The present study methodology might be currently applied in screening programmes...

..Gastric cancer may be suspected with otherwise unexplained positive faecal occult blood testing...

..CONCLUSIONS: Although centers scored, on average, well within standards recommended by national authorities, this study suggests the opportunity of interlaboratory quality control to achieve more homogeneous criteria...

..This might be regarded as unacceptable and however would involve high costs and a major organization effort...

..The lack in the USL of epidemiologic competence and of cost/benefit considerations and the need for political decisions about cancer prevention programs are stressed...

..65 (95% confidence interval (CI) 0.26-1.64) and 0.15 (95% CI 0.07-0.31), for adenocarcinoma and squamous cancer, respectively. The duration of the protective effect was shorter in women below the age of 40 years than in older women...

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..The purpose of this study was to compare the diagnostic accuracy of digital mammography with that of screen-film mammography in concurrent cohorts participating in the same population-based screening program...

..Over the age of 74 years, encouraging individualized decisions may be more appropriate and may indicate further screening for those subjects for whom the potential benefit outweighs the potential negative effects...

..The burden of cervical cancers might increase in the future if no specific preventive strategies for adenocarcinoma are implemented...

..7% of cases, while 21% of cases were negative. In conclusion, AMP provides a viable alternative to HC2, with good agreement for samples with high-grade cytology and similar sensitivity in detecting CIN2+ lesions...

..CONCLUSIONS: Because HPV testing is highly sensitive, it may be useful as an alternative to the current policy of 6-month repeat cytology for women with ASCUS...

..To compare the performance of screen-film and digital mammography in the assessment of screen-detected breast lesions...

..Burlington, NC) is an automated device that was designed to screen conventionally prepared cervical smears and, more recently, thin-layer slide preparations. The system has been tested in large clinical trials...

..e. 507/10,000 men). Variations in detection rates among screening centers related among others to biopsy compliance and age range...

..The differences between countries seem to reflect both underlying prostate cancer incidence and screening policy. The trials have the power to show definitive results in 2005-2008...

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..As diagnostic assessment of minimal lesions is far from being 100% accurate, this policy would also considerably increase the frequency of unnecessary benign biopsies. All these negative effects might turn out to be unacceptable...

..Immediate evaluation of the screening history of incident cases of cervicocarcinoma should be mandatory in any screening program...

..The evidence that ASCUS detection option implies a higher detection rate of CIN2> and subsequently a lower cost per CIN2> detection must be considered with caution and deserves confirmation by other comparative studies...

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..An increase in frequency of precancerous lesions for cervical cancer in more recent birth cohorts supports the need to keep screening coverage and efficiency as high as possible...

..We evaluated the results obtained by 130 Italian radiologists undergoing a proficiency test of clinical mammography...

..Seeding proficiency tests with cancers with minimal signs was of no benefit as far as evaluation is concerned...

..Screening every year would achieve too limited an increase in sensitivity, compared to biennal screening, to be worth the difficulties of doubling organizational efforts and costs...

..Research is needed to improve differentiation between malignant and benign diseases in B3 lesions using diagnostic or predictive methods...

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..Refinement in CAD algorithms, in combination with increasing implementation of digital mammography, may improve the potential use of CAD in mammography reading, but will require prospective evaluation...

..To evaluate the direct costs of first and repeat colorectal cancer screening by immunochemical faecal occult blood testing (I-FOBT)...

..To assess the role of breast ultrasonography as a complement to negative mammography in radiologically dense breasts...

..Randomized trials are needed to determine the clinical value of detecting additional disease which changes surgical treatment in women with apparently localized breast cancer...

..AutoPap-assisted smear reading has been proposed prior to conventional manual reading; the latter may be unnecessary for cases reported as No Further Review (NFR) and would be required for cases reported as Review (REV)...