M Zappa

..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...

..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...

..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...

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

..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...

..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...

..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...

..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...

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

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

..58, 95% CI : 0.45-0.74). This study confirmed that new treatments and the first rounds of the screening programme contributed to reducing mortality from breast cancer...

..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...

..The study evaluated the results of an experimental screening protocol for colorectal cancer by fecal occult blood testing in a municipality of the Province of Florence...

..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...

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

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

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

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..CONCLUSIONS: The present study provides further evidence that PAPNET-assisted screening may allow the detection of a few extra cases of CIN2+ lesions with respect to conventional reading, though at a very high cost...

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

..The aim of the present study was to examine whether the implementation of an organised mammographic screening programme in Florence has been successful in reducing socioeconomic inequalities in breast cancer survival...

..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...

..Intervention could save much psychological distress, since associated linear growth failure can exacerbate adolescents' feelings of being different and unwell...

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..85). The introduction of breast cancer screening programmes in Italy is associated with a reduction in breast cancer mortality attributable to the additional impact of service screening over and above the background access to mammography...

..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...

..PSAV is widely variable over time, particularly at low PSA values. PSAV might be of value as an indicator for diagnostic assessment and random sextant biopsy in a screening setting...

..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...

..7% for female breast and 99.6% for lung cancer. With the limit of multiple strong dependence between sources, the two-way capture-recapture method seems a simple and useful tool for estimating the completeness of cancer registration...

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

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..The impact of these functional problems in terms of quality of life should also be assessed, but it is our impression that there is need for much greater attention to the issue of long-term survivor sequelae...

..96 in the [5-10] year time window, suggesting minimal or any length bias. Consistent with the results of randomised trials, these analyses of service screening data document a mortality reduction of 36% at 5-10 years after diagnosis...

..The slight decrease in mortality in the LS area (11%) could be mainly due to better care. A reduction of about 30% is attributable to screening in the ES area over the period 1985-2000...

..Further efforts are necessary to implement screening extension and to improve data collection...

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

..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...

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

..Estimate the hospitalization fraction preventable by extending the vaccination program...

..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...

..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 latex agglutination test (LAT) has the advantage of being a fully automated, quantitative test. The aim of this study is to interpret the overall experience with LAT according to different positivity thresholds...

..For Mib1 the results showed some discrepancies. In addition to adequate standardization of procedures, these data confirm that the reliability of the immunocytochemistry is strictly linked to accurate analysis of the results...

..We assessed whether HPV testing with triage by p16-INK4A overexpression can increase specificity while maintaining sensitivity...

..The study was aimed to investigate the awareness of a sample of Italian family doctors as regards tobacco epidemiology and smoking cessation strategies...

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..We conducted a study to estimate population coverage and detection rate (DR) achievable through different strategies of colorectal cancer (CRC) screening...

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

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..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...

..The unadjusted detection rate ofhistologically confirmed CIN2 or more severe was 2.7 per 1000 screened women (3.0 per 1000, standardised on the Italian population, truncated 25-64)...

..If HPV testing is applied with cytology-triage, a single HPV test may cost 20-30% more than a conventional Pap to result in the same overall cost per CIN2+ detected...

..To study the impact of different cervical cancer screening strategies including HPV testing...

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..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...

..HPV-positive women were directly referred to colposcopy if aged 35 or older; if younger, they were retested after 1 year...

..However, reported experiences showed good results in terms of attendance and DR, although some critical aspects need to be carefully addressed when planning and implementing screening activity...

..Our study confirms that Pap-test screening, particularly in middle-aged and older women, is an effective public health intervention with encouraging results also for the prevention of cervical adenocarcinoma...

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..3% received an invitation to have a mammography. Imbalance in coverage still exists between Northern and Central Italy and the South: figures are 92.4%, 98.6%, and 39.3%. The national crude attendance rate was 5 7.8%...

..Despite this rise, quality indicators were stable. However, in a few programmes, the use of excessively broad criteria in the interpretation of cytology decides an excessively high rate of referrals to colposcopy...

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

..Most recurrences after LEEP occur in the first 3 years, and non-recurrent cases at that date may stop intensive follow-up and return to current cytological screening every 3 years...

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

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

..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...

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

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..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...

..We compared the participation and detection rates achievable through different strategies of colorectal cancer screening...

..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)...

..Screening may have had at least some impact in reducing cervical adenocarcinoma incidence in several countries during the 1990s...

..The survival analysis by specific subgroups did not support the hypothesis that the difference in prognosis was attributable to differential treatment...

..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...

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..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...

..We present the baseline screening outcomes...

..To compare conventional cervical testing (CCT) and liquid-based cytology (LBC) within a randomized trial performed during 2001-2002 in the Abruzzo Region of Italy, including a cost-outcome comparative analysis...

..The unadjusted detection rate of histologically confirmed CIN2 or more severe was 2.7 per 1,000 screened women (2.6 standardised on the Italian population, truncated 25-64)...

..CONCLUSION: A set of digital images can be a useful tool for evaluating and improving interobserver reproducibility. A two-day course on digital images could be an ideal modality for introducing this new technology...

..The results of blind reading of smears obtained with liquid-based cytology in patients previously screened by conventional cytology were compared...

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..Routine axillary ultrasonography, with cytology of sonographically visible lymph nodes, followed by immediate axillary dissection only in case of positive cytology proved to be the best approach in terms of cost-benefit ratio...

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..Improving prevention and treatment of somatic diseases of psychiatric patients is important to reduce excess mortality from natural causes...

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