Do Physicians Understand Cancer Screening Statistics? A National Survey of Primary Care Physicians in the United States ------------------------------------- Annals of Internal Medicine March 6, 2012 vol. 156 no. 5 340-349 ------------------------------------- Physicians received scenarios about the effect of 2 hypothetical screening tests: The effect was described as improved 5-year survival and increased early detection in one scenario and as decreased cancer mortality and increased incidence in the other... 297 physicians who practiced both inpatient and outpatient medicine were surveyed in 2010, and 115 physicians who practiced exclusively outpatient medicine were surveyed in 2011... Most primary care physicians mistakenly interpreted improved survival and increased detection with screening as evidence that screening saves lives. Few correctly recognized that only reduced mortality in a randomized trial constitutes evidence of the benefit of screening. Link to abstract.
_New Initiatives for Cervical Screening in Newfoundland and Labrador Oct. 27, 2011: A snippet: "The Provincial Cervical Cytology Registry changes include implementation of a follow-up system that will ensure that women with abnormal Pap test results receive care in a timely manner and women who are well screened and in low risk groups can extend intervals between Pap tests. The screening program will focus on providing Pap tests to those women who have not been screened recently." Full story.
Screening for Lung Cancer: It Works, but Does It Really Work? Gerard A. Silvestri After the publication of the NLST (National Lung Screening Trial) results, physicians will be faced with whether to begin ordering low-dose computed tomography (LDCT) of the chest to screen for lung cancer in patients with a history of tobacco use. Despite the encouraging reduction in deaths observed by using LDCT in the NLST study population, recommending adoption of lung cancer screening in general practice is premature. More. First published September 5, 2011 on annals.org. Annals of Internal Medicine, Oct. 18, 2011.
Risk Factors and Other Epidemiologic Considerations for Cervical Cancer Screening. Despite the success of cervical cancer screening programs, questions remain about the appropriate time to begin and end screening. This review explores epidemiologic and contextual data on cervical cancer screening to inform decisions about when screening should begin and end...In conclusion, the available evidence suggests that cervical cancer screening should not begin before 21 years of age. Full study here. First published Oct. 17, 2011 on annals.org. Annals of Internal Medicine.
Cumulative Probability of False-Positive Recall or Biopsy Recommendation After 10 Years of Screening Mammography After 10 years of annual screening, more than half of women will receive at least 1 false-positive recall, and 7% to 9% will receive a false-positive biopsy recommendation. Biennial screening appears to reduce the cumulative probability of false-positive results after 10 years but may be associated with a small absolute increase in the probability of late-stage cancer diagnosis. Abstract. Annals of Internal Medicine. Oct. 18, 2011, 155 (8), 481-492.
Ultrasound and blood test screening doesn't reduce risk of death from ovarian cancer
June 3, 2011 * Study results released at a recent conference strongly suggest that screening for cancer antigen 125 (CA-125) and with transvaginal ultrasound does not reduce the risk of death from ovarian cancer. "In a clinical trial that included nearly 80,000 women, those who received ovarian cancer screening did not have a reduced risk of death from ovarian cancer compared to women who received usual care, but did have an increase in invasive medical procedures and associated harms as a result of being screened..." Click to read the press release. A physician has blogged about the findings, and the study is here: JAMA. 2011; 305[22] 2295-2303.
Home fecal screening kits in NS
CPOP Talk, Winter 2010 - The Colon Cancer
Prevention Program in Nova Scotia
has been extended to the Pictou County Health Authority, which will give 50 to
74-year-olds in the New Glasgow area access to a home fecal screening kit. By
the spring of 2011, all regions in the province are expected to have the
program in place. The objective is to have people screen themselves using the
kit before they have any symptoms, and then pursue medical treatment if
necessary. www.cancercare.ns.ca/en/home/preventionscreening/coloncancerprevention/default.aspx
Screening for distress
CPOP Talk, Summer 2010 - Cancer Care Nova Scotia
has been implementing the Screening for Distress program, which asks health
care professionals to administer an assessment to patients. The one-page
questionnaire includes practical, physical and psychosocial items. Responses
form the basis of a discussion about the kind of help that may prove useful. Cancer
patient navigators in four regional health districts began screening patients in
the fall of 2009, with the three remaining districts starting in August of 2010.
The Head and Neck clinic in the Capital Health Cancer Care Program has begun screening,
with the thoracic clinic gearing up to begin in August. The Cape Breton Cancer
Centre intends to start in September. A slide presentation from May 2010 is here.
High risk, low screening
CPOP Talk, Summer 2010 - In an effort to enhance understanding in order
to help improve interventions, a team at five universities in the US has
examined factors that might predict screening for colorectal cancer (CRC). They
looked specifically at the role of perceived susceptibility on people’s
intention to seek screening. By studying 1,001 white males working in the
automotive industry, the researchers found that individuals who see their risk
of CRC as high are more uncomfortable with screening. The quest continues to
understand the fine points of that connection (including social influence) and
how those might play out with interventions. Source: www.ncbi.nlm.nih.gov/pubmed/20658212
Mammogram results often wrong, U.S. study finds. More than half of healthy women who have an annual mammogram will get at least one false positive result over a 10-year period, and 7 to 9 per cent will undergo a biopsy that doesn't turn out to show cancer, U.S. researchers said on Monday. Reuters, Oct. 18, 2011
