Objectives: Screening for second primary cancer (SPC) is one of the key components of cancer survivorship care. The aim of the present study was to explore oncologists' experience with promoting second primary cancer screening. Methods: Two focus group interviews were conducted with 12 oncologists of diverse backgrounds. Recurrent issues were identified and placed into thematic categories. Results: Most of the oncologists did not consider SPC screening promotion as their responsibility and did not cover it in routine care. All of the study participants had experience with unexpected SPC cases, and they were under emotional tress. There was no systematic manner of providing SPC screening. Oncologists usually prescribe SPC screening in response to patients' requests, and there was no active promotion of SPC screening. Short consultation time, limited knowledge about cancer screening, no established guideline for SPC screening, and disagreement with patients about oncologists' roles were major barriers to its promotion. An institution-based shared care model was suggested as a potential solution for promoting SPC screening given current oncology practices in Korea. Conclusion: Oncologists could not effectively deal with the occurrence of SPC, and they were not actively promoting SPC screening. Lack of knowledge, limited health care resources, and no established guidelines were major barriers for promoting SPC screening to cancer survivors. More active involvement of oncologists and a systematic approach such as shared-care models would be necessary for promoting SPC screening considering increasing number of cancer survivors who are vulnerable.
Purpose: This study was conducted to identify the factors influencing second primary cancer (SPC) screening practice by examining the relationships of physical symptoms, knowledge and attitudes regarding SPC screening, perceived risk, primary cancer type, and demographic factors of cancer survivors. Methods: Participants were 308 survivors of stomach, colon, or breast cancer recruited from 2 university hospitals in Korea. Data were collected using a questionnaire and analyzed using IBM SPSS 21.0 and AMOS 18.0. Results: The proportion of participants taking all cancer screenings according to national guidelines was 40%. They had moderate knowledge and a relatively positive attitude regarding SPC screening and high cancer risk perception. The participants had taken fewer SPC screenings after than before cancer diagnosis. The factors influencing cancer risk perception were age, physical symptoms, knowledge regarding SPC and primary cancer type (stomach). The factors influencing SPC screening practice were age, gender, economic status, knowledge regarding SPC screening, and primary cancer types (colon). Conclusion: It is important for clinical professionals to recognize that survivors of cancer are susceptible to another cancer. Education on SPC screening for these survivors should focus on communicating with and encouraging them to have regular cancer screenings.
To evaluate the costs of the hypertension screening program of the Korea Medical Insurance Corporation, the records of the screening examinations were used. The sample size was 49,983 of the 906,554 people insured by the Corporation and was obtained by two-stage stratification random sampling. The alternatives for efficiency of the screening program, which were divided into three categories : modification of the screening test package, application of other hypertension diagnostic criteria, and selective approach of tested groups by age, were evaluated according to the cost per patient detected. The results of this study were as follows In the hypertension screening system, the cost per patient detected was Won 30,883. The most nonsensitive test for hypertension detection was ophthalmoscopy, which was examined during the second stage of screening. If the ophthalmoscope examination was excluded, olny one person was not detected, which was 0.2% of detected persons, and the cost per patient detected decreased to Won 28,098. The most efficient modification of the screening test package was measurement of blood pressure through the first and second stages of screening. The cost per patient detected by this modification was Won 24,408. The application of other diagnostic critera, which were more restricted criteria, increased the cost per patient detected by 3.7%-6.7%. The cost per patient detected were Won 170,582 for persons less than 39 years old, Won 20,032 for persons 40 to 59 years old, and Won 8,675 for persons 60 years old and over. In conclusion, the best alternative suggested with respect to efficiency and practical application excluded the ophthalmoscope examination of second stage screening and restricted the target population to persons greater than 40 years old. The application of this alternative decreased 54.9% of the screening costs and the cost per patient detected was Won 15,222. This study was limited in that measurement of effectivenes was not of the ultimate goal of screening, which is decreasing morbidity and mortality, but was of disease detection as the short-term objective.
Journal of Korean Institute of Industrial Engineers
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v.19
no.3
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pp.25-35
/
1993
Economic screening procedures using a correlated variable are proposed to assure that the proportion of conforming items is above a desired level after screening. It is assumed that the performance variable and the screening variable are jointly normally distributed. Two screening procedures are considered. In the first screening procedure, all of the items are inspected on the screening variable. If an item fails to meet the screening specifications, it is rejected and excluded from shipment without inspection of the performance variable. In the second screening procedure, the item which fails to meet the screening specifications is inspected on the performance variable. If the value of the performance variable is within specifications the item is accepted, and the item is rejected otherwise. Cost models are constructed which involve cast from an accepted nonconforming item, cost from a rejected item, and quality inspection cost. Methods of finding optimal cutoff value on a screening variable are presented and numerical examples are given.
Cole, Stephen R.;Gregory, Tess;Whibley, Alex;Ward, Paul;Turnbull, Deborah;Wilson, Carlene;Flight, Ingrid;Esterman, Adrian;Young, Graeme P.
Asian Pacific Journal of Cancer Prevention
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v.13
no.12
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pp.5989-5994
/
2012
Background: There is little information on longitudinal patterns of participation in faecal occult blood test (FOBT) based colorectal cancer (CRC) screening or on demographic or behavioural factors associated with participation in re-screening. The lack of an agreed system for describing participatory behaviour over multiple rounds also hampers our ability to report, understand and make use of observed associations. Our aims were to develop a system for describing patterns of participatory behaviour in FOBT-based CRC screening programs and to identify factors associated with particular behavioural patterns. Methods: A descriptive framework was developed and applied to a data extract of screening invitation outcomes over two rounds of the NBCSP. The proportion of invitees in each behaviour category was determined and associations between behaviour patterns and demographic and program factors were identified using multivariate analyses. Results: We considered Re-Participants, Dropouts, Late Entrants and Never Participants to be the most appropriate labels for the four possible observed participatory categories after two invitation rounds. The screening participation rate of the South Australian cohort of the NBCSP remained stable over two rounds at 51%, with second round Dropouts (10.3%) being balanced by Late Entrants (10.5%). Non-Participants comprised 38.7% of invitees. Relative to Re-Participants, Dropouts were older, more likely to be female, of lower SES, had changed their place of residence between offers had a positive test result in the first round. Late Entrants tended to be in the youngest age band. Conclusions: Specific demographic characteristics are associated with behavioural sub-groups defined by responses to 2 offers of CRC screening. Targeted group-specific strategies could reduce dropout behaviour or encourage those who declined the first invitation to participate in the second round. It will be important to keep first round participants engaged in order to maximise the benefit of a CRC screening program.
Roder, David Murray;Ward, Gail Heather;Farshid, Gelareh;Gill, Peter Grantley
Asian Pacific Journal of Cancer Prevention
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v.15
no.14
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pp.5901-5908
/
2014
Background: Data from BreastScreen Australia Screening and Assessment Services (SAS) for 2002-2010 were analysed to determine whether some SAS characteristics were more conducive that others to high screening performance, as indicated by high priority performance indicators and standards. Materials And Methods: Indicators investigated related to: numbers of benign open biopsies, screen-detected invasive cancers, and interval cancers, and wait times between screening and assessment. Multivariate Poisson regression was undertaken using as candidate predictors of performance, SAS size (screening volume), urban or rural location, year of screening, accreditation status, and percentages of clients from culturally and linguistically diverse backgrounds, rural and remote areas, and socio-economically disadvantaged areas. Results: Performance standards for benign biopsies and invasive cancer detection were uniformly met irrespective of SAS location and size. The interval cancer standard was also met, except in 2003 when the 95% confidence interval of the rate still incorporated the national standard. Performance indicators improved over time for: benign open biopsy for second or subsequent screening rounds; rates of invasive breast cancer detection for second or subsequent screening rounds; and rates of small cancer detection. No differences were found over time in interval cancer rates. Interval cancer rates did not differ between non-metropolitan and metropolitan SAS, although state-wide SAS had lower rates. The standard for wait time between screening and assessment (being assessed ${\leq}28$ days) was mostly unmet and this applied in particular to SAS with high percentages of culturally and linguistically diverse women in their screening populations. Conclusions: Gains in performance were observed, and all performance standards were met irrespective of SAS characteristics, except wait times to assessment. Additional descriptive data should be collected on SAS characteristics, and their associations with favourable screening performance, as these may be important when deciding on SAS design
International journal of advanced smart convergence
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v.9
no.2
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pp.1-7
/
2020
As the demand for health screening increases, there is a need for efficient design of screening items. We build machine learning models for health screening and recommend screening items to provide personalized health care service. When offline, a synthetic data set is generated based on guidelines and clinical results from institutions, and a machine learning model for each screening item is generated. When online, the recommendation server provides a recommendation list of screening items in real time using the customer's health condition and machine learning models. As a result of the performance analysis, the accuracy of the learning model was close to 100%, and server response time was less than 1 second to serve 1,000 users simultaneously. This paper provides an adaptive and automatic recommendation in response to changes in the new screening environment.
Multistage screening is a common practice when a component has a critical effect on the function of the assembly. A defect in a component might incur malfunction of an electronic device, resulting in a great amount of loss. Multistage screening, including duplicated screening inspections, may provide a good solution for this problem when inspection errors are present. In the company studied here, the manufacturing process of the multiple layer chip capacitor includes two-stage screening. In the first stage, screening inspection is performed repeatedly until no defects are found in the lot. In the second stage, sampling inspection is performed by a group of experts prior to shipment. In this article, we review the procedure used in the field and suggest a revised model of the multiple screening procedure and solution method for this situation. The usefulness of the proposed model is discussed through a practical example.
The Community based cancer screening program passed in 1960 was a milestone for initiating a national and local health program in Japan. And since then local governments and Cancer Society have been developing and providing cancer screening programs of Stomach, Cervix, Breast and Colorectum for population. To apply the effectiveness of community based cancer screening program, it is important to understand the key issue related to cancer screening participation of population and technology of cancer detection. The purpose of this study was to understand the community based cancer screening program in Japan, and to apply the information for establishment of community based cancer screening program in Korea. The characteristics of community based cancer screening program in Japan were as follows. The first, community based cancer screening program was implemented by the National Health and Medical Services Law for the Aged since 1983. The second, Cancer Society and Cancer Detection Center were core for cancer screening program. The third, the budget for cancer screening program was established by the National Health and Hygiene. The fourth, the continuous quality control for medical staff was provided by Cancer Society and Cancer Detection Center The fifth, the efforts for the promotion of cancer screening rate.
Twenty years have passed since a prenatal screening for Down syndrome and neural tube defect was applied to obstetric field. The Quad test (AFP, hCG, uE3, Inhibin-A) of the second trimester and the combination test (PAPP-A, hCG, NT) of the first trimester became popular now. The recent trend of prenatal screening is to combine these two screening tests together in order to increase a detection rate of Down syndrome. Three types of screening methods are introduced as follows; integrated test, sequential test and contingent test. In addition to combination of each test, an incorporation of characteristic ultrasound findings of Down syndrome is suggested for its risk calculation. The absence of fetal nasal bone would be a very useful marker especially in the first trimester screening test. According to a change of way calculating risk of Down syndrome, obstetrician's role will be more increased not by passive participation, but by active participation using ultrasound in risk calculation.
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