early detection of cancer

癌症的早期检测
  • 文章类型: Journal Article
    背景:胰腺癌的早期发现是通过为患者提供治愈性治疗来降低死亡率的重要步骤。已对风险人群中的筛查策略以及通过不同的检测方法进行了经济评估。然而,尚未进行筛查研究的综合,以告知资源分配,以便在疾病区域内进行早期发现。因此,评估胰腺癌筛查成本效益和成本的研究应进行系统回顾.
    方法:将对报告胰腺癌筛查的成本效益或成本的经济学评价进行系统评价。电子数据库Medline,WebofScience和EconLit将不受地理或时间限制进行搜索。两名独立审核员将根据预定义的标准选择符合条件的研究。将使用综合卫生经济评估报告标准声明和经济评估清单中的偏差来评估研究质量。一个审阅者将提取相关数据,第二个审阅者将交叉检查与提取表的合规性。关键项目将包括筛选个体的特征,使用的筛查策略,和成本,健康影响和成本效益作为研究产出。审稿人之间的意见分歧将通过咨询第三位审稿人来解决。
    背景:本研究不需要伦理批准,因为不会收集原始数据。结果将通过在会议上的演讲和在同行评审的期刊上发表来传播。系统评价的结果将为未来胰腺筛查的经济评估提供信息,为医疗资源优先级的决策提供指导。
    CRD42023475348。
    BACKGROUND: The early detection of pancreatic cancer is an important step in reducing mortality by offering patients curative treatment. Screening strategies in risk populations and by means of different detection methods have been economically evaluated. However, a synthesis of screening studies to inform resource allocation towards early detection within the disease area has not been done. Therefore, studies evaluating the cost-effectiveness and costs of screening for pancreatic cancer should be systematically reviewed.
    METHODS: A systematic review of economic evaluations reporting the cost-effectiveness or costs of pancreatic cancer screening will be conducted. The electronic databases Medline, Web of Science and EconLit will be searched without geographical or time restrictions. Two independent reviewers will select eligible studies based on predefined criteria. The study quality will be assessed using the Consolidated Health Economic Evaluation Reporting Standards statement and the Bias in Economic Evaluation checklist. One reviewer will extract relevant data and a second reviewer will cross-check compliance with the extraction sheet. Key items will include characteristics of screened individuals, the screening strategies used, and costs, health effects and cost-effectiveness as study outputs. Differences of opinion between the reviewers will be solved by consulting a third reviewer.
    BACKGROUND: Ethics approval is not required for this study since no original data will be collected. The results will be disseminated through presentations at conferences and publication in a peer-reviewed journal. The results of the systematic review will inform future economic evaluations of pancreatic screening, which provide guidance for decision-making in healthcare resource prioritisation.
    UNASSIGNED: CRD42023475348.
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  • 文章类型: Journal Article
    背景:乳腺癌是全球最常见的影响女性的癌症,低收入国家的死亡率过高,包括埃塞俄比亚。诊断阶段是一个明确定义的预测系统,可确定乳腺癌死亡的可能性。与晚期相比,早期乳腺癌在诊断时具有更好的治疗效果。尽管有许多关于早期乳腺癌比例不同的乳腺癌女性的初步研究,目前没有关于埃塞俄比亚早期诊断乳腺癌比例的汇总数据.这项研究集中在埃塞俄比亚诊断时早期乳腺癌的合并比例。
    方法:通过使用关键术语,Medline通过Pub-Med,谷歌学者,科学直接,在埃塞俄比亚搜索了HINARI和Medley的乳腺癌,共检索到288篇文章。筛选文章后,使用纽卡斯尔-渥太华量表评估每篇文章的质量。最后,41篇文章用于最终的合并比例。使用随机效应模型来估计纳入研究的合并患病率和异质性,然后使用预测间隔进行评估。
    结果:在埃塞俄比亚医院诊断的早期乳腺癌合并比例为36%,95%的置信区间为31-41%,95%的预测区间为28-45%。
    结论:埃塞俄比亚大多数乳腺癌患者(64%)诊断为晚期。这导致了埃塞俄比亚妇女乳腺癌的高死亡率。因此,根据世界卫生组织的建议,我们建议埃塞俄比亚应该重视乳腺癌的早期检测.
    BACKGROUND: Breast cancer is the most common cancer-affecting women globally, with disproportionally high mortality rates in lower-income countries, including Ethiopia. The stage at diagnosis is a well-defined predictive system that determines the likelihood of breast cancer mortality. Early-stage breast cancer at diagnosis is associated with better treatment outcomes as compared with late stage. Although there are numerous primary studies on women with breast cancer with different proportions of early-stage breast cancer, there is currently no summary data on what proportion of breast cancer was diagnosed at early-stage in Ethiopia. This study focused on a pooled proportion of early-stage breast cancer at diagnosis in Ethiopia.
    METHODS: By using key terms, Medline through Pub-Med, Google Scholar, Science Direct, HINARI and Medley were searched about breast cancer in Ethiopia, and a total of 288 articles were retrieved. After screening the articles and quality of each article was assessed using Newcastle-Ottawa Scale. Finally, 41 articles were used for the final pooled proportion. A random effects model was used to estimate the pooled prevalence and heterogeneity of included studies that were then assessed by using prediction interval.
    RESULTS: Pooled proportion of early-stage breast cancer at diagnosis in Ethiopian hospitals was found to be 36% with a 95% confidence interval ranging from 31 to 41% and a 95% prediction interval ranging from 28 to 45%.
    CONCLUSIONS: Most breast cancer patients (64%) in Ethiopia are diagnosed at a late-stage. This contributes to the high mortality rates of breast cancer among women in Ethiopia. Therefore, in line with recommendations by the World Health Organization, we recommend that there should be an emphasis in Ethiopia to focus on early detection of breast cancer.
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  • 文章类型: Systematic Review
    背景:在美国,与其他种族/种族群体相比,拉丁美洲人的宫颈癌发病率最高,部分原因是在筛查方面存在显著差异。妨碍获得和参与筛查的社会和结构条件包括语言障碍,关注文档状态,后勤问题(例如,交通运输,有限的门诊时间),以及关于谦虚和滥交的文化信仰。为了克服这些挑战,自我取样用于人乳头瘤病毒(HPV)DNA检测已成为在这一人群中促进宫颈癌筛查的潜在有前景的方法.因此,本系统综述旨在评估美国拉丁裔人群中HPV自我取样的可接受性.
    方法:使用EBSCOhost和PubMed数据库,我们搜索了过去20年(2003-2023年)发表的研究,这些研究描述了拉丁美洲人参与HPV自我取样.11篇文章符合纳入标准。
    结果:大多数研究是在佛罗里达州进行的,加州,波多黎各,是单臂设计,并涉及使用社区卫生工作者和西班牙语材料(例如,小册子)。在整个研究中,大多数参与者报告说,自采样在易用性方面是可以接受的,舒适(缺乏疼痛),隐私,和便利;然而,一些妇女担心自我取样的准确性,或者她们是否正确地进行了样本收集。
    结论:考虑到高可接受性,在面临重大筛查障碍的人群中,自行采集宫颈阴道样本进行HPV检测可能为增强参与宫颈癌筛查提供可行的选择.
    BACKGROUND: Latinas experience the greatest cervical cancer incidence compared with other ethnic/racial groups in the United States (US) due in part to significant disparities in screening uptake. Social and structural conditions that impede access to and participation in screening include language barriers, concerns about documentation status, logistical issues (e.g., transportation, limited clinic hours), and cultural beliefs regarding modesty and promiscuity. To overcome these challenges, self-sampling for human papillomavirus (HPV) DNA testing has emerged as a potentially promising method for promoting cervical cancer screening among this population. Thus, this systematic review aimed to assess the acceptability of HPV self-sampling among US Latinas.
    METHODS: Using EBSCOhost and PubMed databases, we searched for studies published in the past two decades (2003-2023) that described participation in HPV self-sampling among Latinas. Eleven articles met inclusion criteria.
    RESULTS: The majority of studies were conducted in Florida, California, and Puerto Rico, were single-arm designs, and involved the use of community health workers and Spanish-language materials (e.g., brochures). Across studies, the majority of participants reported that self-sampling was acceptable with respect to ease of use, comfort (lack of pain), privacy, and convenience; however, some women were concerned about the accuracy of self-sampling or whether they had performed sample collection correctly.
    CONCLUSIONS: Given the high acceptability, self-collection of cervicovaginal samples for HPV testing may offer a feasible option for enhancing participation in cervical cancer screening in this population that encounters significant barriers to screening.
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  • 文章类型: Journal Article
    背景:有组织的乳腺癌筛查(BCS)计划是50-69岁女性预防德国第六大死亡原因的有效措施。尽管国家筛查计划的实施始于2005年,但参与率尚未达到欧盟标准。目前尚不清楚哪些社会人口统计学因素以及如何与BCS出勤率相关。这项范围审查旨在确定在德国实施有组织的筛查计划后,50-69岁女性在BCS出勤率方面的社会人口统计学不平等。
    方法:遵循PRISMA指南,我们搜索了科学网,Scopus,MEDLINE,PsycINFO,跟随PCC的CINAHL(人口,概念和上下文)标准。我们纳入了定量研究设计的主要研究,并审查了50-69岁女性的BCS出勤率,并收集了2005年以来德国的数据。制定了收获图,描绘了不同的社会人口统计学不平等以及最近两年或更少的BCS出勤率和终身BCS出勤率的影响大小方向。
    结果:我们筛选了476篇标题和摘要以及33篇全文。总的来说,分析了27条记录,14是国家报告,和13篇同行评议的文章。在收获地块中确定并总结了八个社会人口统计学变量:年龄,教育,收入,迁移状态,区的类型,就业状况,合伙同居和健康保险。生活在农村地区且缺乏私人保险的低收入和移民背景的老年妇女对BCS邀请的反应更积极。然而,从一生的角度来看,这些协会只适用于移民背景,在收入和城市居住权方面被逆转,并辅以伴侣同居。最后,生活在前东德萨克森州的妇女,梅克伦堡-西波美拉尼亚,萨克森-安哈尔特,和图林根,以及前西德下萨克森州,在过去两年中,BCS出勤率较高。
    结论:需要高质量的研究来确定在德国没有参加BCS的风险较高的女性,以解决现有研究的高异质性,特别是因为整体出勤率仍然低于欧洲标准。
    背景:https://osf.io/x79tq/。
    BACKGROUND: Organized breast cancer screening (BCS) programs are effective measures among women aged 50-69 for preventing the sixth cause of death in Germany. Although the implementation of the national screening program started in 2005, participation rates have not yet reached EU standards. It is unclear which and how sociodemographic factors are related to BCS attendance. This scoping review aims to identify sociodemographic inequalities in BCS attendance among 50-69-year-old women following the implementation of the Organized Screening Program in Germany.
    METHODS: Following PRISMA guidelines, we searched the Web of Science, Scopus, MEDLINE, PsycINFO, and CINAHL following the PCC (Population, Concept and Context) criteria. We included primary studies with a quantitative study design and reviews examining BCS attendance among women aged 50-69 with data from 2005 onwards in Germany. Harvest plots depicting effect size direction for the different identified sociodemographic inequalities and last two years or less BCS attendance and lifetime BCS attendance were developed.
    RESULTS: We screened 476 titles and abstracts and 33 full texts. In total, 27 records were analysed, 14 were national reports, and 13 peer-reviewed articles. Eight sociodemographic variables were identified and summarised in harvest plots: age, education, income, migration status, type of district, employment status, partnership cohabitation and health insurance. Older women with lower incomes and migration backgrounds who live in rural areas and lack private insurance respond more favourably to BCS invitations. However, from a lifetime perspective, these associations only hold for migration background, are reversed for income and urban residency, and are complemented by partner cohabitation. Finally, women living in the former East German states of Saxony, Mecklenburg-Western Pomerania, Saxony-Anhalt, and Thuringia, as well as in the former West German state of Lower Saxony, showed higher BCS attendance rates in the last two years.
    CONCLUSIONS: High-quality research is needed to identify women at higher risk of not attending BCS in Germany to address the existing research\'s high heterogeneity, particularly since the overall attendance rate still falls below European standards.
    BACKGROUND: https://osf.io/x79tq/ .
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  • 文章类型: Systematic Review
    超过50%的口腔癌(OC)患者被诊断为晚期疾病,预后和生活质量差。支持改善早期OC检测的迫切需要。通过微创方法鉴定有效的分子标记已成为OC筛选的有希望的策略。本系统综述总结并评估了在非侵入性或微创性样品中鉴定的用于OC检测的DNA甲基化标记物的性能。PubMed的MEDLINE,Scopus,Embase,和CochraneLibrary数据库进行了系统搜索,以评估非侵入性和/或微创样本中DNA甲基化标记的研究(口腔冲洗/唾液,口腔刷,和血液)来自OC患者。两名研究人员独立提取了研究人群特征的数据,候选甲基化标记,测试样品,DNA甲基化测定,和性能诊断结果。使用诊断准确性研究质量评估2工具评估方法学研究质量。31项研究符合本系统评价的纳入标准。在口腔冲洗/唾液(n=17)中评估DNA甲基化标记,口腔刷(n=9),和血液(n=7)样品。甲基化特异性PCR(MSP)和定量MSP是最常见的DNA甲基化测定。关于唾液的诊断性能值,口腔刷,和血液DNA甲基化标记,敏感性和特异性介于3.4-100%和21-100%之间,9-100%和26.8-100%,22-70%和45.45-100%,分别。不同的基因甲基化小组对OC检测显示出良好的诊断性能。该系统综述公开了在非侵入性(唾液或口腔冲洗液)或微创(口腔刷或血液)样品中测试DNA甲基化标记作为OC检测的新策略的有希望的价值。然而,进一步验证,多中心,和前瞻性研究队列必须进行,以确认在这种情况下特定DNA甲基化标记的临床价值。
    More than 50% of oral cancer (OC) patients are diagnosed with advanced-stage disease associated with poor prognosis and quality of life, supporting an urgent need to improve early OC detection. The identification of effective molecular markers by minimally invasive approaches has emerged as a promising strategy for OC screening. This systematic review summarizes and evaluates the performance of the DNA methylation markers identified in non- or minimally invasive samples for OC detection. PubMed\'s MEDLINE, Scopus, Embase, and Cochrane Library databases were systematically searched for studies that evaluated DNA methylation markers in non-invasive and/or minimally invasive samples (oral rinse/saliva, oral brush, and blood) from OC patients. Two investigators independently extracted data on study population characteristics, candidate methylation markers, testing samples, DNA methylation assay, and performance diagnostic outcomes. Methodological study quality was assessed with the Quality Assessment for Studies of Diagnostic Accuracy-2 tool. Thirty-one studies met the inclusion criteria for this systematic review. DNA methylation markers were evaluated in oral rinse/saliva (n = 17), oral brush (n = 9), and blood (n = 7) samples. Methylation-specific PCR (MSP) and quantitative-MSP were the most common DNA methylation assays. Regarding diagnostic performance values for salivary, oral brush, and blood DNA methylation markers, sensitivity and specificity ranged between 3.4-100% and 21-100%, 9-100% and 26.8-100%, 22-70% and 45.45-100%, respectively. Different gene methylation panels showed good diagnostic performance for OC detection. This systematic review discloses the promising value of testing DNA methylation markers in non-invasive (saliva or oral rinse) or minimally invasive (oral brush or blood) samples as a novel strategy for OC detection. However, further validation in large, multicenter, and prospective study cohorts must be carried out to confirm the clinical value of specific DNA methylation markers in this setting.
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  • 文章类型: Systematic Review
    背景:全球癌症病例正在上升,年轻人的人数明显增加。筛查和早期检测可有效降低死亡率。工作场所可以在促进癌症筛查方面发挥作用。这项系统评价调查了工作场所乳房的有效性,肺,结直肠,和宫颈癌筛查干预措施,以及影响其有效性的因素。
    方法:六个数据库(Embase,Medline,WebofScience,CINAHL,科克伦图书馆,Scopus)被搜查,并使用效应方向图分析了癌症筛查的促进和癌症筛查的吸收。有效性程度(即,知识或筛查率的变化)也进行了评估。
    结果:总计,确定了13,426篇文章。在筛选和应用资格标准后,21篇文章被纳入分析。对于所有工作场所癌症筛查促进干预措施,都看到了积极的效果方向。癌症筛查促进干预措施的有效性导致4/7乳腺癌的知识或筛查摄入量变化>30%。3/4的宫颈癌和1/3的结直肠癌筛查促进干预措施。对于工作场所癌症筛查摄取干预措施,大多数(18/22)观察到积极的效应方向.癌症筛查摄取干预显示4/7乳腺癌筛查率的变化幅度>30%,5/10的结直肠癌和1/5的宫颈癌工作场所干预。没有肺癌研究合格。积极影响有效性的因素包括对健康和以前的医疗保健使用的兴趣,而对癌症的恐惧和筛查的尴尬对有效性产生负面影响。
    结论:工作场所癌症筛查促进和摄取干预可有效提高癌症筛查知识,增加对筛查试验的摄取。
    BACKGROUND: Cancer cases are rising globally, with a noticeable rise in younger adults. Screening and early detection are effective in decreasing mortality. Workplaces can play a role in promoting cancer screening uptake. This systematic review investigated the effectiveness of workplace breast, lung, colorectal, and cervical cancer screening interventions, and the factors impacting their effectiveness.
    METHODS: Six databases (Embase, Medline, Web of Science, CINAHL, Cochrane Library, Scopus) were searched, and cancer screening promotion and cancer screening uptake was analysed using effect direction plots. Magnitude of effectiveness (i.e., change in knowledge or screening rate) was also evaluated.
    RESULTS: In total, 13,426 articles were identified. After screening and applying the eligibility criteria, 21 articles were included in the analysis. A positive effect direction was seen for all workplace cancer screening promotion interventions. Magnitude of effectiveness for cancer screening promotion interventions resulted in a > 30% change in knowledge or screening uptake in 4/7 of breast cancer, in 3/4 of cervical cancer and 1/3 colorectal cancer screening promotion interventions. For workplace cancer screening uptake interventions, a positive effect direction was observed for the majority (18/22). Cancer screening uptake interventions showed a > 30% change in magnitude of screening rate in 4/7 breast cancer, 5/10 colorectal cancer and in 1/5 cervical cancer workplace interventions. No studies for lung cancer were eligible. Factors positively influencing effectiveness included an interest in health and previous healthcare use, while fear of cancer and embarrassment of screening negatively influenced effectiveness.
    CONCLUSIONS: Workplace cancer screening promotion and uptake interventions can effectively improve cancer screening knowledge and increase uptake of screening tests.
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  • 文章类型: Journal Article
    世界卫生组织将消除宫颈癌作为公共卫生问题的愿景是可以实现的,但是消除必须公平地实现,包括智障人士。需要在智障人士的生活背景下更好地了解宫颈筛查。本研究系统回顾了智力残疾人群宫颈筛查参与率的研究,以及影响参与的促进者和障碍。
    系统地搜索了六个电子数据库:MEDLINE,CINAHL,Scopus,PsycINFO,Embase和Pro-Quest中央社会科学合集。1986年至2023年之间在英语同行评审期刊上发表的实证研究有资格被纳入。通过向前和向后引用跟踪确定了更多的文章,并手动搜索两个关键期刊的索引列表。两位作者筛选了这些研究,使用标准化软件程序提取数据并整理研究结果。使用DerSimonian和Laird方法进行荟萃分析,以估计患病率和比值比(ORs)的合并效应大小。社会生态模型(SEM)被用作主题分析影响子宫颈筛查参与的促进因素和障碍的框架。
    六十三篇文章符合入选标准。其中,42人报告了子宫颈筛查参与率,24人报告了智障人士子宫颈筛查的促进者或障碍。总的来说,研究报告筛查患病率为35%(95%CI:26%至45%),这表明,超过三分之一的智障人士接受了子宫颈筛查。合并比值比为0.30(95%CI:0.23至0.41)表明,与没有智力残疾的人相比,智力残疾的人进行宫颈筛查测试的可能性大大降低。大多数研究检查了影响宫颈筛查的个人和人际关系因素。其中包括:(i)智障人士的恐惧和焦虑,(ii)阻止筛查参与的错误假设,(三)支持人的作用,(iv)教育的需要,(v)可获取的信息,准备筛查的时间,(vi)患者与提供者的沟通,包括获得知情同意的挑战,(七)医疗保健提供者缺乏信心。
    未来的研究,政策和实践工作必须解决智障人士参与子宫颈筛查的障碍,并确保这些努力是共同产生和社区主导的。这对于确保全球和地方消除宫颈癌努力的公平性至关重要。
    UNASSIGNED: The World Health Organisation\'s vision of eliminating cervical cancer as a public health problem is achievable, but elimination must be achieved equitably, including for people with intellectual disability. A better understanding of cervical screening within the context of the lives of people with intellectual disability is needed. This study systematically reviewed research on the rates of cervical screening participation among people with intellectual disability, and facilitators and barriers that affect participation.
    UNASSIGNED: Six electronic databases were systematically searched: MEDLINE, CINAHL, Scopus, PsycINFO, Embase and Pro-Quest Central Social Sciences Collection. Empirical studies published between 1986 and 2023, in English language peer-reviewed journals were eligible for inclusion. Further articles were identified through forward and backward citation tracking, and hand-searching the index lists of two key journals. Two authors screened the studies, extracted the data and collated study outcomes using a standardised software program. A meta-analysis was performed using the DerSimonian and Laird method to estimate pooled effect sizes in prevalence rates and odds ratios (ORs). The socio-ecological model (SEM) was used as a framework to thematically analyse facilitators and barriers impacting participation in cervical screening.
    UNASSIGNED: Sixty-three articles met the inclusion criteria. Of these, 42 reported on rates of cervical screening participation and 24 reported on facilitators or barriers to cervical screening for people with intellectual disability. Overall, the studies reported a screening prevalence of 35% (95% CI: 26% to 45%), indicating that just over a third of people with intellectual disability have had cervical screening. The pooled odds ratio of 0.30 (95% CI: 0.23 to 0.41) indicated that people with intellectual disability are significantly less likely to have a cervical screening test compared with people without intellectual disability. Most studies examined individual and interpersonal factors impacting cervical screening. These included: (i) fear and anxiety among people with intellectual disability, (ii) misassumptions preventing screening participation, (iii) the role of support people, (iv) the need for education, (v) accessible information, and time to prepare for screening, (vi) patient-provider communication including challenges obtaining informed consent, and (vii) healthcare provider lack of confidence.
    UNASSIGNED: Future research, policy and practice efforts must address barriers to cervical screening participation among people with intellectual disability and ensure these efforts are co-produced and community-led. This is critical to ensuring equity in global and local efforts to eliminate cervical cancer.
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  • 文章类型: Journal Article
    背景:宫颈癌,列为全球第四最常见的妇科癌症,在2018年,估计有570,000人丧生,并导致31.1万例新病例。这种疾病不成比例地影响了生活在贫困中的人们,并且在医疗保健系统薄弱的国家中更为普遍。低收入和中等收入国家,特别是在撒哈拉以南非洲,由于获得疫苗的机会有限,面临更高的发病率和死亡率,筛选,和治疗。世界卫生组织建议对25岁以上的女性进行定期筛查,到2030年为低收入和中等收入国家设定90-70-90的目标。尽管以前的知识有限,该研究旨在评估2024年埃塞俄比亚女性医疗保健专业人员宫颈癌筛查实践和相关因素的汇总患病率.
    目的:本研究旨在综合埃塞俄比亚女性卫生工作者宫颈癌筛查实践及相关因素的现有文献。
    方法:通过GoogleScholar的搜索引擎搜索研究,PubMed,科克伦图书馆使用关键词/MeSH术语进行搜索宫颈癌;利用;预防实践。使用CochranQ检验和I2统计量评估异质性。使用具有95%置信区间的随机效应模型进行合并的患病率和比值比估计。
    结果:本系统综述和荟萃分析包括7项研究。埃塞俄比亚女性卫生工作者中宫颈癌筛查的总体汇总患病率为18%。工作地点(OR=2.858;95%CI:0.412,5.305),知识(OR=3.457;95%CI:2.314,4.601),工作经验(OR=5.421;95%CI:4.178,6.664),诊断(OR=10.787;95%CI:06.197,15.377)和曾经接受过宫颈癌患者的护理(OR=2.93;95%CI:2.004,3.856)是女性医护人员中与宫颈癌筛查实践显著相关的合并相关因素.
    结论:发现宫颈癌筛查预防措施的实施不理想。我们的发现强调了在这些人群中提高认识的重要性,这对于动员当地社区至关重要。必须向女性卫生工作者提供有关宫颈癌的持续教育。卫生部应与各种组织合作,以确保所有医疗机构都能获得具有成本效益的筛查服务。
    BACKGROUND: Cervical cancer, ranking as the fourth most common gynecological cancer worldwide, claimed an estimated 570,000 lives and resulted in 311,000 new cases in 2018. This disease disproportionately affects those living in poverty and is more prevalent in countries with weak healthcare systems. Low and middle-income nations, particularly in Sub-Saharan Africa, face higher incidence and mortality rates due to limited access to vaccines, screening, and treatment. The world health organization recommends regular screening for women from age 25, setting a 90-70-90 target for low- and middle-income countries by 2030. Despite limited previous knowledge, the study aims to assess the pooled prevalence of cervical cancer screening practices and associated factors among female healthcare professionals in Ethiopia in 2024.
    OBJECTIVE: The study aimed to synthesize the existing literature on cervical cancer screening practice and associated factors among female health workers in Ethiopia.
    METHODS: Studies were searched through the search engine of Google Scholar, PubMed, and Cochrane Library. Searching was made using Keywords/ MeSH terms Cervical cancer; utilization; Preventive practice. Heterogeneity was assessed using the Cochran Q test and I2 statistics. A random-effects model with a 95% confidence interval was used for the pooled prevalence and odds ratio estimations.
    RESULTS: Seven studies were included in this systematic review and meta-analysis. The overall pooled prevalence of cervical cancer screening practice among female health workers in Ethiopia was 18%. Work place(OR = 2.858;95% CI: 0.412, 5.305),knowledge(OR = 3.457; 95% CI: 2.314, 4.601), work experience(OR = 5.421; 95% CI:4.178,6.664),being diagnosed(OR = 10.787; 95% CI: 06.197,15.377) and ever cared of cervical cancer patient (OR = 2.93; 95% CI: 2.004, 3.856) were the pooled associated factors that are significantly associated with cervical cancer screening practice among female health care worker.
    CONCLUSIONS: The implementation of preventive measures for cervical cancer screening was found to be suboptimal. Our findings underscore the importance of enhancing awareness among this demographic, which is crucial in mobilizing local communities. It is imperative to provide continuous education to female health workers regarding cervical cancer. The Ministry of Health should collaborate with various organizations to ensure the accessibility of cost-effective screening services in all healthcare facilities.
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  • 文章类型: Systematic Review
    背景:肺癌筛查(LCS)的心理社会影响会对个体造成伤害,并成为筛查参与和依从性的障碍。早期数据表明,LCS的心理社会影响受某些因素(例如社会人口统计学特征和信念)的调节。但是缺乏证据综合。本系统综述旨在了解LCS期间心理社会负担的个体水平风险因素,作为制定识别和支持参与者的策略的前兆。并提高LCS参与度。
    方法:在四个数据库中搜索了以英文发表的全文文章,报道了LCS期间参与者因素与心理社会结果之间的任何关联。研究质量由两名独立的研究者进行评估;研究结果以叙述方式进行综合。该审查已在PROSPERO预先注册,并遵守PRISMA指南。
    结果:纳入了35篇文章;大多数(33/35)研究被评估为高或中等偏倚风险。研究设计是pre-post(n=13),横截面(n=13),定性(n=8)和混合方法(n=1),主要在美国进行(n=17)。LCS的心理负担各不相同,通常与年龄较小有关,女性性别,当前吸烟状况或吸烟史增加,教育水平较低,较低的社会经济群体,没有结婚或同居,也没有经历过癌症。然而,结果喜忧参半,并且在所有因素中也报告了非显著关联.信仰(例如宿命论,病耻感和对LDCT结果的期望)和并存的心理负担也与心理社会结果有关,但证据很少.风险感知之间的关联,其他参与者因素和其他社会心理结果尚无定论,可能反映了个人在风险概念化方面的偏见。
    结论:据报道,一些参与者因素与LCS的社会心理影响有关,虽然研究异质性和高偏倚风险需要更稳健的评估。进一步研究感知,信念和期望可用于改善LCS期间的心理社会结果。
    BACKGROUND: Psychosocial impacts of lung cancer screening (LCS) can cause both harm to individuals and serve as barriers to screening participation and adherence. Early data suggest that the psychosocial impacts of LCS are moderated by certain factors (e.g. sociodemographic characteristics and beliefs), but evidence synthesis is lacking. This systematic review aimed to understand individual-level risk factors for psychosocial burden during LCS as a precursor to developing strategies to identify and support participants, and improve LCS engagement.
    METHODS: Four databases were searched for full-text articles published in English reporting any association between participant factors and psychosocial outcomes experienced during LCS. Study quality was assessed by two independent investigators; findings were synthesised narratively. The review was pre-registered with PROSPERO and adhered to PRISMA guidelines.
    RESULTS: Thirty-five articles were included; most (33/35) studies were assessed at high or moderate risk of bias. Study designs were pre-post (n = 13), cross-sectional (n = 13), qualitative (n = 8) and mixed-methods (n = 1) and conducted primarily in the United States (n = 17). Psychological burden in LCS varied, and was often associated with younger age, female gender, current smoking status or increased smoking history, lower education, lower socio-economic group, not being married or co-habiting and experience with cancer. However, results were mixed, and non-significant associations were also reported across all factors. Beliefs (e.g. fatalism, stigma and expectation of LDCT results) and comorbid psychological burden were also linked to psychosocial outcomes, but evidence was sparse. Associations between risk perception, other participant factors and other psychosocial outcomes was inconclusive, likely reflecting individual biases in risk conceptualisation.
    CONCLUSIONS: Several participant factors are consistently reported to be associated with psychosocial impacts of LCS, though study heterogeneity and high risk of bias necessitate more robust evaluation. Further research on how perceptions, beliefs and expectations can be used to improve psychosocial outcomes during LCS is needed.
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  • 文章类型: Journal Article
    皮肌炎(DM)和多发性肌炎是特发性炎症性肌病(IIMs),与实体器官恶性肿瘤最相关,和较不常见的血液恶性肿瘤。我们讨论与弥漫性大B细胞淋巴瘤相关的DM病例。随后回顾了有关发病机制的文献,临床课程,治疗,和预后。讨论了IIM患者潜在淋巴增生性疾病(LPDs)的诊断和管理的各种挑战。该案例表明了对IIM和LPD之间关联保持警惕的重要性。讨论了IIM患者的癌症筛查,包括最近出版的IIM相关癌症筛查国际指南。需要更多的研究来解决IIM中癌症筛查的知识空白。
    Dermatomyositis (DM) and polymyositis are idiopathic inflammatory myopathies (IIMs), most associated with solid organ malignancies, and less commonly hematological malignancies. We discuss a case of DM associated with diffuse large B-cell lymphoma, followed by a review of literature on the pathogenesis, clinical course, treatment, and prognosis. Various challenges with the diagnosis and management of underlying lymphoproliferative disorders (LPDs) in patients with IIM are discussed. The case demonstrates the importance of being vigilant of the association between IIM and LPD. Cancer screening in patients with IIM is discussed, including the recently published International Guideline for IIM-Associated Cancer Screening. More research is required to address knowledge gaps in cancer screening in IIM.
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