Public Health Interest Research Articles

Environmental injustice in the air quality for digital platform delivery workers in Bogotá, Colombia, 2021

Air quality is a matter of interest for public health due to its rapid deterioration in low- and middle-income countries and the effects of polluted air on the health of populations. To explore the air quality conditions in which digital platform delivery workers carry out their work, evaluating the localities of Kennedy and Usaquén in Bogotá, 2021. We developed a mixed parallel convergent study based on four sources of information: 1) Ethnographic observation in five commercial locations of the two localities; 2) Monitoring of PM10 and PM2.5 in 56 delivery routes using a low-cost sensor; 3) Daily logs of the routes to support the device data interpretation, and 4) A semi-structured interview applied to the drivers to explore their danger perception during the routes. We identified elements causing environmental injustice among digital platform delivery workers between the two study locations. The routes made by the delivery drivers in the locality of Kennedy registered higher concentrations of PM10 and PM2.5, compared to the values observed in Usaquén. The sources of air pollution identified by the delivery drivers through ethnographic observation and the router logbook showed the worst parameters in Kennedy. We evidenced that air quality, urban equipment, road infrastructure, mobile sources, and geospatial location are elements that mark the presence of environmental injustice for the digital platform delivery drivers in the studied localities. To reduce this inequity, it is necessary for digital delivery platforms and the district government to implement strategies that reduce the exposure and emission of air pollutants to protect the health of digital platform delivery workers.

Serological evidence of human exposure to foodborne zoonotic parasites in Romanian patients and possible association with food habits and hygiene

Humans may become accidental dead-end hosts for a series of zoonotic foodborne parasites, of which Toxoplasma gondii, Echinococcus spp., Toxocara spp., and Trichinella spiralis are of major public health interest, due to their potential pathological implications. The aims of the study were to evaluate the exposure to these pathogens in north-western Romania, and to investigate their potential association to risk factors. From June 2022 to January 2024, 554 patients admitted to a tertiary hospital in north-western Romania were screened for the presence of IgG antibodies against T. gondii, Echinococcus spp., Toxocara canis, and T. spiralis by ELISA, and potential risks were assessed using a questionnaire. Overall, 225 samples (40.6%) were positive for at least one pathogen. The highest seroprevalence for IgG was found for T. gondii (33.9%), followed by Echinococcus spp. (9.1%), T. spiralis (2.9%), and T. canis (1.1%). For T. spiralis, raw meat consumption was associated with positivity. For T. gondii, increased age, rural environment, contact with cats, consumption of unwashed fruits/vegetables and drinking water from unverified sources were significantly associated to seropositivity. The present study provides new insights into the epidemiological status of zoonotic foodborne parasite in Romania, underlining the need to increase awareness on the importance of water, sanitation and food habits in relation with this neglected pathology.

Wastewater Target Pathogens of Public Health Importance for Expanded Sampling, Houston, Texas, USA.

Building on the success of initiatives put forth during the COVID-19 pandemic response, US health officials are expanding wastewater surveillance programs to track other target pathogens and diseases of public health interest. The Houston Health Department in Houston, Texas, USA, conducted a hypothesis-generating study whereby infectious disease subject matter experts suggested potential targets. This study addressed 2 criteria recommended by the National Academies of Sciences, Engineering, and Medicine for selecting wastewater targets. Results can be used as a basis of a questionnaire for a future population-based study to recommend targets of highest priority to include for expanded wastewater sampling.

Drug Shortages: A Scoring System to Evaluate and Prioritize the Clinical Importance of Drugs in Canada

Drug shortages are an ongoing global health issue and pose significant challenges to policy-makers and health care providers. They may result from various factors (e.g., supply chain disruptions and recalls) and have a negative impact on patient outcomes and health care expenditures. The ability to accurately predict drugs at risk of a shortage would be a vital aspect in the effective management of drug shortages and help ensure proactive measures for consistent drug supply and optimized patient care; however, these drugs must also be prioritized in a meaningful way to identify high priority targets among the large number of drugs in the market and help ensure resources are allocated to the most important at-risk drugs. The purpose of this Environmental Scan aimed to identify a systematic method of objectively evaluating and ranking the value of drugs based on important clinical criteria and adapt the selected tool to prioritize the clinical importance of drugs in Canada. A total of 5 potential scoring systems were considered, and 1 scoring system was selected and adapted (based on expert panel member feedback). Finally, an assessment of 9 clinical criteria was made across 5 broad categories. The criteria include an evaluation of disease severity, size of the population, clinical guidelines, comparator interventions limitations (unmet needs), improvement of efficacy or effectiveness, improvement of safety and tolerability, improvement of patient-reported outcomes (PRO), type of medical service (e.g., symptom relief, prolonging life, cure), and public health interest. The proposed tool can be used in situations where decision-making requires an objective and systematic evaluation of drugs' clinical importance. Additionally, it will help inform a drug shortage risk framework in Canada, which will consider both the clinical importance and supply chain risks of drugs as part of the Health Canada Drug Shortages Task Force.

Hazardous Elements in the Edible Portion of Perna perna Mussels: Relation with the COVID-19 Pandemic Period and Assessment of the Risk to Human Health.

In this work, the concentrations of hazardous elements (As, Cd and Pb) in the edible portion of the Perna perna mussel from Southeast Brazil were analyzed to understand the effects of the COVID-19 pandemic on the coastal environment and to evaluate the quality of this fishery resource. Decreases in anthropogenic chemical outputs to the environment were expected to occur during the COVID-19 pandemic, with decreases in element concentrations in mussels. The ranges of median concentrations (µgg-1dw) in the pre- and pandemic periods were 5.4-16.1 and 2.2-10.6 for As; 0.2-0.6 and 0.1-0.5 for Cd; and 1.2-3.2 and 0.7-1.8 for Pb, respectively. Temporal variations (prepandemic x pandemic) were more significant than spatial variations (five sampling sites). The relationships between the concentrations of hazardous elements and isotopic ratios (δ15N and δ13C) suggested that food sources were more diverse across the sampling sites during the pandemic period, when individuals exhibited less efficient trophic transfer. The concentrations of Cd and Pb were below the tolerable maximum limit, whereas for As, they were above the limit; however, these concentrations are not a risk to human health, as most As was present in the least toxic organic form. The intake estimates were below the tolerable intake limits, and only Pb concentrations are at risk of causing concern if the intake of mussels increases. This is the first study in Brazil that presents a spatial-temporal comparison of hazardous elements in marine fauna considering COVID-19 as a temporal landmark. The results are of interest for both public health and environmental health management in a post-COVID-19 scenario.

Evaluating the impact of COVID-19 on routine childhood immunizations coverage in Zambia.

There are growing concerns about the comeback of vaccine-preventable diseases. Epidemics exert shocks which affect other health performance indicators such as routine immunizations. Early model forecasts indicate decreased use of immunization services, which puts children at greater risk. Concerns about an increase in morbidity and mortality for illnesses other than COVID-19, particularly in children missing routine vaccinations, are of public health interest. In this study, we evaluate COVID-19 effects on the uptake of routine immunization in Zambia.This was an interrupted time series study. National data on routine immunization coverage between January 2017 and December 2022 were analyzed. Interrupted time series analysis was performed to quantify changes in immunization utilization. To determine if changes in the underlying patterns of utilization of immunization service were correlated with the commencement of COVID-19, seasonally adjusted segmented Poisson regression model was utilised.Utilization of health services was similar with historical levels prior to the first case of COVID-19. There was a significant drop in immunization coverage for measles dose two (RR, 0.59; 95% CI: 0.43-0.80). A decreased slope was observed in immunization coverage of Rotavirus dose one (RR, 0.97; 95% CI: 0.96-0.98) and Rotavirus dose two (RR, 0.97; 95% CI: 0.96-0.98). A growing slope was observed for Oral Poliovirus two (RR, 1.007; 95% CI: 1.004-1.011) and Oral Poliovirus three (RR, 1.007; 95% CI: 1.002-1011). We also observed a growing slope in BCG Bacille Calmette-Guerin (BCG) (RR, 1.001; 95% CI: 1.000-1011) and Pentavalent one (RR, 1.00; 95% CI: 1.001-1008) and three (RR, 1.004; 95% CI: 1.001-1008).The COVID-19 pandemic has had a number of unintended consequences that have affected the use of immunization services. Ensuring continuity in the provision of health services, especially childhood immunization, during pandemics or epidemics is crucial. Therefore, Investing in robust healthcare infrastructure to withstand surges, training and retaining a skilled workforce capable of handling emergencies and routine services simultaneously is very cardinal to avoid vaccine-preventable diseases, causing long-term health effects especially child mortality.

The Origins of “Confidential Commercial Information” at the FDA

This Viewpoint reviews regulations regarding FDA’s handing of confidential commercial information, explains how these regulations serve as a barrier to disclosure of information in the interest of public health, and suggests how information could be carefully shared to improve health outcomes and advance research.

The prevalence of gambling and problematic gambling: a systematic review and meta-analysis

Gambling behaviours have become of increased public health interest, but data on prevalence remain scarce. In this study, we aimed to estimate for adults and adolescents the prevalence of any gambling activity, the prevalence of engaging in specific gambling activities, the prevalence of any risk gambling and problematic gambling, and the prevalence of any risk and problematic gambling by gambling activity. We performed a systematic review and meta-analysis. We systematically searched for peer-reviewed literature (on MEDLINE, Embase, and PsycInfo) and grey literature to identify papers published between Jan 1, 2010, and March 4, 2024. We searched for any gambling, including engagement with individual gambling activities, and problematic gambling data among adults and adolescents. We included papers that reported the prevalence or proportion of a gambling outcome of interest. We excluded papers of non-original data or based on a biased sample. Data were extracted into a bespoke Microsoft Access database, with the Joanna Briggs Institute Critical Appraisal Tool used to identify the risk of bias for each sample. Representative population survey estimates were firstly meta-analysed into country-level prevalence estimates, using metaprop, of any gambling, any risk gambling, problematic gambling, and by gambling activity. Secondly, population-weighted regional-level and global estimates were generated for any gambling, any risk gambling, problematic gambling, and specific gambling activity. This review is registered on PROSPERO (CRD42021251835). We screened 3692 reports, with 380 representative unique samples, in 68 countries and territories. Overall, the included samples consisted of slightly more men or male individuals, with a mean age of 29·72 years, and most samples identified were from high-income countries. Of these samples, 366 were included in the meta-analysis. Globally, 46·2% (95% CI 41·7-50·8) of adults and 17·9% (14·8-21·2) of adolescents had gambled in the past 12 months. Rates of gambling were higher among men (49·1%; 45·5-52·6) than women (37·4%; 32·0-42·5). Among adults, 8·7% (6·6-11·3) were classified as engaging in any risk gambling, and 1·41% (1·06-1·84) were engaging in problematic gambling. Among adults, rates of problematic gambling were greatest among online casino or slots gambling (15·8%; 10·7-21·6). There were few data reported on any risk and problematic gambling among adolescent samples. Existing evidence suggests that gambling is prevalent globally, that a substantial proportion of the population engage in problematic gambling, and that rates of problematic gambling are greatest among those gambling on online formats. Given the growth of the online gambling industry and the association between gambling and a range of public health harms, governments need to give greater attention to the strict regulation and monitoring of gambling globally. Australian National Health and Medical Research Council.

A Systematic Review of the Distribution and Prevalence of Viruses Detected in the Peromyscus maniculatus Species Complex (Rodentia: Cricetidae).

The North American Deermouse, Peromyscus maniculatus, is one of the most widespread and abundant mammals on the continent. It is of public health interest as a known host of several viruses that are transmissible to humans and can cause illness, including the acute respiratory disease Hantavirus Pulmonary Syndrome (HPS). However, recent taxonomic studies indicate that P. maniculatus is a complex of multiple species, raising questions about how to identify and interpret three decades of hantavirus monitoring data. We conducted a systematic review investigating the prevalence and spatial distribution of viral taxa detected in wild populations allocated to P. maniculatus. From the 46 relevant studies published from 2000 to 2022, we extracted and analyzed spatial occurrence data to calculate weighted populational prevalences for hantaviruses. We found that detection efforts have been concentrated in the Western United States and Mexico with a focus on the spread of Sin Nombre virus, the primary causative agent of HPS. There are significant gaps in the existing literature both geographically and in regard to the types of hantaviruses being sampled. These results are significantly impacted by a recent taxonomic split of P. maniculatus into four species, which results in the relabeling of 92% of hantavirus observations. Considering the uncertain, and likely multiple, phylogenetic histories of these viral hosts should be a key emphasis of future modeling efforts.

Seroprevalence, Risk Factors and Immunological Response against Hepatitis B Virus Among Students of Usmanu Danfodiyo University Sokoto, Nigeria

Study’s Excerpt The seroprevalence of Hepatitis B Virus (HBV) among university students was investigated. Both serological markers of HBV and immune response were assessed. The results revealed significant associations between infection and high-risk behaviors. Full Abstract Hepatitis B Virus is of major public health interest as it accounts for significant mortality globally. The study aimed to determine the seroprevalence of HBV infection, the possible potential risk factors, and the immunological response among students of Usmanu Danfodiyo University, Sokoto, from December 2022 to April 2023. Structured questionnaires were used to collect sociodemographic information as well as possible risk factors related to the infection. Out of 139 study participants (10 females and 129 males screened randomly for HBsAg using a rapid HBsAg test kit, 17 (12.2%) were seropositive, and 122 (87.8%) were seronegative. The sera of the positive participants were further screened for HBeAg, anti-(HBs, HBe, and HBc) using one-step cassette diagnostic kits. Of the 17 positive samples screened, none were reactive for anti-HBs antibodies and HBeAg.; while 15 were positive anti-HBc and anti-HBe, indicating a response to natural infection. Sexual activity, unprotected sexual practices, use of already used sharp objects, and awareness of HBV infection were significantly associated (P<0.05) with the viral infection. The study indicates high endemicity in the study area. It is recommended that Nigerian Universities mandate the Hepatitis B virus vaccine for newly intake students. More awareness should be created about the dangers of unprotected sexual practice use or sharing of used sharp objects, among other possible factors.

Умови застосування примусових заходів медичного характеру

The conditions for applying compulsory medical measures are an important topic that requires careful study and understanding, especially in the context of human rights and medical ethics. Decisionmaking on the application of such measures should be based on specific circumstances and strike a balance between the needs of the individual and the interests of public health. The practice of applying compulsory medical measures is determined by the legislation of each country and international standards. As a rule, they are allowed only in cases of an urgent threat to the life or health of a person or other persons, when an individual cannot make an informed and conscious decision about treatment due to mental illness or other circumstances. At the same time, the use of compulsory medical measures should be limited in time and as effective as possible to achieve the goal of ensuring the safety and well-being of the individual. In addition, it should be accompanied by appropriate human rights guarantees, such as the right to information, consultation and legal protection. This article analyzes the conditions under which coercive medical measures may be applied. In particular, it examines the ethical, legal and practical aspects of this issue, taking into account the rights and interests of patients, as well as the possible consequences for their health and well-being. The article includes a review of relevant international and national legislation, case law and recommendations of professional medical organizations on the use of compulsory medical measures. The author also examines modern approaches to this issue and possible ways to resolve it within the framework of ethical and legal norms. The author of the article provides substantiated recommendations for improving the legislation and practice of applying compulsory medical measures in order to ensure maximum protection of rights and decent treatment of patients in medical institutions.

Metagenomic profiling of raw wastewater in Portugal highlights microbiota and resistome signatures of public health interest beyond the usual suspects

In response to the rapid emergence and dissemination of antimicrobial resistant bacteria (ARB) and genes (ARGs), integrated surveillance systems are needed to address antimicrobial resistance (AMR) within the One Health Era. Wastewater analyses enable biomarker monitoring at the sewershed level, offering timely insights into pathogen circulation and ARB/ARGs trends originating from different compartments. During two consecutive epidemic waves of the COVID-19 pandemic in Portugal, taxonomic and functional composition of raw urban wastewater from two wastewater treatment plants (WWTPs) representing one million in equivalent population, located in the main urban areas of the country, were profiled by shotgun metagenomics. Hospital wastewater from two central hospitals located in the WWTPs catchment areas were also sequenced. The resistome and virulome were profiled using metagenomic assemblies without taxonomic constraint, and then specifically characterized for ESKAPE pathogens.Urban and hospital wastewater exhibited specific microbiota signatures, Pseudomonadota dominated in the first and Bacteroidota in the latter. Correlation network analyses highlighted 85 (out of top 100) genera co-occurring across samples. The most frequent ARGs were classified in the multidrug, tetracyclines, and Macrolides, Lincosamides, Streptogramins (MLS) classes. Links established between AMR determinants and bacterial hosts evidenced that the diversity and abundance of ARGs is not restricted to ESKAPE, being also highly predominant among emergent enteropathogens, like Aeromonas and Aliarcobacter, or in the iron (II) oxidizer Acidovorax. The Aliarcobacter genus accumulated high abundance of sulphonamides and polymyxins ARGs, while Acinetobacter and Aeromonas hosted the highest abundance of ARGs against beta-lactams. Other bacteria (e.g. Clostridioides, Francisella, Vibrio cholerae) and genes (e.g. vanA-type vancomycin resistance) of public health interest were detected, with targeted monitoring efforts being needed to establish informative baseline data. Altogether, results highlight that wastewater monitoring is a valuable component of pathogen and AMR surveillance in healthy populations, providing a community-representative snapshot of public health trends beyond priority pathogens.

Protection of public health at the level of supranational organizations

Emergence of international integration processes raises new issues of the development of the legislative and regulatory framework at the supranational level for public health benefit. The paper explains the need to actively protect the interests of public health at the supranational level based on the analysis of relevant aspects of the policy, structure, functioning and experience of the largest regional integration structures – the Eurasian Economic Union and the European Union. The review of the basic principles, approaches and measures is carried out, using the example of ensuring food safety, which is directly related to solving the problem of prevention and control of infectious and non-communicable diseases. The relevant regulatory framework of the World Trade Organization (WTO), as well as the development of technical regulation, are discussed. The relevance of cooperation between supranational structures and the World Health Organization and other relevant UN organizations in the field of public health is emphasized. Specialists in this field are called upon to participate in the regulation of international integration processes, including the activities of the WTO, trade and investment agreements, and tariff policy.

To give or not to give? Pandemic vaccine donation policy

ObjectivesThe purpose of this work is to characterize scenarios under which it may be in a donor country's own public health interests to donate vaccine doses to another country before its own population has been fully vaccinated. In these scenarios, vaccinating other countries can delay the evolution of new variants of the virus, decrease total deaths, and, in some cases, decrease deaths in the donor countries. Study designWe simulate the effects of different vaccine donation policies using an epidemiological model employing COVID-19 transmission parameters. MethodsWe use the epidemiological model of Holleran et al. that incorporates virus mutation to simulate epidemic progression and estimate numbers of deaths arising from several vaccine allocation policies (donor-first, non-donor-first, and vaccine sharing) across a number of scenarios. We analyze the results in light of herd immunity limits derived in Holleran et al. ResultsWe identify realistic scenarios under which a donor country prefers to donate vaccines before distributing them locally in order to minimize local deaths during a pandemic. We demonstrate that a non-donor-first vaccination policy can delay, sometimes dramatically, the emergence of more-contagious variants. Even more surprising, donating all vaccines is sometimes better for the donor country than a sharing policy in which half of the vaccines are donated, and half are retained because of the impact donation can have on delaying the emergence of a more contagious virus. Non-donor-first vaccine allocation is optimal in scenarios in which the local health impact of the vaccine is limited or when delaying the emergence of a variant is especially valuable. ConclusionIn all cases, we find that vaccine distribution is not a zero-sum game between donor and non-donor countries, illustrating the general moral reasons to donate vaccines. In some cases, donor nations can also realize local health benefits from donating vaccines. The insights yielded by this framework can be used to guide equitable vaccine distribution in future pandemics.

Emergence of dengue fever: sentinel travellers uncover outbreak in Sharm El-Sheikh, Egypt, May 2024.

Dengue fever (DF) is a leading travel-related illness worldwide. Outbreaks from imported cases occurred in Europe. Case detection serves both patient safety and public health interests in origin and destination countries. We report a cluster of DF cases imported to Italy by travellers to Sharm El-Sheik, a highly touristic destination.

World Psychiatric Association-Asian Journal of Psychiatry Commission on Public Mental Health

Although there is considerable evidence showing that the prevention of mental illnesses and adverse outcomes and mental health promotion can help people lead better and more functional lives, public mental health remains overlooked in the broader contexts of psychiatry and public health. Likewise, in undergraduate and postgraduate medical curricula, prevention and mental health promotion have often been ignored. However, there has been a recent increase in interest in public mental health, including an emphasis on the prevention of psychiatric disorders and improving individual and community wellbeing to support life trajectories, from childhood through to adulthood and into older age. These lifespan approaches have significant potential to reduce the onset of mental illnesses and the related burdens for the individual and communities, as well as mitigating social, economic, and political costs. Informed by principles of social justice and respect for human rights, this may be especially important for addressing salient problems in communities with distinct vulnerabilities, where prominent disadvantages and barriers for care delivery exist. Therefore, this Commission aims to address these topics, providing a narrative overview of relevant literature and suggesting ways forward. Additionally, proposals for improving mental health and preventing mental illnesses and adverse outcomes are presented, particularly amongst at-risk populations.

Research status and hotspots of social frailty in older adults: a bibliometric analysis from 2003 to 2022.

Social Frailty is a significant public health concern affecting the elderly, particularly with the global population aging rapidly. Older adults with social frailty are at significantly higher risk of adverse outcomes such as disability, cognitive impairment, depression, and even death. In recent years, there have been more and more studies on social frailty, but no bibliometrics has been used to analyze and understand the general situation in this field. Therefore, by using CiteSpace, VOSviewer, and Bilioshiny software programs, this study aims to analyze the general situation of the research on social frailties of the older adults and determine the research trends and hot spots. A bibliometric analysis was conducted by searching relevant literature on the social frailty of the older adults from 2003 to 2022 in the Web of Science core database, using visualization software to map publication volume, country and author cooperation networks, keyword co-occurrences, and word emergence. We analyzed 415 articles from 2003 to 2022. Brazil has the highest number of articles in the field of social frailty of the older adults, and the United States has the highest number of cooperative publications. Andrew MK, from Canada, is the most published and co-cited author, with primary research interests in geriatric assessment, epidemiology, and public health. "Social Vulnerability," "Health," "Frailty," "Mortality," and "Older Adult" are among the research hotspots in this field. "Dementia," "Alzheimer's disease," "Population," and "Covid-19" are emerging research trends in social frailty among the older adults. This scientometric study maps the research hotspots and trends for the past 20 years in social frailty among the older adults. Our findings will enable researchers to better understand trends in this field and find suitable directions and partners for future research.

Social health organizations: an analysis of the specialties and exams contracted by the State of São Paulo, Brazil.

Social Health Organizations (SHOs) are private entities that receive resources from governments for the management of public healthcare services. With the history of market interest in public health and the high volume of resources transferred to SHOs, one must question if the market logic continues to be inserted in this management model. The understanding of the dynamics of providing healthcare services to the population in the different contracts may help to understand how possible changes in the contracted services may have an influence. This is a descriptive-exploratory study using quantitative and qualitative approaches. Documental research was conducted through the collection of data from management contracts and amendments. The State of São Paulo was chosen because of its economic representativeness and for being the pioneer state in the implementation of SUS services managed by SHO. Medical specialties were included in 184 renegotiations (6.14%) and excluded in 187 (6.24%), whereas non-medical services were included in 26 renegotiations (2.97%) and excluded in 144 (16.44%). Regarding examinations, 101 renegotiations (18.07%) had their goals increased and 60 (10.73%) reduced, while 6 renegotiations (1.07%) included exams and 12 (2.14%) excluded them.

Organizações sociais de saúde: análise sobre as especialidades e exames contratados pelo Estado de São Paulo, Brasil

Abstract Social Health Organizations (SHOs) are private entities that receive resources from governments for the management of public healthcare services. With the history of market interest in public health and the high volume of resources transferred to SHOs, one must question if the market logic continues to be inserted in this management model. The understanding of the dynamics of providing healthcare services to the population in the different contracts may help to understand how possible changes in the contracted services may have an influence. This is a descriptive-exploratory study using quantitative and qualitative approaches. Documental research was conducted through the collection of data from management contracts and amendments. The State of São Paulo was chosen because of its economic representativeness and for being the pioneer state in the implementation of SUS services managed by SHO. Medical specialties were included in 184 renegotiations (6.14%) and excluded in 187 (6.24%), whereas non-medical services were included in 26 renegotiations (2.97%) and excluded in 144 (16.44%). Regarding examinations, 101 renegotiations (18.07%) had their goals increased and 60 (10.73%) reduced, while 6 renegotiations (1.07%) included exams and 12 (2.14%) excluded them.

Are cancer screening recommendations from top US cancer centers concordant with the USPSTF guidelines?

10535 Background: The USPSTF is an independent volunteer organization of multi-disciplinary national experts in disease prevention that publishes evidence-based non-binding recommendations for screening diseases, including cancer. Herein we assessed the congruence of cancer screening recommendations between the USPSTF and the Top 10 US Cancer Centers (as per the U.S News and World Report). Methods: This cross-sectional study compared the published screening recommendations from the Top 10 US Cancer Centers for colorectal (CRC), lung (LC), cervical (CC), prostate (PC), and breast cancers (BC) in average risk patients, to those of the USPSTF. The variables of interest included: screening tests, recommendation direction (for/against), strength, frequency, age of start, age of end, and discussion about risks and benefits. Data extraction was done by 2 authors and discrepancies resolved by mutual consensus and discussion with a third author. Results: We demonstrate the differences between the screening recommendations from the Top 10 Cancer Centers relative to those from the USPSTF (Table). Conclusions: Our study found significant variability between the screening recommendations from the 2022-2023 USNWR top 10 cancer centers and the evidence-based USPSTF guidelines for BC, PC, CC, and CRC. The recommendations for LC were overall in line with those of the USPSTF. The discordance was almost always in the direction of the cancer centers recommending more screening beyond the USPSTF’s recommendations, and often without discussion of potential risks and harms. This inconsistency could create confusion to the public, and therefore, a consistent messaging across the cancer centers congruent with the USPSTF recommendations and including a nuanced discussion of benefits and risks may be in the best public health interest.[Table: see text]