Mass Screening Research Articles

Nigeria received 10 Ultra-Portable digital X-rays (UPDX) with Computer-Aided Detection (CAD) from the Stop TB Partnership, as part of the USAID-funded introducing New Tools Project (iNTP). The UPDX machines (Delft Light systems) were deployed to 8 states for TB screening and triaging algorithms for early TB detection. This study sought to explore the perspectives of health workers and clients on the operational feasibility and ease-of-use of the UPDX with CAD, with a view to determining the acceptability, enablers and barriers to effective use and exploring the perceived ease-of-use by the end-users. This is a cross-sectional descriptive study, conducted between April and June 2023, using mixed quantitative and qualitative methods to determine the feasibility, acceptability, and ease-of-use of the UPDX with CAD in Nigeria. Purposive sampling was done for 57 respondents made up of radiographers, radiologists, key informants, TBLS/DOT nurses and clients. All aged from 20-60 years. They reported ease-of-use and access to screening, portability, availability in hard-to-reach areas, usefulness for mass screening in communities, comparable quality of x-ray with fixed x-ray, rapid results and had challenges with equipment/implementation costs, fears of irradiation, lack of collaboration with other programs and inability to use UPDX-with-CAD on children < 4 years. All (100%) strongly agreed that the UPDX/accessories were easy to set up, considered themselves proficient with operating the UPDX and to a lesser extent agreed that the programs and software are user-friendly and easy to set up. They however disagreed that the device is portable enough for one person to carry. Our study gave insight into the barriers and facilitators of acceptance and use of integrating new health technology into existing health systems and findings suggest that the implementation of the UPDX with CAD is feasible in Nigeria with very good perception on acceptability and ease-of-use for community TB screening activities.

Background: Lung cancer is a major cause of death. Japan has a higher rate of early detection of lung cancer, which is attributed to the impact of chest X-ray examinations implemented as mass screening. This study describes the characteristics and outcomes of patients with lung cancer in Japan, where chest X-ray screening is recommended for everyone aged >40 years old. Methods: This observational study linked the Kyoto City Integrated Database with data from a nationwide cancer registry in Japan. This study assessed individuals aged ≥65 years diagnosed with primary lung cancer between 2014 and 2018. Patients were categorized into the screened or unscreened groups based on their screening history within 1 year before diagnosis. Results: Of 4473 patients with lung cancer, 231 were included in the screened group. The screened group had a mortality rate of 25% at 1.7 years and 50% at 5.6 years, versus 25% at 0.5 years and 50% at 1.8 years for the unscreened group. Conclusions: Patients with primary lung cancer who underwent lung cancer screening had longer survival and better overall health at diagnosis than those who did not undergo screening. Further study is required to estimate the effectiveness of chest X-ray lung cancer screening.

Next-generation sequencing (NGS) has the potential to revolutionize newborn screening (NBS) by enabling the early identification of actionable genetic conditions not detectable by traditional methods. However, its integration into routine screening programs remains limited due to challenges related to feasibility, interpretation, and clinical impact. To investigate the acceptability and feasibility as well as the clinical implications of an NGS-based NBS program using DNA extracted from dried blood spots (DBSs). This prospective, nonpharmacological, interventional, single-center cohort study was proposed to parents whose newborns were delivered between October 1, 2023, and July 31, 2024, in a tertiary-level hospital in Turin, Italy, serving as a referral center for high-risk pregnancies. Newborns were consecutively selected at birth and enrolled after obtaining parental consent during the maternity stay. Whole-exome sequencing (WES) using an in silico panel of 521 genes associated with pediatric-onset, actionable conditions. Only pathogenic or likely pathogenic variants were reported. Primary outcome was the technical feasibility of WES on DBSs. Secondary outcomes were establishment of a genomic sequencing database for rapid reanalysis if subsequent clinical indications arise and preliminary qualitative evaluation of selected example cases to explore the clinical implications of NGS-based NBS results to inform future implementation in routine care. Of 4709 eligible newborns, 4067 (86.4%) were enrolled (2078 males [51.1%]; mean [SD] gestational age, 38.7 [1.9] weeks). Sequencing was successful in 4054 of newborns (99.7%). Of 4054 newborns analyzed, 542 (13.4%) screened positive. After orthogonal confirmation and family segregation studies, 568 actionable molecular diagnoses were retained, affecting 529 newborns (13.0%). During follow-up, 45 newborns underwent WES reanalysis due to clinical suspicion of a genetic disease, of whom 9 (20.0%) received a diagnosis not included in the initial screening panel. Genomic NBS using WES from DBSs was technically feasible and allowed early identification of actionable genetic conditions. Integration of genomic methods into NBS, although ethical, logistical, and clinical challenges remain, is a logical step but requires adequate genetic counseling and long-term follow-up.

The paper presents a new method for automated no-reference quantitative assessment of the quality of digital retinal images for diabetic retinopathy screening. The proposed method does not require localization of anatomical structures and is based on the analysis of the central fragment of the image in the green spectral channel using the Weibull distribution scale parameter for integrating local quality estimates. A comparative analysis of 36 no-reference functions was carried out, two evaluation measures that showed the best results were selected. It was experimentally shown that using a central fragment 50–67% of the original image size allows increasing the accuracy of image quality assessment by 40 % compared to full-image analysis. Scaling this fragment to 512×512 pixels reduces the image analysis time by up to 20 times without losing accuracy. The effectiveness of the method was confirmed on three thousand images from various sources: Kaggle and DDR databases, Belarusian clinical data. The developed approach does not require reference data and can be integrated into mass screening systems of fundus images, reducing the workload of specialists and increasing the availability of diagnostics for patients with limited computing resources.

Low bone mass, an often-undiagnosed precursor to osteoporosis, significantly increases fracture risk and poses a substantial public health challenge. This study aimed to develop and validate a deep learning model, OsPenScreen, for the opportunistic detection of low bone mass using routine chest X-rays (CXRs). OsPenScreen, a convolutional neural network-based model, was trained on 77,812 paired CXR and dual-energy X-ray absorptiometry (DXA) datasets using knowledge distillation techniques. Validation was performed across four independent datasets (5,935 images) from diverse institutions. The model's performance was assessed using area under the curve (AUC), accuracy, sensitivity, and specificity. Grad-CAM visualizations were employed to analyze model decision-making. Osteoporosis cases were pre-excluded by a separate model; OsPenScreen was applied only to non-osteoporotic cases. Our model achieved an AUC of 0.95 (95% CI: 0.94-0.97) on the external test datasets, with consistent performance across sex and age subgroups. The model demonstrated superior accuracy in detecting cases with significantly reduced bone mass and showed focused attention on weight-bearing bones in normal cases versus non-weight-bearing bones in low bone mass cases. OsPenScreen represents a scalable and effective tool for opportunistic low bone mass screening, utilizing routine CXRs without additional healthcare burdens. Its robust performance across diverse datasets highlights its potential to enhance early detection, preventing progression to osteoporosis and reducing associated healthcare costs.

Introduction The third most common cause of cancer-related death worldwide is hepatocellular carcinoma (HCC), a malignant liver tumor that usually arises in patients with cirrhosis and chronic liver disease. New biomarkers are required for bidirectional validation of HCC in clinical practice because of its early asymptomatic stage, high mortality rate, and rapid tumor growth, as well as the high rate of false-positive results obtained for the commonly used serum marker alpha-fetoprotein (AFP).MethodsThis study used gas chromatography–ion mobility spectrometry (GC-IMS) combined with chemometrics to analyze the differences in volatile organic compounds (VOCs) in the serum of patients with and without hepatocellular carcinoma (HCC) in order to explore new biomarkers of HCC.ResultsThe GC-IMS analysis detected 31 VOCs in serum, including 8 ketones, 11 aldehydes, 6 alcohols, 2 esters, and 1 furans, many of which differed in content between the controls and the patients with HCC.ConclusionsThe VOCs obtained from the use of these analytical devices can serve as a reference for developing low-cost equipment in the future. Considering its high efficiency and low cost, the detection of volatile organic compounds can be used as an auxiliary means of diagnosis or for mass screening of the population.

Introduction. The high prevalence of chest X-ray and fluorographic examinations creates significant workload for the radiology department. One promising solution for optimizing the preventive radiography and fluorography pipelines is employing artificial intelligence (AI) technologies. This approach demonstrates effectiveness in triaging studies based on binary assessment (“normal”/”abnormal”). Evaluation of this method identified shortcomings in the form of false-negative results requiring further study and improvement.Aim: To evaluate potential methods for reducing false-negative results in automated triage of preventive chest radiographic examinations using AI-powered software.Material and Methods. In a retrospective diagnostic study conducted from May 1, 2025, to June 30, 2025, we analyzed 411 cases of false-negative results identified during evaluation of automated triage powered by three different AI models. The study utilized data from preventive chest radiographic examinations performed in outpatient setting and mass screening examinations of the adult population in Moscow. Images were re-analyzed by two expert radiologists (&gt; 10 years of experience) considering the available clinical information and patient history data. Analytical and descriptive statistical methods were used.Results. The majority (n = 266) of false-negative results were associated with missed infiltrative changes and pulmonary foci. The remaining clinically significant discrepancies were observed in 24 cases.Analysis of archival data and patient histories identified additional information that, when integrated into AI-powered services, could influence study interpretation and reduce false-negative risk. Such data were found in 68.3% of cases (n = 198) with clinically significant omissions and in 5% (n = 6) with clinically insignificant omissions.Conclusion. Reducing false-negative results requires an integrated approach: implementing duplicate AI services, improving physician referral quality, and integrating clinical data and previous patient study results into AI algorithms, necessitating development of multimodal AI software.

Economic and organizational impact of a paediatric mass screening program for coeliac disease in Italy.

Mass Screening of Celiac Disease: A Crossing Point Between Secondary and Primary Prevention?

Piezoelectric suppression for rapid detection of Methamphetamine Hydrochloride via 14N nuclear quadrupole resonance.

On the overinterpretation of mass screening data - the example of mobile mRNA.

ObjectiveTo compare routine high risk human papillomavirus (hrHPV) screening with cytological screening in two screening rounds in a well established, routine screening programme for cervical cancer.DesignPopulation based cohort study.SettingFinland’s Mass Screening Registry, 2012-22, with diagnostic follow-up examinations until October 2024.Participants1 180 491 women participating at least once in cytological test (PAP smear) or hrHPV based cervical cancer screening between 2012 and 2022.Main outcome measuresNumbers and proportions of attendees, positive routine test results, follow-up screening referrals, colposcopy referrals, and incidence of cervical intraepithelial neoplasia ≥grade 2 (CIN2+) in the first and second hrHPV and cytological screening rounds. Results adjusted for age, year, region, and education.ResultsData for 1 574 688 full screening rounds were analysed. The overall referral rate for colposcopy was 3.37% (n=12 273) in the hrHPV group and 0.98% (n=11 895) in the cytology group, with an adjusted risk ratio of 2.97 (95% confidence interval (CI) 2.87 to 3.07). The overall rate for detection of CIN2+ was 0.92% in the hrHPV group and 0.35% in the cytology group, with an adjusted risk ratio of 2.17 (2.04 to 2.31). For the second hrHPV screening round compared with the first screening round, the adjusted risk ratio was 0.77 (0.71 to 0.84) for referral for colposcopy and 0.57 (0.46 to 0.72) for detection of CIN2+. Actual rates for referral for colposcopy were 3.54% (n=11 709) in the first hrHPV screening round and 2.42% (n=564) in the second screening round. The rate for detection of CIN2+ for hrHPV screening was 0.98% (n=3 248) in the first hrHPV screening round and 0.38% (n=88) in the second screening round. In cytological screening, no observed reduction was seen in either the referral rate or CIN2+ findings. After a negative hrHPV test in the first screening round, CIN2+ was detected in only 0.2% of women (n=44/314 286) in the second screening round.ConclusionsWithin a well established, population based national screening programme, the results of the study indicated that hrHPV screening with a five year interval was effective and safe. hrHPV screening identified precancerous lesions earlier than cytological screening. The incidence of CIN2+ was low in the second screening round in women with a negative hrHPV test result in the initial round and in those aged ≥50 years, and hence a longer screening interval for specific subgroups should be considered.

BackgroundChronic kidney disease (CKD) presents a global health challenge, requiring efficient assessment tools for effective management. Albuminuria assessment serves as a crucial indicator of CKD diagnosis, stage-classification, and progression risk. However, for the large-scale screening, the current laboratory-based methods lack portability and entail delays. Point-of-care (PoC) solutions like dipsticks offer promise, but sensitivity limitations persist.ObjectiveTo address this gap, we evaluated Proflo-U®, a novel fluorescent-based urine albumin measurement technology with the potential for PoC deployment, with the immunoturbidity-based Beckman Coulter system.ResultsOur study, based on a blinded comparison of 255 patient samples, revealed a high correlation (R2>0.9) between Proflo-U® and Beckman Coulter based measurement. Proflo-U® has been able to demonstrate comparable diagnostic accuracy, with strong sensitivity and specificity across different urine albumin concentration categories. Statistical analyses supported its reliability, and Receiver Operating Characteristic (ROC) analysis highlighted its clinically acceptable diagnostic accuracy.ConclusionOur findings suggest that Proflo-U® holds potential for mass screening initiatives in resource-limited settings to enable early CKD detection and management.

Objectives: Oral cancer is a serious disease whose prognosis worsens greatly with late detection and diagnosis. Therefore, a demand is pressing for a cost-effective model that is optimal for mass screening for oral cancer. So, this study aims to test oral cancer screening at the workplace to detect the prevalence of oral premalignant and malignant lesions in an institution-based campaign and to correlate it to the risk factors. Methods: The cross-sectional study recruited all the employees of an institution. Information about the risk factors (smoking/ tobacco and alcohol use, sharp dental restorations) was gathered. Then, comprehensive intra-oral examination and lymph node examination were performed to detect any abnormalities. Results: The study targeted 398 employees, 96 of whom declined participation. Therefore, oral screening was performed on 302 participants. The results showed zero oral malignancies, but oral findings were detected in 17 participants: frictional keratosis in 13 (4.3%), smoker’s keratosis in 2 (0.7%), and oral lichen planus in 2 (0.7%), which is an oral potentially malignant lesion. Chronic irritation and smoking were the only risk factors significantly associated with the detected lesions. Conclusions: Oral cancer screening at the workplace was valuable in detecting the most common risk factors in the studied population. However, it revealed some embarrassment of the screened population that impaired the participation rate. Future studies should adopt some modification in the examination settings to overcome this limitation.

The long-term outcomes of regression in autism spectrum disorder (ASD) remain unclear. Previous evidence suggests that autistic individuals with regression have poorer adulthood outcomes across various indices than those without regression. We compared two groups-those with and without regression in ASD-among 168 participants from a population-based birth cohort study. These individuals were born in northern Yokohama, Japan, between 1988 and 1996 and were diagnosed with ASD by age seven. Participants were classified into groups based on real-time records from a community-oriented mass screening system. This study focused on four outcomes: IQ at age five, IQ in adulthood, incidence of epilepsy, and composite social ability score. None of the outcomes showed significant differences between the two groups. The standardized effect size (where a positive value favors the non-regression group) was 0.06 (95% CI: -0.08 to 0.21) for the composite social ability score, -0.16 (95% CI: -0.55 to 0.22) for IQ at age five, and -0.15 (95% CI: -0.62 to 0.33) for IQ in adulthood. The risk ratio of epilepsy in the regression group compared to the non-regression group was 0.59 (95% CI: 0.22 to 1.5). No significant differences were observed in any of the four outcomes between autistic individuals with or without regression. The confidence intervals of the effect sizes indicate that the impact of regression on IQ and psychosocial adaptation in adulthood, if present, is likely to be small to intermediate.

Hepatitis C virus microelimination among men who have sex with men in Taiwan: Our progress, achievements, and remaining challenges.

A novel skin test for an in vivo assessment of SARS-CoV-2-specific T-cell immunity was developed using CoronaDermPS, a multiepitope recombinant polypeptide encompassing MHC II–binding CD4+ T-cell epitopes of the SARS-CoV-2 structural proteins (S, E, M) and full length nucleocapsid (N). In silico epitope prediction and modeling guided antigen design, which was expressed in Escherichia coli, was purified (>95% purity) and formulated for intradermal administration. Preclinical evaluation in guinea pigs, mice, and rhesus macaques demonstrated a robust delayed type hypersensitivity (DTH) response at optimal doses (10–75 µg), with no acute or chronic toxicity, mutagenicity, or adverse effects on reproductive organs. An integrated clinical analysis included 374 volunteers stratified by vaccination status (EpiVacCorona, Gam-COVID-Vac, CoviVac) prior to COVID-19 infection (Wuhan/Alpha, Delta, Omicron variants), and SARS-CoV-2–naïve controls. Safety assessments across phase I–II trials recorded 477 adverse events, of which >88% were mild and self-limiting; no severe or anaphylactic reactions occurred. DTH responses were measured at 24 h, 72 h, and 144 h post-injection by papule and hyperemia measurements. Overall, 282/374 participants (75.4%) exhibited a positive skin test. Receiver operating characteristic analysis yielded an overall AUC of 0.825 (95% CI: 0.726–0.924), sensitivity 79.5% (95% CI: 75.1–83.3%), and specificity 85.5% (95% CI: 81.8–88.7%), with comparable diagnostic accuracy across vaccine, and variant subgroups (AUC range 0.782–0.870). CoronaDerm-PS–based skin testing offers a simple, reproducible, and low-cost method for qualitative evaluation of T-cell–mediated immunity to SARS-CoV-2, independent of specialized laboratory equipment (Eurasian Patent No. 047119). Its high safety profile and consistent performance across diverse cohorts support its utility for mass screening and monitoring of cellular immune protection following infection or vaccination.

Cholangiocarcinoma (CCA) is a prevalent malignancy in countries along Mekong basin, closely linked to chronic infections caused by Opisthorchis viverrini (OV). Early detection of OV-infected individuals holds significant promise for screening at-risk populations in endemic regions. Recent advancements in immunochromatographic methods have led to the development of a rapid diagnostic test (RDT) based on urinary antigens. However, the current interpretation relies on visual assessment of T-band color intensity, which can be subjective and prone to variability. Furthermore, aggregating data at the regional/country level demands data digitization, a time and resource intense task that introduces further errors. To address this limitation, we introduce the OV-RDT platform, a cloud-based system incorporating artificial intelligence (AI) designed to standardize the reading and interpretation of OV-RDT results while facilitating mass screening campaigns for opisthorchiasis. This cross-platform solution, available on Android and iOS devices, consists of three key components: a mobile application, an intelligent dashboard, and a cloud server cluster. The server cluster has two main components the data processing server and the AI server. The AI server operates two AI-based models systematically developed and validated for image quality assessment and T-band grading of OV-RDT test kit images. The data processing server periodically retrieves and processes data from the cloud database, enabling comprehensive daily visualization through the intelligent dashboard. Validation through extensive field testing was conducted specifically in the northeastern region of Thailand, where opisthorchiasis prevalence is among the highest globally, demonstrating remarkable effectiveness by processing over 100,000 samples. While our platform shows excellent performance in this endemic region, external validation in other geographical areas would be necessary to establish broader generalizability. The EfficientNet-B5-based deep learning model used in the platform exhibited impressive performance in both image quality assessment (98% accuracy) and infection grading classification (95% accuracy in detecting OV infection status). The platform’s user-friendly interface has achieved high satisfaction rates (4.41/5.00) among healthcare workers, while its intelligent dashboard offers real-time analytics and geospatial visualization capabilities. This integrated approach marks a significant advancement in mass screening for opisthorchiasis, potentially enhancing early detection rates and supporting more effective public health interventions in Southeast Asia and the Mekong Basin countries. This study addresses the critical need for mass screening in northeastern Thailand, where liver fluke infection rates are particularly severe; however, the platform’s performance in other regions requires future validation studies.

ABSTRACTThe development of affordable and user‐friendly diagnostic tools for early warning and monitoring progression of chronic kidney disease (CKD) is crucial to reducing CKD‐related morbidity and mortality. This study reports on (1) a protein‐templated AIEgen, Ir@BSA, which emits intense green phosphorescence with a quantum yield up to 69.40% and a lifetime up to 1839.40 ns in aqueous solution; (2) a straightforward protocol for Cys C quantitation, which employs Ir@BSA as the phosphorescent signal indicator and papain as the biomolecular recognition element, respectively; and (3) a smartphone‐based portable phosphorescence reader (termed as SAPD), which can stably excite and accurately collect phosphorescence signals from the paper‐based arrays. Quantitation of Cys C in clinical serum samples using SAPD integrated with the paper‐based arrays highlights its remarkable advantages including high sensitivity (0.36 µg mL−1) and specificity, cost‐effectiveness (∼$67.5 per set), portability (∼450 g), good precision (RSD ≤ 8.25 %), good accuracy (comparable to clinical standard latex immune‐turbidimetric method), and high throughput (16 samples per experiment). More importantly, this study reveals the significant potential of Cys C as an early warning marker of CKD progression. The reported method enables Cys C quantitation anywhere, anytime, by anyone, and is ideally suited for mass screening for CKD and home monitoring of CKD progression, facilitating early diagnosis and proactive management of CKD.

The Hepatitis B-virus is the etiological agent of an infection that affects liver functions and potentially causes disorders. Approximately, 300million people are living with acute or chronic HBV-infections worldwide, and only a fraction of them have access to medical care. The sub-Saharan African (SSA) regions house around 80million of reported infection cases, and certain SSA-groups like pregnant women and drug-addict are among the most vulnerable. In as much as there is insufficient national data on young adult groups, this study aims to determine HBV-prevalence and associated factors of infections within a student population in the Southeastern part of Gabon. A university-based cross-sectional study was conducted among Gabonese students from March to July 2023. Laboratory assessment of HBV-markers was done to estimate infection status of on-campus students. Furthermore, chi-squared and multivariate logistic regression analyses were performed to determine association between variables. With an infection sero-prevalence rate of 5.6% from a total of 462 participants, mostly undergraduates, 26- and 184-samples tested positive for HBsAg- and Anti-HBc-markers, respectively. Viral loads were then detected for 13 of those positive for HBsAg-markers. Several factors were associated with having Anti-HBc markers, whereas the use of condom was determinant in acquiring HBsAg-markers. The odds of having contact with HBsAg-markers were significant with regular alcohol consumption. While the odds of having Anti-HBc-markers were significantly increased in older students, in those sharing shaped materials (2-folds), and even higher in those having HBV-family history (6-folds). This screening effort demonstrated that HBV is circulating among Gabonese students and highlighted possible associated factors. Preventive measures should be elaborated including mass screening to identify and treat HBV-carriers, raising awareness on the necessity of adopting safe behaviors and lifestyles among other learners and young adults living on- and off-campus.