Detection Program Research Articles

Factors Influencing Early Detection of Breast Cancer Through Clinical Breast Examination (SADANIS) at the North City Health Center, Gorontalo City

Early detection/screening is a secondary prevention effort that is considered the most rational to reduce the death rate due to breast cancer. Clinically early detection of breast cancer is carried out in the target group of women of childbearing age, but the priority for the early detection program in Indonesia is women aged 30-50 years. The research aims to analyze factors influencing early detection of breast cancer through clinical breast examination (SADANIS) at the North City Health Center, Gorontalo City. Analytical survey research method with a cross-sectional study design. The population is women aged 30-50 years who visited the KIA-KB services at the North City Health Center in February 2024, amounting to 136 visitors. Sampling used the Slovin formula, so the total sample was 101 people. Analysis was carried out using the chi-square test and multiple logistic regression test. Based on a multivariate test using a multiple logistic regression test on variables that influence early detection of breast cancer with SADANIS, namely family/husband support, health worker support, and exposure to information, the results obtained are that the family/husband support variable has a significant value of 0.027 <0.05 with a value of Exp(B) = 12.522 which means that family/husband support has a 12.52 times higher risk of influencing early detection of breast cancer. The conclusion of this study is The variable family/husband support is the variable that has the most influence on the early detection of breast cancer with SADANIS

The importance of informing about the preventive program for early detection of prostate cancer- a preliminary pilot study

ObjectivesThe aim was to determine the knowledge of men about prostate cancer and screening methods, and the influence of these factors on participation in prostate cancer screening. Participants and methodsParticipants in this observational and cross-sectional study were men aged 40 to 79 years. Participation in the study was voluntary. Data were collected in May 2023 via an anonymous online survey. ResultsThere is a lack of knowledge about prostate cancer among men in Istria. Most receive information from the media, while a smaller number receive information from physicians. Most have heard that there is a PSA test, but few know that it is a method for early detection. Subjects have different perceptions of digital rectal examination and other screening methods. Some men are afraid of discomfort and pain during the examination, while others do not consider this a problem. Most indicate that they intend to participate in screening in the future and that early detection of prostate cancer is important and a positive attitude towards it influences the decision to participate in the screening program. ConclusionThe lack of knowledge about prostate cancer among men in Croatia is evident. Although most of the respondents do not consider themselves as a risk group, a positive attitude towards early detection affects the participation in prevention programs. Raising awareness and educating men about prostate cancer and available screening methods are key to increasing the number of participants in prevention programs and reducing the incidence of this disease.

Barriers and Facilitators to Breast and Cervical Cancer Screenings for Hispanic Women in a Rural State

Abstract Introduction The Centers for Disease Control and Prevention (CDC) and the Division of Cancer Prevention of Control administer the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), designed to increase early detection of cancers among low-income uninsured and underinsured women. However, rates of cancer diagnosis and survivorship differ among women of different ethnicities. We investigated two questions: 1) what are the potential barriers and facilitators for women to complete recommended breast and cervical cancer screenings, and 2) are the barriers and facilitators different for Hispanic women when compared to non-Hispanic White women? Methods We used a community-based participatory research approach and mixed methods: qualitative interviews with women enrolled in the program and a systematic process improvement approach to identify root causes of completing or not completing screenings. We conducted semi-structured interviews in English (n = 11) and Spanish (n = 9) and analyzed responses using fishbone diagrams. Results We recruited 20 participants in four categories: (a) non-Hispanic White women who completed screenings (n = 9), (b) non-Hispanic White women who did not complete screenings (n = 2), (c) Hispanic women who completed screenings (n = 7), and (d) Hispanic women who did not complete screenings (n = 2). Among all women, facilitators included assistance from program staff with appointments and reminders. Hispanic women reported barriers including language difficulties and confusion about the program. Non-Hispanic White women identified barriers as confusion about the role of insurance. Conclusions We found that there are differences in barriers and facilitators for non-Hispanic White women and Hispanic women due to language, the role of insurance, and the level of trust in the program. Reasons for not completing screenings for Hispanic women were structural and systemic in nature; reasons for non-Hispanic White women were based on personal choices.

A PROPOSED METHOD FOR SPEECH AND LANGUAGE TESTING WITHIN A HEARING SCREENING PROGRAM FOR CHILDREN STARTING SCHOOL

This article sets out a proposal for how one might expand hearing screening in school children so as to include testing of speech mastery. From 2008 to 2019, the Institute of Physiology and Pathology of Hearing (IPPH) implemented a program to screen the hearing of Polish children starting school, covering over 1 million children. Its success prompted the development of a screening model to cover the entire process of verbal communication. One result was the "Equal Start in Education", a program implemented from 2019 to 2022 in the Lublin province, otherwise known as the "Lublin Program for Early Detection and Therapy of Communication Disorders in Children Starting School". It was conducted by the University Children’s Clinical Hospital in Lublin and the Maria Curie-Sklodowska University, in cooperation with IPPH, and was designed to assess hearing, auditory processing, voice, and speech-language. The program was successful in addressing various issues related to the screening of all communication skills. Here we present findings from the program and propose a testing procedure used to evaluate speech. The screening procedure might be applied more widely in the future, and could diagnose those children requiring audiological and speech-language therapy.

Primary human papillomavirus testing vs cotesting: clinical outcomes in populations with different disease prevalence.

Implementation of primary human papillomavirus (HPV) testing has been slow in the United States perhaps because of concerns of decreased sensitivity compared with concurrent HPV and cytology testing ("cotesting"). We used the National Breast and Cervical Cancer Early Detection Program and the Kaiser Permanente of Northern California cohort to quantify potential trade-offs with primary HPV compared with cotesting in 4 US populations with differing precancer or cancer prevalence. In all settings, cotesting required more lab tests and more colposcopies compared with primary HPV testing. Additional cervical intraepithelial neoplasia grade 3 or cancer immediately detected from cotesting vs primary HPV decreased with decreasing population-average cervical intraepithelial neoplasia grade 3 or cancer prevalence from 71 per 100 000 screened among never or rarely screened individuals in the National Breast and Cervical Cancer Early Detection Program (prevalence = 1212 per 100 000) to 4 per 100 000 screened among individuals with prior HPV-negative results in Kaiser Permanente of Northern California (prevalence = 86 per 100 000). These data suggest that cotesting confer an unfavorable benefit-to-harm ratio over primary HPV testing.

The Safe Catch: AI Protects Your Health from Formalin-Laced Fish

In Bangladesh, where fish is a staple food, ensuring its safety from formalin contamination poses a critical challenge due to its perishable nature. This study introduces an intelligent application employing digital image processing for the rapid and non-intrusive detection of formalin in fish. Leveraging image analysis of fish eyes, the system distinguishes between formalin and non-formalin treated fish. The proposed architecture, utilizing EfficientNet-B3 and VGG-16 models, achieved a 98.05% and 98% accuracy rate in training and validation on the dataset. This method offers a swift and accurate means of examination without damaging sample preparation, particularly beneficial in large-scale operations where manual inspection is impractical. Unlike human senses, digital image processing algorithms remain impartial, overcoming human biases and subjective judgments. Challenges persist, such as the diverse appearance of fish and external factors like varying illumination, which may impact the reliability and effectiveness of image processing programs for formalin detection. Nonetheless, this technology holds promise in addressing the pressing need for dependable and automated formalin detection in the fish supply chain, ensuring food safety and public health.

Taiwan national lung cancer early detection program for heavy smokers and non-smokers with family history of lung cancer.

8009 Background: Lung cancer incidence in Taiwan has been rising with the epidemiological profiles distinct from Western country. Notably, nonsmoking lung cancers accounts for more than 60% and half of lung cancers were diagnosed in advanced stages. For early detection, a national program is therefore initiated to offer biennial low-dose computed tomography (LDCT) screening for heavy smokers and subjects with lung cancer family history (LCFH). Here, we report basic screening findings, analyze relevant effectiveness in reducing advanced lung cancer, and project the potential benefit of mortality reduction. Methods: Taiwan National Lung Cancer Early Detection Program was launched on July 1, 2022 to offer heavy smokers (30 pack-years) and nonsmokers (including light smokers) with a LCFH aged 45-74 years for female and aged 50-74 years for male. This is a continuous screening program using before and after study design for evaluation. We provided the overall first-year basic screening findings until Dec 31, 2023 and did per protocol analysis of stage II+ cancer reduction in comparison with tumor stage distribution in the year preceding the introduction of the national program. The corresponding findings were presented for subjects with LCFH and heavy smokers. The result for heavy smoker was compared with those per-protocol findings from previous randomized controlled trials. The potential mortality reduction was further projected. Results: A total of 78,000 individuals participated in this program, male 44,381 (56.9%) female 33,619 (43.1%); 31,111 participants (39.9%) were heavy smokers, 43,853 (56.2%) nonsmokers but with a LCFH, and 3,036 (3.9%) had both risk factors. Lung cancer confirmed in 956 subjects by surgery or biopsy, 85.0% were stage 0-1. The lung cancer detection rate was 1.2%. Subjects with a LCFH exhibited a higher detection rate (overall: 1.6%, nonsmokers: 1.7% and light smokers 0.9%) compared to heavy smokers (0.7%) and both (1.1%). Early detection of LDCT led to a statistically significant 77% (51%-89%) of reducing advanced stage of lung cancer, 53% (-3%-78%) reduction for heavy smokers, consistent with the corresponding 36%-64% reduction derived from the NLST trial and the Nelson trial, and 85% (67%-93%) reduction for nonsmokers with a LCFH. The benefit of reducing stage II or severe in conjunction with five-year stage-specific survival rate further projected 55% (10%-78%) of mortality reduction from lung cancer. Conclusions: This is the first large-scale LC screening service enrolling 40% heavy smokers and 60% non-smoker with a LCFH. The potential effectiveness of early detection was demonstrated for both targets. As the results based on per-protocol analysis for heavy smoker were consistent with those of previous evidence-based studies the similar and significant intention-to-treat results as before while waiting for the subsequent follow-up would be expected.

Cancer Screening in Low- and Middle-Income Countries.

The worldwide cancer burden is growing, and populations residing in low- and middle-income countries (LMICs) are experiencing a disproportionate extent of this growth. Breast, colorectal, and cervical cancers are among the top 10 most frequently diagnosed malignancies, and they also account for a substantial degree of cancer mortality internationally. Effective screening strategies are available for all three of these cancers. Individuals from LMICs face substantial cost and access barriers to early detection programs, and late stage at diagnosis continues to be a major cause for cancer mortality in these communities. This chapter will review the epidemiology of breast, colorectal, and cervical cancers, and will explore prospects for improving global control through novel approaches to screening in cost-constrained environments.

A simple measurement method for in-situ temperature-dependent piezoelectric coefficient d 33 of piezoelectric materials

Piezoelectric materials have been widely used in sensors, actuators, and transducers due to their positive and inverse piezoelectric effects, which can convert electrical and mechanical energy into one another. The most important parameter to evaluate the piezoelectric properties of materials is their piezoelectric coefficient (d 33). The value of d 33 varies with temperature. The measurement of temperature-dependent d 33 is a difficult task and at present, the equipment used to measure the temperature-dependent d 33 has many limitations. To overcome these limitations, the current study proposes an in situ temperature-dependent d 33 measuring method based on the inverse piezoelectric effect of piezoelectric materials. The newly developed measuring equipment contains a laser vibrometer, and automatic detection program including data processing. Moreover, the image is displayed on LabVIEW program. Compared with the quasi-static temperature-dependent d 33 measurement method, the KNN- based piezoelectric material demonstrated the reliability of this measurement method.

Deciphering the Puzzle: Literature Insights on Chlamydia trachomatis-Mediated Tumorigenesis, Paving the Way for Future Research.

Some infectious agents have the potential to cause specific modifications in the cellular microenvironment that could be propitious to the carcinogenesis process. Currently, there are specific viruses and bacteria, such as human papillomavirus (HPV) and Helicobacter pylori, that are well established as risk factors for neoplasia. Chlamydia trachomatis (CT) infections are one of the most common bacterial sexually transmitted infections worldwide, and recent European data confirmed a continuous rise across Europe. The infection is often asymptomatic in both sexes, requiring a screening program for early detection. Notwithstanding, not all countries in Europe have it. Chlamydia trachomatis can cause chronic and persistent infections, resulting in inflammation, and there are plausible biological mechanisms that link the genital infection with tumorigenesis. Herein, we aimed to understand the epidemiological and biological plausibility of CT genital infections causing endometrial, ovarian, and cervical tumors. Also, we covered some of the best suitable in vitro techniques that could be used to study this potential association. In addition, we defend the point of view of a personalized medicine strategy to treat those patients through the discovery of some biomarkers that could allow it. This review supports the need for the development of further fundamental studies in this area, in order to investigate and establish the role of chlamydial genital infections in oncogenesis.

Detection of Throat Disorders Based on Thermal Image Using Digital Image Processing Methods

Throat disorders are often considered trivial for some people, but if they are not treated immediately they can result in more severe conditions and require a longer time to cure this disorder. Objective, safe and comfortable detection of throat disorders is important because throat disorders are an indication of inflammation which, if not treated immediately, can have negative consequences. This research aims to detect throat disorders based on thermal images using digital image processing methods. Image capture was carried out with the same color pallete range on the camera, namely 33°C-38°C. The image obtained is then cropped in the ROI, then the image is threshold with a gray degree of 190. Pixels that have a gray degree above 190 are converted to white, while those below the threshold are converted to black. Next, the percentage of each white and black area is calculated compared to the total ROI area. If the percentage of white area is greater than 38% compared to the area of ​​the throat then it is identified as having a throat disorder, whereas if the percentage of white is less than 38% then it is identified as not having a throat disorder. The detection program created provides an accuracy of 87.5% on sample data of 8 test data.

Stroke Detection Using Logistic Regression

In this study, we present a stroke detection algorithm developed in Python, addressing a critical aspect of medical informatics. Drawing on a comprehensive public dataset, the detection program utilizes a logistic regression method to achieve an impressive accuracy rate of 94%. The dataset encompasses diverse demographic and health-related variables, such as marital status, age, BMI, heart disease history, working status, smoking habits, and glucose levels, which are all compared to whether or not that patient had a stroke.

Coalition for Global Hearing Health Hearing Care Pathways Working Group: Guidelines for Clinical Guidance for Readiness and Development of Evidence-Based Early Hearing Detection and Intervention Programs.

Editor's Note: The following article discusses the timely topic Clinical Guidance in the areas of Evidence-Based Early Hearing Detection and Intervention Programs. This article aims to discuss areas of services needed, guidance to countries/organizations attempting to initiate early hearing detection and intervention systems. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. In Ear and Hearing, our long-term goal for the Point of View article is to stimulate the field's interest in and to enhance the appreciation of the author's area of expertise. Hearing is an important sense for children to develop cognitive, speech, language, and psychosocial skills. The goal of universal newborn hearing screening is to enable the detection of hearing loss in infants so that timely health and educational/therapeutic intervention can be provided as early as possible to improve outcomes. While many countries have implemented universal newborn hearing screening programs, many others are yet to start. As hearing screening is only the first step to identify children with hearing loss, many follow-up services are needed to help them thrive. However, not all of these services are universally available, even in high-income countries. The purposes of this article are (1) to discuss the areas of services needed in an integrated care system to support children with hearing loss and their families; (2) to provide guidance to countries/organizations attempting to initiate early hearing detection and intervention systems with the goal of meeting measurable benchmarks to assure quality; and (3) to help established programs expand and improve their services to support children with hearing loss to develop their full potential. Multiple databases were interrogated including PubMed, Medline (OVIDSP), Cochrane library, Google Scholar, Web of Science and One Search, ERIC, PsychInfo. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. Eight essential areas were identified to be central to the integrated care: (1) hearing screening, (2) audiologic diagnosis and management, (3) amplification, (4) medical evaluation and management, (5) early intervention services, (6) family-to-family support, (7) D/deaf/hard of hearing leadership, and (8) data management. Checklists are provided to support the assessment of a country/organization's readiness and development in each area as well as to suggest alternative strategies for situations with limited resources. A three-tiered system (i.e., Basic, Intermediate, and Advanced) is proposed to help countries/organizations at all resource levels assess their readiness to provide the needed services and to improve their integrated care system. Future directions and policy implications are also discussed.

Editorial Vol.14(1)

With great satisfaction, the Research Management Cell (RMC) of Mahendra Multiple Campus, Dharan, announces the successful publication of the annual multi-disciplinary peer-reviewed research journal named Dristikon, as vol. 14(1) includes the editorial peer-review process that almost all scholarly and research articles published in the journal go through before being published to meet the requirements of the peer-review process that UGC, Nepal, and international standards guide. The purpose of the peer review procedure is to guarantee that the legitimate article gets approved, the disorganized piece gets fixed up, and the invalid article gets turned down. The editorial board has approved the suggestions of the reviewer. A thorough double-blinded peer review process is applied to every paper submitted for publication to guarantee its quality before it is published. A research article’s main goal is to present new information backed by evidence, and all the authors’ statements should be carefully examined before publication. In other ways, ChatGPT has shown to be more beneficial. Its ability to generate more sophisticated sentences is greater than unedited ones. It can produce a revised paragraph in a matter of seconds, and it's now free for everyone to use. The accepted papers, which covered the particular subjects of Nepali, English, Sanskrit, Economics, Education, Science, and Management, were added to the issue after the necessary changes and adjustments from the review process. The journal carefully adheres to the requirements of the APA 7th edition and vehemently rejects any information that has been copied without proper citation, as determined by the iThenticate plagiarism detection program. The writer's thoughts are their own, and neither the editorial board nor the publisher endorses anything that is written in the articles. After they are published, all manuscripts belong to the publishing company. As the Dristikon continues to grow and thrive, we hope that readers' inspiration and support will do the same. Your feedback and recommendations for future developments are also welcome and will be considered. The articles in this publication were submitted by authors in both Roman and Devanagari alphabetical order and were received from both campus and other colleges and institutions. To improve the journal's qualitative content, intellectuals, readers, and observers are invited to submit articles and comments. We appreciate the insightful feedback and recommendations from the peer reviewers. The editorial board would like to express its sincere gratitude to everyone who has contributed to the research publications. Additionally, we would like to express our gratitude to Assoc. Prof. Chandra Kumar Rai, Campus Chief for his unwavering assistance with finances and administration of the production of this journal.

Prospects of utilizing the Korean satellite program for geological disaster detection and analysis

Prospects of utilizing the Korean satellite program for geological disaster detection and analysis

#2201 Assessment of long-term cardiovascular comorbidities in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis

Abstract Background and Aims ANCA associated vasculitis (AAV) is closely correlated to elevated cardiovascular disease (CVD) rates, positioning it a one of the leading causes of death among these patients. The impact of AAV on the risk of CVD has not been described in large prospective cohorts with a long-term follow up. The aim of our study was to evaluate the occurrence of cardiovascular events, encompassing major adverse cardiovascular events (MACE), to delineate associated risk factors, and to draw comparisons with other cohorts of patients diagnosed with CKD. Method We included 848 patients with a diagnosis of AAV who participated in 7 EUVAS RCTs (NORAM, CYCAZAREM, CYCLOPS, MEPEX, IMPROVE, RITUXVAS, and MYCYC), recruited from 74 centers in 17 European countries. The three-point MACE outcome was defined as acute myocardial infarction (AMI), stroke, or death from cardiovascular event. We used multivariate logistic regression analysis to assess the risk factors of MACE. Patients from our cohort were compared to the patients from the Chronic Renal Insufficiency Cohort (CRIC), which is a multicenter, prospective observational cohort study of participants with CKD. Results During the median follow up of 8 years (range 0-24.5, IQR: 2.9-13.6), 100 (11.8%) patients developed diabetes, 98 (13.4%) coronary heart disease (CHD), 90 (12.1%) hypertension, 70 (9.6%) deep vein thrombosis (DVT), 43 patients (5.9%) had a stroke and 28 (3.8%) an AMI. The number of MACE during FU was 144 (17%). MACE was more frequent among patients older than 65 years (n = 62 (43.1%); p-value: 0.013). CVD was the primary cause of death in 43 patients (14%). During the first 5 years after randomization, there was a significant increase in the number of cardiovascular events compared to the period 6 years- end of follow up (CHD: n = 55 vs n = 23, p ≤ 0.001; DVT: n = 55 vs n = 29; p < 0.001; stroke: n = 35 vs n = 24, p-value < 0.001). The prognostic factors for MACE in our cohort were hemodialysis dependency during RCT, age, male sex, previous history of CHD and stroke, and occurrence of diabetes during follow up. Within the subset of patients who underwent kidney biopsy, those in the crescentic class (n = 16) followed by the mixed class (n = 15) exhibited a significant higher incidence of MACE (p = 0.02). When compared to the cohort of patients with CKD from the CRIC study, the risk for CHD was higher (13.4% (95% CI: 11.16-16.11) vs 5.4% (95% CI 4.5-6.5); respectively; RR: 2.49 (95% CI 1.91-3.24); p-value<0.01). Additionally, there was a higher risk for stroke (5.6% (95% CI 4.2-7.4) vs 2.8% (95% CI 2.2- 3.7); RR 1.97 (95% CI: 1.33- 2.91) p-value: 0.0006). Conclusion Patients with AAV had an increased risk of stroke and CHD compared to patients with CKD from other etiologies. During the first years after diagnosis, there is an increased risk for CVD occurrence. The prognostic factors for MACE in our cohort were hemodialysis dependency, age, male sex, previous story of CHD and stroke, and diabetes during follow up. Patients with AAV should be considered at high cardiovascular risk; therefore, the therapeutic approach should include the management of traditional cardiovascular risk factors and lifestyle modification. Efforts should be made to meet strict therapeutic targets and to implement early CVD detection programs.

Organization and Structures for Detection and Monitoring of CKD Across World Countries and Regions: Observational Data From a Global Survey

Rationale & ObjectiveEstablished therapeutic interventions effectively mitigate the risk and progression of chronic kidney disease (CKD). Countries and regions have a compelling need for organizational structures that enable early identification of people with CKD who can benefit from these proven interventions. We aimed to report the current global status of CKD detection programs. Study DesignA multinational cross-sectional survey. Setting & ParticipantsStakeholders, including nephrologist leaders, policymakers, and patient advocates from 167 countries, participating in the International Society of Nephrology (ISN) survey from June to September 2022. OutcomesStructures for the detection and monitoring of CKD, including CKD surveillance systems in the form of registries, community-based detection programs, case-finding practices, and availability of measurement tools for risk identification. Analytical ApproachDescriptive statistics. ResultsOf all participating countries, 19% (n=31) reported CKD registries and 25% (n=40) reported implementing CKD detection programs as part of their national policies. There were variations in CKD detection program, with 50% (n=20) using a reactive approach (managing cases as identified) and 50% (n=20) actively pursuing case-finding in at-risk populations. Routine case-finding for CKD in high-risk populations was widespread, particularly for diabetes (n=152; 91%) and hypertension (n=148; 89%). Access to diagnostic tools, estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR), was limited, especially in low-income (LICs) and lower-middle-income (LMICs) countries, at primary (eGFR: LICs 22%, LMICs 39%, UACR: LICs 28%, LMICs 39%) and secondary/tertiary healthcare levels (eGFR: LICs 39%, LMICs 73%, UACR: LICs 44%, LMICs 70%), potentially hindering CKD detection. LimitationsA lack of detailed data prevented an in-depth analysis. ConclusionThis comprehensive survey highlights a global heterogeneity in the organization and structures (surveillance systems, detection programs and tools) for early identification of CKD. Ongoing efforts should be geared toward bridging such disparities to optimally prevent the onset and progression of CKD and its complications.

A newborn Screening Programme for Inborn errors of metabolism in Galicia: 22 years of evaluation and follow-up

BackgroundThere is a notable lack of harmonisation in newborn screening (NBS) programmes worldwide. The Galician programme for early detection of inborn errors of metabolism (IEM) was one of the first NBS programmes in Europe to incorporate mass spectrometry (July 2000). This programme currently screens for 26 IEMs in dried blood and urine samples collected 24–72 h after birth.ResultsIn its 22-year history, this programme has analysed samples from 440,723 neonates and identified 326 cases of IEM with a prevalence of 1:1351. The most prevalent IEMs were hyperphenylalaninaemia (n = 118), followed by medium chain acyl-CoA dehydrogenase deficiency (MCADD, n = 26), galactosaemia (n = 20), and cystinurias (n = 43). Sixty-one false positives and 18 conditions related to maternal pathologies were detected. Urine samples have been identified as a useful secondary sample to reduce the rate of false positives and identify new defects. There were 5 false negatives. The overall positive value was 84.23%. The fatality rate over a median of 12.1 years of follow-up was 2.76%. The intelligence quotient of patients was normal in 95.7% of cases, and school performance was largely optimal, with pedagogic special needs assistance required in < 10% of cases. Clinical onset of disease preceded diagnosis in 4% of cases. The age at which first NBS report is performed was reduced by 4 days since 2021.ConclusionsThis study highlights the benefits of collecting urine samples, reduce NBS reporting time and expanding the number of IEMs included in NBS programmes.

Impact of OLD/Emphysema in LC Mortality Risk in Screening Programs: An Analysis of NLST and P-IELCAP

IntroductionThe impact of obstructive lung disease (OLD) and emphysema on lung cancer (LC) mortality in patients undergoing LC screening is controversial. MethodsPatients with spirometry and LC diagnosed within the first three rounds of screening were selected from the National Lung Screening Trial (NLST) and from the Pamplona International Early Lung Cancer Detection Program (P-IELCAP). Medical and demographic data, tumor characteristics, comorbidities and presence of emphysema were collected. The effect of OLD and emphysema on the risk of overall survival was assessed using unadjusted and adjusted Cox models, competing risk regression analysis, and propensity score matching. ResultsData from 353 patients with LC, including 291 with OLD and/or emphysema and 62 with neither, were analyzed. The median age was 67.3 years-old and 56.1% met OLD criteria, predominantly mild (1: 28.3%, 2: 65.2%). Emphysema was present in 69.4% of the patients. Patients with OLD and/or emphysema had worse survival on univariate analysis (HR: 1.40; 95% CI: 0.86–2.31; p=0.179). However, after adjusting for LC stage, age, and sex, the HR was 1.02 (95% CI: 0.61–1.70; p=0.952). Specific LC survival between both groups showed an adjusted HR of 0.90 (95% CI: 0.47–1.72; p=0.76). Propensity score matching found no statistically significant difference in overall survival (HR: 1.03; 95% CI: 0.59–1.9; p=0.929). ConclusionThe survival of LC patients diagnosed in the context of screening is not negatively impacted by the coexistence of mild OLD and/or emphysema.

Outcomes of Resected Lung Cancer Diagnosed Through Screening and Incidental Pulmonary Nodule Programs in a Mississippi Delta Cohort

IntroductionEarly lung cancer detection programs improve surgical resection rates and survival but may skew toward more indolent cancers. MethodsHypothesizing that differences in stage-stratified survival indicate differences in biological aggressiveness and possible length-time and overdiagnosis bias, we assessed a cohort who had curative-intent resection, categorized by diagnostic pathways: screening, incidental pulmonary nodule program, and non–program based. Survival was analyzed using Kaplan-Meier plots, log-rank tests, and Cox regression, comparing aggregate and stage-stratified survival across cohorts with Tukey’s method for multiple testing. ResultsOf 1588 patients, 111 patients (7%), 357 patients (22.5%), and 1120 patients (70.5%) were diagnosed through screening, pulmonary nodule, and non–program-based pathways; 0% versus 9% versus 6% were older than 80 years (p = 0.0048); 17%, 23%, and 24% had a Charlson Comorbidity score greater than or equal to 2 (p = 0.0143); 7%, 6%, and 9% had lepidic adenocarcinoma; 26%, 31%, and 34% had poorly or undifferentiated tumors (p = 0.1544); and 93%, 87%, and 77% had clinical stage I (p < 0.0001).Aggregate 5-year survival was 87%, 72%, and 65% (p = 0.0009), including 95%, 74%, and 74% for pathologic stage I. Adjusted pairwise comparisons showed similar survival in screening and nodule program cohorts (p = 0.9905). Nevertheless, differences were significant between screening and non–program-based cohorts (p = 0.0007, adjusted hazard ratio 0.33 [95% confidence interval: 0.18–0.6]) and between nodule and nonprogram cohorts (adjusted hazard ratio 0.77 [95% confidence interval: 0.61–0.99]). Stage I comparisons yielded p = 0.2256, 0.1131, and 0.911. In respective pathways, 0%, 2%, and 2% of patients with stage I disease who were older than 80 years had a Charlson score greater than or equal to 2 (p = 0.3849). ConclusionsNeither length-time nor overdiagnosis bias was evident in NSCLC diagnosed through screening or incidental pulmonary nodule programs.