Screening Programs For Early Detection Research Articles

Outcome of Breast Cancer Management Comparative Cross Sectional Study in Sudan and Greece

Introduction: Prognosis of breast cancer depends mainly on early detection of the disease it is also well known the stage at diagnosis is inversely associated with the five-year survival rate nodal involvement is main prognostic factor. Other factors are associated with the prognosis of breast cancer like the molecular subtype of the tumor, socioeconomic status of the patient, and the modalities of treatment received. The management of the patient is going to be planned according to stage at diagnosis, aggressiveness of the breast cancer disease; of course, the timing of investigation and treatment is influenced by the socioeconomic status of the patient. We have recorded invasive or non- invasive breast cancer at the time of diagnosis, site of the disease right, left or bilateral, type of surgery. Comparison of these factors in two countries both of them they have no national screening program for breast cancer like Sudan and Greece, but there is difference in population education. The breast cancer patients in Greece are treated at specialized breast units and in Sudan patients are treated in general hospitals by general surgeons. General objectives: To evaluate different modalities of breast cancer treatment set up and outcomes of breast cancer in both countries Sudan and Greece. Methods: The study is a comparative cross sectional case control study performed at Bashair Alneelain University Teaching & Elsharif Hospitals in Sudan, Hippokrateion General Hospital of the University of Athens and Alexandra General Hospital of the University of Athens in Greece. Inclusion criteria: included female patients that were diagnosed with breast cancer underwent appropriate treatment and with five years survival rate. The study compared 100 breast cancer patients from Sudan and 94 breast cancer patients from Greece. Control 100 female patients from Sudan and 66 female patients from Greece diagnosed with a benign disease of the breast. Informed consent was obtained in all cases. Results: The first result we found more invasive breast cancer in Sudan than in Greece (42.27%), and (9.28%) for noninvasive than Greece (29.8%), and (19.07%) respectively, the p-value of chi-square test (.001) more bilateral breast cancer in Greek patients. There is significant increase of mastectomy in Sudan than in Greece, more chemotherapy on the other hand more conservative breast surgery and hormonal therapy in Greece and recurrence occurs on the contralateral breast. Conclusion: Breast cancer patients in Sudan presents at late stage, younger age group with negative estrogen receptors tumors and higher rate of local recurrence. Breast cancer cases in Greece are diagnosed at earlier stage and old age group than in Sudan, bilateral, estrogen receptors positive treated with hormonal therapy and conservative breast surgery. Management of breast cancer at specialized breast clinics gives better outcome even in countries where there is no national screening program for early detection of breast cancer.

Squamous cell carcinoma of the uterine cervix metastasising to the thyroid gland: a case report

BackgroundCarcinoma of the uterine cervix (cervical cancer) metastasising to the thyroid gland is a rare phenomenon and only a few cases have been reported. We discuss a patient with cervical cancer presenting with thyroid and cervical lymph node metastasis, exploring the diagnostic difficulty, evaluation and treatment options.Case presentationA previously well 56-year-old female presented with multiple neck lumps for 4 months duration. Examination of the neck revealed multiple firm/hard left cervical lymph nodes with a hard thyroid nodule. There were no abdominal masses however, vaginal examination revealed a hard, unhealthy cervix. Contrast enhanced computed tomography revealed a growth in the uterine cervix with lymph node enlargement in the abdomen, chest and neck along with multiple thyroid nodules. Biopsy of the cervix and cervical lymph node and fine needle aspiration cytology of the thyroid nodules were performed, all revealing a squamous cell carcinoma. Pan-endoscopy performed to rule out any concurrent cancer of the upper aerodigestive tract was negative. The patient was started on palliative therapy, but succumbed to the disease after 6 months.Discussion and conclusionPatients who present with a thyroid nodule along with multiple cervical lymph nodes should be thoroughly assessed for possible metastatic cancers. Metastasis to the thyroid gland indicates a poor prognosis in the background of carcinoma or the uterine cervix. More awareness among the public and primary care providers is necessary regarding freely available screening programmes for early detection of cervical cancer.

"Why the Time is Ripe for India to Develop a National DDH* Screening Programme" (DDH* = Developmental Dysplasia of the Hip).

This editorial discusses the prevailing situation in India as regards early detection of Developmental Dysplasia of the Hip (DDH) and proposes the reasons why this is necessary and what could be the best modalities to apply for this complex situation in a developing country like India. The present time is the best time to develop a National Screening Program for early detection of DDH.

PREVENTION AND EARLY DETECTION OF CONDYLOMA ACUMINATA IN HUMAN IMMUNODEFICIENCY VIRUS/ACQUIRED IMMUNODEFICIENCY SYNDROME

Abstract Human Immunodeficiency Virus infection/Acquired Immunodeficiency Syndrome in Indonesia continues to increase. HIV is a sexually transmitted infection that is often accompanied by condyloma acuminata or genital warts. The incidence of condyloma acuminata in HIV/AIDS patients is reported to vary from 10 to 30% and is associated with low CD4+ levels or at an advanced stage of HIV/AIDS. Condyloma acuminata is caused by the Human Papilloma virus which can develop into malignancy. The purpose of this activity were to increase knowledge about the disease, risk factors, and efforts to prevent condyloma acuminata, as well as to conduct early detection of condyloma acuminate disease in HIV/AIDS patients. The service was carried out through direct education to HIV/AIDS patients who went to the VCT polyclinic at dr. H. Abdul Moeloek. Early detection was done by screening new cases of HIV/AIDS patients. This activity was held for three months and was attended by 112 participants. The results of the activity showed that education could increase the knowledge about the disease, risk factors, and efforts to prevent condyloma acuminata and found 14.3% of condyloma acuminata diseases in the screening program for early detection of disease. The continuity of education and screening program for condyloma

Prevalence and associated risk factors for diabetic retinopathy at first ophthalmological contact

Background: Type 2 diabetes mellitus (DM) is now considered as a growing global public health concern due to cost associated with diabetic micro and macrovascular complications. Diabetic retinopathy (DR) is one of the leading causes of vision loss. Accurate estimation of prevalence of DR among diabetic patients and associated risk factors are of crucial importance to plan and execute preventive strategies in the community.
 Aims and Objectives: The present cross sectional hospital based observational study was undertaken to determine the prevalence of DR in diabetic patients at their first ophthalmological contact and toevaluate associated risk factors.
 Materials and Methods: In this cross sectional hospital based observational study, all diabetic patients visiting ophthalmology clinic for the first time after being diagnosed as diabetic were enrolled. After recording demographic data and biochemical findings, each patient was investigated for DR and correlated with associated risk factors.
 Results: Of 1699 patients, majority (68.9%) of them had come to ophthalmology clinic with complaint of decreased vision. Only 16.12 % (274) patients had been referred for retinal exam by treating physician. DR was prevalent in 242(16.98%) non-referred and 31(11.31%) referred patients. Mean age and mean duration of diabetes was significantly higher in non-referred patients. Vision threatening DR was also significantly higher in nonreferred patients. Prevalence of DR was significantly correlated with age at presentation, duration of diabetes, rural background, uncontrolled diabetes, systolic blood pressure and high BMI.
 Conclusion: Low referral by treating physician and lack of awareness among patient accounts for late presentation of diabetic patients to ophthalmologist. Beyond just developing strategies to promote screening programs for early detection and management of DR, education of the patients,comprehensive planning and coordination between ophthalmologist and physician can go a long way to decrease the economic and social burden of preventable blindness due to diabetic retinopathy.

The Economic Burden Associated with the Management of Different Stages of Breast Cancer: A Retrospective Cost of Illness Analysis in Saudi Arabia.

Globally, breast cancer management is associated with a heavy economic burden, but its impact in Saudi Arabia has not been fully quantified. The aim of this study was to estimate the economic burden of breast cancer management at various disease stages, in Saudi Arabia, from a payer perspective. We conducted a retrospective, multicenter cost of illness study in two governmental healthcare centers from January to December 2018, using the data of 300 patients at different breast cancer stages. A micro-costing, bottom-up method was used, and descriptive and inferential statistics were analyzed. The total estimated cost for treating breast cancer during the study period was $13.345 million USD, with the average cost per patient ranging from $14,249 USD in stage I to $81,489 USD in stage IV (p < 0.001). Medication cost was the main driver of total healthcare spending, followed by hospitalization and diagnostic tests. The cost of targeted therapy drugs represented 67% of the total medication costs, mostly driven by trastuzumab-based regimens. The economic burden of breast cancer management in Saudi Arabia is substantial and increases significantly with disease advancement. Early detection screening programs, evaluating the value of highly expensive interventions, and considering biosimilars, may contribute toward cost savings.

Changing Indications for Penetrating Keratoplasty in Bahrain in a Tertiary Referral Centre.

PurposeTo study the changing indications for Penetrating keratoplasty in Bahrain and to compare them with published data.Patients and MethodsA Retrospective review of available records of patients who underwent penetrating keratoplasty at a tertiary center in Bahrain (1996−2015). The trend of each indication was analyzed. The study was subdivided into three periods for correlation purposes. Pearson Coefficient r and the p values were used for interpretation of data. The results were compared with similar studies.ResultsA total of 298 patients underwent keratoplasty in the study period, which is from 1996 until 2015 (missing data 2009–2011). Keratoconus was found to be the leading indication, accounting for 33% of the total cases, followed by trachoma 27%, followed by aphakic and pseudophakic bullous keratopathies 13%. Trachoma showed a statistically significant decreasing trend (p < 0.001), Keratoconus had an increasing trend (p<0.001). Bullous keratopathy showed an increasing trend (p = 0.001) with an abrupt rise after 2012.ConclusionCorneal scarring due to old trachoma was the leading indication for keratoplasty 20 years ago in Bahrain. However, due to improvement of health awareness, hygiene, and the socioeconomic status, this has regressed with keratoconus becoming the leading indication from 2002 onwards. A surge of bullous keratopathy was noted after 2012, placing it as the second commonest indication. This may be due to the introduction of phacoemulsification technique for cataract surgery, and perhaps because the nature of the institute being a teaching hospital. Keratoconus is the leading indication and showed an increasing trend. It is recommended to perform a keratoconus screening program for early detection and prevention.

A mixed-methods study to evaluate the acceptability of information leaflets for breast cancer screening.

To obtain feedback regarding the comprehension and acceptability of an information leaflet on breast cancer screening among women. Women usually receive a leaflet inviting them to participate in breast cancer screening programmes for early detection of breast cancer. These leaflets include relevant information about mammograms to aid with decision-making. It is important to know how the target population perceives these leaflets, as this may influence the attitude towards breast cancer screening. A mixed-methods study (concurrent triangulation design). Participants were 41 women aged between 40-60years in the north of Spain. The leaflet included information about breast cancer, mammograms, benefits/risks of screening, and the breast cancer mortality and survival rates in relation to screening. Three written methods were used to assess the leaflet: a readability assessment (Flesch Index) and two comprehension assessments (Cloze and multiple-choice questions). In addition, 26 semi-structured interviews were conducted to explore the women's opinions regarding comprehension, acceptability and the contribution of the leaflet as a decision aid. The COREQ checklist was used to guarantee the quality and rigour of the qualitative study. Overall, women found the leaflet fairly easy to read and most understood the content. Some women found the information on mortality alarming, difficult to understand and a cause for rejection. The leaflet was viewed as a decision aid, although further information was requested on mammograms, the need for complementary tests and the risks and symptoms of breast cancer. The leaflet was accepted by women and, overall, easy to understand. The participation of the target population enabled the content and format of the leaflet to be adjusted to their needs. Nurses can contribute towards improving the breast cancer screening leaflets, considering women's perceptions surrounding screening.

Screening for Retinoblastoma: A Systematic Review of Current Strategies.

The aim of this study was to review the literature on various screening programs, devices, and applications described for the early detection of retinoblastoma. Systematic review article. A PubMed® search was performed to identify articles published with specific reference to screening of neonates, infants and children for retinoblastoma. Various devices and mobile phone-based applications based on altered red reflex are finding their way into community screening. Diagnosis of retinoblastoma by newborn eye screening is emphasized in several countries, and red reflex is the most widely employed technique. Several screening programs for early detection of retinoblastoma are evolving in the developing countries, but the practices are not uniform. Universal newborn screening should be the norm. Newer tools and software can be utilized to screen infants on a community scale. Focussed research on revolutionizing digital imaging for a versatile screening tool holds promise for early diagnosis of retinoblastoma.

The Biological Significance of Long noncoding RNAs Dysregulation and their Mechanism of Regulating Signaling Pathways in Cervical Cancer.

Despite the remarkable decrease in cervical cancer incidence due to the availability of the HPV vaccine and implementation of screening programs for early detection in developed countries, this cancer remains a major health problem globally, especially in developing countries where most of the cases and mortality occur. Therefore, more understanding of molecular mechanisms of cervical cancer development might lead to the discovery of more effective diagnosis and treatment options. Research on long noncoding RNAs (lncRNAs) demonstrates the important roles of these molecules in many physiological processes and diseases, especially cancer. In the present review, we discussed the significance of lncRNAs altered expression in cervical cancer, highlighting their roles in regulating highly conserved signaling pathways, such as mitogen-activated protein kinase (MAPK), Wnt/β-catenin, Notch, and phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathways and their association with the progression of cervical cancer in order to bring more insight and understanding of this disease and their potential implications in cancer diagnosis and therapy.

New Frontiers in the Prevention, Diagnosis, and Treatment of Alzheimer's Disease.

One of the major puzzles in medical research and public health systems worldwide is Alzheimer's disease (AD), reaching nowadays a prevalence near 50 million people. This is a multifactorial brain disorder characterized by progressive cognitive impairment, apathy, and mood and neuropsychiatric disorders. The main risk of AD is aging; a normal biological process associated with a continuum dynamic involving a gradual loss of people's physical capacities, but with a sound experienced view of life. Studies suggest that AD is a break from normal aging with changes in the powerful functional capacities of neurons as well as in the mechanisms of neuronal protection. In this context, an important path has been opened toward AD prevention considering that there are elements of nutrition, daily exercise, avoidance of toxic substances and drugs, an active social life, meditation, and control of stress, to achieve healthy aging. Here, we analyze the involvement of such factors and how to control environmental risk factors for a better quality of life. Prevention as well as innovative screening programs for early detection of the disease using reliable biomarkers are becoming critical to control the disease. In addition, the failure of traditional pharmacological treatments and search for new drugs has stimulated the emergence of nutraceutical compounds in the context of a "multitarget" therapy, as well as mindfulness approaches shown to be effective in the aging, and applied to the control of AD. An integrated approach involving all these preventive factors combined with novel pharmacological approaches should pave the way for the future control of the disease.

The prevalence and predictors of refractive error among school children in Riyadh, Saudi Arabia.

PURPOSE:Refractive error (RE) is one of the most common ocular disorders among children worldwide. This study aimed to investigate the prevalence of RE and possible risk factors among school children in Riyadh.METHODS:This is a cross-sectional study using data collected at various schools. To achieve the aim of the study, we selected a random sample of 850 school children aged 6–15 years. The examination was based on the RESC protocol and included full visual assessment. Furthermore, a questionnaire was sent to the parents of the participants to ascertain information about lifestyle factors. We constructed a logistic regression model to evaluate the predictors of RE.RESULTS:Close to a third of the children had a RE. Of those identified as having the condition, 60% did not wear glasses (newly diagnosed). Nearly all the children (95.4%) in our sample reported using electronic devices, according to parents. No association was found between using electronic devices and having a RE (P = 0.26). Doing outdoor activities was associated with 52% lower odds of a RE (odds ratio = 1.52).CONCLUSION:We found a higher prevalence of uncorrected RE than previously reported in other Saudi studies. About 60% of children who had RE were not wearing glasses, highlighting the need for a standardized school screening program for early detection and management. Outdoor activities were associated with a lower likelihood of having a RE. These findings might support initiatives to encourage outdoor activities among school children.

Association between sociodemographic variables and awareness of diabetic retinopathy among type 2 diabetic patients

Background: Early detection of diabetic retinopathy (DR) is the most important factor in reducing the blinding complications due to diabetes. Study of the various socio-demographic factors affecting awareness of DR will help us to formulate effective screening programs for early detection. Objectives of the study were to find the sociodemographic determinants associated with awareness of DR and to evaluate the association of stage of DR with awareness about diabetic retinopathy.Methods: A cross sectional study was conducted among 384 patients who had been diagnosed with diabetes mellitus in various medical camps and diabetic clinics at Thiruvananthapuram. Socio demographic variables and awareness were assessed using structured self-administered questionnaire. Dilated fundus evaluation was done and retinopathy classified. Data entered to excel sheet and analysis done using statistical software (SPSS version 20).Results: Among the 384 patients, 44.9% were diagnosed to have diabetic retinopathy. Among the diagnosed 41.6% had mild non proliferative DR (NPDR), 33.0% had moderate NPDR, 11.45% had severe NPDR. 13.4% of subjects were diagnosed to have proliferative DR. 53.1% of the subjects with diabetic retinopathy had clinically significant macular edema. There was no statistically significant association between the stage of DR to awareness. Among the socio demographic variables, significant positive association with level of awareness was obtained for duration of diabetes (OR=10.96; p=0.004)Conclusions: Duration of diabetes was significantly associated with level of awareness. There was no statistically significant association between the stage of diabetic retinopathy to awareness. This signifies the urgent need to intensify our diabetic retinopathy awareness programs.

NON-SMALL CELL CARCINOMA OF LUNG WITH METASTASIS TO DELTOID MUSCLE: A RARE AND UNUSUAL PRESENTATION

SESSION TITLE: Medical Student/Resident Lung Cancer Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Lung cancer is the leading cause of cancer-related death worldwide. Major risks factors include tobacco smoking and environmental pollution. Despite its high incidence, the lack of efficacious screening programs for early detection and presence of non-specific symptoms mimicking other respiratory diseases lead to late-stage diagnosis [1]. Lung cancer is known to metastasize to most organs, including brain, bone, liver, adrenal glands, and lymph nodes due to their abundant blood supply [2]. Metastatic spread of lung cancer to skeletal muscle, however, is an extremely rare finding seen in less than 1% of all cases [3]. Skeletal muscle metastases most commonly arise from primary tumors of the gastrointestinal and genitourinary tracts [4], with the muscles most frequently affected being the thigh, iliopsoas, and paraspinous muscles [5]. Multiple hypotheses have been formulated to explain the low prevalence of muscle metastases, which include muscle contractility, tissue pressure, variable blood flow, oxygen free-radical production, cellular and humoral immunity, and hypersensitivity reactions. CASE PRESENTATION: We are reporting a 61-year-old male presenting with left shoulder pain since motor vehicle accident, cough and weight loss. X-ray of shoulder was unremarkable. CT chest showed 10.0 x 7.4 cm mass noted in the left upper lobe concerning for neoplasm. MRI left shoulder showed significant edema involving the deltoid muscle with no drainable fluid. IR US guided deltoid biopsy showed poorly differentiated adenocarcinoma that favored the result of lung mass biopsy as well. DISCUSSION: Skeletal muscle is an extraordinarily rare site of metastasis of lung cancer and usually favors aggressive disease. Non-small cell lung cancer metastasis to skeletal muscle is seen in <1% of cases. Diagnosis is usually obtained by fine needle biopsy of muscle. Adenocarcinoma of the lung with metastatic spread to skeletal muscles described in the literature as more aggressive with median survival of approximately 6 months. The best effective treatment is currently unknown. CONCLUSIONS: Lung cancer is the most common cause of cancer related deaths worldwide, with non-small cell lung cancer (NSCLC) making up 8% of all cases. Skeletal metastatic disease is extremely rare, especially to upper extremities and if present usually affects injured muscle site.Alteration of muscle physiology increases susceptibility to cancer spread. The lactic acid producing activity of tumors has been described as a factor that contributes to the formation of new blood vessels by signaling low perfusion to an area of the body. This neovascularization produces a more hospitable environment for tumor growth. Muscle injury may decrease muscle ability to remove lactic acid. Increased vascular perfusion to injured areas has been associated with increased susceptibility for metastatic disease. Reference #1: Seely S. Possible reasons for the high resistance of muscle to cancer. Med Hypotheses. 1980;6(2):133–137. doi:10.1016/0306-9877(80)90079-1. https://pubmed.ncbi.nlm.nih.gov/7393016-possible-reasons-for-the-high-resistance-of-muscle-to-cancer/ Reference #2: Perisano C, Spinelli MS, Graci C, et al. Soft tissue metastases in lung cancer: a review of the literature. Eur Rev Med Pharmacol Sci. 2012;16(14):1908–1914. https://www.europeanreview.org/article/2667 Reference #3: Surov A, Kohler J, Wienke A, Gufler H, Bach AG, Schramm D, et al. Muscle metastasis: comparison of features of different primary tumors. Cancer imaging 2014;14:21 DISCLOSURES: No relevant relationships by Muhammad Faisal Aslam, source=Web Response No relevant relationships by Ritika Kompella, source=Web Response No relevant relationships by Luis Medina Mora, source=Web Response No relevant relationships by Anastasia Novikov, source=Web Response No relevant relationships by Theo Trandafirescu, source=Web Response No relevant relationships by Salim Yaghi, source=Web Response

Andalusian program for early detection of diabetic retinopathy: implementation and 15-year follow-up of a population-based screening program in Andalusia, Southern Spain

IntroductionDiabetic retinopathy (DR) is a preventable cause of vision loss and blindness worldwide. We aim at analyzing the impact of a population-based screening program of DR using retinal photography with...

Racial/Ethnic Differences in Early Detection and Screening for Chronic Kidney Disease Among Adults in Hawaii: A 10-Year Population Health Study.

IntroductionNative Hawaiian and Asian American populations are the most understudied racial/ethnic groups in chronic kidney disease (CKD) research. The objective of our study was to describe sociodemographic and comorbidity risk factors of chronic kidney disease among 2,944 community-dwelling Native Hawaiian, Filipino, Chinese, Japanese, and non-Hispanic white participants who attended the National Kidney Foundation of Hawaii Kidney Early Detection Screening program during 2006–2017.MethodsWe used multivariable logistic regression models to examine the association between age, sex, race/ethnicity, and the major risk factors for CKD (diabetes, hypertension, cardiovascular disease, hypercholesterolemia, overweight and obesity, and smoking) with elevated urine albumin to creatinine ratio (ACR) among adults aged 18 or older in 5 racial/ethnic groups in Hawaii: Native Hawaiian, Filipino, Chinese, Japanese, and non-Hispanic white.ResultsIn the age- and sex-adjusted model, Native Hawaiian participants were significantly more likely than non-Hispanic white participants to have an ACR of 30.0 mg/g or more (odds ratio [OR] = 1.50; 95% CI, 1.15–1.95; P = .003). In the model that adjusted for CKD risk factors, the difference between Native Hawaiian and non-Hispanic white participants became nonsignificant (OR = 1.27; 95% CI, 0.96–1.69; P = .09]). The higher prevalence of chronic conditions among Native Hawaiians partially explained their higher risk of having an elevated ACR. Filipinos had significantly higher odds than non-Hispanic whites of elevated ACR in the age- and sex-adjusted model (OR = 1.44; 95% CI, 1.14–1.84; P = .003) and after adjustment for CKD risk factors (OR = 1.36; 95% CI, 1.06–1.74; P = .01).ConclusionCulturally targeted interventions are needed to improve health outcomes among Native Hawaiians and Asian Americans, particularly Filipinos, with CKD. Such interventions should focus on early kidney disease management so that disease progression can be delayed.

Incidence of interval colorectal cancer: A tertiary hospital report

AbstractColorectal cancer (CRC) remains the leading cause of death in Taiwan despite mandatory CRC screening programs for early detection. The development of CRC between periods of follow‐up remains a Taiwanese health and economic burden. This study aimed to investigate the relationship between consequent progression of polyps and interval CRC and identify potential risk factors. This retrospective chart review study reviewed 1671 CRC patients between 1 January 2002 and 31 December 2018, in Kaohsiung Chang Gung Memorial Hospital for interval CRC analysis. Interval CRC is defined as CRC diagnosed within 5 years after a negative colonoscopy. We further analyzed potential risk factors associated with interval CRC such as sex, age, underlying disease, and previous pathologic type of polyps by univariate and multivariate analyses. A total of 44 patients developed interval CRC in this study (2.63%). Ten patients were from the proctologist division and five from the gastroenterology department. Mean diagnostic interval was 919.45 ± 547.78 days in male and 897.87 ± 586.14 days in female patients. Multivariate analysis showed that right‐side colon polyp demonstrated independent risk factors for interval CRC development in our observation (P &lt; .001; hazard ratio (HR), 3.897; 95% confidence interval (CI), 1.934‐7.780). In conclusion, interval CRC prevalence in a cohort is 2.63%. Location of polyps over the right colon is relevant to interval CRC occurrence.

Incidence and Survival Rates of Gynecological Malignancies in The United States Before and After the HPV Vaccine

Intoduction: Gynecological malignancies are one of the most common cancers in women and have high mortality rates in the United States. In this study, we aimed to analyze the incidence and mortality rates of gynecological malignancies in 2011-2015 and compare these data with the corresponding parameters of 2001-2005. We chose these intervals of years for contrasting, as HPV vaccines have been actively used since 2006. HPV vaccine is known to prevent cervical cancer but has unknown impact on other gynecological malignancies. The aim of the is study is to check if incidence and survival of gynecological malignancies has changed before and after application of HPV vaccine Material and Methods: The Surveillance, Epidemiology and End Results (SEER) cancer registry 2005-2011 and 2011-2015 database was investigated and patients with gynecological malignancy were identified. Data were obtained using SEER*Stat version 8.3.5. A statistical analysis on the incidence rate and mortality rate was performed. Data were exported using case-listing session in SEER*Stat and were analyzed using SPSS version 25. Results: Overall 125,357 cases with a gynecological malignancy were identified in 2011-2015 in comparison with 102,534 cases in the period of 2001-2005. The incidence of cervical cancer decreased in the period of 2011-2015 compared with the period from 2001 to 2005 (median incidence rates 3.9 and 4.3 per 100.000 persons, respectively, p &lt; 0.05), while incidence of uterine (15.3 and 12.0 per 100.000 persons persons, respectively) and vulvar (1.55 and 1.86 per 100.000 persons, respectively) has increased ( p &lt; 0.05). There was no change in the incidence rate of ovarian cancer (7.28 and 7.19 per 100.000 persons). Survival rates for cervix, uterine, ovarian and vulva cancer have increased. However, zero time error couldn’t be avoided in statistical analysis. Conclusion: As a result of widespread screening with Pap smear test and availability of human papilloma virus vaccine the incidence of cervix cancer has declined. Increase in vulvar and uterine cancer incidence may be attributed to lack of effective screening program for early detection of these type of cancers and most probably HPV vaccine has no effect on their incidence. Survival of gynecological malignancies has increased over years which may be explained by better treatment options or earlier detection.

Vision-threatening diabetic retinopathy necessitating vitrectomy in a tertiary care hospital in coastal Karnataka, South India

Background: The proportion of diabetic patients having vision-threatening diabetic retinopathy and those needing to undergo vitrectomy was documented.&#x0D; Methods: A cross-sectional observational study was conducted at a tertiary care hospital in coastal Karnataka, South India. All patients with diabetes mellitus visiting the ophthalmology department in the study period were screened for retinopathy, and the data regarding the presence of maculopathy and proliferative retinopathy were included as vision-threatening retinopathy.&#x0D; Results: Of the 1,435 diabetic patients included, 38.4% had retinopathy changes due to diabetes, with 8.71% having vision-threatening retinopathy and 1.81% needing vitrectomy.&#x0D; Conclusion: Although the proportion of vision-threatening retinopathy is small, the rapidly increasing diabetic population requires the setting up of more resources for tackling this condition, at least at the tertiary levels of the health-care system. However, considering the increased human and economic resources involved in setting up vitrectomy units, more emphasis on strengthening screening programs for early detection and referral to reduce the progression of retinopathy to advanced stages would be appropriate.

Cervical cancer mortality in young adult European women

BackgroundThe process of social, political and economic transformation, which took place in Central and Eastern Europe in the early 90's, has affected many spheres of Europeans' lives, including health-associated issues. These changes also had an impact on mortality rates due to cervical cancer (CC). Therefore, the aim of this study was to analyse CC mortality trends in Europe after 1990. MethodsData on death due to CC, uterine cancers and unspecified uterine cancers, in women aged 20–44, were taken from the WHO Mortality Database. Trends in European countries between 1990 and 2017 were assessed using the Joinpoint Regression Program. ResultsMost of the countries experienced a decrease in CC mortality. Although the lowest rates were observed in EU15 Member States, the highest decreases were observed in Central and Eastern Europe. However, there are still differences in mortality in these countries. There are also a few countries like Belarus, Latvia and Ukraine, which experienced an increase in mortality. The range of mortality across Europe in 2017 was between 0.6 and 5.2/100,000 women. ConclusionsIt is essential to introduce well-organised screening programmes for early detection of CC with coverage of a correspondingly high percentage of the population, particularly in East-Central Europe, as well as to introduce high-coverage HPV vaccination in all European countries.