Cancer worry frequency vs. intensity and self-reported colorectal cancer screening uptake: A population-based study.

OBJECTIVES: Many studies of cancer worry use items measuring frequency or intensity. Little is known about how each of these relate to cancer screening uptake. This study compared the association between worry frequency vs. intensity and colorectal cancer screening intention/uptake. METHODS: Across four surveys (2014-2016), we collected data from 2878 screening-eligible men and women (aged 60-70) in England. Measures included single-items assessing cancer worry frequency and intensity, and a derived combination of both. We also assessed self-reported past faecal occult blood testing uptake (ever vs. never), intention to participate when next invited (yes vs. no), and demographics. Using logistic regression, we compared a model containing sociodemographic characteristics (Model 1), with four models adding cancer worry frequency (Model 2), intensity (Model 3), both (Model 4), or the combined measure (Model 5). RESULTS: A model with cancer worry intensity and demographics (Model 3) explained significantly more variance in uptake and intention ( R2 = 0.068 and 0.062, respectively) than demographics alone (Model 1: R2 = 0.058 and 0.042; p < 0.001), or a model with demographics and cancer worry frequency (Model 2: R2 = 0.059 and 0.052; p < 0.001). The model was also equally as effective as models including both the frequency and intensity items (Model 4: R2 = 0.070 n.s. and 0.062 n.s.), or using the derived combination of both (Model 5: R2 = 0.063 n.s. and 0.053 n.s.). CONCLUSION: A single item measure of cancer worry intensity appeared to be most parsimonious for explaining variance in colorectal cancer screening intention and uptake.This work was supported by Cancer Research UK (grant number C1418/A14134)

“I haven’t had that information, even though I think I’m really well-informed about most things”: a qualitative focus group study on Australian women’s understanding and views of potentially modifiable risk factors for breast cancer

This study aimed to explore current knowledge, understanding and experience of potentially modifiable risk factors for breast cancer, and views on current and future communication strategies for this information and related interventions

Promoting early presentation of breast cancer in older women: Implementing an evidence-based intervention in routine clinical practice

Background: Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods: We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions: The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women

Effects of coronavirus disease pandemic on tuberculosis notifications, Malawi

The coronavirus disease (COVID-19) pandemic might affect tuberculosis (TB) diagnosis and patient care. We analyzed a citywide electronic TB register in Blantyre, Malawi and interviewed TB officers. Malawi did not have an official COVID-19 lockdown but closed schools and borders on March 23, 2020. In an interrupted time series analysis, we noted an immediate 35.9% reduction in TB notifications in April 2020; notifications recovered to near prepandemic numbers by December 2020. However, 333 fewer cumulative TB notifications were received than anticipated. Women and girls were affected more (30.7% fewer cases) than men and boys (20.9% fewer cases). Fear of COVID-19 infection, temporary facility closures, inadequate personal protective equipment, and COVID-19 stigma because of similar symptoms to TB were mentioned as reasons for fewer people being diagnosed with TB. Public health measures could benefit control of both TB and COVID-19, but only if TB diagnostic services remain accessible and are considered safe to attend.Peer reviewe

Impact of COVID-19 on tuberculosis notifications in Blantyre Malawi: an interrupted time series analysis and qualitative study with healthcare workers.

COVID-19 may impact on tuberculosis (TB) diagnosis and care. We analysed a city-wide electronic TB register in Blantyre, Malawi and interviewed TB officers. Malawi had no official “lockdown” but closed schools and borders on 23 March 2020. In interrupted time series analysis, there was an immediate 35.9% reduction in TB notifications (95% CI 22.0 to 47.3%) in April, which recovered to near pre-pandemic numbers by December 2020, but with 333 (95% CI 291 to 375) fewer cumulative notifications than anticipated. Women and girls were impacted (30.7% fewer cases, 95% CI 28.4 to 33.0%) more than men and boys (20.9% fewer, 95% CI 18.5 to 23.3). Fear of COVID-19 infection, temporary facility closure, inadequate protective equipment and COVID-19 stigma with similar presenting symptoms to TB were mentioned. Public health measures could benefit both TB and COVID-19, but only if diagnostic services remain accessible and are considered safe to attend

Promoting early presentation of breast cancer in older women: sustained effect of an intervention to promote breast cancer awareness in routine clinical practice

Abstract Background Older women have poorer survival from breast cancer, which may be at least partly due to poor breast cancer awareness leading to delayed presentation and more advanced stage at diagnosis. In a randomised trial, an intervention to promote early presentation of breast cancer in older women increased breast cancer awareness at 1 year compared with usual care (24 versus 4%). We examined its effectiveness in routine clinical practice. Methods We piloted the intervention delivered by practising health professionals to women aged about 70 in four breast screening services. We measured the effect on breast cancer awareness at 1 year compared with comparison services, where women did not receive the intervention. Results At 1 year, 25% of women in pilot services were breast cancer aware compared with 4% in comparison services (p = 0.001). The components of breast cancer awareness were knowledge of breast cancer non-lump symptoms (pilot: 63% vs comparison: 82% at 1 year; OR = 2.56, 95% CI 1.92-3.42), knowledge of age related risk (pilot: 8% vs comparison: 36% at 1 year; OR = 5.56, 95% CI 4.0-7.74) and reported breast checking (pilot: 70% vs comparison: 78% at 1 year; OR = 1.49, 95% CI 1.13-1.96). Conclusion The intervention may be as effective in routine clinical practice as in a randomised controlled trial. This intervention has the potential to reduce patient delay in the diagnosis of breast cancer in older women. Trial registration The PEP trial was registered with the International Standard Registered Clinical/soCial sTudy Number (ISRCTN) as a clinical trial ( ISRCTN31994827 ) on 3rd October 2007

The Lung Image Database Consortium (LIDC):ensuring the integrity of expert-defined "truth"

RATIONALE AND OBJECTIVES: Computer-aided diagnostic (CAD) systems fundamentally require the opinions of expert human observers to establish “truth” for algorithm development, training, and testing. The integrity of this “truth,” however, must be established before investigators commit to this “gold standard” as the basis for their research. The purpose of this study was to develop a quality assurance (QA) model as an integral component of the “truth” collection process concerning the location and spatial extent of lung nodules observed on computed tomography (CT) scans to be included in the Lung Image Database Consortium (LIDC) public database. MATERIALS AND METHODS: One hundred CT scans were interpreted by four radiologists through a two-phase process. For the first of these reads (the “blinded read phase”), radiologists independently identified and annotated lesions, assigning each to one of three categories: “nodule ≥ 3mm,” “nodule < 3mm,” or “non-nodule ≥ 3mm.” For the second read (the “unblinded read phase”), the same radiologists independently evaluated the same CT scans but with all of the annotations from the previously performed blinded reads presented; each radiologist could add marks, edit or delete their own marks, change the lesion category of their own marks, or leave their marks unchanged. The post-unblinded-read set of marks was grouped into discrete nodules and subjected to the QA process, which consisted of (1) identification of potential errors introduced during the complete image annotation process (such as two marks on what appears to be a single lesion or an incomplete nodule contour) and (2) correction of those errors. Seven categories of potential error were defined; any nodule with a mark that satisfied the criterion for one of these categories was referred to the radiologist who assigned that mark for either correction or confirmation that the mark was intentional. RESULTS: A total of 105 QA issues were identified across 45 (45.0%) of the 100 CT scans. Radiologist review resulted in modifications to 101 (96.2%) of these potential errors. Twenty-one lesions erroneously marked as lung nodules after the unblinded reads had this designation removed through the QA process. CONCLUSION: The establishment of “truth” must incorporate a QA process to guarantee the integrity of the datasets that will provide the basis for the development, training, and testing of CAD systems

STOPPIT Baby Follow-Up Study:The Effect of Prophylactic Progesterone in Twin Pregnancy on Childhood Outcome

Funding: This study was funded by the Chief Scientist Office, Scotland (grant number CZH/2/575) and the charity, Tommy’s. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Data Availability: The STOPPIT Baby Follow-up Study uses two linked datasets, the STOPPIT clinical trial data and routine NHS data collected by Information Services Division (ISD), NHS Scotland. The governance and ethics approvals for this project around anonymity for the participants do not permit us to deposit the linked dataset on a publicly available website. Individuals wishing to access the STOPPIT clinical trial data should contact Professor Jane E Norman [email protected] or Professor John Norrie [email protected] for access. General information on how to access data held by ISD for research purposes is available from ISD’s research coordination team – see http://www.isdscotland.org/Products-and-​Services/eDRIS. Please contact Rachael Wood [email protected] for queries about the specific ISD data used in this study.Peer reviewedPublisher PD

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| &lt; 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe