124,026 research outputs found

    Breast, colon, and prostate screening in the adult population of Croatia: does rural origin matter?

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    INTRODUCTION: The aim of this study was to investigate the utilization of breast, colon and prostate cancer screening in the adult Croatian population in a period without national cancer screening programs, with a special interest in respondents' rural versus urban origin. ----- METHODS: Self-reported screening utilization was investigated in the Croatian Adult Health Survey, which collected health-related information from a representative sample of the adult Croatian population. Breast cancer screening was investigated in women aged over 40 years, while colon and prostate screening was investigated in respondents aged over 50 years. The data were analysed using binary logistic regression. ----- RESULTS: One in five women reported breast cancer screening uptake in the year preceding the survey (22.5%), while only 4.5% reported a colon screening. A total of 6.1% men reported colon screening, while 13.7% of men reported having a prostate cancer screening. Respondents with rural origin reported all sites screening utilization less frequently than those of urban origin (breast: 14.5% vs 27.4%; prostate: 9.6% vs 16.3%; colon-men: 5.7% vs 6.3%; colon-women: 3.6% vs 5.1%; respectively). Multivariable models indicated that people with higher socio-economic status more commonly reported breast and prostate cancer screening uptake. Access to health care was the only independent variable associated with colon cancer screening in men, and the strongest variable associated with colon cancer screening in women. Rural origin was associated only with lower odds of breast screening (adjusted odds ratio 0.60 [95% confidence interval 0.48-0.74]), while in the remaining models, rural origin was not a significant predictor for cancer screening uptake. ----- CONCLUSIONS: Opportunistic cancer screening uptake is low in the Croatian adult population, with existing socio-economic differences in breast and prostate screening, and their absence in colon cancer screening. Rural origin was significantly associated with breast screening, even after adjustment to socioeconomic status and problems in access to health care. Lack of rural origin significance in the other screening sites could be related to small sample sizes of people who reported opportunistic utilization. Overall, access to health care is the strongest cancer screening predictor, and this should have a prominent role in the development of a systematic cancer screening program on a national level

    Am J Prev Med

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    BackgroundThe National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast cancer screening to medically underserved, low-income women aged 40\u201364 years. No study has evaluated NBCCEDP\u2019s effect on breast cancer mortality.PurposeThis study estimates life-years saved by NBCCEDP breast cancer screening compared with screening in the absence of NBCCEDP and with no screening.MethodsA breast cancer simulation model based on existing Cancer Intervention and Surveillance Modeling Network models was constructed. The screening module from these models was modified to reflect screening frequency for NBCCEDP participants. Screening data for uninsured women represented what would have happened without the program. Separate simulations were performed for women who received NBCCEDP (Program) screening, women who potentially received screening without the program (No Program), and women who received no screening (No Screening). The impact of NBCCEDP was estimated as the difference in life-years between the Program and No Program, and the Program and No Screening scenarios. The analysis was performed in 2008\u20132009.ResultsAmong 1.8 million women who were screened between 1991 and 2006, the Program saved 100,800 life-years compared with No Program and 369,000 life-years compared with No Screening. Per woman screened, the Program saved 0.056 life-years (95% CI=0.031, 0.081) compared with No Program and 0.206 life-years (95% CI=0.177, 0.234) compared with No Screening. Per woman with invasive breast cancer and screen-detected invasive cancer, the Program saved 0.41 and 0.71 life-years, respectively, compared with No Program.ConclusionsThese estimates suggest that NBCCEDP breast cancer screening has reduced mortality among medically uninsured and underinsured low-income women.CC999999/Intramural CDC HHS/United States2018-03-09T00:00:00Z21406272PMC5844559vault:2753

    Improved breast cancer survival following introduction of an organized mammography screening program among both screened and unscreened women: a population-based cohort study

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    Introduction: Mammography screening reduces breast cancer mortality through earlier diagnosis but may convey further benefit if screening is associated with optimized treatment through multidisciplinary medical care. In Norway, a national mammography screening program was introduced among women aged 50 to 69 years during 1995/6 to 2004. Also during this time, multidisciplinary breast cancer care units were implemented. Methods: We constructed three cohorts of breast cancer patients: 1) the pre-program group comprising women diagnosed and treated before mammography screening began in their county of residence, 2) the post-program group comprising women diagnosed and treated through multidisciplinary breast cancer care units in their county but before they had been invited to mammography screening; and 3) the screening group comprising women diagnosed and treated after invitation to screening. We calculated Kaplan-Meier plots and multivariable Cox proportional hazard models. Results: We studied 41,833 women with breast cancer. The nine-year breast cancer-specific survival rate was 0.66 (95%CI: 0.65 to 0.67) in the pre-program group; 0.72 (95%CI: 0.70 to 0.74) in the post-program group; and 0.84 (95%CI: 0.80 to 0.88) in the screening group. In multivariable analyses, the risk of death from breast cancer was 14% lower in the post-program group than in the pre-program group (hazard ratio 0.86; (95%CI: 0.78 to 0.95, P = 0.003)). Conclusions: After nine years follow-up, at least 33% of the improved survival is attributable to improved breast cancer management through multidisciplinary medical care

    Breast cancer screening and the World Trade Center Health Program

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    The World Trade Center (WTC) Health Program provides screenings and treatment for health conditions, including breast cancer, related to the September 11th terrorist attacks. Breast cancer screening may be available as a part of the health monitoring exam assuming certain requirements are met.Publication date from document properties.WTCFlyer_breastcancer_v4.pdfIs breast cancer screening available through the World Trade Center Health Program? -- What is breast cancer screening? -- How does the WTC Health Program decide to screen for breast cancer? -- What breast cancer screening tests can I receive through the WTC Health Program? -- What is the risk from breast cancer screening? -- What happens if I receive a positive result? -- What happens if I receive a negative result? -- Can I still be screened through my personal physician who is not a part of the WTC Health Program?2013671

    An Evaluation of the Client Navigator Program for Enhanced Breast and Cervical Cancer Screening Among Underserved Women in the State of Georgia

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    Screening for breast and cervical cancers can reduce morbidity and mortality through early detection, yet many women are not getting regular lifesaving screenings as recommended. 2 The National Breast and Cervical Detection Program (NBCCEDP) was established in 1990 in order to provide low-income, uninsured, and underserved women access to breast and cervical cancer screening and diagnostic services. Georgia’s participation in the NBCCEDP led to the development of The Breast and Cervical Cancer Program (BCCP), which provides cancer screening to women 40 to 64 years of age who are uninsured and/or underinsured and at or below 200% poverty level. Deaths from breast and cervical cancers could be avoided if screening rates increased among women at risk. In order to better eliminate barriers to screening, Georgia’s Breast and Cervical Cancer Program uses client navigators to communicate with minority populations. The purpose of my thesis study was to assess the effectiveness of the Client Navigator Program utilized to enhance breast and cervical cancer screening rates for women throughout Georgia. Evaluation findings demonstrated that personal characteristics of Client Navigators, internal characteristics of the program itself, resources provided by the program, and program partnerships were the areas of greatest program strength. Funding was repeatedly listed as the greatest program threat. Findings from this study provide insights for how the overall program can be improved in the future, and thus, improving health outcomes for women who are at greatest risk of breast and cervical cancer throughout the state

    BreastScreen Australia monitoring report 2012–2013

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    The BreastScreen Australia monitoring report 2012–2013 presents the latest national statistics in the monitoring of BreastScreen Australia, which aims to reduce illness and death resulting from breast cancer through organised screening to detect cases of unsuspected breast cancer in women, thus enabling early intervention. Around 55% of women in the target age group 50–69 took part in the program, with more than 1.4 million women screening in 2012–2013. Breast cancer mortality in 2012 was 44 deaths per 100,000 women

    Korean women: breast cancer knowledge, attitudes and behaviors

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    INTRODUCTION: Clustered within the nomenclature of Asian American are numerous subgroups, each with their own ethnic heritage, cultural, and linguistic characteristics. An understanding of the prevailing health knowledge, attitudes, and screening behaviors of these subgroups is essential for creating population-specific health promotion programs. METHODS: Korean American women (123) completed baseline surveys of breast cancer knowledge, attitudes, and screening behaviors as part of an Asian grocery store-based breast cancer education program evaluation. Follow-up telephone surveys, initiated two weeks later, were completed by 93 women. RESULTS: Low adherence to the American Cancer Society's breast cancer screening guidelines and insufficient breast cancer knowledge were reported. Participants' receptiveness to the grocery store-based breast cancer education program underscores the importance of finding ways to reach Korean women with breast cancer early detection information and repeated cues for screening. The data also suggest that the Asian grocery store-based cancer education program being tested may have been effective in motivating a proportion of the women to schedule a breast cancer screening between the baseline and follow-up surveys. CONCLUSION: The program offers a viable strategy to reach Korean women that addresses the language, cultural, transportation, and time barriers they face in accessing breast cancer early detection information

    Breast Cancer Screening in Racialized Women: Implications for Health Equity

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    Inequalities across the breast cancer continuum due to racialization have significantly affected women's access to screening programs, diagnosis, treatment and survival. To ensure there is equitable access to quality care there needs to be a better understanding of broader systemic issues. Despite the existence of breast cancer prevention strategies across Canada, inequitable access to screening has barred many women from receiving adequate medical attention. More than half of recent immigrants (those who have been in Canada for less than 10 years) who are eligible for screening did not utilize the program in the previous two years compared to 26 percent of Canadian-born women. Currently, prevention through screening is the primary form of breast cancer control in Canada, thus the differential access to screening among social, geographic, demographic and racial groups can severely affect one's chances of surviving. This paper provides an overview of inequitable outcomes across the breast cancer continuum due to racialization, with a particular focus on screening. It provides a brief description of racial and ethnic differences in screening utilization, diagnosis and survival drawing on local, national, and international data. It also provides a summary of important barriers to screening in racialized and ethnic minority women. It concludes with implications for Ontario and the Greater TorontoArea (GTA), and identifies possible directions forward.Racial, ethnic and socioeconomic differences in breast cancer screening have an important impact on the chance of both developing and dying from breast cancer. Therefore, we must acknowledge the negative impact of racialization and racism on health outcomes in Canada. In order to adequately address this problem, there is a need for community-based research that allows us to gain better insight into the perceptions, lived experiences and the multiple and often competing needs of women across racialized and immigrant communities in Ontario

    The Implications of Insurance Status on Presentation, Surgical Management and Mortality among Non-Metastatic Breast Cancer Patients in Indiana

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    Background The National Breast and Cervical Cancer Early Detection Program seeks to reduce health care disparities by providing uninsured and underinsured women access to screening mammograms. The objective of this study is to identify the differences in presentation, surgical management, and mortality among nonmetastatic uninsured patients diagnosed through Indiana's Breast and Cervical Cancer Program compared with patients with private and government (Medicare or Medicaid) insurance. Methods Study data were obtained using the Indiana state cancer registry and Indiana's Breast and Cervical Cancer Program. Women aged 50 to 64 with an index diagnosis of stage 0 to III breast cancer from January 1, 2006 to December 31, 2013, were included in the study. Bivariate intergroup analysis was conducted. Kaplan-Meier estimates between insurance types were compared using the log rank test. All-cause mortality was evaluated using a mixed effects model. Results The groups differed significantly for sociodemographic and clinical variables. Uninsured Indiana Breast and Cervical Cancer Program patients presented with later disease stage (P < .001) and had the highest overall mortality (hazard ratio 2.2, P = .003). Surgical management only differed among stage III patients (P = .012). Conclusion To improve insurance-based disparities in Indiana, implementation of the Breast and Cervical Cancer Program in conjunction with expansion of insurance coverage to vulnerable low-income populations need to be optimized

    Trends of Mammography Use in a National Breast Cancer Screening Program, 2004-2008

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    Purpose: Korea started breast cancer screening as part of the National Cancer Screening Program (NCSP) in 1999. In order to identify under-served groups, we investigated mammography uptake in the National Breast Cancer Screening Program. Materials and Methods: The study population was participants in the National Breast Cancer Screening Program from 2004 to 2008. We analyzed participation rates by insurance type, age group, and area of residence. Results: Total participation rates for breast cancer screening increased from 18.2% in 2004 to 35.0% in 2008. The participation rate in the group aged 60 to 69 years showed the greatest increase, 21.3%, among the four age groups. Although the screening rate increased continuously, the participation rate of the Medical Aid Program (MAP) group was low compared to the National Health Insurance (NHI) group. Moreover, the increasing trend of mammography uptake in the MAP group was much lower than that of the NHI group. Conclusion: The participation rate for breast cancer screening in the NCSP in Korea has increased. However, the participation rate in mammography among MAP recipients is still lower than that of NHI beneficiaries. To increase mammography uptake, it is important to make it available to everyone by ensuring inclusion of all population subgroups.ope
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