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Community‐based multiple screening model
Author(s) -
Chen Tony HsiuHsi,
Chiu YuehHsia,
Luh DihLing,
Yen MingFang,
Wu HuiMin,
Chen LiSheng,
Tung TaoHsin,
Huang ChihChung,
Chan ChangChuan,
Shiu MingNeng,
Yeh YenPo,
Liou HorngHuei,
Liao ChaoSheng,
Lai HsinChih,
Chiang ChunPin,
Peng HuiLing,
Tseng ChuenDen,
Yen MingShyen,
Hsu WeiChih,
Chen ChihHung
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20171
Subject(s) - medicine , asymptomatic , papanicolaou stain , odds ratio , overdiagnosis , confidence interval , disease , cancer , cervical cancer
BACKGROUND Multiple disease screening may have several advantages over single disease screening because of the economics of scale, with the high yield of detecting asymptomatic diseases, the identification of multiple diseases or risk factors simultaneously, the enhancement of the attendance rate, and the efficiency of follow‐up. METHODS An integrated model of community‐based multiple screening was designed and conducted between 1999 and 2001 in Keelung, Taiwan. The authors used a Papanicolaou (Pap) smear screening program as a base to integrate other screening regimens encompassing four other neoplastic diseases and three nonneoplastic chronic diseases. Screening methods, the interscreening interval, and the follow‐up for each screening regimen were designed based on evidence‐based literature and current national screening policy. RESULTS A total of 42,387 subjects participated in the screening activities. A 25% increase in the attendance rate for Pap smear screening was demonstrated after the introduction of multiple disease screening programs. At the first screen, this program yielded a total of 677 asymptomatic neoplasms (16.0 per 1000), including a large proportion of precancerous lesions and small presymptomatic tumors without lymph node involvement. The association between the occurrence of neoplasm and the presence of comorbid nonneoplastic chronic disease was found to be statistically significant (odds ratio, 1.64; 95% confidence interval, 1.38–1.94 [ P < 0.05]). The authors also identified 5314 subjects with metabolic syndrome who were at a greater risk for colorectal and oral neoplasias. CONCLUSIONS The results of the current study demonstrate that an outreach and community‐based multiple screening program not only enhances attendance rates but also has a high yield of early cases of various diseases simultaneously, and provides a natural opportunity to elucidate the correlation between neoplastic disease and nonneoplastic chronic disease. Cancer 2004. © 2004 American Cancer Society.