Recent diagnostic procedures for colorectal cancer screening: are they cost-effective?

Colorectal cancer [CRC] is the third most common cancer worldwide and the fourth most common cause of death. Reduction in mortality rates in some countries worldwide are most likely ascribed to CRC screening and/or improved treatments. We reviewed the most relevant articles which discuss the cost-effectiveness of colorectal cancer screening procedures, in particular, the recent ones through the last eight years. The effectiveness of screening estimated by discounted life years gained [LYGs] compared to no screening, differed considerably between the studies. Despite these differences, all studies consistently emphasized that screening for CRC was cost-effective compared with no screening for each of the recognized screening strategies. Newer technologies for colorectal cancer screening, including computed tomographic colonography [CTC], faecal DNA test, and Pillcam Colon are less invasive and accurate, however, they are not cost-effective, as their cost was higher than all other established screening strategies. When compliance and adherence to such new techniques are increased more than the established strategies they would be more cost-effective particularly CTC

Association of maternal work with adverse perinatal outcome

Little information exists about the effect of work during pregnancy and adverse perinatal outcome in our country, Egypt, as a developing one. In order to investigate such relationship, 2419 women were interviewed shortly after delivery in the three main public and Health Insurance hospitals in Alexandria, Egypt during a period of 4 months. There were 730 [30.2%] working and 1689 [69.8%] non-working parturients. Detailed description of working status was analysed, along with risk profile which was compared between both groups. There was no significant association between different work characteristics and perinatal outcomes. There was an excess rate of small-for-gestational-age [SGA] and perinatal death among the non-working group, while preterm delivery was significantly increased among those who worked throughout the whole pregnancy. After adjusting for confounders, the risk of preterm delivery was no more significant [OR = 1.2 and 95% CI = 0.96 - 1.71. On the other hand, working status had a beneficial effect on SGA and perinatal death [OR = 0.41, 0.26 and 95% CI = 0.26-0.64 and 0.14-0.48, respectively]. These results cast doubt on the hazardous element of work and adverse pregnancy outcome and work per se doesn't constitute a health risk factor but may even have a positive social impact on pregnancy