A review of international progress in colorectal cancer screening programs / 上海预防医学

Objective:To summarize the international experience in colorectal cancer population screening programs， so as to provide reference for the development and promotion of similar programs in China. Methods:We used “colorectal cancer population screening program” as key words to search the database of CNKI and Web of Science in this study. Results:A total of 18 reports （including 17 programs） were selected from 187 Chinese and 1 256 English literatures. International colorectal cancer screening programs were organized to target asymptomatic 50-74 years old population for fecal immunochemical test every two years and recommend participants with positive result to take further colonoscopy. These programs reduced the incidence of colorectal cancer and adenoma， which were beneficial to early diagnosis and treatment in colorectal cancer patients. They also showed good cost-effectiveness. Conclusion:Based on the domestic and foreign experiences， we suggest to further improve colorectal cancer screening programs in China， including designing evidence-based and feasible strategies， attaching importance to the implementation and management of the programs， and simultaneously implementing project monitoring and effectiveness evaluation.

Mass Eradication of Helicobacter pylori to Prevent Gastric Cancer: Theoretical and Practical Considerations

Although the age-adjusted incidence of gastric cancer is declining, the absolute number of new cases of gastric cancer is increasing due to population growth and aging. An effective strategy is needed to prevent this deadly cancer. Among the available strategies, screen-and-treat for Helicobacter pylori infection appears to be the best approach to decrease cancer risk; however, implementation of this strategy on the population level requires a systematic approach. The program also must be integrated into national healthcare priorities to allow the limited resources to be most effectively allocated. Implementation will require adoption of an appropriate screening strategy, an efficient delivery system with a timely referral for a positive test, and standardized treatment regimens based on clinical efficacy, side effects, simplicity, duration, and cost. Within the population, there are subpopulations that vary in risk such that a "one size fits all" approach is unlikely to be ideal. Sensitivity analyses will be required to identify whether the programs can be utilized by heterogeneous populations and will likely require adjustments to accommodate the needs of subpopulations.

Population Screening for Colorectal Cancer Means Getting FIT: The Past, Present, and Future of Colorectal Cancer Screening Using the Fecal Immunochemical Test for Hemoglobin (FIT)

Fecal immunochemical tests for hemoglobin (FIT) are changing the manner in which colorectal cancer (CRC) is screened. Although these tests are being performed worldwide, why is this test different from its predecessors? What evidence supports its adoption? How can this evidence best be used? This review addresses these questions and provides an understanding of FIT theory and practices to expedite international efforts to implement the use of FIT in CRC screening.

Pesquisaje y prevención de la diabetes mellitus tipo 2 en población de riesgo / Screening and prevention of diabetes mellitus type 2 in risky population

La prevalencia de diabetes mellitus tipo 2 (DM 2) ha mostrado un rápido incremento en los últimos años, por lo que reducir su incidencia es una prioridad de las políticas de salud pública en todos los países, tanto desarrollados como en vías de desarrollo. La prevención de la enfermedad es la acción que normalmente se emana desde los servicios de salud y que considera a los individuos y a las poblaciones como expuestas a factores de riesgo identificables, que suelen ser con frecuencia asociados a diferentes conductas de riesgo de los individuos. La modificación de estas conductas de riesgo constituye una de las metas primordiales de la prevención de la enfermedad. El propósito de las pruebas de pesquisaje es identificar individuos con riesgo de padecer la enfermedad con o sin síntomas de esta. Si las pruebas de pesquisaje resultan positivas, entonces se realiza una prueba diagnóstica que nos dice si el paciente presenta la enfermedad

The prevalence of type 2 diabetes mellitus (DM2) has shown rapid growth in recent years, so reducing its incidence is a priority of public health policy in both developed and developing countries. The prevention of this disease is the action that normally emanates from health services which considers individuals and populations exposed to identifiable risk factors. These factors often tend to be associated with different risk behaviors of individuals. Modifying these risk behaviors is one of the primary goals of this disease prevention. The purpose of this screening test is to identify individuals at risk of disease having symptoms or not. If screening tests are positive, then a diagnostic test is performed to know whether the patient has the disease

Prenatal Population Screening for Fragile X Carrier and the Prevalence of Premutation Carriers in Korea

PURPOSE: Fragile X carrier detection before or at early pregnancy through a wide screening program may not only confer a risk of having offspring with Fragile X syndrome (FXS), but may also confer a risk for Fragile X-associated primary ovarian insufficiency and Fragile X-associated tremor/ataxia syndrome. However, prior to the implementation of such a program, the carrier prevalence in a population and the availability of effective screening test should be evaluated. The aim of our study was to determine the prevalence of premutation carriers and to evaluate the feasibility of screening test. MATERIALS AND METHODS: The blood samples were obtained from 8,641 pregnant women with no family history of mental retardation. We performed a three-primer CGG repeat primed (RP) PCR using the AmplideX(TM) FMR1 PCR kit (Asuragen, Inc. Austin, TX, USA). Samples showing full mutation alleles were reflexed to Southern blot analysis for methylation status and sizing. RESULTS: Among the 8,641 women, we found 8 premutation carriers (1:1,090, 0.09%) and 46 women with an intermediate allele (1:190, 0.53%). No woman was found to carry the fully mutated allele. All the detected alleles were within the CGG repeat range of 8-117. Among the 8,641 samples, 29 and 30 CGG repeats represent 66.6% of all cases. The CGG RP PCR method provides robust detection of expanded alleles and resolves allele zygosity, thus minimizing the number of samples that require Southern blot analysis. CONCLUSION: This is the first study that has focused on the prevalence of FXS premutation carriers and FMR1 allele distribution in normal pregnant women. These data have important implications for population-based fragile X carrier screening in Korea.

Prenatal Population Screening for Fragile X Carrier and the Prevalence of Premutation Carriers in Korea

PURPOSE: Fragile X carrier detection before or at early pregnancy through a wide screening program may not only confer a risk of having offspring with Fragile X syndrome (FXS), but may also confer a risk for Fragile X-associated primary ovarian insufficiency and Fragile X-associated tremor/ataxia syndrome. However, prior to the implementation of such a program, the carrier prevalence in a population and the availability of effective screening test should be evaluated. The aim of our study was to determine the prevalence of premutation carriers and to evaluate the feasibility of screening test. MATERIALS AND METHODS: The blood samples were obtained from 8,641 pregnant women with no family history of mental retardation. We performed a three-primer CGG repeat primed (RP) PCR using the AmplideX(TM) FMR1 PCR kit (Asuragen, Inc. Austin, TX, USA). Samples showing full mutation alleles were reflexed to Southern blot analysis for methylation status and sizing. RESULTS: Among the 8,641 women, we found 8 premutation carriers (1:1,090, 0.09%) and 46 women with an intermediate allele (1:190, 0.53%). No woman was found to carry the fully mutated allele. All the detected alleles were within the CGG repeat range of 8-117. Among the 8,641 samples, 29 and 30 CGG repeats represent 66.6% of all cases. The CGG RP PCR method provides robust detection of expanded alleles and resolves allele zygosity, thus minimizing the number of samples that require Southern blot analysis. CONCLUSION: This is the first study that has focused on the prevalence of FXS premutation carriers and FMR1 allele distribution in normal pregnant women. These data have important implications for population-based fragile X carrier screening in Korea.