ABSTRACT
Objective@#To explore two visual acuity standards for examining uncorrected visual acuity (UCVA) to define poor vision in lower grade elementary school students, and to compare the difference of screening myopia rates when combined with non cycloplegic auto refraction (NCAR), so as to provide a scientific basis for standardizing UCVA examination methods using CAR as the gold standard of authenticity and reliability.@*Methods@#From March 22nd to April 9th, 2023, a total of 549 first and second grade students aged 7-8 years from a primary school in Hefei City were selected for the study by convenient cluster sampling method. Two methods were employed for UCVA examination:the first method involved charts where the student could not make mistakes in identifying at least half of the characters per line (V1), and the second method used charts with character sizes ranging from 4.0 -4.5, 4.6-5.0 and 5.1-5.3, without allowing 1, 2 and 3 errors per line (V2). While NCAR was performed, then 187 students underwent CAR examination. Paired Wilcoxon rank-sum test and McNemar test were used to compare the differences between V1 and V2 methods in defining poor vision and screening myopia rates. Using CAR as the gold standard, the authenticity and reliability of defining screening myopia rates through the combination of V1 and V2 methods along with NCAR were evaluated.@*Results@#The UCVA examination results for V1 and V2 showed statistically significant differences in both the right eye [5.0(4.9,5.0), 4.9(4.8,5.0)] and the left eye [ 5.0 (4.9,5.0), 4.9(4.8,5.0)] ( Z=-13.95, -13.34, P <0.01). The detection rates of poor vision for the right eye were 43.53% for V1 and 63.21% for V2, and the left eye with 44.08% for V1 and 62.11% for V2, with statistically significant differences ( χ 2= 106.01 , 95.09, P <0.01). When screening myopia rates were assessed for UCNA methods combined with NCAR, the right eye rates were 21.49% for V1 and 24.59% for V2, and the left eye rates were 21.31% for V1 and 23.13% for V2, with statistically significant differences ( χ 2=15.06, 8.10, P <0.01). Using CAR as the gold standard, the detection rates in the right eye and left eye were 16.58 % and 17.11%, respectively. The Youden indices for defining screening myopia in the right eye were 0.80 for V1 and 0.79 for V2, and the left eye with 0.85 for V1 and 0.83 for V2. The agreement rates for the right eye were 91.98 % for V1 and 89.30% for V2, and the left eye with 94.12% for V1 and 91.98% for V2. The Kappa values for the right eye were 0.73 for V1 and 0.67 for V2, and the left eye with 0.81 for V1 and 0.75 for V2.@*Conclusions@#Authenticity and reliability of two UCVA examination methods combined with NCAR in defining screening myopia are higher in V1 than V2 methods. It is recommended to unify the visual acuity examination methods by requiring the correct identification of more than half of the total number of visual markers in a row.
ABSTRACT
Abstract@#Adolescent idiopathic scoliosis (AIS) is the most common type of spinal deformity, which progress rapidly in adolescence. Patients without intervention can cause serious cardiopulmonary diseases as well as physical and mental health problem. Early screening and intervention can reduce probability that progress to operation and improve the prognosis. At present, China has not carried out extensive screening for scoliosis, and has not developed a unified screening standard, resulting in cross sectional comparison between various studies. The article focuses on the current situation of adolescent scoliosis research and the dispute of screening and puts forward suggestions.
ABSTRACT
Abstract@#Depression severely affects the healthy development of adolescents and has become a major public health challenge in China. The outbreak and normalization of COVID-19 have posed a serious challenge to the prevention and treatment of depression in adolescents. Given the characteristics of adolescent physical and mental development and depression pathology, the prevention and control of depression in adolescents should be shifted to an earlier stage. "Screening and dynamic monitoring" should be an important way to shift the focus of prevention and control of depression in adolescents. "Population based prevention" should be an important guarantee for achieving the shift toward early prevention and control of depression in adolescents, which builds a solid barrier for the mental health protection and promotion among Chinese adolescents.
ABSTRACT
Abstract@#Vertebral column defects can have adverse effects on the physical and mental health of children and adolescents. Early screening and diagnosis is conducive to the correction of the disease, which can effectively slow down or stop the process of abnormal spinal curvature in children and adolescents. However, in terms of cost-effectiveness, there are different opinions around the world on the inclusion of school screening for abnormal spinal curvature into routine health services. This article reviews the concept and classification of vertebral column defects in children and adolescents, the epidemic situation, screening methods and significance by consulting the relevant literature at home and abroad, so as to provide reference for the prevention and treatment of the disease.
ABSTRACT
Childhood nonalcoholic fatty liver disease (NAFLD) is one of the most common cause of chronic liver diseases in children and adolescents; its unique histopathological and clinical features may lead to its progression to liver fibrosis, liver cirrhosis, and liver cancer, and compared with adult NAFLD, it is more likely to cause other diseases and increase mortality rate. Therefore, early identification of risk factors for childhood NAFLD, effective screening of high-risk population, active prevention, and early diagnosis and treatment are key to effective clinical management of this disease. This article elaborates on the risk factors, screening methods, and preventive healthcare measures for childhood NAFLD, in order to standardize the comprehensive management of NAFLD, reduce the prevalence rate of NAFLD, delay its progression, and alleviate the economic and public health burden brought by the disease.
ABSTRACT
The screening, early diagnosis and early treatment project of the upper gastrointestinal cancer had achieved good results since its launch. However, from a national perspective, the endoscopic screening of upper gastrointestinal cancer was still not optimistic, such as the poor rate of the early diagnosis, the low rate of 5-year survival in rural areas, and the disparity of the standardized screening and diagnosis in different areas. Therefore, the situation of upper gastrointestinal cancer prevention and treatment is still severe. Under the guidance of the "Healthy China 2030" plan, based on the international experience and domestic actual circumstance, it is suggested that the screening of high-risk population in high-risk areas should be changed into the opportunistic screening in primary medical institutions. The opportunistic screening could expand the coverage of the screening, early diagnosis and early treatment project of the upper gastrointestinal cancer, and increase the early diagnosis rate in rural areas and primary medical institutions, which could improve the 5-year survival rate of patients with the upper gastrointestinal cancer, and then achieve the sustainable development of the cancer prevention and treatment in China.
ABSTRACT
Objective@#This study aimed to evaluate the validity and predictive value of different methods for myopia screening, and to provide the most effective method of myopia screening.@*Methods@#A total of 7 441 students of grade 1-12 selected from 36 primary and middle schools in 12 counties in Jiangsu Province were enrolled in this study for ophthalmological examination, and uncorrected visual acuity (UCVA, Plan A), noncycloplegic autorefraction (NCAR, Plan B) and combination of UCVA and NCAR (Plan C) were included in the examination. Receiver operating characteristics (ROC) curve was performed to determine the cut-off values (The gold standard is cycloplegic refraction: SE≤0.5 D), and positive predictive value, sensitivities, specificities and other indicators of three screening tests were compared and calculated.@*Results@#The AUC of the combination test for uncorrected visual acuity(UCVA) and noncycloplegic autorefraction (NCAR) was nearly 1(0.91, 95%CI=0.90-0.92), and the sensitivity, specificity, Yoden index, diagnostic coincidence rate, positive predictive value and negative predictive value were 92.4%，89.5%，0.82，91.1%，91.3%，90.8%, respectively, but the index of the younger pupils in primary schools was relatively low. The result of screening plan A for students of middle and high school students was the closest to that of myopia diagnosis.@*Conclusion@#Combination test, which was recommended by China National Health Commission, can be a practical solution for school students for myopic screening. Under the condition of no mydriatic refraction, Plan A could be considered for myopia screening especially for middle and high school students. For the younger pupils, it is suggested to use the internationally recommended myopia screening strategy, that is, SE ≤ 0.50D after mydriasis.
ABSTRACT
Objective@#To assess the impact of Chinese Cervical Cancer Screening Program for Rural Area (NACCSPRA) on population-based screening rates.@*Methods@#The subjects were selected from 2013-2014 Chinese Chronic Diseases and Risk Factors Surveillance (CDRFS2013), which adopting multi-stage stratified cluster sampling from 31 provinces. A total of 169 632 participants aged 18 years and older in 297 surveillance points were interviewed, of whom 65 476 women aged 35-64 years were included in the analysis. The surveillance points in CDRFS 2013 were divided into the screening areas and the control areas by matching points in CDRFS2014 with counties in NACCSPRA. The difference in socioeconomic status between areas was compared. The screening rates and 95% confidence interval (95%CI) were estimated by Tylar series variance method. The Propensity Score was evaluated for individuals by multivariate logistic regression and the greedy matching method based on propensity score value was used to conduct 1∶1 matching sample for the screening areas and the control areas. After matching, multivariate conditional logistic regression model was fitted to assess the impact of national cervical cancer screening intervention on the likelihood of undergoing cervical cancer screening at population level.@*Results@#Among 65 476 subjects, 48.6% (n=31 794) was in the screening areas. Before matching, in the rural area the screening rate in the screening areas (24.0% (4 763/19 838), 95%CI: 21.8%-26.3%) was higher than that in the control areas (15.6% (2 331/14 942), 95%CI: 13.4%-17.8%); whereas in the urban area the screening rate in the screening areas (28.5% (3 413/11 956), 95%CI: 26.1%-31.0%) was similar to that in the control areas (26.3% (4 923/18 740), 95%CI: 24.1%-28.4%). After matching, in rural area the screening rate in the screening areas (23.2% (3 454/14 875), 95% CI: 20.9%-25.5%) was higher than that in the control areas (15.6% (2 315/14 875), 95% CI: 13.3%-17.8%); in urban area the screening rate in the screening areas (28.7% (3 202/11 146), 95% CI: 26.2%-31.2%) was higher than that in the control areas (23.1% (2 571/11 146), 95%CI: 20.9%-25.3%). Multivariate conditional logistic regression model showed that the cervical cancer screening rates in intervention areas significantly increased among women aged 35-64 years both in urban areas (OR=1.44, 95%CI: 1.34-1.54) and rural areas (OR=1.78, 95%CI: 1.67-1.90) as compared with those in control areas.@*Conclusion@#The implementation of Chinese cervical cancer screening program during the five years substantially increased the population-based screening rates both in urban and rural areas.
ABSTRACT
Objective@#To evaluate the reliability and validity of warning signs checklist developed by the National Health and Family Planning Commission of the People′s Republic of China (NHFPC), so as to determine the screening effectiveness of warning signs on developmental problems of early childhood.@*Method@#Stratified random sampling method was used to assess the reliability and validity of checklist of warning sign and 2 110 children 0 to 6 years of age(1 513 low-risk subjects and 597 high-risk subjects) were recruited from 11 provinces of China. The reliability evaluation for the warning signs included the test-retest reliability and interrater reliability. With the use of Age and Stage Questionnaire (ASQ) and Gesell Development Diagnosis Scale (GESELL) as the criterion scales, criterion validity was assessed by determining the correlation and consistency between the screening results of warning signs and the criterion scales.@*Result@#In terms of the warning signs, the screening positive rates at different ages ranged from 10.8%(21/141) to 26.2%(51/137). The median (interquartile) testing time for each subject was 1(0.6) minute. Both the test-retest reliability and interrater reliability of warning signs reached 0.7 or above, indicating that the stability was good. In terms of validity assessment, there was remarkable consistency between ASQ and warning signs, with the Kappa value of 0.63. With the use of GESELL as criterion, it was determined that the sensitivity of warning signs in children with suspected developmental delay was 82.2%, and the specificity was 77.7%. The overall Youden index was 0.6.@*Conclusion@#The reliability and validity of warning signs checklist for screening early childhood developmental problems have met the basic requirements of psychological screening scales, with the characteristics of short testing time and easy operation. Thus, this warning signs checklist can be used for screening psychological and behavioral problems of early childhood, especially in community settings.
ABSTRACT
Objective To explore the diagnostic value of HR -HPV combined with TCT in the diagnosis of cervical cancer and precancerous lesion.Methods 1 198 cervical specimens were selected for the study.The results of HR -HPV detection and TCT detection were analyzed,with the pathological results as the gold standard,the diag-nostic value of HR -HPV and TCT in the diagnosis of cervical cancer and precancerous lesion were discussed. Results With increasing pathological grade,TCT positive rate increased gradually,there was a correlation between them(r =0.629,P <0.05).With increasing pathological grade,HR -HPV positive rate increased gradually,there was a correlation between them(r =0.684,P <0.05).The sensitivity of HR -HPV combined with TCT in the differ-ential diagnosis of cervical cancer,precancerous lesions was 100.00%,specificity was 79.64%,missed diagnosis rate was 0.00%,the misdiagnosis rate was 20.36%.Conclusion HR -HPV combined with TCT examination has high clinical value in the diagnosis of cervical cancer and precancerous lesions.
ABSTRACT
Objective To analyze the effect of Chinese diabetes risk score in health checkup of elderly population and to explore the risk factors of abnormal glucose metabolism in the elderly patients.Methods Chinese diabetes risk score(C-DRs)screening,glucose tolerance test(OGTT),blood biochemical parameters and history collection were performed in 1 181 elderly people participating the health checkup.The area under the ROC curve(AUC)was used to evaluate the accuracy of the screening method.The effect of different cumulative C-DRs on screening target population was reflected by the Gordon index.Multivariate logistic regression analysis was used to analyze relevant risk factors for the glucose metabolic abnormalities.Results The AUC of screening for diabetes was 0.749(95%CI:0.715-0.782),and the best cut-point value was 32.5 points.The sensitivity was 86.50%,the specificity was 60.84%,and the Gordon index was 0.47(P=0.000).The AUC of screening for the pre-diabetes was 0.760(95%CI:0.733-0.787),and the best cut-point was 33.5 points.The sensitivity was 70.89%,the specificity was 68.72%,and the Gordon index was 0.40(P=0.000).The AUC of screening for MS was 0.797(95% CI:0.772-0.823),and the best cut-point value was 32.5 points.The sensitivity was 83.62%,the specificity was 64.90%,and the Gordon index was 0.49(P=0.000).The AUC of screening for insulin resistance was 0.609(95%CI:0.645-0.734),and the best cut-point value was 30.5 points.The sensitivity was 81.25%,the specificity was 44.81%,and the Gordon index was 0.26(P=0.000).Multiple logistic regression analysis showed that age over 80 years,abdominal obesity(waist circumference,male ≥ 90 cm,female ≥ 85 cm),hypertension,hypertriglyceridemia,family history of diabetes were risk factors for abnormality of glucose metabolism in the elderly.The odd ratio values of the above were 1.557,1.543,1.495,1.569,1.625,1.715(all P<0.05).Conclusions Chinese diabetes risk score may be used to screen for diabetes,metabolic syndrome and insulin resistance in the elderly population.Old age,abdominal obesity,hypertension,hypertriglyceridemia and family history of diabetes are independent risk factors for abnormal glucose metabolism in the elderly population.
ABSTRACT
Objective To assess the awareness and knowledge about cervical cancer,cervical cancer screen-ing and human papillomavirus(HPV)of women in Chengdu.Methods A total of 1 077 women aged 19 -71 years old were recruited and assessed in their awareness and knowledge about cervical cancer and its issues.The collection of data was based on the questionnaire items.Results The awareness rates of cervical cancer,cervical cancer screen-ing,and HPV were 71.1%,23.2%,16.0%,respectively.There were significant differences in the awareness and knowledge about cervical cancer,cervical cancer screening and HPV between different ages(χ2 =89.238,16.532, 20.182,all P 40 -50 years old)was highest,the awareness rates of cervical cancer,cervical cancer screening,and HPV were 81.3%,27.7%,20.2% respectively.There were significant differ-ences in the awareness and knowledge about cervical cancer,cervical cancer screening and HPV between different marital status(χ2 =60.899,20.853,16.255,all P <0.05).There were significant differences in the awareness and knowledge about cervical cancer,cervical cancer screening and HPV between different education levels (χ2 =228.026,42.648,32.495,all P <0.05 ).The awareness of people accepted university education was highest,the awareness rates of cervical cancer,cervical cancer screening,and HPV were 87.6%,30.9%,21.6% respectively. There were significant differences in the awareness and knowledge about cervical cancer,cervical cancer screening and HPV between different income levels(χ2 =21.604,8.124,9.224,all P <0.05).Conclusion This study demon-strates a very low level of knowledge about cervical cancer,cervical cancer screening and HPV of women in Chengdu. In order to reduce the incidence rate and mortality of cervical cancer in Chengdu,it is strongly needed to make exten-sive health education to raise awareness of cervical cancer and HPV.
ABSTRACT
Objective: To evaluate the performance and application value of several triage strategies for high-risk human papillomavirus (HR-HPV) DNA testing as primary screening of human cervical cancer. Methods: The data from cross-sectional population-based studies for screening human cervical cancer carried out in Xiangyuan county of Shanxi province, China, 2003 were reanalyzed. Totally 1788 women were included in this study. All women were screened by liquid-based cytology (LBC), HR-HPV DNA testing-hybrid capture 2 (HPV-HC2) (for primary screening and analysis of high- and low-level viral loads), and visual inspection with acetic acid (VIA), then all positive women in any test were referred for colposcopy. If the colposcopy result was positive, the woman was referred for biopsy for the final pathological result. This study simulated the strategy in which HPV-HC2 testing was used as primary screening of cervical cancer, then LBC, VIA, HPV-HC2 high- and low-level viral load tests were used as the triage for HPV-positive women. The above strategies were compared by sensitivity, specificity, colposcopy referral rate and other indexes for high-grade squamous intraepithelial lesion (HSIL) and invasive cervical cancer. Moreover, the application value of the above strategies was analyzed by receiver operator characteristic (ROC) curve and the area under curve (AUC) (αcorrection = 0.0125). Results: The colposcopy referral rate, sensitivity, specificity and positive predictive value (PPV) of HPV primary screening with HPV-HC2 for detecting HSIL and invasive cervical cancer were 18.1%, 95.7%, 85.0% and 20.4%, respectively. After HPV primary screening, the referral rates of three strategies of triage with LBC, VIA and HR-HPV-HC2 low viral load were decreased to 8.7%, 4.5% and 9.8%, respectively; the specificity values were increased to 94.3%, 97.5% and 93.1%, respectively; the positive predictive values were increased to 37.2%, 46.9% and 32.0%, respectively; the sensitivity values were decreased to 84.1%, 55.1% and 81.2%, respectively. The difference of AUC between HPV primary screening and its combination with the triage of LBC or HPV-HC2 low viral load was not statistically significant (both P > 0.012 5), but the difference of AUC between HPV primary screening and its combination with the triage of VIA or HPV-HC2 high viral load was statistically significant (both P < 0.001). Conclusion: Considering the economy and adaptability, increasing the cut-off of HPV DNA testing (cut-off ≥10 pg/mL) to improve the screening efficiency of human cervical cancer is feasible and effective in low-resource and less-developed areas. HR-HPV primary screening with the triage of LBC can be introduced widespreadly in high-developed areas. HR-HPV primary screening with the triage of VIA is feasible in rural areas, but the skills of the health care providers responsible for testing should be trained and improved.
ABSTRACT
Objective To evaluate the screening effect of osteoporosis self-assessment tool for Asians (OSTA) in middle aged and elderly healthy men in Chengdu.Methods A total of 4042 healthy men aged 40 to 106 years received dual energy X-ray absorptiometry (DXA) assay,and OSTA index evaluation.Measurement sites included lumbar spine (L1-4),left femoral neck,trochanter,Ward's area,total hip and femoral shaft.All persons were classified into highosteoporosis-group (OSTA≤-4),mediumosteoporosis-group (-4 ＜ OSTA≤≤-1),low osteoporosis-group (OSTA＞-1),or the low risk-group (OSTA＞-1) and high risk-group (OSTA≤-1) by OSTA scores.T-scores were compared between different measurement sites detected by DXA.The sensitivity,specificity,Kappa value and the area under receiver operating characteristic (ROC) curve (AUC) of OSTA in screening osteoporosis were evaluated.Results The prevalence of osteopenia and osteoporosis in lumbar spine,proximal femur were gradually increased along with aging.The detection rate of osteoporosis in lumbar spine and proximal femur were 16.2％ and 24.0％ respectively in subjects aged over 80 years.OSTA index in low-risk,medium-risk group,high-risk group were 85.0％,11.0％,4.0％ respectively.The detection rate of osteoporosis in lumbar spine and proximal femur were 2.6％ and 1.6％ in low-risk group,10.4％ and 10.4％ in medium-risk group,and 29.3％ and 30.5％ in high-risk group,respectively.Taking OSTA ≤-1 as the cut-off value,the sensitivity and specificity of OSTA in screening osteoporosis in lumbar spine and femur by T-score＜-1 were 28.1％,28.7 ％,89.0％ and 92.4％ respectively,and by T-score≤-2.5 were 51.6％,63.2％,86.7％ and 86.8％ respectively.The consistency of diagnosis result between T-score and OSTA index according to the three versus two risk levels was 0.153 and 0.197 versus 0.195 and 0.243 Kappa value,respectively.The AUC of OSTA index for lumbar spine and femur by T-score＜-1 and T-score≤-2.5 were 0.689 and 0.823,and for different age groups and different measurement sites were 0.639 and 0.899 (all P＜0.001).Conclusions OSTA index has a certain ability in screening osteoporosis in men aged over 50 years.There are different screening results on osteoporosis among the different age groups.
ABSTRACT
Objective To investigate the clinical significance of irregular antibody screening positive patients in the blood transfusion.Methods From September 2003 to September 2012,5 260 samples of blood test were given pre-transfusion irregular antibody detection,and the patients with positive antibody screening were statistically analyzed.Results Of 5 260 samples,38 cases (6.8％) had irregular antibodies,the difference between males and females was statistically significant(x2 =2.646,P ＜ 0.05).The Rh blood group had the highest proportion in irregular antibodies;pregnancy history and history of blood transfusion group,pregnancy history group,history of blood transfusion group were significantly higher than those without history of pregnancy and transfusion history groups,the difference was statistically significant (x2 =28.827,P ＜ 0.05).Conclusion Screening of irregular antibodies plays an important role in the safety of clinical blood transfusion.
ABSTRACT
Objective To establish the normative screening model and apply it to screen and manage the stroke risk group ,and to observe its application effect .Methods The screening management team in our department was set up for establishing the norma-tive stroke screening model .Then the stroke screening works were carried out in the outpatient department and the community pop-ulation .The screened groups of stroke high risk were implemented the 1-year control according to the guidelines of stroke screening and intervention .Results 9 631 individuals of stroke risk were screened ,among them 1 786 high-risk patients were screened out with a rate of 18 .55% .The interventions on the risk factors existing in the high-risk patients were implemented .The comparison of blood glucose ,blood pressure ,blood fat ,fat index ,smoking ,physical exercise and reasonable diet before and after interventions in the high-risk patients showed statistically significant differences (P<0 .05) .Conclusion Establishment of the normative manage-ment model of stroke screening is the important guarantee to do a good job of stroke screening and control for high risk group ,and significantly decreases the risk factors for high risk group .
ABSTRACT
Objective To compare the application of three diagnostic criteria for metabolic syndrome(MS) among the elderly in community. Methods 773 elderly people in the community were diagnosed for MS by the Chinese Medical Association Diabetes Society (CDS),International Diabetes Federation (IDF) and revised National Cholesterol Education Prongram-Adult Treatment Panel(ATP Ⅲ* ) criteria,respectively.The diagnosis accordance rates were compared among the different diagnostic criteria. Results The MS prevalence rates in the elderly were 32.5％ (251/773),53.4％ (413/773) and 47.2％ (365/773) according to CDS,IDF and ATP Ⅲ* criteria,respectively and there were significant difference among the criteria (Q=173.10,P＜0.01 ).The MS prevalence was higher in women than in men especially by IDF [57.3％ (284/487)vs.45.1％ (129/286),x2=12.64,P＜0.01]and ATPⅢ* criteria [53.0％(258/487)vs. 37.4％ (107/286),x2=17.52,P＜0.01].The coincidences in the diagnosis of MS were 88.6％ (Kappa=0.773,P＜0.01)using IDF and ATPⅢ * definitions,75.7％ using CDS and ATPⅢ *,and 73.7％ using CDS and IDF.Conclusions The agreement in the diagnosis of MS using IDF and ATPⅢ* definitions is higher than using CDS and IDF or ATPⅢ * definitions.
ABSTRACT
La medicina preventiva clínica nos provee de los fundamentos para realizar un chequeo médico individual en forma sistemática y profesional. Las recomendaciones de la USPSTF son un referente a tener en cuenta porque, están construídas sobre evidencias, pero deben ser adaptadas a la epidemiología y a la cultura de donde proviene el consultante. Junto con las alteraciones biológicas (biomédicas), deben ser considerados los determinantes psico-sociales dentro de los factores de riesgo, ya que pueden ser tanto o más importante para la salud de las personas, que aquellos biológicos
Preventive medicine provide a unique perspective useful, to get effective and professional clinical screening. USPSTF provide important evidence based recommendations to be considered in clinical practice; but it should be adapted according local epidemiological conditions. The psychosocial perspective should be considered together with the biomedical approach in order to improve the screening effectiveness
Subject(s)
Humans , Preventive Medicine , Epidemiology , Neoplasms/prevention & control , Primary Prevention , Chile , Mass Screening , Multiphasic Screening , Diagnostic Tests, Routine , Early Detection of Cancer , Secondary Prevention , Tertiary Prevention , Neoplasms/epidemiologyABSTRACT
Objective To analyze the relation of hypermethylated secreted frizzled-related protein 2 (SFRP2) gene in feces and peripheral blood of colorectal cancer(CRC) patient with Dukes stages and histological types,and to evaluate SFRP2 gene for screening and judging the pathogenetic condition of CRC.Methmls Methylation-specific PCR assay was performed to analyze SFRP2 gene promoter methylation status in a blinded fashion in tumor tissues,stool and pefipheral blood samples taken from 169 CRC patients,63 patients with adenoma,46 with hyperplastic polyp and 30 endoscopically normal subjects.Results SFRP2 gene Was hypermethylated in 88.2%.65.1%and 45.7% of CRC.adenoma and non-adenomatous polyp tissues,in 84.0%,46.0% and 32.6%of corresponding fecal samples,and in 66.9%,6.4%and 2.2% of corresponding peripheral blood samples,respectively.In contrast,no methylated SFRP2 gene was detected in mucosal tissues and peripheral blood of normal controls,while two cases of matched fecal samples from normal controls were detected with hypermethylated SFRP2.Moreover,no significant correlation were observed between SFRP2 hypermethylation and clinicopathological features including sex,age,size,location and Dukes stage,but there was a significant correlation between SFRP2 hypermethylation and tumor difierentiation and infiltration.SFRP2 hypermethylation in peripheral blood of CRC patients was positively correlated with the Dukes stage. Condusions Hypermethylation of SFRP2 gene in feces works as a molecular biomarker for CRC screening.The hypermethylation of SFRP2 gene is positively related with Dukes stage.