Quality monitoring and evaluation of neonatal diseasescreening in Zhejiang Province / 预防医学

Abstract@#Neonatal disease screening is a major tool for prevention of birth defects, and monitoring and evaluation of neonatal disease screening facilitates the improvements in screening quality and efficiency. A strict quality control of screening, diagnosis, treatment and follow-up of neonatal diseases is performed in Zhejiang Provincial Center for Quality Control of Neonatal Disease Screening. In this study, the data pertaining to screening of neonatal inherited metabolic diseases, hearing loss and congenital heart diseases were collected in Zhejiang Province from 2018 to 2020, and the screening rate, recall rate of suspected screening-positive neonates, and detection rate of diseases were calculated to assess the quality of neonatal disease screening. The screening rate and recall rate of neonatal inherited metabolic diseases, hearing loss and congenital heart diseases were high in Zhejiang Province, and the detection of screened diseases was stable, indicating a high overall quality of neonatal disease screening. Increasing the impact of neonatal disease screening and consolidating the screening achievements should be given a high priority during the future quality control of neonatal disease screening in Zhejiang Province.

Quality evaluation of tandem mass spectrometry screening for neonatalinherited metabolic diseases in Zhejiang Province from 2009 to 2021 / 预防医学

Objective@#To evaluate the quality of tandem mass spectrometry (MSMS) screening for neonatal inherited metabolic diseases in Zhejiang Province from 2009 to 2021.@*Methods@#The data pertaining to MSMS screening for neonatal inherited metabolic diseases in Zhejiang Province from 2009 to 2021 were collected from the database created by Zhejiang Provincial Center for Neonatal Disease Screening. The percentage of MSMS screening, percentage of recall of suspected screening-positive infants and incidence of neonatal inherited metabolic diseases were analyzed retrospectively to evaluate the quality of MSMS screening for inherited metabolic diseases.@*Results@#A total of 4 706 916 newborns were screened among 8 297 039 live births by MSMS in Zhejiang Province from 2009 to 2021, and the percentage of MSMS screening increased from 5.48% to 97.54%, with a mean percentage of 56.73%. Of 46 838 suspected screening-positive infants, 45 527 infants were recalled, and the percentage of recall increased from 94.57% to 98.62%, with a mean percentage of 97.20%. A total of 1 038 infants were definitively diagnosed with inherited metabolic diseases in Zhejiang Province from 2009 to 2021, with an overall incidence rate of 1/4 535, and the incidence rates of amino acid metabolic disorder, fatty acid oxidation metabolic disorder and organic acid metabolic disorder were 1/11 767, 1/13 763 and 1\15 902, respectively. Of the 11 cities in Zhejiang Province, the highest percentage of tandem mass spectrometry screening for inherited metabolic diseases was found in Hangzhou City (83.01%), and the highest percentage of recall of suspected screening-positive infants was se en in Zhoushan City (99.08%). @*Conclusions@#A high percentage of MSMS screening for neonatal inherited metabolic diseases was observed in Zhejiang Province from 2009 to 2021; however, there was a region-specific percentage of screening, and the recall of suspected screening-positive infants remains to be improved.

Screening results of neonatal diseases and exploration of management mode in Yichang in 2017-2019 / 公共卫生与预防医学

Objective To retrospectively analyze the results of neonatal diseases screening in Yichang from 2017 to 2019, understand the incidence and recall of the diseases, and explore the management mode of neonatal disease screening suitable for this region. Methods The subjects were newborns who were delivered in Yichang midwifery institutions from 2017 to 2019 and were screened for neonatal diseases. Heel blood of the newborns was collected for the screening of neonatal diseases, including congenital hypothyroidism (CH), phenylketonuria (PKU), G6PD deficiency, congenital adrenal hyperplasia (CAH) and thalassemia. Those newborns with positive initial screening were recalled for reexamination and confirmation. The recall rates of different diseases were compared by Chi-square test. Results There were 85 891 live births in Yichang area from 2017 to 2019, and 84 063 cases were screened for neonatal diseases, with a screening rate of 97.87%. A total of 6 043 cases were positive in the initial screening, of which 5,047 cases were recalled, with a recall rate of 83.52%. The recall rates of the traditional two diseases (CH and PKU) and the new three diseases (CAH, G6PD deficiency and thalassemia) were significantly different ( χ2= 197.93, P＜0.01). A total of 501 cases were diagnosed. The incidence rate of CH was 1/1,911, the incidence rate of PKU was 1/12 009, the incidence rate of CAH was 1/28 021, the incidence rate of G6PD deficiency was 1/1 121, and the incidence rate of thalassemia was 1/226. Conclusions The neonatal disease screening rate increased year by year in Yichang, but the recall rate of suspicious positive initial screenings decreased. It is necessary to explore a more suitable management mode for the five neonatal disease screenings in this region, improve the recall rate of children with positive screening, reduce the incidence of disabled children, and improve the quality of the birth population.

The Relationship between Cancer Screening Rates and Promotional Methods in Incheon Metropolitan City / 보건행정학회지

BACKGROUND: National cancer screening reduces mortality from stomach, colon, breast, and cervical cancer. However, cancer screening rates remain lower than 50% in Korea. This research was designed to make effective guidelines for cancer screening promotion to increase participation rate in cancer screening. METHODS: Data was collected from Incheon regional cancer center's telephone survey ‘Recognition of cancer prevention and control’ of 861 Incheon citizens over age 40. Logistic regression was used to analyse a relationships between cancer screening rates and promotional methods. PASW SPSS ver. 18.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. RESULTS: About 27.4% of respondents (236 of 861 respondents) have recognized the promotional program of Incheon regional cancer center for cancer screening participation. Cancer screening rate was associated with age group, educational level for stomach cancer, age group, bus advertisement (odds ratio, 1.19 to 2.75) for colon cancer, educational level, residential area for breast cancer, and age group for cervical cancer. CONCLUSION: There was relationship between stomach cancer screening rates and promotional methods. Therefore, cancer screening promotion guidelines to increase participation rate should be considered.

National Health Screening Program of Korea

National Health Screening Program of Korea for chronic diseases was started in 1980. During the last 20 years, the problems of the program has been discussed. The problems discusses were as follows: (1) The current guideline is based on weak rationale, without concrete evidence-based decisions (2), The goal of the screening program was not set based on evidence, and there has been no evaluation for the effectiveness of the program (3), the program consists of test items without the diseases (4), the program was run by separate municipalities, so it was not organized for the subjects, and finally (5), there has been no remarkable reduction in incidence or prevalence of the related diseases. To improve the program, there have been many efforts including new national screening program called 'National screening program for the transitional period' in 2007 and launching the National Health Screening Act in 2009. The brief history of the National Health Screening program of Korea was reviewed. The Goal of the National Screening program is to reduce the mortality and/or morbidity of the target disease. To achieve this goal, the basic aspects of the Program should be fulfilled. Proper Guidelines, high screening uptake rate, high quality, appropriate follow-up program were discussed. And national screening programs are not so commonly provided internationally. Only Japan provide national health screening program and Japanese program was renovated in 2008. The aim, contents and the procedure of the Japanese program was reviewed. Finally, the aspects that should be discussed for the improvement of the national health screening program was listed.

Cancer Screening Rate and Related Factors in Rural Area / 예방의학회지

OBJECTIVES: Cancer is the second most frequent cause of death in Korea. Cancer screening tests can save lives through early detection. Enhancing the cancer screening rate is an important strategy for reducing cancer mortality. The purpose of our study was to evaluate the screening rate and related factors in a rural area. The study investigated relationships between sociodemographic characteristics, several preventive behaviors, and the experience of several cancer screening behaviors. MATERIALS AND METHODS: The study population was recruited voluntarily from the three rural areas(Myen) in Chungju city. The participants completed structured questionnaire from July 21, 1998 to July 26, 1998. RESULTS: The proportions of the study population who had previously received stomach, liver, breast, or cervix cancer screening tests were 24.5%, 18.5%, 27.0%, 59.2% respectively. The 1-year screening rates of stomach, liver, breast, and cervix cancer were 7.4%, 6.8%, 8.6%, 15.6% respectively. In multivariate logistic analysis, some sociodemographic variables, preventive behaviors, or psychological variables were significantly associated with several cancer screening tests. Those who had previously received a stomach cancer screening test were significantly associated with the presence of chronic disease, physician? recommendation, use of alcohol family history of cancer, or previous liver cancer screening test. Those who had previously received a liver cancer screening test were associated with education level, physician? recommendation and previous stomach cancer screening test. Those who had received a cervix cancer screening test were significantly associated with education level, presence of a transportation vehicle, physician? recommendation use of alcohol and previous breast cancer screening test. And those who had received a previous breast cancer screening test were significantly associated with age, marital status, and earlier cervix cancer screening test. CONCLUSION: Based on the results of this study a strategy to promote cancer screening and health objectives at the district level can be made.

Factors Associated with the Use of Pap Test in a Rural Area / 예방의학회지

OBJECTIVES: To construct basic data to develop strategies for achieving higher Pap test coverage rate by evaluating factors associated with the use of Pap test through population-based survey. METHODS: 16.4%(671) of the 4,090 women, who were eligible population for this study, in 3 Myens of Chung-ju City participated in this study voluntarily from July 21 to 26, 1997. After basic physical examination by trained doctors, they were interviewed with structured questionnaire by well-educated interviewers. RESULTS: It shows that only 54.3% of study participants experienced Pap test. The strongest factor which is related with the use of Pap test was the history of having breast screening tests(aOR=8.71, 95% CI=4.25-17.84). Probability of ever having Pap test was also higher in married women(aOR of single=0.46, 95% CI=0.29-0.72), younger(Ptrend<0.05), more educated (Ptrend<0.001), non-smoker (aOR of smoker=0.26, 95% CI=0.12-0.55), women of ever having hepatitis test(aOR=2.60, 95% CI=1.73-3.88) in multiple linear logistic analysis. CONCLUSIONS: This study suggests that several factors significantly associated with the use of Pap test, and especially, high-risk population for cervical cancer such as women of older ages, less educated, living alone are less likely to have the Pap test. We should concentrate on encouraging high-risk women in the use of Pap test to improve Pap test coverage rate.