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  1. Schliemann D, Ramanathan K, Ibrahim Tamin NSB, O'Neill C, Cardwell CR, Ismail R, et al.
    BMJ Open, 2022 Sep 01;12(9):e058420.
    PMID: 36581978 DOI: 10.1136/bmjopen-2021-058420
    INTRODUCTION: Colorectal cancer (CRC) is the second most common cancer in Malaysia and cases are often detected late. Improving screening uptake is key in down-staging cancer and improving patient outcomes. The aim of this study is to develop, implement and evaluate an intervention to improve CRC screening uptake in Malaysia in the context of the COVID-19 pandemic. The evaluation will include ascertaining the budgetary impact of implementing and delivering the intervention.

    METHODS AND ANALYSIS: The implementation research logic model guided the development of the study and implementation outcome measures were informed by the 'Reach, Effectiveness, Adoption, Implementation and Maintenance' (RE-AIM) framework. This CRC screening intervention for Malaysia uses home-testing and digital, small media, communication to improve CRC screening uptake. A sample of 780 people aged 50-75 years living in Segamat district, Malaysia, will be selected randomly from the South East Asia Community Observatory (SEACO) database. Participants will receive a screening pack as well as a WhatsApp video of a local doctor to undertake a stool test safely and to send a photo of the test result to a confidential mobile number. SEACO staff will inform participants of their result. Quantitative data about follow-up clinic attendance, subsequent hospital tests and outcomes will be collected. Logistic regression will be used to investigate variables that influence screening completion and we will conduct a budget impact-analysis of the intervention and its implementation. Qualitative data about intervention implementation from the perspective of participants and stakeholders will be analysed thematically.

    ETHICS AND DISSEMINATION: Ethics approval has been granted by Monash University Human Research Ethics Committee (MUHREC ID: 29107) and the Medical Review and Ethics Committee (Reference: 21-02045-O7G(2)). Results will be disseminated through publications, conferences and community engagement activities.

    TRIAL REGISTRATION NUMBER: National Medical Research Register Malaysia: 21-02045-O7G(2).

    Matched MeSH terms: Early Detection of Cancer/methods
  2. Dunn RA, Tan AK
    Breast J, 2011 Jul-Aug;17(4):399-402.
    PMID: 21615819 DOI: 10.1111/j.1524-4741.2011.01098.x
    As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays.
    Matched MeSH terms: Early Detection of Cancer/methods*
  3. Teo CH, Ling CJ, Ng CJ
    Am J Prev Med, 2018 Jan;54(1):133-143.
    PMID: 29254551 DOI: 10.1016/j.amepre.2017.08.028
    CONTEXT: Globally, uptake of health screening in men remains low and the effectiveness of interventions to promote screening uptake in men is not well established. This review aimed to determine the effectiveness of interventions in improving men's uptake of and intention to undergo screening, including interventions using information and communication technology and a male-sensitive approach.

    EVIDENCE ACQUISITION: Studies were sourced from five electronic databases (October 2015), experts, and references of included studies. This study included RCTs or cluster RCTs that recruited men and reported uptake of or intention to undergo screening. Two researchers independently performed study selection, appraisal, and data extraction. The interventions were grouped into those that increase uptake and those that promote informed decision making. They were further sub-analyzed according to types of intervention, male-sensitive, and web- and video-based interventions. The analysis was completed in December 2016.

    EVIDENCE SYNTHESIS: This review included 58 studies. Most studies were on prostate cancer (k=31) and HIV (k=11) screening. Most of the studies had low methodologic quality (79.3%) and after excluding them from the analysis, one study found that educational intervention (which was also male-sensitive) was effective in improving men's intention to screen (risk ratio=1.36, 95% CI=1.23, 1.50, k=1) and partner educational intervention increased men's screening uptake (risk ratio=1.77, 95% CI=1.48, 2.12, k=1). Video-based educational interventions reduced prostate cancer screening uptake (risk ratio=0.89, 95%CI=0.80, 0.99, k=1) but web-based interventions did not change men's screening intention or uptake.

    CONCLUSIONS: This review highlights the need to conduct more robust studies to provide conclusive evidence on the effectiveness of different interventions to improve men's screening behavior.
    Matched MeSH terms: Early Detection of Cancer/methods*
  4. Oncology Committee, Asia and Oceania Federation of Obstetrics and Gynecology, Tse KY, Ushijima K, Tan AL, Intasorn P, Pariyar J, et al.
    J Obstet Gynaecol Res, 2023 Apr;49(4):1230-1243.
    PMID: 36726190 DOI: 10.1111/jog.15566
    BACKGROUND: Despite the introduction of cervical cancer screening and human papillomavirus (HPV) vaccines, the utilization pattern was not standardized. The aim of this study was to elicit the current prevention care in Asia-Oceania.

    METHODS: An online questionnaire was circulated to different countries/cities in Asia-Oceania. The primary objective was to evaluate the coverage of HPV vaccination and cervical screening programs. The secondary objectives were to study the structures of these programs. Five case scenarios were set to understand how the respondents manage the abnormal screening results.

    RESULTS: Fourteen respondents from 10 countries/cities had participated. Cervical cancer ranked the first in Myanmar and Nepal. About 10%-15% did not have national vaccination or screening program. The estimated coverage rate for vaccination and screening varied from less than 1% to 70%, which the coverage ran in parallel with the incidence and mortality rates of cervical cancer. All regions approved HPV vaccines, although only four provided free or subsidized programs for nonavalent vaccine. Cervical cytology remained the most common screening tool, and 20%-30% relied heavily on visual inspection using acetic acid. The screening age groups varied in different regions. From the case scenarios, it was noted that some respondents tended to offer more frequent screening tests or colposcopy than recommended by international guidelines.

    CONCLUSION: This study revealed discrepancy in the practice of cervical cancer prevention in Asia-Oceania especially access to HPV vaccines. There is an urgent need for a global collaboration to eliminate cervical cancer by public education, reforming services, and medical training.

    Matched MeSH terms: Early Detection of Cancer/methods
  5. Lam DC, Liam CK, Andarini S, Park S, Tan DSW, Singh N, et al.
    J Thorac Oncol, 2023 Oct;18(10):1303-1322.
    PMID: 37390982 DOI: 10.1016/j.jtho.2023.06.014
    INTRODUCTION: The incidence and mortality of lung cancer are highest in Asia compared with Europe and USA, with the incidence and mortality rates being 34.4 and 28.1 per 100,000 respectively in East Asia. Diagnosing lung cancer at early stages makes the disease amenable to curative treatment and reduces mortality. In some areas in Asia, limited availability of robust diagnostic tools and treatment modalities, along with variations in specific health care investment and policies, make it necessary to have a more specific approach for screening, early detection, diagnosis, and treatment of patients with lung cancer in Asia compared with the West.

    METHOD: A group of 19 advisors across different specialties from 11 Asian countries, met on a virtual Steering Committee meeting, to discuss and recommend the most affordable and accessible lung cancer screening modalities and their implementation, for the Asian population.

    RESULTS: Significant risk factors identified for lung cancer in smokers in Asia include age 50 to 75 years and smoking history of more than or equal to 20 pack-years. Family history is the most common risk factor for nonsmokers. Low-dose computed tomography screening is recommended once a year for patients with screening-detected abnormality and persistent exposure to risk factors. However, for high-risk heavy smokers and nonsmokers with risk factors, reassessment scans are recommended at an initial interval of 6 to 12 months with subsequent lengthening of reassessment intervals, and it should be stopped in patients more than 80 years of age or are unable or unwilling to undergo curative treatment.

    CONCLUSIONS: Asian countries face several challenges in implementing low-dose computed tomography screening, such as economic limitations, lack of efforts for early detection, and lack of specific government programs. Various strategies are suggested to overcome these challenges in Asia.

    Matched MeSH terms: Early Detection of Cancer/methods
  6. Ari ES, Dioso RIP, Sotunsa JO
    BMC Womens Health, 2023 Jul 04;23(1):356.
    PMID: 37403114 DOI: 10.1186/s12905-023-02353-9
    INTRODUCTION: Cervical cancer is the fourth most common cancer in women globally and the second most common cancer in low- to middle-income countries, and its screening rate is yet to reach the 70% WHO target. Most interventions that proved effective in improving screening participation in some communities did not achieve the desired behavioral outcome in some settings.

    AIM: This study aimed to evaluate the effectiveness of care-seeking behavior interventions on cervical cancer screening participation.

    METHOD: A pragmatic multiphase mixed methods design was adopted for this study, and three phases of the human-centered design process were used for data collection. Deductive thematic analysis was used for qualitative data, while SPSS was used for quantitative data analysis.

    RESULTS: The findings show a significant relationship between participants' tribes p values (0.03) 0.05 and screening participation. Before the intervention, most (77.4%) were afraid of exposing their private parts; 75.9% were afraid of being diagnosed with cervical cancer; and the majority felt the procedure was embarrassing and painful. Free screening, awareness, and knowledge, offering transport, the use of influencers, and sample collection by a female care provider are among other facilitators to screening. Screening participation improved from 11.2% preintervention to 29.7% postintervention (average mean screening score from 1.890.316 to 1.70000.458). All participants who were screened postintervention said the procedure was not embarrassing or painful and that they were not afraid of the procedure or the screening environment.

    CONCLUSION: In conclusion, screening habits in the community were low before intervention, as this may have resulted from women's feelings and past experiences with screening services. Sociodemographic variables may not directly predict screening participation. Care-seeking behavior interventions have significantly increased screening participation postintervention.

    Matched MeSH terms: Early Detection of Cancer/methods
  7. Sachithanandan A, Lockman H, Azman RR, Tho LM, Ban EZ, Ramon V
    Med J Malaysia, 2024 Jan;79(1):9-14.
    PMID: 38287751
    INTRODUCTION: The poor prognosis of lung cancer has been largely attributed to the fact that most patients present with advanced stage disease. Although low dose computed tomography (LDCT) is presently considered the optimal imaging modality for lung cancer screening, its use has been hampered by cost and accessibility. One possible approach to facilitate lung cancer screening is to implement a risk-stratification step with chest radiography, given its ease of access and affordability. Furthermore, implementation of artificial-intelligence (AI) in chest radiography is expected to improve the detection of indeterminate pulmonary nodules, which may represent early lung cancer.

    MATERIALS AND METHODS: This consensus statement was formulated by a panel of five experts of primary care and specialist doctors. A lung cancer screening algorithm was proposed for implementation locally.

    RESULTS: In an earlier pilot project collaboration, AI-assisted chest radiography had been incorporated into lung cancer screening in the community. Preliminary experience in the pilot project suggests that the system is easy to use, affordable and scalable. Drawing from experience with the pilot project, a standardised lung cancer screening algorithm using AI in Malaysia was proposed. Requirements for such a screening programme, expected outcomes and limitations of AI-assisted chest radiography were also discussed.

    CONCLUSION: The combined strategy of AI-assisted chest radiography and complementary LDCT imaging has great potential in detecting early-stage lung cancer in a timely manner, and irrespective of risk status. The proposed screening algorithm provides a guide for clinicians in Malaysia to participate in screening efforts.

    Matched MeSH terms: Early Detection of Cancer/methods
  8. Jailani AS, Balqis-Ali NZ, Tang KF, Fun WH, Samad SA, Jahaya R, et al.
    BMC Public Health, 2023 Nov 14;23(1):2243.
    PMID: 37964260 DOI: 10.1186/s12889-023-17132-2
    INTRODUCTION: High-risk human papillomavirus (HPV) screening is vital for early cervical cancer detection and treatment. With the introduction of the national cervical cancer screening programme and screening registry in Malaysia, there is a need to monitor population-based HPV screening uptake and high-risk HPV prevalence as part of cervical cancer surveillance.

    OBJECTIVE: To determine the prevalence and sociodemographic factors predicting high-risk HPV infection in Malaysia based on a public, community-based cervical cancer screening registry targeting women at risk of getting HPV infection.

    METHODS: The study used data from the Malaysian cervical cancer screening registry established by the Family Health Development Division from 2019 to 2021. The registry recorded sociodemographic data, HPV test details and results of eligible women who underwent HPV screening at public primary healthcare facilities. A vaginal sample (via self-sampling or assisted by a healthcare provider) was used for DNA extraction for HPV detection and genotyping. Registry data were extracted and analysed to determine prevalence estimates of high-risk HPV infection. Multifactorial logistic regression analysis was conducted to determine predictors of high-risk HPV infection. All analyses were performed using Stata version 14.

    RESULTS: The programme screened a total of 36,738 women during the study period. Women who attended the screening programme were mainly from urban areas, aged 30-39 years, and of Malay ethnicity. The prevalence of high-risk HPV infection was 4.53% among women screened, with the yearly prevalence ranging from 4.27 to 4.80%. A higher prevalence was observed among urban settling women, those aged 30-49 years, those of Indian ethnicity, and those without children. The results from logistic regression showed that women from urban areas, lower age groups, of Indian or Chinese ethnicity, and who are self-employed were more likely to be infected with high-risk HPV.

    CONCLUSION: Targeted and robust strategies to reach identified high-risk groups are needed in Malaysia. In addition, the registry has the potential to be expanded for an improved cervical cancer elimination plan.

    TRIAL REGISTRATION: Trial registration number: NMRR ID-22-00187-DJU.

    Matched MeSH terms: Early Detection of Cancer/methods
  9. Ng KH, Lau S
    Med Phys, 2015 Dec;42(12):7059-77.
    PMID: 26632060 DOI: 10.1118/1.4935141
    Breast density is a strong predictor of the failure of mammography screening to detect breast cancer and is a strong predictor of the risk of developing breast cancer. The many imaging options that are now available for imaging dense breasts show great promise, but there is still the question of determining which women are "dense" and what imaging modality is suitable for individual women. To date, mammographic breast density has been classified according to the Breast Imaging-Reporting and Data System (BI-RADS) categories from visual assessment, but this is known to be very subjective. Despite many research reports, the authors believe there has been a lack of physics-led and evidence-based arguments about what breast density actually is, how it should be measured, and how it should be used. In this paper, the authors attempt to start correcting this situation by reviewing the history of breast density research and the debates generated by the advocacy movement. The authors review the development of breast density estimation from pattern analysis to area-based analysis, and the current automated volumetric breast density (VBD) analysis. This is followed by a discussion on seeking the ground truth of VBD and mapping volumetric methods to BI-RADS density categories. The authors expect great improvement in VBD measurements that will satisfy the needs of radiologists, epidemiologists, surgeons, and physicists. The authors believe that they are now witnessing a paradigm shift toward personalized breast screening, which is going to see many more cancers being detected early, with the use of automated density measurement tools as an important component.
    Matched MeSH terms: Early Detection of Cancer/methods*
  10. Juliana N, Shahar S, Chelliah KK, Ghazali AR, Osman F, Sahar MA
    Asian Pac J Cancer Prev, 2014;15(14):5759-65.
    PMID: 25081698
    Electrical impedance tomography (EIT) is a potential supplement for mammogram screening. This study aimed to evaluate and feasibility of EIT as opposed to mammography and to determine pain perception with both imaging methods. Women undergoing screening mammography at the Radiology Department of National University of Malaysia Medical Centre were randomly selected for EIT imaging. All women were requested to give a pain score after each imaging session. Two independent raters were chosen to define the image findings of EIT. A total of 164 women in the age range from 40 to 65-year-old participated and were divided into two groups; normal and abnormal. EIT sensitivity and specificity for rater 1 were 69.4% and 63.3, whereas for rater 2 they were 55.3% and 57.0% respectively. The reliability for each rater ranged between good to very good (p<0.05). Quantitative values of EIT showed there were significant differences in all values between groups (ANCOVA, p<0.05). Interestingly, EIT scored a median pain score of 1.51±0.75 whereas mammography scored 4.15±0.87 (Mann Whitney U test, p<0.05). From these quantitative values, EIT has the potential as a health discriminating index. Its ability to replace image findings from mammography needs further investigation.
    Matched MeSH terms: Early Detection of Cancer/methods*
  11. Farid ND, Aziz NA, Al-Sadat N, Jamaludin M, Dahlui M
    PLoS One, 2014;9(9):e106469.
    PMID: 25188003 DOI: 10.1371/journal.pone.0106469
    Breast cancer is the most common cause of deaths and the most frequently diagnosed cancer among women worldwide. This study aimed to determine the prevalence of breast cancer screening, specifically on clinical breast examination, and the predictors of its uptake among women in Malaysia. A cross-sectional study was carried out in five selected districts whereby women aged between 20 to 64 years old, from a total of 1000 households were interviewed. A total of 1192 women responded to the survey of which 53.3% reported had ever done clinical breast examination. Significant associations with clinical breast examination were noted for income and distance from the hospital. These factors should be considered in developing interventions aimed at promoting clinical breast examination. In particular, healthcare providers should be proactive in raising awareness about clinical breast examination among women in Malaysia.
    Matched MeSH terms: Early Detection of Cancer/methods*
  12. Abdul Rashid RM, Mohamed M, Hamid ZA, Dahlui M
    Asian Pac J Cancer Prev, 2013;14(10):5901-4.
    PMID: 24289597
    OBJECTIVE: To compare the effectiveness of different methods of recall for repeat Pap smear among women who had normal smears in the previous screening.
    DESIGN: Prospective randomized controlled study.
    SETTING: All community clinics in Klang under the Ministry of Health Malaysia.
    PARTICIPANTS: Women of Klang who attended cervical screening and had a normal Pap smear in the previous year, and were due for a repeat smear were recruited and randomly assigned to four different methods of recall for repeat smear.
    INTERVENTION: The recall methods given to the women to remind them for a repeat smear were either by postal letter, registered letter, short message by phone (SMS) or phone call.
    MAIN OUTCOME MEASURES: Number and percentage of women who responded to the recall within 8 weeks after they had received the recall, irrespective whether they had Pap test conducted. Also the numbers of women in each recall method that came for repeat Pap smear.
    RESULTS: The rates of recall messages reaching the women when using letter, registered letter, SMS and phone calls were 79%, 87%, 66% and 68%, respectively. However, the positive responses to recall by letter, registered letter, phone messages and telephone call were 23.9%, 23.0%, 32.9% and 50.9%, respectively (p<0.05). Furthermore, more women who received recall by phone call had been screened (p<0.05) compared to those who received recall by postal letter (OR=2.38, CI=1.56-3.62).
    CONCLUSION: Both the usual way of sending letters and registered letters had higher chances of reaching patients compared to using phone either for sending messages or calling. The response to the recall method and uptake of repeat smear, however, were highest via phone call, indicating the importance of direct communication.
    Study site: Klinik Kesihatan, Kelang, Selangor, Malaysia
    Matched MeSH terms: Early Detection of Cancer/methods*
  13. Dahlui M, Ramli S, Bulgiba AM
    Asian Pac J Cancer Prev, 2011;12(6):1631-4.
    PMID: 22126511
    Breast cancer is the most common cancer in Malaysian females. The National Cancer Registry in 2003 and 2006 reported that the age standardized incidence of breast cancer was 46.2 and 39.3 per 100,000 populations, respectively. With the cumulative risk at 5.0; a woman in Malaysia had a 1 in 20 chance of developing breast cancer in her lifetime. The incidence of cancer in general, and for breast cancer specifically was highest in the Chinese, followed by Indians and Malays. Most of the patients with breast cancers presented at late stages (stage I: 15.45%, stage II: 46.9%, stage III: 22.2% and stage IV: 15.5%). The Healthy Lifestyles Campaign which started in the early nineties had created awareness on breast cancer and after a decade the effort was enhanced with the Breast Health Awareness program to promote breast self examination (BSE) to all women, to perform annual clinical breast examination (CBE) on women above 40 and mammogram on women above 50. The National Health Morbidity Survey in 2006 showed that the prevalence rate of 70.35% by any of three methods of breast screening; 57.1% by BSE, 51.8% by CBE and 7.6% by mammogram. The current screening policy for breast cancer focuses on CBE whereby all women at the age of 20 years and above must undergo breast examination by trained health care providers every 3 years for age between 20-39 years, and annually for age 40 and above. Several breast cancer preventive programs had been developed by various ministries in Malaysia; among which are the RM50 subsidy for mammogram by the Ministry of Women, Family and Community Development and the SIPPS program (a call-recall system for women to do PAP smear and CBE) by the Ministry of Health. Measures to increase uptake of breast cancer screening and factors as to why women with breast cancer present late should be studied to assist in more development of policy on the prevention of breast cancer in Malaysia.
    Matched MeSH terms: Early Detection of Cancer/methods*
  14. Megat Mohd Azlan PI, Chin SF, Low TY, Neoh HM, Jamal R
    Proteomics, 2019 05;19(10):e1800176.
    PMID: 30557447 DOI: 10.1002/pmic.201800176
    Dysbiosis of gut microbiome can contribute to inflammation, and subsequently initiation and progression of colorectal cancer (CRC). Throughout these stages, various proteins and metabolites are secreted to the external environment by microorganisms or the hosts themselves. Studying these proteins may help enhance our understanding of the host-microorganism relationship or they may even serve as useful biomarkers for CRC. However, secretomic studies of gut microbiome of CRC patients, until now, are scarcely performed. In this review article, the focus is on the roles of gut microbiome in CRC, the current findings on CRC secretome are highlighted, and the emerging challenges and strategies to drive forward this area of research are addressed.
    Matched MeSH terms: Early Detection of Cancer/methods*
  15. Lo CH, Chai XY, Ting SSW, Ang SC, Chin X, Tan LT, et al.
    Cancer Med, 2020 05;9(9):3244-3251.
    PMID: 32130790 DOI: 10.1002/cam4.2821
    BACKGROUND: Breast cancer is the leading cause of death among women worldwide. Studies have identified breast density as a controversial risk factor of breast cancer. Moreover, studies found that breast density reduction through Tamoxifen could reduce risk of breast cancer significantly. To date, no study on the association between breast density and breast cancer has been carried out in Malaysia. If breast density is proven to be a risk factor of breast cancer, intervention could be carried out to reduce breast cancer risk through breast density reduction.

    PURPOSE: To determine if density of breast is an independent risk factor which will contribute to development of breast cancer.

    MATERIALS AND METHODS: A prospective cohort study is carried out in two hospitals targeting adult female patients who presented to the Breast Clinic with symptoms suspicious of breast cancer. Participants recruited were investigated for breast cancer based on their symptoms. Breast density assessed from mammogram was correlated with tissue biopsy results and final diagnosis of benign or malignant breast disease.

    RESULTS: Participants with dense breasts showed 29% increased risk of breast cancer when compared to those with almost entirely fatty breasts (odds ratio [OR] 1.29, 95% CI 0.38-4.44, P = .683). Among the postmenopausal women, those with dense breasts were 3.1 times more likely to develop breast cancer compared with those with fatty breasts (OR 3.125, 95% CI 0.72-13.64, P = .13). Moreover, the chance of developing breast cancer increases with age (OR 1.046, 95% CI 1.003-1.090, P cancer cannot be ruled out. The study is limited by a small sample size and subjective assessment of breast density. More studies are required to reconcile the differences between studies of contrasting evidence.

    Matched MeSH terms: Early Detection of Cancer/methods*
  16. Lopes G, Stern MC, Temin S, Sharara AI, Cervantes A, Costas-Chavarri A, et al.
    J Glob Oncol, 2019 02;5:1-22.
    PMID: 30802159 DOI: 10.1200/JGO.18.00213
    PURPOSE: To provide resource-stratified, evidence-based recommendations on the early detection of colorectal cancer in four tiers to clinicians, patients, and caregivers.

    METHODS: American Society of Clinical Oncology convened a multidisciplinary, multinational panel of medical oncology, surgical oncology, surgery, gastroenterology, health technology assessment, cancer epidemiology, pathology, radiology, radiation oncology, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (Consensus Ratings Group) for two round(s) of formal ratings.

    RESULTS: Existing sets of guidelines from eight guideline developers were identified and reviewed; adapted recommendations form the evidence base. These guidelines, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of 75% or more.

    CONCLUSION: In nonmaximal settings, for people who are asymptomatic, are ages 50 to 75 years, have no family history of colorectal cancer, are at average risk, and are in settings with high incidences of colorectal cancer, the following screening options are recommended: guaiac fecal occult blood test and fecal immunochemical testing (basic), flexible sigmoidoscopy (add option in limited), and colonoscopy (add option in enhanced). Optimal reflex testing strategy for persons with positive screens is as follows: endoscopy; if not available, barium enema (basic or limited). Management of polyps in enhanced is as follows: colonoscopy, polypectomy; if not suitable, then surgical resection. For workup and diagnosis of people with symptoms, physical exam with digital rectal examination, double contrast barium enema (only in basic and limited); colonoscopy; flexible sigmoidoscopy with biopsy (if contraindication to latter) or computed tomography colonography if contraindications to two endoscopies (enhanced only).

    Matched MeSH terms: Early Detection of Cancer/methods
  17. Abdullah N, Abd Jalal N, Ismail N, Kamaruddin MA, Abd Mutalib NS, Alias MR, et al.
    Cancer Epidemiol, 2020 04;65:101656.
    PMID: 31923638 DOI: 10.1016/j.canep.2019.101656
    BACKGROUND: There has been a rapid increase in colorectal cancer (CRC) cases in Asian countries, including Malaysia. CRC is usually diagnosed at a late stage, and early detection of CRC is vital in improving survival. This study was conducted to determine the uptake rate of the immunochemical faecal occult blood test (iFOBT), the response rate to colonoscopy, and the CRC detection rate. We also wanted to identify the association between colorectal neoplasia and the Asia Pacific Colorectal Cancer Screening (APCS) scoring system.

    METHODS: We recruited 2264 individuals from The Malaysian Cohort participants aged 35-65 years who consented to colorectal screening using the iFOBT kit from July 2017 until January 2019.

    RESULTS: The response rate and positive iFOBT test rate of this study were 79.6% and 13.1% respectively. Among those with positive results, 125 individuals (52.7%) underwent colonoscopy; CRC was detected in six of them while 45 others (36.0%) had polyps. The overall CRC detection rate was 0.3% while the colorectal neoplasia detection rate (both colorectal cancer and colorectal polyps) was 2.3%. The APCS scoring indicated a significant association with colorectal neoplasia risk, with increasing trend by severity from moderate to high risk (3.46-11.14) compared to low risk. Most of the participants who were positive for iFOBT were those at high risk.

    CONCLUSIONS: The awareness of CRC risk and iFOBT screening are important strategies for early detection of CRC. We showed a CRC detection rate of 0.3 % among those who volunteered to have the iFOBT screening.

    Matched MeSH terms: Early Detection of Cancer/methods*
  18. Rahmat K, Ab Mumin N, Ng WL, Mohd Taib NA, Chan WY, Ramli Hamid MT
    Ultrasound Med Biol, 2024 Jan;50(1):112-118.
    PMID: 37839984 DOI: 10.1016/j.ultrasmedbio.2023.09.011
    OBJECTIVE: The aim of the work described here was to assess the performance of automated breast ultrasound (ABUS) as an adjunct to digital breast tomosynthesis (DBT) in the screening and diagnostic setting.

    METHODS: This cross-sectional study of women who underwent DBT and ABUS from December 2019 to March 2022 included opportunistic and targeted screening cases, as well as symptomatic women. Breast density, Breast Imaging Reporting and Data System categories and histopathology reports were collected and compared. The PPV3 (proportion of examinations with abnormal findings that resulted in a tissue diagnosis of cancer), biopsy rate (percentage of biopsies performed) and cancer detection yield (number of malignancies found by the diagnostic test given to the study sample) were calculated.

    RESULTS: A total of 1089 ABUS examinations were performed (age range: 29-85 y, mean: 51.9 y). Among these were 909 screening (83.5%) and 180 diagnostic (16.5%) examinations. A total of 579 biopsies were performed on 407 patients, with a biopsy rate of 53.2%. There were 100 (9.2%) malignant lesions, 30 (5.2%) atypical/B3 lesions and 414 (71.5%) benign cases. In 9 cases (0.08%), ABUS alone detected malignancies, and in 19 cases (1.7%), DBT alone detected malignancies. The PPV3 in the screening group was 14.6%.

    CONCLUSION: ABUS is useful as an adjunct to DBT in the opportunistic screening and diagnostic setting.

    Matched MeSH terms: Early Detection of Cancer/methods
  19. Velentzis LS, Hawkes D, Caruana M, Brotherton JM, Smith MA, Roeske L, et al.
    Tumour Virus Res, 2023 Jun;15:200255.
    PMID: 36736490 DOI: 10.1016/j.tvr.2023.200255
    Australia's cervical screening program transitioned from cytology to HPV-testing with genotyping for HPV16/18 in Dec'2017. We investigated whether program data could be used to monitor HPV vaccination program impact (commenced in 2007) on HPV16/18 prevalence and compared estimates with pre-vaccination benchmark prevalence. Pre-vaccination samples (2005-2008) (n = 1933; WHINURS), from 25 to 64-year-old women had been previously analysed with Linear Array (LA). Post-vaccination samples (2013-2014) (n = 2989; Compass pilot), from 25 to 64-year-old women, were analysed by cobas 4800 (cobas), and by LA for historical comparability. Age standardised pre-vaccination HPV16/18 prevalence was 4.85% (95%CI:3.81-5.89) by LA; post-vaccination estimates were 1.67% (95%CI:1.21-2.13%) by LA, 1.49% (95%CI:1.05-1.93%) by cobas, and 1.63% (95%CI:1.17-2.08%) for cobas and LA testing of non-16/18 cobas positives (cobas/LA). Age-standardised pre-vaccination oncogenic HPV prevalence was 15.70% (95%CI:13.79-17.60%) by LA; post-vaccination estimates were 9.06% (95%CI:8.02-10.09%) by LA, 8.47% (95%CI:7.47-9.47%) by cobas and cobas/LA. Standardised rate ratios between post-vs. pre-vaccination rates were significantly different for HPV16/18, non-16/18 HPV and oncogenic HPV: 0.34 (95%CI:0.23-0.50), 0.68 (95%CI:0.55-0.84) and 0.58 (95%CI:0.48-0.69), respectively. Additional strategies (LA for all cobas positives; combined cobas and LA results on all samples) had similar results. If a single method is applied consistently, it will provide important data on relative changes in HPV prevalence following vaccination.
    Matched MeSH terms: Early Detection of Cancer/methods
  20. Hon HJ, Chong PP, Choo HL, Khine PP
    Asian Pac J Cancer Prev, 2023 Jul 01;24(7):2207-2215.
    PMID: 37505749 DOI: 10.31557/APJCP.2023.24.7.2207
    OBJECTIVE: The low screening coverage and reluctance of women in participation lead to low uptake in cervical screening tests. Hence the majority of cervical cancer patients visiting the hospitals are diagnosed at advanced stage, often leading to poor survival rate. This paper aims to review and compile available cancer screening devices so that more people in this field will adopt suitable devices in cervical cancer screening routine depending on requirements which may encourage the uptake in cervical screening tests.

    METHODS: This paper reviews devices invented for different cervical cancer screening methods, which are Pap smear test, visual inspection with acetic acid (VIA) or Lugol's iodine (VILI), and HPV (human papillomavirus)-DNA (deoxyribonucleic acid) self-test in terms of functionality, performance in solving the limitations of screening procedure and additionally where applicable, the cervical cell collection efficacy and abnormality detection accuracy. The devices are either available in the market, published in research articles or published in international patent databases.

    RESULT: The reviewed devices either simplified the screening procedure to improve the clinical efficiency and accuracy in screening, reduced the pain and discomfort experienced by women during screening procedures, or achieved both outcomes.

    CONCLUSION: Many devices have been invented to improve the screening procedures which may potentially improve the uptake in cervical screening tests and encourage the organization of screening campaigns to reduce cervical cancer incidence.

    Matched MeSH terms: Early Detection of Cancer/methods
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