Analysis of screenings in medicine (systematic review)

• Kirill A. Serenko

Abstract

Screening is now considered to be one of the most important prophylactic measures. Nevertheless, mass implementation of screenings must follow their comprehensive assessment according to requirements based on analysis of efficiency (socio-demographic, clinical, economical, expert) and safety. Historical aspects of screening studies, goals and principles and evolution of their approaches, main forms and characteristics, mistakes and disadvantages, risks, benefits and harms of typical screenings and the concept of ideal screening are depicted in this article. In conclusion it is said, that screening is not a means of early diagnostics and screening implementation should take into consideration all the needed demands.

Keywords:public health; prophylaxis; medical examination; medical test; screening; early diagnostics; early detection; medical service; medical advice

References

1. Ulumbekova G.E., Ginoyan A.B., Petrachkov I.V. Factors of influence on mortality from neoplasms and diseases of the circulation system in the Russian Federation from 2019 to 2020. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VShOUZ [ORGZDRAV: News, Opinions, Training. Bulletin of VShOUZ]. 2021; 3 (25): 4–23. (in Russian)

2. Pogosova N.V., Yufereva Yu.M., Samorodskaya I.V., Boytsov S.A. Preventive screening: pros and cons. Kardiovaskulyarnaya terapiya i profilaktika [Cardiovascular Therapy and Prevention]. 2016; 15 (3): 4–13. (in Russian)

3. Fletcher S.W., Fletcher R.H. Evidence-based approach to prevention. In: UpToDate. 2017.

4. Marcus P.M., Bergstralh E.J., Fagerstrom R.M., et al. Lung cancer mortality in the Mayo Lung Project: impact of extended follow-up. J Natl Cancer Inst. 2000; 92: 1308.

5. National Lung Screening Trial Research Team; Aberle D.R., Adams A.M., et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365: 395.

6. Wilson J.M.G., Jungner G.; World Health Organization. Principles and practice of screening for disease. 1968.

7. Howlader N., Noone A.M., Krapcho M., et al. (eds). SEER Cancer Statistics Review, 1975–2017. National Cancer Institute. URL: https://seer.cancer.gov/csr/1975_2017/ (date of access April 01, 2019).

8. Andermann A., Blancquaert I., Beauchamp S., Déry V. Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bull World Health Organ. 2008; 86 (4): 317–9.

9. Rusk H.A. Prevention of chronic illness: chronic illness in the United States. AMA Arch Intern Med. 1958; 101 (4): 843–4.

10. Bretthauer M., Loberg M., Wieszczy P., Kalager M., Emilsson L., Garborg K., et al. Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med. 2022; 387 (17): 1547–56.

11. Mango V., Bryce Y., Morris E.A., Gianotti E., Pinker K. Commentary ACOG Practice Bulletin July 2017: breast cancer risk assessment and screening in average-risk women. Br J Radiol. 2018; 91 (1090): 20170907.

12. Si S., Moss J.R., Sullivan T.R., et al. Effectiveness of general practice-based health checks: a systematic review and meta-analysis. Br J Gen Pract. 2014; 64: e47.

13. Krogsboll L.T., Jorgensen K.J., Gronhoj Larsen C., Gotzsche P.C. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev. 2012; 10: CD009009.

14. Ran T., Cheng C.Y., Misselwitz B., et al. Cost-effectiveness of colorectal cancer screening strategies – a systematic review. Clin Gastroenterol Hepatol. 2019; 17: 1969.

15. Thorner R.M., Remein Q.R. Principles and procedures in the evaluation of screening for disease. In: PHS Publication No. 846. Washington, 1961.

16. Bell K.J., Del Mar C., Wright G., et al. Prevalence of incidental prostate cancer: a systematic review of autopsy studies. Int J Cancer. 2015; 137: 1749.

17. Schröder F.H., Hugosson J., Roobol M.J., et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014; 384: 2027.

18. Lei S., Zheng R., Zhang S., Wang S., Chen R., Sun K., et al. Global patterns of breast cancer incidence and mortality: a population-based cancer registry data analysis from 2000 to 2020. Cancer Commun (Lond). 2021; 41 (11): 1183–94.

19. Nelson H.D., O’Meara E.S., Kerlikowske K., et al. Factors associated with rates of false-positive and false-negative results from digital mammography screening: an analysis of Registry Data. Ann Intern Med. 2016; 164: 226.

20. Woolf S.H., Harris R. The harms of screening: new attention to an old concern. JAMA. 2012; 307: 565.

21. Welch H.G., Black W.C. Overdiagnosis in cancer. J Natl Cancer Inst. 2010; 102: 605.

22. Bouck Z., Calzavara A.J., Ivers N.M., et al. Association of low-value testing with subsequent health care use and clinical outcomes among low-risk primary care outpatients undergoing an annual health examination. JAMA Intern Med. 2020; 180: 973.

23. Lansdorp-Vogelaar I., Gulati R., Mariotto A.B., et al. Personalizing age of cancer screening cessation based on comorbid conditions: model estimates of harms and benefits. Ann Intern Med. 2014; 161: 104.

24. Gross C.P. Cancer screening in older persons: a new age of wonder. JAMA Intern Med. 2014; 174: 1565.

25. Lee S.J., Boscardin W.J., Stijacic-Cenzer I., et al. Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark. BMJ. 2013; 346: e8441.

26. Viera A.J. Overview of preventive care in adults. In: UpToDate. 2020.

27. Royce T.J., Hendrix L.H., Stokes W.A., et al. Cancer screening rates in individuals with different life expectancies. JAMA Intern Med. 2014; 174: 1558.

28. Kim S.Y., Kim H.S., Park H.J. Adverse events related to colonoscopy: global trends and future challenges. World J Gastroenterol. 2019; 25 (2): 190.

29. Siegel R.L., Miller K.D., Goding Sauer A., Fedewa S.A., Butterly L.F., Anderson J.C., et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020; 70 (3): 145–64.

30. Smith-Bindman R., Lipson J., Marcus R., et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med. 2009; 169: 2078.

31. Buys S.S., Partridge E., Black A., et al. Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial. JAMA. 2011; 305: 2295.

32. Ho P.J., Bok C.M., Ishak H.M.M., Lim L.Y., Liu J., Wong F.Y., et al. Factors associated with false-positive mammography at first screen in an Asian population. PLoS One. 2019; 14 (3): e0213615.

33. Croswell J.M., Kramer B.S., Kreimer A.R., et al. Cumulative incidence of false-positive results in repeated, multimodal cancer screening. Ann Fam Med. 2009; 7: 212.

34. Fowler F.J. Jr, Barry M.J., Walker-Corkery B., et al. The impact of a suspicious prostate biopsy on patients’ psychological, socio-behavioral, and medical care outcomes. J Gen Intern Med. 2006; 21: 715.

35. Klotz L. Prostate cancer overdiagnosis and overtreatment. Curr Opin Endocrinol Diabetes Obes. 2013; 20 (3): 204–9.

36. Schilling F.H., Spix C., Berthold F., et al. Neuroblastoma screening at one year of age. N Engl J Med. 2002; 346: 1047.

37. Woods W.G., Gao R.N., Shuster J.J., et al. Screening of infants and mortality due to neuroblastoma. N Engl J Med. 2002; 346: 1041.

38. Xiong T., Richardson M., Woodroffe R., et al. Incidental lesions found on CT colonography: their nature and frequency. Br J Radiol. 2005; 78: 22.

39. Rocco B., Grasso A., Sosnowski R., dell’Orto P.G., Albo G., Castle E., et al. pSa mass screening: is there enough evidence? Centr Eur J Urol. 2012; 65 (1): 4.

40. Dong W., Gang W., Liu M., Zhang H. Analysis of the prognosis of patients with testicular seminoma. Oncol Lett. 2016; 11 (2): 1361–6.

41. Friedman G.D., Collen M.F., Fireman B.H. Multiphasic Health Checkup Evaluation: a 16-year follow-up. J Chronic Dis. 1986; 39: 453.

42. Avins A.L., Pressman A., Ackerson L., et al. Placebo adherence and its association with morbidity and mortality in the studies of left ventricular dysfunction. J Gen Intern Med. 2010; 25: 1275.

43. Zipkin D.A., Umscheid C.A., Keating N.L., et al. Evidence-based risk communication: a systematic review. Ann Intern Med. 2014; 161: 270.

44. Hoffmann T.C., Del Mar C. Patients’ expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med. 2015; 175: 274.

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