Community-Based Multiple Screening Model: Design, Implementation, and Analysis of 42,387 Participants Taiwan Community-Based Integrated Screening Group
Journal
Cancer
Journal Volume
100
Journal Issue
8
Pages
1734-1743
Date Issued
2004
Author(s)
Chiu Y.-H.
Luh D.-L.
Yen M.-F.
Wu H.-M.
Chen L.-S.
Tung T.-H.
Huang C.-C.
Shiu M.-N.
Yeh Y.-P.
HORNG-HUEI LIOU
Liao C.-S.
Peng H.-L.
Tseng C.-D.
Yen M.-S.
Hsu W.-C.
Chen C.-H.
Abstract
BACKGROUND. Multiple disease screening may have several advantages over single disease screening because of the economics of scale, with the high yield of detecting asymptomatic diseases, the identification of multiple diseases or risk factors simultaneously, the enhancement of the attendance rate, and the efficiency of follow-up. METHODS. An integrated model of community-based multiple screening was designed and conducted between 1999 and 2001 in Keelung, Taiwan. The authors used a Papanicolaou (Pap) smear screening program as a base to integrate other screening regimens encompassing four other neoplastic diseases and three nonneoplastic chronic diseases. Screening methods, the interscreening interval, and the follow-up for each screening regimen were designed based on evidence-based literature and current national screening policy. RESULTS. A total of 42,387 subjects participated in the screening activities. A 25% increase in the attendance rate for Pap smear screening was demonstrated after the introduction of multiple disease screening programs. At the first screen, this program yielded a total of 677 asymptomatic neoplasms (16.0 per 1000), including a large proportion of precancerous lesions and small presymptomatic tumors without lymph node involvement. The association between the occurrence of neoplasm and the presence of comorbid nonneoplastic chronic disease was found to be statistically significant (odds ratio, 1.64; 95% confidence interval, 1.38-1.94 [P < 0.051). The authors also identified 5314 subjects with metabolic syndrome who were at a greater risk for colorectal and oral neoplasias. CONCLUSIONS. The results of the current study demonstrate that an outreach and community-based multiple screening program not only enhances attendance rates but also has a high yield of early cases of various diseases simultaneously, and provides a natural opportunity to elucidate the correlation between neoplastic disease and nonneoplastic chronic disease. ? 2004 American Cancer Society.
SDGs
Other Subjects
adult; aged; article; breast cancer; cancer screening; chronic disease; colorectal cancer; community care; comorbidity; controlled study; diabetes mellitus; evidence based medicine; female; follow up; human; hyperlipidemia; hypertension; liver cancer; major clinical study; male; metabolic disorder; mouth cancer; neoplasm; Papanicolaou test; precancer; priority journal; risk factor; Taiwan; uterine cervix cancer; Adult; Aged; Breast Neoplasms; Chronic Disease; Colorectal Neoplasms; Community Health Services; Community-Institutional Relations; Comorbidity; Female; Humans; Male; Mass Screening; Middle Aged; Neoplasms; Research Design; Taiwan; Uterine Cervical Neoplasms; Vaginal Smears
Type
journal article