• Title/Summary/Keyword: overdiagnosis

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Have we Comprehensively Evaluated the Effectiveness of Endoscopic Screening for Gastric Cancer?

  • Hamashima, Chisato
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3591-3592
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    • 2015
  • Endoscopy has been increasingly used in clinical practice and as a standardized examination procedure for gastrointestinal diseases. However, only a few studies on endoscopic screening for evaluating mortality reduction from gastric cancer have been carried out. Even if a high detection rate is obtained in clinical practice, such a rate cannot be directly accepted as evidence providing the effectiveness of cancer screening. Endoscopic screening for gastric cancer is not an exception of possibility to detect overdiagnosis. If detection rate is used for the evaluation of the effectiveness of cancer screening, the possibility of overestimating the effectiveness of cancer screening cannot be ruled out. To avoid the effect of overdiagnosis and confirm the effectiveness of endoscopic screening, mortality reduction from gastric cancer must be carefully evaluated by conducting reliable studies. The burden of gastric cancer remains real and this cannot be ignored in Eastern Asian countries. To determine the best available method for gastric cancer screening, evaluation of its effectiveness is a must. Endoscopic screening for gastric cancer has shown promising results, and thus deserves further comprehensive evaluation to reliably confirm its effectiveness and how its optimal use can be strategically promoted.

Cytologic Analysis of Fibroadenomas of Breast Overdiagnosed as High Risk Group in Fine Needle Aspiration Cytology (세침흡인 세포검사상 고위험군 유방병변으로 진단한 섬유선종의 세포학적 분석)

  • Park, Sung-Hye;Yoon, Gil-Sook;Choi, Mi-Sun;Khang, Shin-Kwang
    • The Korean Journal of Cytopathology
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    • v.10 no.2
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    • pp.127-131
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    • 1999
  • Among total 108 cases of biopsy-proven fibroadenomas of the breast which obtained from the files of the Asan Medical Center during one year period from October 1998 to September 1999, 23 cases cytologically diagnosed as high risk group were reviewed to retrieve the mis-loading factors. Initial cytologic diagnoses of 23 cases were proliferative breast lesion with atypia(high risk) on 21 cases(91.3%) and papillary neoplasm in 2 cases(8.7%). When we reanalysed 23 cases by Masood scoring system, they were classified as one non-proliferative breast lesion(4.3%), 16 proliferative breast lesions without atypia (69.6%), and 6 proilferative breast lesions with atypia(25.1%). None were subject to the category of carcinoma. Cytologic features loading to the overdiagnosis of high grade epithelial lesions were as follows; cellular dissociation without nuclear atypia, nuclear pleomorphism, anisonucleosis, and occasional macronucleoli without nuclear enlargement, lack of myxoid stroma, and few naked stromal cells. To avoid cytologic overdiagnosis of fibroadenoma, mild to moderate nuclear pieomorphism without nuclear enlargement and cellular dissociation without nuclear atypia should not be regarded as criteria of high risk group.

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Trend Analysis of Thyroid Cancer Research in Korea with Text Mining Techniques

  • Lee, Tae-Gyeong;Heo, Seong-Min;Shin, Seung-Hyeok;Yang, Ji-Yeon
    • Journal of the Korea Society of Computer and Information
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    • v.23 no.12
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    • pp.153-161
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    • 2018
  • In this paper, we propose a text-centered approach to identify the research trend of thyroid cancer in Korea. We incorporate statistical analysis, text mining and machine learning techniques with our clinical insights to find connective associations between terminologies and to discover informative clusters of literatures. The incidence of thyroid cancer in Korea increased rapidly in the 2000s, which fueled the debate regarding overdiagnosis, but recently the number of patients undergoing surgery has decreased significantly due to conscious reform efforts from various circles. We analyzed the abstracts and keywords of related research papers from DBpia. It was found that most were case reports in the 1980s, and some papers in the 1990s discussed the early detection of thyroid cancer by mass screening. While many papers focused on different diagnostic techniques and the detection of small cancers in the 2000s, many emphasized more on the quality of life of patients in the 2010s. There was an apparent change in the topics of thyroid cancer research over past decades. The results of this study would serve as a reference guide for current and future research directions.

Impact of PSA and DRE on Histologic Findings at Prostate Biopsy in Turkish Men Over 75 Years of Age

  • Verim, Levent;Yildirim, Asif;Basok, Erem Kaan;Peltekoglu, Erol;Pelit, Eyup Sabri;Zemheri, Ebru;Tokuc, Resit
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6085-6088
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    • 2013
  • Prostate specidic antigen (PSA) and digital rectal examination (DRE) are the known predictive factors for positive prostate biopsies differing according to the age, region and race. There have been only very limited studies about the impact of PSA on histological findings at prostate biopsy in Turkey. The aim of this study was to evaluate the impact of PSA and clinical stage on histologic findings of prostate biopsy in men older than 75 years of age as a first study in the Turkish population. A total of 1,645 consecutive prostate biopsies were included, with 194 men aged 75 or older. Cancer was identified in 104 patients (53.6%). Of the 104 positive biopsies, Gleason scores were less than 7 in 53 (49%) patients, 7 or greater in 51 (51%) patients. Positive prostate biopsies were significantly correlated with advanced age (p=0.0001), abnormal DRE (p=0.0001) and raised PSA (p=0.0001). The prostate volume was significantly correlated with advanced age especially in prostate cancer patients over 75 years, compared with those under 75 (p=0.0001). These results are useful for counseling men older than 75 years for prostate cancer detection. However, PCa screening decisions are currently based on urologist judgment and detection of latent asymptomatic disease is an important concern regarding costs, overdiagnosis, overtreatment and quality of life (QOL) for men aged 75 years and older. Healthy old patients with a long life expectancy need to be carefully evaluated for eligibility for PCa screening.

Construction of IoT Environment for XMPP Protocol Based Medical Devices Using Powershell (Powershell을 이용한 안전한 XMPP 프로토콜 기반의 의료기기 IoT환경 구축 제안)

  • Park, Yeon-Jin;Lee, Kuen-Ho
    • Journal of Internet of Things and Convergence
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    • v.2 no.2
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    • pp.15-20
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    • 2016
  • MicroSoft Windows 10 IoT version, released in August 2015, successfully drew consumer interest by introducing the familiar Windows into the IoT market, and enabled an easier system construction of IoT web servers. Meanwhile, overdiagnosis has recently emerged as a controversy in medical society. Establishment of communication between IoT servers and medical devices will send treatment results to users and activate communication between hospitals, greatly reducing this problem. The IoT server, with its limited resources, utilizes lightweight protocols that do not generate traffic and are easy to use. This paper proposes IoT networks which will enable medical devices to easily provide ubiquitous environments to their users, through utilization of the lightweight Simple Service Discovery Protocol (SSDP) and the secure Extensible Messaging and Presence Protocol (XMPP).

What Do Korean Women Know and Want to Know about Thyroid Cancer? A Qualitative Study

  • Lee, Bomyee;Park, Jae Young;Shin, Hye Young;Park, Sang Hee;Choi, Eun-Bi;Yoo, Jisu;Choi, Kui Son;Jun, Jae Kwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2901-2907
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    • 2016
  • Background: Despite increasing debate about overdiagnosis and overtreatment of thyroid cancer in Korea, information to guide decisions on whether or not to undergo screening for and treatment of abnormal lesions of the thyroid is lacking. Moreover, studies have yet to outline what lay people know and want to know about thyroid cancer. The primary aim of this study was to explore general awareness of thyroid cancer among Korean women, their sources of information, and their satisfaction with the information they are provided. The secondary aim was to investigate information needs about thyroid cancer. Materials and Methods: A qualitative study using focus group interviews was conducted. Twenty-nine women were divided into four groups: (1) participants who had never undergone thyroid ultrasound screening; (2) those who had undergone screening, (3) those who continued to undergo regular check-ups with ultrasonography for benign nodules of the thyroid; and (4) participants who had undergone surgery for thyroid cancer. Results: A widespread lack of awareness of information on thyroid cancer was noted among participants in groups 1 and 2 who were not well aware of thyroid cancer and generally recognized it as a 'good cancer'. Surprisingly, instead of doctors and medical personnel, most participants reported obtaining information from acquaintances and media outlets. Moreover, most participants described dissatisfaction with their experience with screening and a lack of explanation on treatment and test results from medical personnel. Conclusions: Women in Korea seek reliable information on thyroid cancer that could help them to better understand the disease and make informed decisions regarding screening and treatment. More effort is needed from medical personnel to communicate the implications of thyroid cancer, screening results, and treatments thereof to lay people.

Prostate Cancer Epidemiology in a Rural Area of North Western Greece

  • Grivas, N.;Hastazeris, K.;Kafarakis, V.;Tsimaris, I.;Xousianitis, Z.;Makatsori, A.;Raptis, P.;Aspiotis, S.;Ioachim, E.;Ntemou, A.;Kitsiou, E.;Malamou-Mitsi, V.;Sofikitis, N.;Kordela, V.;Papandreou, C.;Agnantis, N.J.;Stavropoulos, N.E.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.999-1002
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    • 2012
  • Epirus is a rural area of North-Western Greece. We reviewed data from 4 hospitals for 4.975 patients who underwent prostate biopsy in Epirus in the twelve year period from 1999 to 2010. Two six -year periods were compared (1999-2004 and 2004-2010). All cases of prostate cancer confirmed by biopsy were recorded and age-standardized incidence rates per 100,000 males were calculated. We also recorded the clinical stage for patients diagnosed in our hospital and correlated this with PSA and Gleason scores. Percentage of positive prostate biopsies was also calculated. There were a total of 1714 new cases during 1999-2010 and the mean annual age-adjusted incidence was 34/100.000. The mean incidences during 1999-2004 and 2005-2010 were 26/100,000 and 42/100,000, respectively. The mean age at diagnosis was 74. The most common Gleason score was 6 and the prevalent clinical stage was T2. Median PSA at diagnosis was 10.8 ng/ml. There was a significant difference between stage cT4 and all other stages regarding PSA value (p=0.000). A positive correlation was found between Gleason score and PSA (p=0.013). These results are in accordance with the incidence rise recorded in neighboring countries of South-East Europe. However we should keep in mind the risk of overdiagnosis and the detection of low-risk cancers that would not have caused morbidity or death during a man's lifetime anyway.

Blood Pressure Cuff Bladders Tailored For Koreans (한국인 맞춤형 혈압계 커프 블래더)

  • Hwang, Lark Hoon;Park, Woo Sung;Na, Seung Kwon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.9
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    • pp.822-829
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    • 2013
  • Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.