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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: cervical cancer,Time interval,Cancer symptoms,seeking cancer care,perceived reasons
- چکیده:
- چکیده انگلیسی: Background: India had the burden of 97,000 new cases of cervical cancer with 60,000 deaths accounting nearly one-third of global cervical cancer deaths during the year 2018. Cervical cancer is the leading cause of cancer mortality in India. The present study aims to estimate the time interval between self-detection of cervical cancer symptoms and seeking care and different barriers for the possible time lag in seeking care. Methods: A cross-sectional study was undertaken from April 2017 to September 2017 in a regional cancer centre in the south of India. The centre has both a population and a hospital-based cancer registry. Cervical cancer cases (N= 210) with histological confirmation were interviewed at the hospital using a pre-tested semi-structured questionnaire. Results: The median time interval between the self-detection of cervical cancer symptoms and first contact with the general physician was 80 [IQR 45-150] days. The overall median time interval between the self-detection of symptoms to the initiation of primary treatment was 123[IQR 83-205] days. The major perceived reason for not seeking medical care was a lack of awareness in identifying cervical cancer symptoms in 183(92.9%) women. Conclusion: The median time of 80 days was observed from the self-detection of cervical cancer symptoms to the first contact with a general physician. Lack of awareness of patients pertaining to cancer symptoms was the major concern in seeking cancer care.
- انتشار مقاله: 16-04-1399
- نویسندگان: Shivaraj Nallur Somanna,Srinivasa Nandagudi Murthy,Ramesh Chaluvarayaswamy,Nea Malila
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Adaptive screening,Clinical Breast Examination,sojourn time,multistage models
- چکیده:
- چکیده انگلیسی:
Objective: To investigate adaptive breast cancer screening policies using clinical breast examination for early detection and mortality reduction in low to middle income countries like India. Methods: Using published data from the Mumbai randomized cluster control trial (1998-2006), we first estimated the mean sojourn time at 5.9 years (95% Confidence Interval: 5.3-6.5) assuming 52% sensitivity of the test. The estimated mean sojourn time was used as a "silent interval" in time varying cellular kinetics with the two stage deterministic clonal expansion model, and we found age specific sojourn times in years as follows: 35-39. 0.8; 40-44, 1.0; 45-49, 1.8; 50-54, 3.2; and 55+, 5.9. Equipped with age specific sojourn times and sensitivity, we investigate adaptive screening policies for various year age groups using different screening intervals, maintaining a constant screen count of 10 and a 6 state Markov transition model. The rationale for using a fixed number of screens was to benchmark the effect of the screening interval. Result: We found that annual screening at ages 35-39 and biennial from 41-49 would achieve a mortality reduction of 27.9%, while annual screening from 38-42 and triennial from 43-58 would achieve a mortality reduction of 25.5%. Biennial screening from 40-60 years of age showed a mortality reduction of 23.6%, indicating inclusion of annual screening might be effective. We demonstrated a modelling framework that could be applied to the final data of randomized controlled trials, such as the ongoing Mumbai and Trivandrum trials in India, for assessing efficacy of annual screening in younger women. Conclusion: The framework could be useful to decide age groups that would yield maximal effectiveness in screening trials with selected screening intervals. Further, the framework could be adapted in other low to middle income countries for designing either screening trials or adaptive screening policies.- انتشار مقاله: 20-12-1395
- نویسندگان: Baban Wagh,Ramesh Chaluvarayaswamy,Debnath Pal
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Adaptive screening,Clinical Breast Examination,sojourn time,multistage models
- چکیده:
- چکیده انگلیسی:
Objective: To investigate adaptive breast cancer screening policies using clinical breast examination for early detection and mortality reduction in low to middle income countries like India. Methods: Using published data from the Mumbai randomized cluster control trial (1998-2006), we first estimated the mean sojourn time at 5.9 years (95% Confidence Interval: 5.3-6.5) assuming 52% sensitivity of the test. The estimated mean sojourn time was used as a "silent interval" in time varying cellular kinetics with the two stage deterministic clonal expansion model, and we found age specific sojourn times in years as follows: 35-39. 0.8; 40-44, 1.0; 45-49, 1.8; 50-54, 3.2; and 55+, 5.9. Equipped with age specific sojourn times and sensitivity, we investigate adaptive screening policies for various year age groups using different screening intervals, maintaining a constant screen count of 10 and a 6 state Markov transition model. The rationale for using a fixed number of screens was to benchmark the effect of the screening interval. Result: We found that annual screening at ages 35-39 and biennial from 41-49 would achieve a mortality reduction of 27.9%, while annual screening from 38-42 and triennial from 43-58 would achieve a mortality reduction of 25.5%. Biennial screening from 40-60 years of age showed a mortality reduction of 23.6%, indicating inclusion of annual screening might be effective. We demonstrated a modelling framework that could be applied to the final data of randomized controlled trials, such as the ongoing Mumbai and Trivandrum trials in India, for assessing efficacy of annual screening in younger women. Conclusion: The framework could be useful to decide age groups that would yield maximal effectiveness in screening trials with selected screening intervals. Further, the framework could be adapted in other low to middle income countries for designing either screening trials or adaptive screening policies.- انتشار مقاله: 20-12-1395
- نویسندگان: Baban Wagh,Ramesh Chaluvarayaswamy,Debnath Pal
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Adaptive screening,Clinical Breast Examination,sojourn time,multistage models
- چکیده:
- چکیده انگلیسی:
Objective: To investigate adaptive breast cancer screening policies using clinical breast examination for early detection and mortality reduction in low to middle income countries like India. Methods: Using published data from the Mumbai randomized cluster control trial (1998-2006), we first estimated the mean sojourn time at 5.9 years (95% Confidence Interval: 5.3-6.5) assuming 52% sensitivity of the test. The estimated mean sojourn time was used as a "silent interval" in time varying cellular kinetics with the two stage deterministic clonal expansion model, and we found age specific sojourn times in years as follows: 35-39. 0.8; 40-44, 1.0; 45-49, 1.8; 50-54, 3.2; and 55+, 5.9. Equipped with age specific sojourn times and sensitivity, we investigate adaptive screening policies for various year age groups using different screening intervals, maintaining a constant screen count of 10 and a 6 state Markov transition model. The rationale for using a fixed number of screens was to benchmark the effect of the screening interval. Result: We found that annual screening at ages 35-39 and biennial from 41-49 would achieve a mortality reduction of 27.9%, while annual screening from 38-42 and triennial from 43-58 would achieve a mortality reduction of 25.5%. Biennial screening from 40-60 years of age showed a mortality reduction of 23.6%, indicating inclusion of annual screening might be effective. We demonstrated a modelling framework that could be applied to the final data of randomized controlled trials, such as the ongoing Mumbai and Trivandrum trials in India, for assessing efficacy of annual screening in younger women. Conclusion: The framework could be useful to decide age groups that would yield maximal effectiveness in screening trials with selected screening intervals. Further, the framework could be adapted in other low to middle income countries for designing either screening trials or adaptive screening policies.- انتشار مقاله: 20-12-1395
- نویسندگان: Baban Wagh,Ramesh Chaluvarayaswamy,Debnath Pal
- مشاهده