Browsing by Subject "Early Detection of Cancer"
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Item Current insights in the etiology, treatment and outcomes of early-onset colorectal cancer(2023-02-17) Kazmi, SyedItem Guarding your gut: understanding colon cancer screening(2023-08-18) Lo, AmyItem Investigation of the Effectiveness of Anal Cancer Screening in HIV Patients(2017-01-17) Bieterman, Andrew; Barnes, Arti; Quinn, Andrew; Anandam, JoselinBACKGROUND: The main risk factor for the development of anal cancer is acquisition of human papilloma virus (HPV), which occurs at a higher probability in human immunodeficiency virus (HIV)-infected individuals. Our hypothesis is that annual screening amongst the highly vulnerable HIV population will result in earlier detection of anal cancer and improved patient outcomes. OBJECTIVE: The main objective of this project is to improve patient outcomes by increasing the number of monthly anal pap smears performed at Amelia Court by 20%, by January 2017. METHODS: The project was conducted at Amelia Court, an HIV clinic attached to a larger safety net hospital in an urban setting. Our baseline data was determined by studying the absolute number of anal Paps performed in a 28 day period. The project utilized a variety of quality improvement tools to analyze the effects of a two-step educational process. Implementation 1: provider re-education program focusing on the importance of anal cancer screening in HIV patients. Implementation 2: creation of an infographic to be displayed in patient rooms, encouraging patients to request anal cancer screening from their providers. RESULTS: Implementation 1: demonstrated a 21.33% increase in the number of anal Paps collected. Implementation 2: anticipated results will be available by November, representing a 28 day cycle. CONCLUSION: The provider re-education program showed an increase in the absolute number of anal Paps performed at Amelia Court. The limited time frame since implementation precludes further analyses at this point. However, initial results suggest that these processes will improve anal cancer outcomes in vulnerable populations.Item Knowledge and Perception of Cervical Cancer and Screening Programs of Women Seeking Care at Monduli Hospital in Tanzania and St. Paul Hospital in Addis Ababa, Ethiopia(2015-04-03) Ghidei, Luwam; Lea, JayanthiAlthough a 2010 survey assessing Tanzanian women's knowledge and attitude towards cervical cancer demonstrated over 75% of respondents correctly identified early marriage and multiparty, other studies demonstrated a lack of knowledge about cervical cancer screening and HPV transmission among patients and nurses. Additionally, many women in Tanzania are not readily represented in such questionnaires. Women who are able to attend clinics with screening programs are generally from higher socioeconomic backgrounds, younger, and more knowledgeable about cervical cancer.15 Educational programs focused on the importance of cervical screening in rural remote areas of Tanzania may have a positive impact on the early detection and identification of patients at early disease stage. Considering both Tanzania and Ethiopia had established VIA programs in 2011 (Figure 5), I developed a questionnaire to assess the knowledge and perception of cervical cancer and cervical cancer screening programs of women in Tanzania and Ethiopia to guide future cervical cancer prevention and screening educational programs in communities.Item Lung cancer screening: yes we scan(2023-07-07) Lederer, PaulItem A Review and Comparison of Breast Cancer and Breast Cancer Screening in Costa Rica and Guatemala in the Context of the Historical Development and Healthcare Infrastructure of Each Country(2021-03-18) King, Taylore; Patrick, Stephen; Chang, Mary; Wells, C. EdwardBACKGROUND: Breast cancer is the most frequently diagnosed cancer in women worldwide. Costa Rica has rates of breast cancer and breast cancer survival comparable to those of highly developed nations and has had tremendous success in the prevention and treatment of the disease. Guatemala has made limited progress in its approach to breast cancer due to its fractured health system and the effects of a recent civil war. Both Central American countries have universal healthcare but have vastly different health outcomes. This dissertation will examine breast cancer and breast cancer screening as it pertains to each country's historical sociopolitical development and healthcare infrastructure. METHODS: A historical review was performed on the development of the government, social security, health system, and population demographics of Costa Rica and Guatemala. An academic review of literature pertaining to breast cancer and breast cancer screening in each country was performed utilizing PubMed searches and health databases. RESULTS: Over the past century, Costa Rica has enjoyed stability and economic growth while Guatemala was devastated by a brutal civil war and genocide. Costa Rica developed an organized and comprehensive public healthcare system which allowed the country to launch successful breast cancer prevention and treatment programs and keep breast cancer-related mortality low despite an increasing incidence rate. Unfortunately, Guatemala has not developed a cancer registry, so all cancer statistics are estimates, but it appears breast cancer mortality has been continuously rising over the past decade. Guatemala's inadequate health system cannot meet the basic healthcare or cancer needs of its population and significant health disparities exist between its rural, indigenous and urban, non-indigenous populations. CONCLUSION: Key differences in the countries' abilities to manage their health systems and thus prevent and treat cancer may explain the observed differences in the respective breast cancer mortality trends. Guatemala remains decades behind Costa Rica in its ability to track and prevent breast cancer throughout the country. As Guatemala continues to develop, many lessons can be learned from its Central American neighbor, Costa Rica, in regard to health system management and breast cancer control programs.Item Sensitivity of Ultrasound and Alpha Fetoprotein for Detection of Hepatocellular Carcinoma in Patients with Cirrhosis(2017-01-17) Sasiponganan, Chayanit; Singal, Amit G.BACKGROUND: Hepatocellular carcinoma (HCC) is the fastest growing cause of cancer related mortality in the United States. Prognosis is strongly tied to early detection, which facilitates curative treatment and long-term survival. Therefore, HCC screening is recommended in at risk patients, i.e. those with cirrhosis. Although ultrasonography is routinely used to screen at-risk patients for HCC, it is operator dependent and its sensitivity outside of prospective cohort studies is poorly described. Further, the benefit of adding serum biomarkers, such as alpha fetoprotein, has also been poorly studied. The aim of our study was to quantify the effectiveness of ultrasound and AFP for HCC detection in patients with cirrhosis. METHODS: We performed a retrospective chart review of patients newly diagnosed with HCC at UT Southwestern and Parkland Health and Hospital System between January 2009 and December 2015. We excluded patients who did not have at least one ultrasound within 12 months prior to HCC diagnosis. Ultrasounds were categorized as positive if there was a suspicious mass > 1 cm and AFP as positive if ≥20 ng/mL, the most common cut-off in clinical practice. Sensitivity was compared between ultrasound alone and combination of ultrasound + AFP using the chi-square test, with statistical significance defined as p<0.05. RESULTS: Of the 925 patients diagnosed with HCC between January 2009 and December 2015, 521 patients had an ultrasound within 12 months prior to HCC diagnosis. The overall sensitivity of ultrasound for HCC detection was 77.5% n=404/521). Of the 521 included patients, 400 had at least one AFP within 12 months of HCC diagnosis. There were 154 patients who had both positive ultrasound and AFP, 143 with positive ultrasound alone, 59 with positive AFP alone, and 44 with negative ultrasound and AFP. The sensitivity of ultrasound alone was 74.3% compared to 89.0% with ultrasound and AFP p<0.001). CONCLUSION: Ultrasound alone has suboptimal sensitivity for HCC detection in clinical practice, highlighting the need for better screening tools. Adding serum biomarkers, such as AFP, can significantly improve HCC detection in clinical practice.Item Solid tumor second malignant neoplasms as a late effect of childhood cancer therapy(2015-09-11) Orlino, Angela M.