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- W2945311573 abstract "<dm:abstracts xmlns:dm=http://www.elsevier.com/xml/dm/dtd><ce:abstract xmlns:ce=http://www.elsevier.com/xml/common/dtd id=abs0001 view=all class=author><ce:section-title id=cesectitle0001>ABSTRACT</ce:section-title><ce:abstract-sec id=abss0001 view=all><ce:simple-para id=spara0008 view=all>Screening is a public health intervention that is a balance of benefit and harm. Appropriate cancer screening and efficacious therapy can reduce cancer-specific mortality, and for some cancers it can reduce incidence. As with any medical intervention, there is also a potential for harm. Indeed, inappropriate screening can cause tremendous harm. In order to exploit screening and save the most lives, we need to appreciate the potential for harm and the potential for benefit.</ce:simple-para><ce:simple-para id=spara0009 view=all>Time and time again, a diagnostic test has been widely adopted as a cancer screening test with less-than-adequate evaluation. The result has been harm—including overdiagnosis, unnecessary treatment and the morbidities associated with that unnecessary treatment. This paper reviews the principles of cancer screening and the history of screening for some major cancers.</ce:simple-para><ce:simple-para id=spara0010 view=all>There are biases associated with observational studies that assess the efficacy of cancer screening interventions and three, in particular, should be carefully considered: lead-time, lenth, and selection biases. These biases are discussed further in this monograph. To eliminate the effects of these biases, the efficacy of cancer screening should ideally be determined in randomized controlled trials with all-cause mortality as an endpoint. All-cause mortality is an unambiguous endpoint and eliminates risk of bias in the assessment of cause of death. Yet, it is not a practical enpoint for a cancer screening trial because it generates a huge (and generally unattainable) sample size requirement. To reduce the sample size requirement, cancer-specific mortality is generally utilized as the endpoint, but even then, tens of thousands of individuals are generally required for each screening trial. Additionally, two forms of assessor bias should be considered whenever cancer-specific mortality is utilized as an endpoint: sticky-diagnosis bias and slippery-linkage bias, and these biases are discussed in this monograph as well.</ce:simple-para><ce:simple-para id=spara0011 view=all>Randonzied trials with cancer-specific mortality as the endpoint have been undertaken to assess screening strategies for breast, colorectal, porstate, lung, ovary, cervix, oral, and liver cancers. The historical background leading up to many of these trials and the trials themselves are discussed in this monograph. The results of these trials have had enormous public health implications. These trials have demonstrated that contemporary screening strategies are efficacious for some cancers but not others. Moreover, these trials have shed light on the potential harms of screening. These harms include false-positives, false-negatives, over-diagnosis, and the potential harms associated with the screening interventions.</ce:simple-para><ce:simple-para id=spara0012 view=all>Newer technologies in imaging and molecular diagnostics are leading to the development of a number of novel screening tests. By appreciating the history of screening, past mistakes will not be repeated as these new technologies evolve. The underlying message of this paper is not that screening is inappropriate; it is that every cancer must be assessed to determine if it is a screenable cancer, and every putative screening test must be carefully assessed and evaluated before it is widely disseminated. Only then will we not repeat history and harm the patients we want to serve.</ce:simple-para></ce:abstract-sec></ce:abstract></dm:abstracts>" @default.
- W2945311573 created "2019-05-29" @default.
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- W2945311573 date "2019-09-01" @default.
- W2945311573 modified "2023-10-14" @default.
- W2945311573 title "Benign hepatic incidentalomas" @default.
- W2945311573 cites W127150380 @default.
- W2945311573 cites W1482477890 @default.
- W2945311573 cites W1542231702 @default.
- W2945311573 cites W1606412512 @default.
- W2945311573 cites W1633772652 @default.
- W2945311573 cites W1848264671 @default.
- W2945311573 cites W1859729966 @default.
- W2945311573 cites W1958875262 @default.
- W2945311573 cites W1965803058 @default.
- W2945311573 cites W1965982503 @default.
- W2945311573 cites W1967847729 @default.
- W2945311573 cites W1968232850 @default.
- W2945311573 cites W1969933266 @default.
- W2945311573 cites W1972887697 @default.
- W2945311573 cites W1973541598 @default.
- W2945311573 cites W1973650767 @default.
- W2945311573 cites W1975912313 @default.
- W2945311573 cites W1976554074 @default.
- W2945311573 cites W1979112110 @default.
- W2945311573 cites W1979739218 @default.
- W2945311573 cites W1980237402 @default.
- W2945311573 cites W1981179348 @default.
- W2945311573 cites W1981631546 @default.
- W2945311573 cites W1981652886 @default.
- W2945311573 cites W1982945694 @default.
- W2945311573 cites W1982946116 @default.
- W2945311573 cites W1983292214 @default.
- W2945311573 cites W1984517737 @default.
- W2945311573 cites W1986332641 @default.
- W2945311573 cites W1988584135 @default.
- W2945311573 cites W1992042229 @default.
- W2945311573 cites W1992433866 @default.
- W2945311573 cites W1993001535 @default.
- W2945311573 cites W1993391616 @default.
- W2945311573 cites W1994167406 @default.
- W2945311573 cites W1994518190 @default.
- W2945311573 cites W1996021592 @default.
- W2945311573 cites W1997428457 @default.
- W2945311573 cites W1998496970 @default.
- W2945311573 cites W1998605623 @default.
- W2945311573 cites W2000102931 @default.
- W2945311573 cites W2000160670 @default.
- W2945311573 cites W2000704336 @default.
- W2945311573 cites W2001150488 @default.
- W2945311573 cites W2001993145 @default.
- W2945311573 cites W2004676062 @default.
- W2945311573 cites W2005588440 @default.
- W2945311573 cites W2006326640 @default.
- W2945311573 cites W2006796492 @default.
- W2945311573 cites W2006897597 @default.
- W2945311573 cites W2007268662 @default.
- W2945311573 cites W2007720704 @default.
- W2945311573 cites W2010311664 @default.
- W2945311573 cites W2011755931 @default.
- W2945311573 cites W2011924388 @default.
- W2945311573 cites W2012572967 @default.
- W2945311573 cites W2013584055 @default.
- W2945311573 cites W2013928529 @default.
- W2945311573 cites W2014601344 @default.
- W2945311573 cites W2015253080 @default.
- W2945311573 cites W2022716291 @default.
- W2945311573 cites W2024945750 @default.
- W2945311573 cites W2027376304 @default.
- W2945311573 cites W2027457253 @default.
- W2945311573 cites W2027867005 @default.
- W2945311573 cites W2028565183 @default.
- W2945311573 cites W2030807349 @default.
- W2945311573 cites W2030922445 @default.
- W2945311573 cites W2032479477 @default.
- W2945311573 cites W2039018302 @default.
- W2945311573 cites W2042137232 @default.
- W2945311573 cites W2042246610 @default.
- W2945311573 cites W2045736767 @default.
- W2945311573 cites W2047204484 @default.
- W2945311573 cites W2048488546 @default.
- W2945311573 cites W2048494970 @default.
- W2945311573 cites W2048743414 @default.
- W2945311573 cites W2050628646 @default.
- W2945311573 cites W2054691317 @default.
- W2945311573 cites W2058712473 @default.
- W2945311573 cites W2059457459 @default.
- W2945311573 cites W2061821924 @default.
- W2945311573 cites W2063244242 @default.
- W2945311573 cites W2066948063 @default.
- W2945311573 cites W2066987351 @default.
- W2945311573 cites W2067763708 @default.