Úvod: Incidence věkově předčasného kolorektálního karcinomu (KRK) celosvětově stoupá. V České republice je aktuálně věková hranice pro celopopulační screening KRK 50 let. Zvažuje se snížení věkové hranice, ale to v praxi naráží na omezenou kapacitu endoskopických pracovišť. Cílem práce bylo zhodnotit riziko nálezu neoplastické léze dle věkových skupin a pohlaví. Metodika: Jedná se o retrospektivní observační studii provedenou v Beskydském gastrocentru v Nemocnici ve Frýdku-Místku v letech 2017–2023. V tomto období byla sledována incidence neoplastických lézí ve věkových skupinách 30–34 let, 35–39 let, 40–44 let, 45–49 let, 50–54 let, 55–59 let, zvlášť pro muže a ženy. K porovnání dvou kategorických proměnných byl použit Chí kvadrát test; p < 0,05 bylo považováno za signifikantní. Výsledky: Za sledované období bylo provedeno celkem 13 352 koloskopií, 7 094 u mužů, 6 258 u žen, 2 678 u pacientů < 50 let, 10 674 u pacientů ≥ 50 let. Charakteristiky pacientů a incidence neoplastických lézí v jednotlivých pětiletých věkových skupinách jsou zobrazeny v tabulkách níže v tomto textu. Incidence neoplastických lézí v každé pětileté věkové skupině byla vždy významně vyšší než v předcházející mladší věkové skupině. Pokud jako referenční skupinu s nejnižším výskytem neoplastických lézí, u které je v současnosti v ČR doporučen screening KRK, bereme ženy 50–54 let, mají statisticky srovnatelné riziko jak muži 45–49 let (p = 0,304), tak muži 40–44 let (p = 0,086). Ženy 45–49 let (p = 0,001) mají statisticky signifikantně nižší riziko než ženy 50–54 let. Závěry: Pokud bychom měli snižovat věkovou hranici pro screening KRK v ČR postupně tak, abychom nezahltili kapacitu endoskopických center, jsou v nejvyšším riziku muži 45–49 let, poté muži 40–44 let a až poté ženy 45–49 let. Samozřejmostí je surveillance osob s rodinným rizikem KRK a časný termín endoskopického vyšetření pro symptomatické pacienty.
Background: Early onset colorectal cancer (CRC; cancer in a person younger than 50 years) has increasing incidence in the last few years. Current age limit for population screening in Czech Republic is 50 years of age. Lowering the age limit is necessary, but this collides with limited capacity of endoscopy units. The aim of our study was to evaluate the risk of neoplastic lesions according to age and gender. Methods: It was an observational retrospective study conducted in a non-university hospital Frýdek-Místek between 2017 and 2023. The incidence of all neoplastic lesions was evaluated in age groups 30–34, 35–39, 40–44, 45–49, 50–54, and 55–59 years separately for men and women. Two dichotomous variables were compared using the Chi square test, where P <0.05 was considered significant. Results: During the study period, 13,352 colonoscopies were done in total (7,094 men, 6,258 women); 2,678 in patients <50 years of age, and 10,674 in patients ≥50 years. The incidence of all neoplastic lesions in each age group was always significantly higher than in the previous age group, the results are shown in the tables below in this text. As we determined the reference group of women 50–54 years of age as the group with the lowest risk of neoplastic lesions currently involved in population screening, the comparable risk of all neoplastic lesions was observed for men 45–49 years of age (P = 0.304) and also for men 40–44 years of age (P = 0.086). Women 45–49 years of age (P = 0.001) have a significantly lower risk of advanced neoplastic lesions than women 50–54 years of age. Conclusions: If we do not want to overload the capacity of endoscopy units, we should lower the age limit for population screening by age and gender groups. According to our retrospective data, the highest risk of neoplastic lesions is found in men 45–49 years of age, and after them men 40–44 years of age. Women 45–49 years of age have a significantly lower risk of CRC.
- MeSH
- časná detekce nádoru metody statistika a číselné údaje MeSH
- dospělí MeSH
- kolorektální nádory * diagnóza etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- rizikové faktory * MeSH
- sexuální faktory MeSH
- služby preventivní péče metody MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
OBJECTIVES: Cervical cancer screening (CCS) is an important public health measure for early detection of cervical cancer and prevents a large proportion of cervical cancer deaths. However, participation in CCS is relatively low and varies substantially by country and socio-economic position. This study aimed to provide up-to-date participation rates and estimates on educational inequalities in CCS participation in 24 European countries with population-based CCS programmes. STUDY DESIGN: This was a cross-sectional study. METHODS: Using data from the European Health Interview Survey (EHIS) conducted in 2019, 80,479 women aged 25-64 years were included in the analyses. First, standardized participation rates and standardized participation rates by educational attainment were calculated for all 24 countries based on each country-specific screening programme organization. Second, a series of generalized logistic models was applied to assess the effect of education on CCS participation. RESULTS: Screening participation rates ranged from 34.1% among low-educated women in Romania to 97.1% among high-educated women in Finland. We observed that lower-educated women were less likely to attend CCS than their higher-educated counterparts. Largest educational gaps were found in Sweden (odds ratio [OR] = 6.36, 95% confidence interval [CI] = 3.89-10.35) and Poland (odds ratio = 5.80, 95% CI = 4.34-7.75). CONCLUSION: Population-based screening initiatives have successfully reduced participation differences between women with medium and high educational attainment in some countries; however, persistent disparities still exist between women with low and high levels of education. There is an urgent need to increase participation rates of CCS, especially among lower-educated women.
- MeSH
- časná detekce nádoru * statistika a číselné údaje MeSH
- disparity zdravotní péče statistika a číselné údaje MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory děložního čípku * diagnóza MeSH
- průřezové studie MeSH
- socioekonomické faktory MeSH
- stupeň vzdělání * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
OBJECTIVES: The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017-2021, focusing on differences between urban and rural practices. METHODS: We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Cooperation and Development typology. RESULTS: We observed minimal declines in 2020 in the rate of prescribing (-1.0%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners (GPs). CONCLUSIONS: Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.
- MeSH
- časná detekce nádoru * statistika a číselné údaje MeSH
- COVID-19 * epidemiologie prevence a kontrola MeSH
- diabetes mellitus * epidemiologie MeSH
- kolorektální nádory * diagnóza epidemiologie MeSH
- lékařská praxe - způsoby provádění * statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- odborná praxe - umístění statistika a číselné údaje MeSH
- pandemie prevence a kontrola MeSH
- praktičtí lékaři statistika a číselné údaje MeSH
- primární zdravotní péče MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Anal cancer (AC) screening is justified in high-risk populations, particularly HIV-positive men having sex with men (MSM). HR-HPV testing could improve the efficiency of cytologically based screening of AC, as in the screening of biologically analogical cervical cancer. The specificity of HR-HPV testing is influenced by the prevalence of HR-HPV infection in the screened population. Reported anal HR-HPV DNA prevalence in MSM is high, but HR-HPV mRNA reflects rather long-term infections and is more specific for high-grade lesions. However, no data were published about HR-HPV DNA and mRNA prevalence in the Czech AC screening population. METHOD: Results of liquid-based anal cytology of 203 predominantly HIV-positive MSM from the Czech AC screening cohort were correlated with results of DNA and E6/E7 mRNA testing of 14 HR-HPV types, and HPV16 genotyping. Eighty-one MSM underwent a standard anoscopy. RESULTS: A total of 109 (53.7%) samples had abnormal cytology, with 12 (5.9%) ASC-H/HSIL, 67 (33.0%) samples cytologically negative, and 27 (13.3%) unsatisfactory. HR-HPV DNA was detected in 134 (66.0%) and HR-HPV RNA in 72 (35.5%) anal smears. HR-HPV mRNA and HPV16 mRNA positivity were associated with abnormal cytology (p = .0037, p = .0021). No significant association was found between HR-HPV DNA or HPV16 DNA positivity and abnormal cytology. No high-grade lesions were revealed by anoscopy. CONCLUSION: Prevalence of anal HR-HPV DNA among Czech MSM is high, however, the prevalence of HR-HPV mRNA is half and associated with abnormal cytology. Our results indicate an increased efficiency of cytological screening when combined with HR-HPV mRNA testing.
- MeSH
- časná detekce nádoru statistika a číselné údaje MeSH
- DNA virů genetika MeSH
- dospělí MeSH
- homosexualita mužská genetika statistika a číselné údaje MeSH
- infekce papilomavirem epidemiologie patologie virologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- messenger RNA genetika MeSH
- mladý dospělý MeSH
- nádory anu genetika patologie MeSH
- prevalence MeSH
- sexuální a genderové menšiny statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
The adenoma detection rate (ADR) is the primary quality indicator for colonoscopies. The polyp detection rate (PDR) is available from administrative data and does not depend on histology verification. The correlation between PDR and ADR and the ADR/PDR conversion factor in preventive colonoscopies were evaluated. In the prospective study, asymptomatic individuals aged 45-75 years with preventive colonoscopy in 2012-2016 were included. Spearman's correlation coefficient was used to assess PDR/ADR for each endoscopist. Conversion factor predicting ADR from PDR was obtained by linear regression and subsequently compared with adenoma to polyp detection rate quotient. One thousand six hundred fourteen preventive colonoscopies performed by 16 endoscopists in 8 screening colonoscopy centres in the Czech Republic were analysed. Correlation between PDR and ADR in all preventive colonoscopies was high and statistically significant (Rs 0.82; P < 0.001). There was a strong correlation between PDR and ADR in men (Rs 0.74; P = 0.002) and in screening colonoscopies (Rs 0.85; P < 0.001). The conversion factor to convert ADR from PDR was 0.72 in all preventive colonoscopies, 0.76 in FOBT+ colonoscopies and 0.67 in screening colonoscopies. ADR may be replaced by PDR in the assessment of colonoscopy quality. The value of the conversion factor varies according to colonoscopy indication and gender of examined individuals; in this Czech study, it was 0.72 in all preventive colonoscopies. The minimum requested ADR of 25 % corresponds to a PDR of 35 %, when converted with the appropriate conversion factor.
- MeSH
- adenom diagnóza epidemiologie patologie prevence a kontrola MeSH
- administrativní požadavky na zdravotní péči statistika a číselné údaje MeSH
- časná detekce nádoru metody statistika a číselné údaje MeSH
- hodnocení rizik metody statistika a číselné údaje MeSH
- kolon diagnostické zobrazování MeSH
- kolonoskopie statistika a číselné údaje MeSH
- kolorektální nádory diagnóza epidemiologie patologie prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- plošný screening metody statistika a číselné údaje MeSH
- polypy tlustého střeva diagnóza epidemiologie patologie MeSH
- prospektivní studie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- sexuální faktory MeSH
- střevní sliznice diagnostické zobrazování patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Public awareness of colorectal cancer (CRC) and uptake of CRC screening remain challenges. The viewpoints of the target population (asymptomatic individuals older than 50) regarding CRC screening information sources and the reasons for and against participation in CRC screening are not well known in the Czech Republic. This study aimed to acquire independent opinions from the target population independently on the health system. AIM: To investigate the viewpoints of the target population regarding the source of information for and barriers and facilitators of CRC screening. METHODS: A survey among relatives (aged 50 and older) of university students was conducted. Participants answered a questionnaire about sources of awareness regarding CRC screening, reasons for and against participation, and suggestions for improvements in CRC screening. The effect of certain variables on participation in CRC screening was analyzed. RESULTS: Of 498 participants, 478 (96%) respondents had some information about CRC screening and 375 (75.3%) had participated in a CRC screening test. General practitioners (GPs) (n = 319, 64.1%) and traditional media (n = 166, 33.3%) were the most common information sources regarding CRC screening. A lack of interest or time and a fear of colonoscopy or positive results were reported as reasons for non-participation. Individuals aged > 60 years [adjusted odds ratio (aOR) = 2.30, 95% confidence interval (CI) (1.42-3.71), P = 0.001], females (aOR = 1.95, 95%CI (1.26-3.01) P = 0.003), and relatives of CRC patients (aOR = 4.17, 95%CI (1.82-9.58) P = 0.001) were more likely to participate in screening. Information regarding screening provided by physicians - GPs: (aOR = 8.11, 95%CI (4.90-13.41), P < 0.001) and other specialists (aOR = 4.19, 95%CI (1.87-9.38), P = 0.001) increased participation in screening. Respondents suggested that providing better explanations regarding screening procedures and equipment for stool capturing could improve CRC screening uptake. CONCLUSION: GPs and other specialists play crucial roles in the successful uptake of CRC screening. Reduction of the fear of colonoscopy and simple equipment for stool sampling might assist in improving the uptake of CRC screening.
- MeSH
- adherence pacienta psychologie statistika a číselné údaje MeSH
- časná detekce nádoru metody psychologie statistika a číselné údaje MeSH
- kolonoskopie psychologie statistika a číselné údaje MeSH
- kolorektální nádory diagnóza prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- okultní krev MeSH
- plošný screening psychologie statistika a číselné údaje MeSH
- průřezové studie MeSH
- průzkumy a dotazníky statistika a číselné údaje MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- strach psychologie MeSH
- věkové faktory MeSH
- zdraví - znalosti, postoje, praxe MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- analýza přežití MeSH
- antigeny CD279 antagonisté a inhibitory imunologie MeSH
- biologická terapie trendy MeSH
- časná detekce nádoru ekonomika metody statistika a číselné údaje MeSH
- incidence MeSH
- lidé MeSH
- melanom * diagnostické zobrazování epidemiologie farmakoterapie MeSH
- mitogenem aktivované proteinkinasy kinas antagonisté a inhibitory MeSH
- protoonkogenní proteiny B-raf antagonisté a inhibitory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
- rozhovory MeSH
- MeSH
- časná detekce nádoru statistika a číselné údaje MeSH
- feces chemie MeSH
- hodnocení programu MeSH
- kolonoskopie využití MeSH
- kolorektální nádory * prevence a kontrola MeSH
- lidé MeSH
- okultní krev MeSH
- plošný screening * metody statistika a číselné údaje MeSH
- vládní programy statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: The aim of the study was to analyse the results of three cycles of mammography screening (MS) in the Croatian National Programme (CNP) for Early Breast Cancer Detection for women aged 50–69 years in the Bjelovar-Bilogora County (BBC) from 2006–2014. METHODS: Data on women aged 50–69 screened during a 9-year period were obtained from the Croatian Cancer Registry and Institute of Public Health reports. Participation rate and performance indicators were examined. RESULTS: The total of 57,428 women were invited to mammography screening in BBC during a 9-year period and 31,402 mammograms in total were performed. The response rate of 84% in BBC was consistently higher than the national average of about 60% reported in 2007, 2013 and 2014. CONCLUSION: The National Programme in BBC has been carried out continuously for nine years with a higher response rate compared with the national average, as a result of additional efforts of the Croatian Institute of Public Health team, as well as good cooperation among all programme stakeholders. It was concluded that to achieve better results in the response of women to screening and consequently reduced mortality from breast cancer is possible through tailored health promotion activities.
- MeSH
- časná detekce nádoru metody statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mamografie statistika a číselné údaje MeSH
- nádory prsu diagnostické zobrazování MeSH
- pacientův souhlas se zdravotní péčí statistika a číselné údaje MeSH
- plošný screening statistika a číselné údaje MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Chorvatsko MeSH
