Single routine offer of a blood test for prostate cancer did not save lives
Offering all men aged 50 to 69 a single, screening prostate-specific antigen (PSA) blood test did not prevent deaths from prostate cancer.
This large trial included 573 UK general practices and over 400,000 men. It found that men who were invited to have a PSA test were 19% more likely to be diagnosed with prostate cancer, but no less likely to die from the condition, over an average 10 years of follow up. Forty per cent of men took up the offer.
Controversy over PSA testing has persisted for ...
New screening pathway could help to identify a rare, single-gene form of diabetes
A screening pathway using blood and urine tests followed by two genetic (DNA) tests identified all people with a rare subtype of diabetes called monogenic diabetes. The screening pathway performed better than current practice based on age at diagnosis and family history which misses 63%. It is, therefore, a useful approach for ruling out this form of diabetes and probably cheaper overall than offering every young person with diabetes DNA testing.
Monogenic diabetes, caused by a mutation in a si...
New evidence confirms three-yearly surveillance interval for people at intermediate risk of bowel cancer
People with benign growths (adenomas), who are at intermediate risk of bowel cancer, benefit from follow-up colonoscopy. However, some of the patientsat the lower end of risk in this intermediate category may not benefit from more than one follow-up.
This NIHR-funded cohort study reviewed data for 11,944 intermediate-risk patients from UK hospitals. Within this group, particular features were identified which placed them at higher risk, such as the presence of larger or highly abnormal adenomas...
Intensive lifestyle interventions can help obese young people lose weight
Obese children and adolescents can lose up to seven pounds over six to 12 months when they engage in at least 52 hours of behaviour-based lifestyle interventions. Minimal benefit was seen with shorter contact time, with less than 25 hours ineffective. The control group gained weight.
Rising obesity in the young is a global concern, which may lead to high rates of obesity-related diseases in adulthood. This review identified trials covering various weight management strategies. Lifestyle-based-i...
Financial incentives do not increase attendance for diabetic eye screening
Two types of financial incentives are not effective at increasing attendance at eye screening for people with diabetes who do not regularly attend screening. Surprisingly, financial incentives may even reduce the numbers of people attending screening.
Retinopathy is a type of eye disease common to people with diabetes. Sight deteriorates only in the later stages and early diagnosis and treatment can prevent blindness. Annual eye screening is offered for people with diabetes but take-up could be...
Postal invitations, even with added incentives, don’t improve NHS health check attendance
Being sent an invitation which included questions about their intention and readiness to attend did not encourage people to have an NHS health check. This was true even when people were offered a £5 voucher to complete the questionnaire.
More people had an opportunistic health check when offered one while they were attending their surgery for another reason, than people who received an invitation letter. People who had health checks after the written invitations had a lower risk of cardio...
Self-testing kits for HPV could be a useful option to tackle low cervical screening rates in young women
Human Papilloma Virus (HPV) self-sampling kits and the opportunity to book appointments had the largest effect in improving cervical screening uptake for those not responding to initial prompts. However, uptake improved only slightly from 27% to 30%, when the kit was sent. A survey of non-attenders showed they value the convenience and privacy of self-testing.
This large NIHR trial tested a range of interventions to increase uptake among women eligible for their first cervical screening test. S...
Intensive management of diabetes detected early at screening shows similar results to standard care
Intensive “early” treatment was similar to national guidance-based treatment at preventing diabetes-related complications or heart disease over five years in this large trial.
General practices in the UK (49 practices), Netherlands and Denmark screened 135,000 asymptomatic adults aged 40 to 69 for type 2 diabetes before offering one of two treatment approaches. Intensive management was geared towards achieving targets for blood glucose, blood pressure and cholesterol levels by provi...
Questionnaires directed at smokers improve detection of chronic lung disease in general practice
Practices using questionnaires to identify individuals at risk of chronic obstructive pulmonary disease (COPD) increased the number of new cases found. In particular, posting questionnaires may be more effective than waiting for people to attend the GP surgery.
Many people with COPD may dismiss or ignore symptoms such as chronic cough. Taking a more proactive approach with smokers or ex-smokers and not just waiting until people present with symptoms may mean earlier diagnosis. This can lead to ...
Accuracy of staff who read mammograms doesn’t decline over time
Changing the order in which readers examine screening mammograms has no effect on breast cancer detection rates, rates of recall for further tests or rates of disagreement between readers.
In the UK each woman’s mammogram is examined by two independent readers (radiologists, radiographers or breast clinicians) who review each batch of mammograms from about 40 women in the same order. Research in other fields has indicated that vigilance can decrease with increasing time spent performing a...