Predictors of Participation in Prostate Cancer Screening among Older Men in Jordan

Big data and variceal rebleeding prediction in cirrhosis patients

Big data has convincing merits in developing risk stratification strategies for diseases. The 6 “V”s of big data, namely, volume, velocity, variety, veracity, value, and variability, have shown promise for real-world scenarios. Big data can be applied to analyze health data and advance research in preclinical biology, medicine, and especially disease initiation, development, and control. A study design comprises data selection, inclusion and exclusion criteria, standard confirmation and cohort establishment, follow-up strategy, and events of interest. The development and efficiency verification of a prognosis model consists of deciding the data source, taking previous models as references while selecting candidate predictors, assessing model performance, choosing appropriate statistical methods, and model optimization. The model should be able to inform disease development and outcomes, such as predicting variceal rebleeding in patients with cirrhosis. Our work has merits beyond those of other colleagues with respect to cirrhosis patient screening and data source regarding variceal bleeding.

Effect of Perceived Self-Vulnerability on Prostate Cancer Screening Uptake and Associated Factors: A Cross-Sectional Study of Public Health Facilities in Western Kenya

Background:

Perceived self-vulnerability to prostate cancer is known to influence screening uptake among men in the general population. However, knowledge gap persists on the influence of perceived self-vulnerability to prostate cancer on uptake of screening among male health workers; a demographic that has health insurance and is assumed to have knowledge of screening services for prostate cancer.

Objective:

This study aimed to assess the effect of perceived self-vulnerability to prostate cancer on screening uptake among male health workers in Kisumu County, western Kenya.

Methods:

This was a hospital-based cross-sectional study with a descriptive and analytical design. A modified self-administered questionnaire on self-vulnerability was issued to 197 male health workers who were randomly sampled from a study population of 336 eligible participants. The study was conducted at purposively selected public health facilities.

Findings:

Level of self-reported screening uptake was 27%. Rural residence (AOR = 0.71: 95% CI, 0.32–1.57, p = 0.019), education level (AOR = 5.01; 95% CI, 1.2–20.86, p = 0.027), participant’s lack of knowledge about screening services covered by health insurance schemes of which they are members (AOR = 0.2, 95% CI, 0.08–0.5, p = 0.001), good perception of health status (AOR = 4; 95% CI: 1.52–10.53, p = 005) were determinants of screening uptake for prostate cancer. Perceived self-vulnerability to prostate cancer didn’t influence screening uptake of participants (p < 0.05). Participants from rural set-up had a higher likelihood of perceiving themselves to be at risk of prostate cancer (AOR = 2.35, 95% CI, 1.17–4.72, p < 0.05) compared to those form urban settings. Old age of 60 years and above (AOR = 3.5, 95% CI: 0.3–40.98, p < 0.002) was predictive of perceived self-vulnerability.

Conclusion:

Findings from this study showed low uptake of screening and low perceived self-vulnerability to prostate cancer. Perceived self-vulnerability did not influence screening uptake for prostate cancer. Screening knowledge of prostate cancer as covered by health insurance, good perception of health status and level of education should be integrated in screening programs that are individualized on the basis of personal preferences and informed decision making regarding the uncertainty of benefit and the associated harms of screening.

Early Detection of Prostate Cancer: Self-Reported Knowledge and Attitude of Physicians in Jordan

Prostate cancer (PC) screening aims to detect PC in early stages, amenable to curative treatment and reduction in disease morbidity and mortality. However, PC screening may be associated with overdiagnosis and complications of unnecessary treatment for indolent disease. Therefore, careful patient selection for PC screening is critical to avoid overestimation and missed diagnosis. The aim of this study was to assess physicians’ knowledge and attitude towards early detection of PC in Jordan and whether their knowledge is an important predictor of their attitude. An electronic, self-reported questionnaire was used to collect data on demographics, knowledge, and attitude of physicians regarding early detection of PC. The participants’ responses were analyzed using descriptive statistics and multiple linear regression. Around 296 physicians agreed to participate in this study. Most respondents were males (75.7%), residents (34%), practiced medicine more than 15 years (29%) and graduated (81.4%) from local universities. Surprisingly, only 28.4% recognized PC as a non-self-detected disease and less than one-half (48.6%) were aware that PC screening tests are not enough to exclude a diagnosis of PC. The median knowledge Percent of Maximum Possible (POMP) score was 59%. Around two-thirds of participants showed a positive attitude towards early detection of PC (median attitude POMP score was 66%). Higher attitude scores were significantly associated with younger age, those working in private hospitals, and those having higher knowledge POMP score (P < .05). This study highlighted that most physicians demonstrated a positive attitude towards PC screening but with moderate level of knowledge that is considered an important predictor of their attitude towards PC early detection. Thus, improving knowledge and awareness of physicians should be considered as a strategy to improve their attitude towards prostate screening practices and informing men of the importance of regular screening.

The association between the knowledge on prostate cancer screening with the beliefs and behaviors of Saudi men attending King Khalid University Hospital

Background:

The evidence showed that prostate cancer (PC) is the second most common malignancy in men globally. Unfortunately, it rarely produces symptoms, and the diagnosis is delayed until the tumor is advanced.

Objectives:

To determine the participants’ uptake of prostate cancer screening (PCS). Also, to assess their perceptions regarding PCS. Furthermore, to evaluate the association between patients’ knowledge of PC and their beliefs and behaviors towards PCS.

Methods:

This cross-sectional study recruited men aged older than 40attending the King Khalid University Hospital (KKUH) between October 2020 and March 2021. SMS messages were sent to a random sample of 228 participants, inviting them to participate in an online self-administered questionnaire. The questionnaire consisted of 1- demography and history of PCS; 2- the knowledge questionnaire about PC; 3-the Champion's Health Belief Model (HBM).

Results:

Out of the 228 participants, 45.2% were men aged 60 years and above, 54.4% with college degrees and postgraduate studies, and 92.5% were married. The median knowledge score was 5, and the range was 12. Most men (72.4%) had a low knowledge score, and 79.4% of them did not have a previous PCS. Men aged 60 + were more likely to undergo the screening than their counterparts, with P values of 0.005. Higher knowledge scores were associated with the perceived benefits of prostate-specific antigen (PSA), digital rectal examination (DRE), and health motivation, P values of 0.0001, 0.0001, and 0.02, respectively. PSA and DRE›s perceived barriers were associated with low knowledge scores, P values of 0.0001 and 0.003, respectively. A higher probability of PCS participation was associated with the older age group, a P value of 0.001. Low participation was associated with perceived barriers of DRE, a P value of 0.031.

Conclusion:

The majority of the participants had poor knowledge regarding PC and PCS. Only a fifth of the men did PCS. High knowledge was associated with PSA and DRE perceived benefits and health motivation.

Characteristics and attitudes of first round invitees in the Irish National Colorectal Cancer Screening Programme

BACKGROUND/OBJECTIVE

Colorectal cancer (CRC) screening is proven to reduce CRC-related mortality. Faecal immunochemical testing (FIT)-positive clients in the Irish National CRC Screening Programme underwent colonoscopy. Round 1 uptake was 40.2%. We sought to identify barriers to participation by assessing knowledge of CRC screening and examining attitudes towards FIT test and colonoscopy.

METHODS

Questionnaires based on a modified Champion's Health Belief Model were mailed to 3500 invitees: 1000 FIT-positive, 1000 FIT-negative and 1500 non-participants. 44% responded: 550 (46%) FIT-positive, 577 (48%) FIT-negative and 69 (6%) non-responders (NR).

RESULTS

25% of respondents (n=286) did not perceive a personal risk of cancer, did not perceive CRC to be a serious disease and did not perceive benefits to screening. These opinions were more likely to be expressed by men (p=0.035). One-fifth (n=251) found screening stressful. Fear of cancer diagnosis and test results were associated with stress. FIT-positive clients, women and those with social medical insurance were more likely to experience stress.

CONCLUSIONS

The CRC screening process causes stress to one-fifth of participants. Greater use of media and involvement of healthcare professionals in disseminating information on the benefits of screening may lead to higher uptake in round 2.

Polymorphisms of 5’-UTR of rad51 gene in prostate cancer

Background. Notwithstanding that prostate cancer is largely studied all over the world for many decades, its etiology is not known and there is an intensive work to elucidate the cause and molecular markers for the development of this male cancer. Polymorphisms in DNA repairing genes may affect the DNA repairing capacity that in turn contributes to cancer development. This study aims to explore the polymorphisms of homologous recombination (HR) RAD51 gene (rs1801320 and rs1801321) as a possible risk factor for developing prostate cancer. Sequencing of 5'-UTR of RAD51 gene (rs1801320 and rs1801321) was studied in 80 DNA samples of prostate cancer and 50 DNA samples from a control group. Our results revealed a significant correlation between rs1801320 G>C polymorphism and the presence of prostate cancer in the Jordanian population (p = 0.041, X2 = 6.377). On the other hand, the rs1801321 G>T polymorphism was not associated with the presence of prostate cancer in the study population (p = 0.27, X2 = 2.6). In conclusion, our results shed a light on the possible role of RAD51 gene polymorphisms in the development of prostate cancer; however, a larger representative study is needed to elucidate a possible role of RAD51 gene polymorphisms in development and prognosis of prostate cancer.

Maturity Level of the Stigma Concept Associated with Cancer Diagnosis in the Nursing Literature

Objective:

This study aimed to evaluate the maturity level of stigma as a concept in nursing and its relationship to care provided for patients with cancer.

Methods:

The four principles of Morse and his colleagues were used to evaluate the maturity level of the stigma concept: epistemological, logical, pragmaticl, and linguistic. Analysis was conducted with the literature published between 2006 and 2016.

Results:

The findings of this study suggest that the concept of stigma in nursing is immature, defined inconsistently, and measured with different instruments. How stigma is defined can influence nurses in their assessment of patients with cancer and identification of their needs.

Conclusion:

Although extensive studies have been conducted in the field of mental illness, it is only recently that the effect of stigma on treatment of cancer patients has attracted attention. Thus, substantial work yet needs to be done to understand the breadth and scope of stigma impacting on individuals with cancer.

What's new in screening in 2015?

PURPOSE OF REVIEW

The aim of this review was to highlight important articles in the field of prostate cancer screening published during 2015 and early 2016. Four major areas were identified for the purpose: screening strategies, post-United States Preventive Services Task Force (USPSTF) 2011-2012, screening trends/patterns, and shared decision making.

RECENT FINDINGS

Several studies furthered the evidence that screening reduces the risk of metastasis and death from prostate cancer. Multiplex screening strategies are of proven benefit; genetics and MRI need further evaluation. Prostate-specific antigen (PSA) screening rates declined in men above age of 50 years, as did the overall prostate cancer incidence following the USPSTF 2011-2012 recommendation against PSA. The consequences of declining screening rates will become apparent in the next few years. More research is needed to identify the most optimal approach to engage in, and implement, an effective shared decision-making in clinical practice.

SUMMARY

Data emerging in 2015 provided evidence on the question of how best to screen and brought more steps in the right direction of 'next-generation prostate cancer screening'. Screening is an ongoing process in all men regardless of whether or not they might benefit from early detection and treatment. After the USPSTF 2011-2012 recommendation, the rates of PSA testing are declining; however, this decline is observed in all men and not solely in those who will not benefit from the screening. The long-term effect of this recommendation might not be as anticipated. More studies are needed on how to implement the best available evidence on who, and when, to screen in clinical practice.