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Cancer Screening
Cancer screening aims to detect cancer before symptoms appear. This may involve blood tests, urine tests, DNA tests, other tests, or medical imaging. The benefits of screening in terms of cancer prevention, early detection and subsequent treatment must be weighed against any harms. Universal screening, also known as mass screening or population screening, involves screening everyone, usually within a specific age group. Selective screening identifies people who are known to be at higher risk of developing cancer, such as people with a family history of cancer. Screening can lead to false positive results and subsequent invasive procedures. Screening can also lead to false negative results, where an existing cancer is missed. Controversy arises when it is not clear if the benefits of screening outweigh the risks of the screening procedure itself, and any follow-up diagnostic tests and treatments. Screening tests must be effective, safe, well tolerated with acceptably low rates of ...
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Screening Mammography
Breast cancer screening is the medical screening of asymptomatic, apparently healthy women for breast cancer in an attempt to achieve an earlier diagnosis. The assumption is that early detection will improve outcomes. A number of screening tests have been employed, including clinical and self breast exams, mammography, genetic screening, ultrasound, and magnetic resonance imaging. A clinical or self breast exam involves feeling the breast for lumps or other abnormalities. Medical evidence, however, does not support its use in women with a typical risk for breast cancer. Universal screening with mammography is controversial as it may not reduce all-cause mortality and may cause harms through unnecessary treatments and medical procedures. Many national organizations recommend it for most older women. The United States Preventive Services Task Force recommends screening mammography in women at normal risk for breast cancer, every two years between the ages of 50 and 74. Other pos ...
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Breast Cancer
Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin. Risk factors for developing breast cancer include obesity, a lack of physical exercise, alcoholism, hormone replacement therapy during menopause, ionizing radiation, an early age at first menstruation, having children late in life or not at all, older age, having a prior history of breast cancer, and a family history of breast cancer. About 5–10% of cases are the result of a genetic predisposition inherited from a person's parents, including BRCA1 and BRCA2 among others. Breast cancer most commonly develops in cells from the lining of milk ducts and the lobules that supply ...
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Life Expectancy
Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth (LEB), which can be defined in two ways. ''Cohort'' LEB is the mean length of life of a birth cohort (all individuals born in a given year) and can be computed only for cohorts born so long ago that all their members have died. ''Period'' LEB is the mean length of life of a hypothetical cohort assumed to be exposed, from birth through death, to the mortality rates observed at a given year. National LEB figures reported by national agencies and international organizations for human populations are estimates of ''period'' LEB. In the Bronze Age and the Iron Age, human LEB was 26 years; in 2010, world LEB was 67.2 years. In recent years, LEB in Eswatini (formerly Swaziland) is 49, while LEB in Japan is 83. The combination of high infant ...
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Disability-adjusted Life Year
The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries. The DALY has become more common in the field of public health and health impact assessment (HIA). It not only includes the potential years of life lost due to premature death, but also includes equivalent years of 'healthy' life lost by virtue of being in states of poor health or disability. In so doing, mortality and morbidity are combined into a single, common metric. Calculation The disability-adjusted life year is a societal measure of the disease or disability burden in populations. DALYs are calculated by combining measures of life expectancy as well as the adjusted quality of life during a burdensome disease or disability for a population. DALYs are related to the quality-adjusted life year (Q ...
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Years Of Potential Life Lost
Years of potential life lost (YPLL) or potential years of life lost (PYLL), is an estimate of the average years a person would have lived if they had not died prematurely. It is, therefore, a measure of premature mortality. As an alternative to death rates, it is a method that gives more weight to deaths that occur among younger people. An alternative is to consider the effects of both disability and premature death using disability adjusted life years. Calculation To calculate the years of potential life lost, the analyst has to set an upper reference age. The reference age should correspond roughly to the life expectancy of the population under study. In the developed world, this is commonly set at age 75, but it is essentially arbitrary. Thus, PYLL should be written with respect to the reference age used in the calculation: e.g., PYLL 5 PYLL can be calculated using individual level data or using age grouped data. Briefly, for the individual method, each person's PYLL is ca ...
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Lead-time Bias
Lead time bias happens when survival time appears longer because diagnosis was done earlier (for instance, by screening), irrespective of whether the patient lived longer. Lead time is duration of time between detection of a disease (by screening or based on a new experimental criteria) and its usual clinical presentation and diagnosis (based on traditional criteria). For instance, it is the time between early detection by screening and the time in which diagnosis would have been made clinically (without screening). It is an important factor when evaluating the effectiveness of a specific test. Relationship between screening and survival The goal of screening is earlier detection - to diagnose a disease earlier than it would be without screening. Therefore, if screening works, it needs to advance in time the moment of diagnosis. In other words, screening needs to introduce a lead time. However, the lead time itself biases survival statistics: people with disease detected by scr ...
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Frailty Syndrome
Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic declines in health and function among older adults. Frailty is a condition associated with ageing, and it has been recognized for centuries. It is also a marker of a more widespread syndrome of frailty, with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss. Frailty has been identified as a risk factor for the development of dementia. As a population ages, a central focus of geriatricians and public health practitioners is to understand, and then beneficially intervene on, the factors and processes that put elders at such risk, especially the increased vulnerability to stressors (e.g. extremes of heat and cold, infection, injury, or even changes in medication) that characterizes many older adults. Geriatric syndromes related to frailty Sarcopenia Sarcopenia is the degenerative loss of skeletal muscle mass, quality, and strength associated ...
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Biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a disease. The tissue is then fixed, dehydrated, embedded, sectioned, stained and mounted before it is generally examined under a microscope by a pathologist; it may also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. An incisional biopsy or core biopsy samples a portion of the abnormal tissue without attempting to remove the entire lesion or tumor. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy. Biopsies are most commonly performed for insight into possible cancerous or inflammatory conditions. Histor ...
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Stomach Cancer
Stomach cancer, also known as gastric cancer, is a cancer that develops from the lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes, including gastric adenocarcinomas. Lymphomas and mesenchymal tumors may also develop in the stomach. Early symptoms may include heartburn, upper abdominal pain, nausea, and loss of appetite. Later signs and symptoms may include weight loss, yellowing of the skin and whites of the eyes, vomiting, difficulty swallowing, and blood in the stool, among others. The cancer may spread from the stomach to other parts of the body, particularly the liver, lungs, bones, lining of the abdomen, and lymph nodes. The most common cause is infection by the bacterium '' Helicobacter pylori'', which accounts for more than 60% of cases. Certain types of ''H. pylori'' have greater risks than others. Smoking, dietary factors such as pickled vegetables and obesity are other risk factors. ...
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Colon Cancer
Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). Signs and symptoms may include blood in the stool, a change in bowel movements, weight loss, and fatigue. Most colorectal cancers are due to old age and lifestyle factors, with only a small number of cases due to underlying genetic disorders. Risk factors include diet, obesity, smoking, and lack of physical activity. Dietary factors that increase the risk include red meat, processed meat, and alcohol. Another risk factor is inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis. Some of the inherited genetic disorders that can cause colorectal cancer include familial adenomatous polyposis and hereditary non-polyposis colon cancer; however, these represent less than 5% of cases. It typically starts as a benign tumor, often in the form of a polyp, which over time becomes can ...
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Positive Predictive Value
The positive and negative predictive values (PPV and NPV respectively) are the proportions of positive and negative results in statistics and diagnostic tests that are true positive and true negative results, respectively. The PPV and NPV describe the performance of a diagnostic test or other statistical measure. A high result can be interpreted as indicating the accuracy of such a statistic. The PPV and NPV are not intrinsic to the test (as true positive rate and true negative rate are); they depend also on the prevalence. Both PPV and NPV can be derived using Bayes' theorem. Although sometimes used synonymously, a ''positive predictive value'' generally refers to what is established by control groups, while a post-test probability refers to a probability for an individual. Still, if the individual's pre-test probability of the target condition is the same as the prevalence in the control group used to establish the positive predictive value, the two are numerically equal ...
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False Negative
A false positive is an error in binary classification in which a test result incorrectly indicates the presence of a condition (such as a disease when the disease is not present), while a false negative is the opposite error, where the test result incorrectly indicates the absence of a condition when it is actually present. These are the two kinds of errors in a binary test, in contrast to the two kinds of correct result (a and a ). They are also known in medicine as a false positive (or false negative) diagnosis, and in statistical classification as a false positive (or false negative) error. In statistical hypothesis testing the analogous concepts are known as type I and type II errors, where a positive result corresponds to rejecting the null hypothesis, and a negative result corresponds to not rejecting the null hypothesis. The terms are often used interchangeably, but there are differences in detail and interpretation due to the differences between medical testing and stati ...
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