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Malu, Ifeanyi N. "Factors Associated with Prostate Cancer Screening Intentions Among Adult Men in Nigeria." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7404.
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Timely detection of prostate cancer (PCA) with prostate-specific antigens (PSA) and digital rectal examinations (DRE) are essential in optimizing incidence, minimizing prevalence, and reducing mortality rates. Given the low levels of participation in cancer screening, this study was conducted to examine the factors men consider when deciding whether to screen for PCA in Nigeria. A cross-sectional, online-based survey of 180 consenting Nigerian men 50 years old and older was carried out. Logistic regression analysis and descriptive statistics were used to analyze the data. Based on the data, there was a moderate positive association between the health belief model constructs and DRE/PSA screening intentions, which were statistically significant (p < 0.05). The results also demonstrated that there were no statistically significant associations between previous screening and age, previous screening and ethnicity, and previous screening and education among men in the sample (all p > 0.05). Of the 180 men surveyed, 29% (n = 53) had been screened for PCA before, while 76% (n = 137) reported no health insurance. Factors significantly associated with screening included income, insurance, and family history of PCA (all p < 0.05). Cancer fatalism, pain, and embarrassment were the most common barriers to screening reported. Focused interventions that help healthcare providers identify barriers quickly could improve screening outcomes. The implications for positive social change from this study include an increase in PCA screening, positive screening intentions, and a decrease in PCA mortality rate among men in Nigeria.
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Egbera, Joyce Ifeanyi. "Male University students’ knowledge, beliefs and attitude towards screening for prostate cancer in Benin City, Nigeria." Thesis, Cape Peninsula University of Technology, 2015. http://hdl.handle.net/20.500.11838/1542.
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DISSERTATION SUBMITTED IN FINAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE MASTERS OF TECHNOLOGIAE IN NURSING
IN THE FACULTY OF HEALTH AND WELLNESS SCIENCES AT THE CAPE PENINSULA UNIVERSITY OF TECHNOLOGY
2015Beliefs and awareness towards prostate cancer screening among men is very crucial for early detection and management of the condition. From various literatures reviewed, prostate cancer is the second leading cause of death amongst men. In Nigeria, it is the most common male cancer and may be as high as that seen in African Americans in the United State. In most developing countries e.g Benin Republic, Gambia, Senegal, Ghana, and Nigeria, access to health care and prostate cancer screening methods for early detection is limited. AIM: The aim of the study is to assess the knowledge, belief and attitude of male students in the Benson Idahosa University, Benin City, Nigeria towards prostate cancer screening in order to curb the high incidence and death rate resulting from this disease. POPULATION: The study populations will be Faculty of Social and management Science students of range 18-35 years at Benson Idahosa University, Benin-City, Nigeria. SAMPLE: All students will be selected from the number of male students that are registered in the Faculty of Social Science. METHODOLOGY: This design selected for this study is qualitative cross-sectional. METHOD OF DATA COLLECTION: Interviews and questionnaires will be used as tool for data collection. KEY FINDINGS: The students had never received information from their health care provider about prostate cancer. Very few were able to identify the possible symptoms of prostate cancer. There is low level of knowledge about prostate cancer screening and they do not know what abnormal prostate specific antigen (PSA) is. Majority of the participants gained informed knowledge about prostate cancer screening for the first time from this study. The students have a pronounced negative attitude towards prostate cancer screening. Lack of awareness about cancer screening programs is also identified as a major barrier why many Nigerian men do not go for screening. The level of education has a positive influence to prostate cancer and screening. Prostate cancer screening is not a taboo to Bini culture. CONCLUSIONS: The findings of this study revealed that there is low level of knowledge about prostate cancer among male university students in Benin-City, Nigeria. RECOMMENDATIONS: Initiation of cancer teachings in schools, churches, and traditional gatherings. Demonstrations with the use posters in public places about prostate cancer menace and screening should be 3 encouraged. There should be implementation of policy that every male student from age 30 be involved in health education and promotion programs for prostate cancer. KEYWORDS: male, University students, knowledge of prostate cancer, beliefs and attitude towards screening for prostate cancer, Prostate cancer screening
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Holt, Jim, and Fereshteh Gerayli. "Prostate Cancer Screening." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/6471.
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Whether to screen for prostate cancer in aging men is a topic that is fairly well researched, but recommendations are controversial, because the evidence supporting any recommendation is equivocal. The evidence clearly does not support routine screening of all average-risk men, but for men aged 55 to 69 years, either not routinely screening, or engaging each man in shared decision making for his individual preference on screening, is reasonable and consistent with the evidence. Many organizations, including the American Cancer Society, have not yet reassessed their guidelines, in response to the US Preventative Services Task Force revised guideline.
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Thorn, Shirley A. "Prostate cancer, the screening conundrum." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0003/MQ32265.pdf.
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Lawson, Deborah A. "Prostate cancer screening practices of Missouri physicians /." free to MU campus, to others for purchase, 1998. http://wwwlib.umi.com/cr/mo/fullcit?p9901254.
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Goeb, Katja Elisabeth. "MRI-spectroscopy in screening for prostate cancer /." Erlangen, 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000253829.
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Moore, Quentin E. "DEVELOPING A PREDICTIVE MODEL FOR PROSTATE CANCER SCREENING INTENT." UKnowledge, 2018. https://uknowledge.uky.edu/nursing_etds/35.
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African Americans bear a disproportionately high burden of cancer incidence and mortality in this country. The purpose of this dissertation was to investigate factors associated with African-American men, who are incarcerated, making informed health decisions about participation in prostate cancer screening, as well as exploring factors that reduce modifiable risk factors for cancer. The United States incarcerates more people per capita than any country in the world and African American men are overrepresented in the U.S. prison system
This dissertation is composed of three manuscripts. The first paper reviews the current literature about the factors that influence African-American males in making informed decisions about whether to participate in prostate cancer screening. The second paper uses existing data from a sample of 129 incarcerated African American men to examine the value of an intervention aimed at reducing modifiable risks for cardiovascular disease – and by extension, cancer – in inmates. The third paper explores predictors of intent to screen (or not) for prostate cancer in incarcerated African-American males, as well as those factors that influence informed decision-making in this population.
These papers provide an overview of factors that influence incarcerated African-American men’s health decisions (health literacy, having a relative with previous diagnosis). These findings can be used to guide future research that addresses African-American male decision-making about personal health outcomes.
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Roemeling, Stijn. "Screening for prostate cancer intermediate outcome measures and active surveillance /." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10628.
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McIntosh, Yeatoe G. "The Relationship between Perceived Personal Risk of getting Prostate cancer and Prostate-Specific Antigen (PSA) Screening." VCU Scholars Compass, 2008. http://scholarscompass.vcu.edu/etd/1579.
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Abstract Title: The Relationship between Perceived Personal Risk of getting Prostate cancer and Prostate-Specific Antigen (PSA) Screening Yeatoe G. McIntosh, MPH Candidate Advisor: Emmanuel Anum, MBChB, MPH, PHD Preceptor: Emmanuel Anum, MBChB, MPH, PHD Background: Prostate cancer is one of the most common cancer diagnoses in the United States. The American Cancer Society estimates that in 2008 28,660 deaths would be attributed to prostate cancer, projecting it to be the leading cause of cancer deaths in U.S. men. Despite the potential threat this cancer presents to men and the potential for improved disease outcomes from early detection, guidelines for screening for prostate cancer are varied, and disparities in screening prevalence exist. In addition, disparities in knowledge about prostate cancer screening and misconceptions about the disease seem widespread. The main purpose of this study was to determine the relationship between perceived personal risk of getting prostate cancer and prostate cancer screening with the Prostate-specific antigen (PSA) test. Methods: Data were collected from the 2003 Health Information National Trends Survey (HINTS). Overall, 1,815 men ages 35 and above were included in the sample after exclusion of men ages 18-34. Logistic regression analyses were conducted to assess the association between perceived personal risk and prostate cancer screening with PSA test, while testing for interaction and further adjusting for possible confounders. A reduced model, in which variables with non-significant Wald chi-squared statistic had been excluded, was compared to the full model to access the change in parameter estimates. Using the model-based approach, we compared models with interaction terms to the one without interaction terms using the likelihood ratio test. Parameter estimates from the best fitting model were reported using the design-based method. SAS version 9.1 statistical software was used for analyses. Results: Among men ages 35-49, those who perceived their risk as high, were significantly less likely to screen than those who perceived their risk as low (OR: 0.20 95% CI: 0.05-0.78). Within ages 50-64 and 65 and above, there were no significant differences between perceived risk levels and PSA testing. Men, who did receive healthcare provider recommendation for screening, were more likely to obtain prostate cancer (PSA) screening than men who did not receive such recommendation (OR: 92.56 95% CI 36.56, 234.36). Conclusions: The relationship between perceived personal risk of getting prostate cancer and PSA screening is modified by age. As men aged, their odds of screening increased. The most significant predictor of PSA screening was health provider recommendation. PSA screening showed no association with either race or household income.
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Mitra, Anita. "Prostate cancer and targeted screening in BRCA1 and BRCA2 Mutation carriers." Thesis, Institute of Cancer Research (University Of London), 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.509785.
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McFarlane, Debrah. "Differences in Perceptions of Prostate Cancer Screening Among Multiethnic Black Men." Thesis, Northcentral University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3682234.
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Prostate cancer (PCa) affects Blacks disproportionately when compared to other groups. PCa is the primary cancer and second cause of cancer mortality among Black men. Some researchers have declared that the high PCa incidence and mortality rates in the Black population are a result of poor screening rates. PCa screening perceptions are reasonably known among African American men; however, limited documentation is available for the ever-expanding population of ethnic Black Caribbean men in the United States. Ethnic Blacks from the Caribbean are at high risk for PCa, with PCa incidence and mortality rates comparable to, or exceeding those of African American men. This quantitative non-experimental comparative analysis study examined differences in the perception of ethnic Blacks toward PCa and PCa screening. Also being examined was the extent and manner in which these PCa perceptions among ethnic Black men differ with respect to specific ethnic groups within the Black population and varied with respect to demographic factors of age, education, marital status, health insurance coverage, and income. The Health Belief Model – Prostate Cancer Scale (HBM-PCS) was theoretical framework used in this study. The HBM-PCS and a Demographic survey were provided to 167 participants (40 to 80 years), recruited via flyers at grocers, shopping malls, plazas, restaurants, and barbershops frequented by ethnic Black men residing in Broward County, Florida. There was a statistically significant difference in Perceived PCa Seriousness with respect to ethnic identity, F(4, 162) = 4.54, MSE = .531, p = .002, η 2 = 0.10. There was also a statistically significant difference in Perceived PCa Screening Barriers with respect to ethnic identity, F(4,162) = 4.08, MSE = .226, p = .004, η2 = 0.09. There was no statistically significant difference in Perceived PCa Screening Benefits with respect to ethnic identity, F(4, 162) = .80, MSE = .188, p= .526, η2 = 0.02. The interaction effect between ethnicity and age F(8, 152) = 2.08, MSE = .180, p= .041, partial eta = .099 and ethnicity and income F(14, 142) = 1.79, MSE = .177, p= .045, partial eta = .150 on perceived PCa screening Benefits were of statistical significance. Perceived PCa Screening Barriers also statistically significantly differed with respect to education level [F(5, 160) = 4.48, MSE = .221, p= .001, η2p = 0.12], income level [F(4, 160) = 6.21, MSE = .216, p < .001, η2p = 0.13], and health insurance coverage [t(165) = 3.22, p < .001]. Future studies should take into consideration additional ethnic Black groups, which should consist of larger samples that are more equally weighted among each ethnic group being examined. Additionally, future studies should focus on how ethnic Black men perceived the benefits of PCa, and how their perceptions of the benefits of screening contribute to, or prevent them from screening for PCa disease. Of interest should also be studies on PCa trajectory in ethnic Black immigrants in the United States, as to whether PCa incidences and mortalities become lessened upon migration from their country of origin.
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Gosselaar, Claartje. "Screening for prostate cancer digital rectal examination: outdated or still valuable? /." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2008. http://hdl.handle.net/1765/13729.
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Boulay, Sherly Marie. "Church-Based Intervention on Prostate Cancer Screening for African American Men." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4775.
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African American men have a significantly higher incidence of prostate cancer, they are diagnosed at a later age, have more advanced stages of cancer at diagnosis, and higher mortality rates than other ethnic group. The purpose of this project, guided by the Ottawa decision support framework and the health belief model, was to investigate whether church leaders could be trained to deliver an educational program about the value of prostate cancer screening to African American males in a church setting. The 2 participants were church leaders in a predominantly African American church. The participants were taught about prostate cancer and the value of screening using videos and informative brochures developed by the National Institute on Aging, the American Cancer Society, and the Centers for Disease Control and Prevention. A researcher-designed pre- and posttest questionnaire was used to measure learning. Data were analyzed using a paired sample t test. Although small sample size may have contributed to lack of statistical significance, the mean score comparison showed knowledge acquisition, thus enabling the trainers to offer the information to members of their congregation, who could then make informed decisions. This study demonstrated the value of using unconventional educational settings, such as churches, to reach populations who might be unaware of their health risks. The results show that church leaders can be trained to have a positive impact on the physical health of their congregations and promote social change by encouraging health care practitioners to investigate alternative settings and methods to educate vulnerable populations about diseases and disease prevention.
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St-Hilaire, Wilgyms. "Prostate Cancer Screening Rates for Haitian Men Based on Demographic Characteristics." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7082.
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Cancer screening is useful for improving survival rates and treatment outcomes, which is why there are screening recommendations for the most prevalent types of cancer. Despite gains in the reduction of cancer-related mortality rate worldwide in the past few years, the Haitian community continues to experience high mortality rates due to cancer. The prevalence of prostate cancer in the Haitian population is among the highest worldwide at 767 per 100,000, with a mortality rate of 403 per 100,000. One of the causes may be the low prostate cancer screening rate in the Haitian community; however, no studies have been focused on an association between demographic factors within this community and the low prostate cancer screening rate. This study's purpose was to address this gap through a cross-sectional quantitative design using the health belief model as a theoretical framework and a convenience sample of 282 Haitian males. The rate of prostate cancer screening among Haitian immigrants living in Brooklyn was examined based on the demographic variables of age, income, and education. Participants' perceptions regarding prostate cancer screening were also evaluated based on the same variables. Loglinear, and binary logistic regression were used for data analysis. Although education was found to be the strongest and only significant predictor variable for prostate cancer screening participation within the target population, no conclusion could be drawn regarding the effect of the select variables on the participants' perceptions on prostate cancer screening. The implications for this study include increased knowledge for public health promotion initiatives and for those in the Haitian community working to reduce the morbidity and mortality rates due to prostate cancer.
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Oliver, JoAnn Simon. "Prostate Cancer Screening Patterns among African American Men in the Rural South." Digital Archive @ GSU, 2008. http://digitalarchive.gsu.edu/nursing_diss/7.
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Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among men in the United States. In African American men, the disease is typically detected at a more advanced stage and mortality is twice the rate of Caucasian men. However, African American men are less likely to participate in prostate cancer screening. The purpose of this descriptive study was to assess the relationship between health beliefs, knowledge, and selected demographic variables (age, income and education) and a man’s decision to participate in prostate cancer screening among African American men dwelling in rural communities. The conceptual framework for the study was the Health Belief Model. Participants for the study were recruited through contacts within rural communities within west central Alabama. A convenience sample of 90 African American men between the ages of 40-82 years of age was recruited. Analysis of the research data indicated that there was a statistically significant difference in motivation (health belief), knowledge, and age of men who participated in prostate cancer screening compared to those who did not participate in prostate cancer screening. Forward logistic regression was used to determine which independent variables [health beliefs (benefits, barriers, motivation); knowledge; age; income; and education] were predictors of prostate cancer screening. Results indicated the overall model of one predictor, motivation, was statistically reliable in predicting prostate cancer screening participation among the rural dwelling men surveyed. The model accounted for 15 to 20% of the variance. The sensitivity of the model in predicting those who would participate in prostate cancer screening was 85%. The odds of those who would participate in prostate cancer screening were 1.3 times greater for each one unit increase in motivation. Results indicate a need for more educational and motivational interventions to promote informed decision making by African American men in regards to prostate screening activities. These interventions need to be culturally sensitive and geared toward African American men, specifically those living in rural areas.
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Baker, Susan Anita. "Prostate Cancer Screening Intention Among African American Men: An Instrument Development Study." [Tampa, Fla] : University of South Florida, 2008. http://purl.fcla.edu/usf/dc/et/SFE0002694.
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Gregory, Daniel J. "Iowa men's decision-making process for prostate cancer prevention via screening with the prostate-specific antigen (PSA) test." Diss., University of Iowa, 2007. http://ir.uiowa.edu/etd/177.
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Yu, Mark. "Examining the Association of Fruit and Vegetable intake and Breast and Prostate Cancer Screening." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1991.
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Breast and prostate cancer incidence and mortality have been steadily decreasing. Reasons for these reductions may be related to increased rates of cancer screening and other factors such as improvements in diet, including consumption of fruits and vegetables. We wanted to determine if individuals who get screened for breast and prostate cancer are more or less likely to consume adequate servings of fruit and vegetables. A cross-sectional study using the BRFSS survey was conducted. Individuals included in this study (n=26,222), were asked about their breast or prostate cancer screening history. They were also asked about their servings per day of fruit and vegetables. Statistical analyses were conducted using the SAS 9.2 software program. Logistic regression analyses were conducted on the variables and potential confounders. Over 40% of individuals who did not screen for breast and prostate cancer were in the 50-59 years of age category. A trend was seen with younger age groups being less likely to consume 3 or more daily servings of fruit and vegetables than their older counterparts. Another trend was seen in education levels. Individuals with lower education were less likely to consume at least 3 daily servings of fruit and vegetables. There was a statistically significant association between cancer screening and servings of fruit and vegetables per day. Individuals who were screened for either breast or prostate cancer were 52% more likely to consume 3 or more servings of fruit and vegetables than those who did not screen for either breast or prostate cancer (OR=1.52, 95% CI: 1.29-1.79). Further research needs to be conducted related to how other health behaviors may be related to cancer screening adherence and fruit/vegetable intake.
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Sennfält, Karin. "Economic studies of health technology changes in prostate cancer care /." Linköping : Center for Medical Technology Assessment, Department of Healt and Society, Linköping University, 2005. http://www.bibl.liu.se/liupubl/disp/disp2005/med889s.pdf.
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McGregor, S. Elizabeth. "Prostate cancer screening, knowledge, attitudes, and practices of Alberta men aged 40 to 74 years." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0023/NQ49518.pdf.
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Barrow, Paul. "Hereditary colorectal cancer : registration, screening and prognostic biomarker analysis." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/hereditary-colorectal-cancer-registration-screening-and-prognostic-biomarker-analysis(45d75b71-edc0-4c9f-a381-9ecda92f2fac).html.
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Aims: The purpose of the research was to investigate the benefits of a hereditary colorectal cancer registry in the management of patients and families with Lynch syndrome. In study one, a systematic review was performed to quantify the impact of registration and screening on colorectal cancer (CRC) incidence and mortality, with comparison between familial adenomatous polyposis (FAP) and Lynch syndrome (LS). In study two, a regional Lynch syndrome registry was utilised to evaluate the uptake of predictive testing and colorectal screening among first-degree relatives (FDRs) and investigate novel methods for engaging at-risk relatives, including an enhanced role for the general practitioner (GP). In study three, the registry was used to investigate proposed associations between Lynch syndrome and prostate and bladder cancer. In study four, mismatch repair-deficient (dMMR) CRCs from Lynch syndrome patients and randomised-controlled trials (RCTs) were used to evaluate a novel prognostic biomarker, beta-2 microglobulin (B2M). Methods: An electronic database search was conducted to identify studies describing CRC incidence and/or mortality in FAP or LS, with comparison of either: 1) screened and unscreened patients or 2) patients ‘before and after’ establishment of the registry. Using the Manchester regional Lynch syndrome registry database, the uptake of predictive testing and colorectal screening among FDRs was assessed with Kaplan-Meier analysis. Novel strategies for improving engagement were explored via a patient advisory group discussion and a regional primary care questionnaire. Cases of prostate and bladder cancer in male mutation carriers and their male FDRs were identified, and cumulative and relative risks were calculated, using expected rates from cancer registry data. DNA from 350 dMMR CRC specimens from Lynch syndrome patients and RCTs were tested for B2M mutations using Sanger sequencing, and correlated with clinical outcome. Results: 43 studies were included in the systematic review (33 FAP; 10 Lynch). Registry-based screening was associated with a significant reduction in CRC incidence and in Lynch syndrome, CRC-related mortality was negligible in those undergoing surveillance. 242 Lynch syndrome families were recorded on the Manchester Lynch syndrome registry. 329 of 591 (55.7%) eligible FDRs had undergone predictive testing. Uptake was significantly lower in males and younger age groups (<25 yrs). Compliance with colorectal screening was excellent following a mutation positive predictive test but poor in untested individuals (97.3% vs 35.0%). Eight prostate cancers were identified in 821 male LS mutation carriers and male FDRs. MSH2 mutation carriers had a ten-fold increased risk of prostate cancer (RR 10.41; 95%CI 2.80, 26.65) but no association with bladder cancer was identified. 69/286 (24.1%) of dMMR CRCs contained significant B2M mutations. B2M mutations were associated with complete absence of recurrence (0/39) during follow-up in the QUASAR trial (stage II), compared with 14/77 (18.2%) in wild-type B2M (p=0.005). Conclusion: Studies consistently report that registration and screening result in a reduction of CRC incidence and mortality in FAP and LS (Level 2a evidence, Grade B recommendation). Funding and managerial support for registries should be made available. Uptake of predictive testing and colorectal screening in Lynch syndrome could be substantially improved, particularly among males and younger age groups, but this requires advances in communication with at-risk relatives. It is unlikely that GPs will actively participate without considerable support from genetics services. A trial of PSA screening in MSH2 mutation carriers from 50 years would be appropriate. B2M mutation status has potential clinical utility as a prognostic biomarker in stage II dMMR CRC.
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Zelaya, Rainel. "Identification of Small Molecules that Inhibit Prostate Cancer Cell Proliferation." Honors in the Major Thesis, University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1659.
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Prostate cancer is the second most often diagnosed cancer and internationally the sixth foremost cause of cancer death in males, as of 2011. Within the United States it is the most common form of cancer in men with 186,000 new cases and with an overall 28,600 deaths in 2008, and it is the second leading kind of cancer-related death in men. The widespread threat that prostate cancer poses against men across the globe cannot be understated, and its initiation and progression must be understood in order to truly comprehend its implicated risks and possible forms of treatment. As its name implies, prostate cancer is a form of cancer that develops in the prostate gland located in the male reproductive system. Its progress starts when standard semen-secreting prostate gland cells mutate into cancer cells. Although its developments may start at the prostate gland, cancer cells may metastasize to other parts of the body through circulation systems such as the lymph nodes. The main sites of metastasis for prostate cancer include the adrenal gland, the bones, the liver and the lungs. Although there are treatments available for prostate cancer, there is no definitive cure. The primary goal of this project was to find an alternative form of treatment, which is what will be necessary to combat this cancer.B.S.
Bachelors
Biomedical Sciences
Biomedical Sciences
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Hill, Owen T. "Improving prostate cancer detection in veterans through the developement of a clinical decision rule for prostate biopsy." [Tampa, Fla] : University of South Florida, 2006. http://purl.fcla.edu/usf/dc/et/SFE0001575.
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Karanfil, Özge 1978. "Why clinical practice guidelines shift over time : a dynamic model with application to prostate cancer screening." Thesis, Massachusetts Institute of Technology, 2016. http://hdl.handle.net/1721.1/107531.
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Thesis: Ph. D., Massachusetts Institute of Technology, Sloan School of Management, 2016.Cataloged from PDF version of thesis.
Includes bibliographical references.
Essay 1: A Dynamic Model for Understanding Long-Term Trends in Prostate Cancer Screening Cancer remains the second leading cause of death in the U.S. after heart disease. After 35 years of routine cancer screening, we still have only a limited understanding of screening dynamics. There is evidence of over-screening and resulting overtreatment in certain cases, and significant provider variation and fluctuations over time in screening criteria. Here I present empirical data for fluctuations in official screening guidelines and in actual practice for the use of the prostate-specific antigen (PSA) test. I explore how these dynamics are affected by the main guideline-issuing organizations in the U.S. and by clinicians, patient groups, and the media. Essay 2: Our Walk to the End of Cancer? Understanding Long-Term Trends in Medical Screening In this study we develop the first integrated, broad boundary feedback theory and formal model to explain the dynamics of medical screening. The theory includes a decision-theoretic core around harms and benefits including the fundamental tradeoff between sensitivity and specificity; and feedbacks that condition guidelines and actual practice. To provide context we use the case of PSA screening for prostate cancer as a motivating example, but our model is generic and applicable to other contexts. We present a behaviorally realistic, boundedly-rational model of detection and selection for health screening that creates oscillations in policy recommendation thresholds of formal guidelines. This core model, entailing only the evidence generation and translation processes, demonstrates how oscillations are natural to this category of problems due to inherent delays in evidence-based screening. These fluctuations lead to long periods during which screening guidelines are suboptimal. Essay 3: A Dynamic Model for Understanding Long-Term Trends in Prostate Cancer Screening Whereas guidelines for routine screening should be based on medical evidence, evidence often has relatively little impact on practice. This situation has led to ongoing controversy and conflict over appropriate guidelines among scientists, clinicians, and patient advocacy groups. There are significant variations in clinical practice, including evidence of over-screening for some diseases, and under-screening for others. To explain the patterns of over-screening, fluctuations, low adherence to guidelines, and conflict, I develop the first explicit broad boundary feedback theory of the dynamics of medical screening, tested in a formal mathematical model. The model presents an extended case study specific to PSA screening for prostate cancer, including realistic presentations for the fundamental tradeoff between test sensitivity and specificity, the natural progression of the disease, and respective changes in population size and composition.
by Özge Karanfil.
A dynamic model for understanding long-term trends in prostate cancer screening -- Our walk to the end of cancer?: understanding long-term trends in medical screening -- A dynamic model for understanding long-term trends in prostate cancer screening.
S.M. in Management Research
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Mukona, Adoniah Mavura. "Attitudes and Beliefs Towards Prostate Cancer Screenings and Diagnosis Among Zimbabwean Physicians." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3052.
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Zimbabwean men at risk of developing prostate cancer (PC) are diagnosed late or not at all. A cross sectional, quantitative study was done in Zimbabwe to establish physicians' attitudes and beliefs towards PC screening and diagnosis. Descriptive statistics were obtained to determine physicians' beliefs and attitudes using the Physician Attitudes and Beliefs Questionnaire Survey. The instrument incorporated validated instruments, the Burns' Cancer Belief Scale and Physician Survey on Prostate Cancer Screening, and demographic questions to measure specific independent variables, potentially influencing attitudes and beliefs. Means and standard deviations were conducted for continuous variables for beliefs and attitudes, and frequencies and percentages for categorical variables were calculated. Data from 206 respondents were analyzed utilizing multiple regression and MANOVA analysis to determine significance. The average Belief score was 3.96 (SD = 1.04), which reflected an overall belief score falling in the neutral range of response options. Linear regression results were significant, F(19, 178) = 2.09, p = 0.007, R2 = 0.18, suggesting that screening, stage of cancer, gender, training location, culture, total years in practice, and specialty accounted for 18% of the variance in Belief score. Attitude score predicted by screening (p = .000), stage of cancer (p = .005), race (p = .000), and culture (p = .020), was also significant. Screening and training location were significant predictors. Results will benefit physicians improve their attitudes using suggested continued education, resulting in improved screening practices and PC diagnosis. The public health system will potentially see PC death rates decline over time increasing life expectancy.
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HAMAJIMA, NOBUYUKI, KENJI WAKAI, GUANG YIN, RIEKO OKADA, SAYO KAWAI, EMI MORITA, ERINA KOYAMA, et al. "DPP4 Genetic Variants Influence Baseline Prostate-Specific Antigen Levels: The J-MICC Study." Nagoya University School of Medicine, 2013. http://hdl.handle.net/2237/17603.
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Louis, Jhonii Price II. "Examining constructs of the Health Belief Model as predictors of Haitian men's intention regarding prostate cancer screening." Thesis, Barry University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10153750.
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Background: The most recent report of Global Burden of Cancer (GLOBOCAN) indicated the incidence rate of prostate cancer in Haiti as 38.6 and the mortality rate as 32.3 per 100,000. The literature supports a high correlation between early prostate cancer screening and low mortality rate from the disease. Yet, the participation of Haitian men in prostate cancer screening remains low (Kleier, 2010). The literature has a lack of research on this matter, which presented the gap to be examined.
Purpose: The purpose of this study was to determine which of these selected constructs of the Health Belief Model (perceived susceptibility, perceived benefits, and perceived barriers) are predictors to the intention of Haitian men regarding prostate cancer screening. Other modifying variables were also considered as predictors to the outcome variable.
Theoretical Framework: The Health Belief Model (HBM) was utilized as the primary guide for the study; the Purnell Model for Cultural Competence served a complementary lens to account for any cultural gap studying this population.
Method: A correlational, predictive cross-section design was used to obtain a convenience sample in Haiti (N = 200). The Champion HBM scale was adapted and modified for prostate cancer; it was administered in Haitian Creole and French. Data were analyzed through descriptive, correlation, logistic regression, and the nonparametric Kruskal-Wallis (H) analysis of variance (ANOVA) to determine predictive correlation among the variables.
Results: Seven hypotheses were tested; all but one was supported. Perceived benefits were found to have a predictive relationship to Haitian men’s intent to screen for prostate cancer [χ2 (3) = 14.47, p = .00]. Further, the nonsignificant Hosmer and Lemeshow statistic, χ2 (8) = 4.33, p = .83 supports that the data was a good fit for the model. No other variable was found to be significant.
Conclusion: The findings from this study can be utilized by nurses and other healthcare professionals to generate and implement culturally appropriate interventions; consequently, these interventions will decrease the morbidity and mortality rates of prostate cancer among Haitian men in Haiti and abroad.
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Dini, Leonardo Infantini. "Perfil do câncer de próstata em um programa de rastreamento na cidade de Porto Alegre." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2002. http://hdl.handle.net/10183/12629.
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Com o aumento da expectativa de vida no Brasil e a possibilidade de detecção precoce através de programas de rastreamento, o câncer de próstata, tem sido considerado um problema de saúde pública. Em um programa de rastreamento voluntário realizado no Hospital de Clínicas de Porto Alegre entre os anos de 1996 e 2000, 3.056 pacientes foram submetidos a um estudo transversal com o objetivo de determinar a prevalência e características do câncer de próstata na amostra. Para a análise estatística foi utilizado o teste qui-quadrado com nível de significância de p < 0,05.A idade média da amostra foi de 60,4 anos e a prevalência do câncer de próstata foi de 2,61%, sendo crescente com o aumento da idade. A sensibilidade e especificidade do PSA foram, respectivamente, 93,8% (IC = 85,4% a 97,7%) e 82,5% (IC = 81,1% a 83,8%), utilizando como ponto de corte do PSA o valor de 4ng/ml. O toque retal apresentou sensibilidade de 60% (IC = 48,4% a 70,6%) e especificidade 83,3% (IC = 81,9% a 84,6%). O número de biópsias realizadas para se diagnosticar um paciente com câncer de próstata foi de 11,9 e variou conforme a faixa etária. No estadiamento clínico, 51,3% dos pacientes eram T1C e 83,75% dos tumores estavam clinicamente confinados ao órgão. Enquanto estudos prospectivos e randomizados que tenham como desfecho a mortalidade não definirem o real papel do diagnóstico precoce do câncer depróstata, os programas de rastreamento devem ser realizados. Este estudo vem ao encontro da necessidade de conhecer a distribuição e as características da doença nas diversas regiões do país.With the increase in life expectancy in Brazil and the possibility of early detection through screening programs, prostate cancer is being considered a public health problem. In a voluntary screening program performed in Hospital de Clínicas de Porto Alegre between the years of 1996 and 2000, 3,056 patients participated in a cross sectional study with the objective of determining the prevalence and features of prostate cancer in the sample. For statistical analysis, qui square test was performed considering a significance level of p < 0.05. The mean age of the sample was 60.4 years, and the prevalence of prostate cancer was 2.61%, increasing with age. The sensitivity and specificity of PSA were, respectively, 93.8% (CI = 85.4% to 97.7%) and 82.5% (CI = 81.1% to 83.8%) considering 4 ng/ml as the cut-off point for PSA. Rectal examination had a sensitivity of 60% (CI = 48.4% to 70.6%) and a specificity of 83.3% (CI = 81.9% to 84.6%). The amount of biopsies performed for diagnosing a patient with prostate cancer was 11.9 and varied according to age. In clinical staging, 51.3% of patients were T1C and 83.75% of tumors were clinically confined to the organ. While prospective and randomized trials with mortality as the endpoint do not define the real role of early diagnosis in prostate cancer, screening programs should be performed. This study meets the need for knowing the distribution and characteristics of the disease in the different regions of the country.
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Törnblom, Magnus. "The diagnostic performance of prostate-specific antigen (PSA) in early detection of prostate cancer : considerations of sensitivity, specificity, lead-time and survival /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-660-X/.
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Reece, Michelle C. "Prostate Cancer and PSA Testing: Implications of Provider-Patient Communication and Shared- Decision Making on National Screening Recommendations." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etd/2390.
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The national recommendations for use of the prostate specific antigen (PSA) test for prostate cancer screening have been modified over the years as scientific evidence emerged. Current screening recommendations discourage widespread PSA screening for men at low to average risk, but provide specific guidelines for shared-decision making between men and their health providers about the benefits and risks of PSA testing. This study was an examination of relationships between men’s assessment of the quality of their care and communication with their health providers, the extent to which providers engage men in recommended discussions about PSA testing, and factors associated with shared-decision making and PSA testing. Secondary data from the U.S. Health Information National Trends Survey 4, Cycle 2 that included men with no history of prostate cancer and in the recommended age ranges for prostate cancer screening were analyzed (N=777). Non-Hispanic white men rated their quality of care higher than men of other races (c2 (49, n=635) = 7.23, p = 0.0098), whereas Hispanic men gave the lowest ratings compared to other men (c2 (49, n=635) = 5.42, p = 0.024). Previous PSA testing was reported by 64% of the men, 56% of whom stated that they discussed screening with their provider and 80% reported that they were asked if they wanted to have the test done. However, only 21% - 39% reported having ever discussed the pros and cons of PSA testing. Discussing PSA testing with a provider was the strongest predictor of obtaining the test (OR=69.5, CI = 23.6 – 204.6) but the effect was significantly modified when providers and patients engaged in the shared-decision making process (OR = 47.42, CI = 14.91 – 150.74). Age, education level and perceived quality of care were consistent, positive predictors of PSA testing. These results indicate there is a gap in provider-patient discussions about PSA screening and suggest that health providers may not be following the recommended guidelines for the content of the discussions needed to facilitate shared-decision making. Effective provider-based interventions to increase shared-decision-making about PSA testing are needed if the national objectives for prostate cancer screening are to be met.
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Silvera-Ndure, Dawn Marie. "Development of a Church-Based Educational Program to Increase Prostate Cancer Screening for Black Men 40 and Older." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2889.
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Prostate cancer is the most common cancer among men in the United States and is one of the leading causes of cancer death among men of all races. However, African-American men are at particularly high risk. These men are diagnosed more often with prostate cancer, are diagnosed later, and are more than twice as likely to die from prostate cancer than are Caucasian men. A strategy to address this inequity was to develop a community based program that would reach this at risk population. The goal of the project was to develop an evidence-based, theory-supported education and referral program to promote prostate cancer prevention screening among African-American men utilizing New York community church settings. The resultant scholarly project aims to motivate the target population towards prostate cancer prevention screening as appropriate through the development of an evidence-based, theory-supported, community-focused education and referral program using self-efficacy theory. This project provides a program, grounded in self-efficacy, that will educate African-American men about prostate cancer, empower them with knowledge regarding risk, motivate them to seek preventative screenings, and obtain care if needed. An evaluation strategy was developed incorporating a post-test questionnaire to measure participant knowledge and self-efficacy along with a process for measuring referrals to local screening and treatment programs. The program will bring about positive social change through empowerment of a population of men suffering from disparate access to care resulting in increased morbidity and mortality. Dissemination of the project will include presentations to the community church leaders and Caribbean healthcare professionals, as well as publication in Parish nursing journals.
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Zimmerman, Suzanne M. (Suzanne Marie). "Designing a Social Marketing Plan to Promote Hispanic Participation at Prostate Cancer Screenings." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc278955/.
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Prostate cancer is the most commonly occurring cancer and the second leading cause of cancer death for men in the United States. Because early prostate cancer is frequently without symptoms and data on how to prevent prostate cancer is lacking, early detection has the greatest potential for decreasing mortality. Studies have shown Hispanics/Latinos to be less likely than whites or African-Americans to utilize prostate cancer screening exams. The purpose of this descriptive study was to design a social
marketing plan which could be used as a model to promote Hispanic/Latino participation at prostate cancer screenings. Information obtained through medical and marketing literature review, the author's experiences serving on the promotion committee of a community-sponsored prostate cancer screening project, and interviews with 51 Hispanic/Latino prostate cancer screening participants is described and incorporated into a guide with recommendations for future program planners.
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Mercer, Shawna Lee. "Prostate cancer screening in the midst of controversy, knowledge, attitudes, beliefs, practices, intentions and personal preferences of Canadian men." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0020/NQ53671.pdf.
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Charvin, Maud. "La participation des hommes au dépistage du cancer de la prostate : le rôle de l'information." Thesis, Normandie, 2019. http://www.theses.fr/2019NORMC422.
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Le dépistage du cancer de la prostate est largement controversé de par l’équilibre de la balance bénéfices-risques de cette procédure. L’enjeu de santé publique est alors d’accompagner au mieux les hommes susceptibles de se faire dépister pour qu’ils puissent être informés et participer au choix. L’objectif de ce doctorat est de contribuer à comprendre pourquoi les hommes participent au dépistage du cancer de la prostate, pour pouvoir améliorer dans un second temps leur accompagnement. Nous avons tout d’abord interrogé des hommes sur leurs connaissances, leurs sources d’informations et leur rôle dans le choix de participer au dépistage du cancer de la prostate. Ces entretiens ont abouti à la nécessité de concevoir un nouvel outil d’information pour améliorer les connaissances des hommes, en particulier sur les risques de la procédure de dépistage. Enfin, nous avons estimé comment les bénéfices et les risques étaient intégrés dans le choix des individus selon si ces derniers avaient eu accès à notre outil d’information. Les résultats de ce travail montrent que les hommes semblent moins favorables à une proposition de dépistage après avoir eu accès à notre outil d’information. Cependant, cela ne modifie pas leur appréciation des bénéfices et des risques du dépistage. Il est nécessaire de poursuivre les efforts pour permettre aux hommes de faire un choix éclairéProstate cancer screening is highly controversial because of the benefit risk ratio. An issue is to support men susceptible to perform this screening towards informed choice and shared decision-making. The aim of this doctorate is to understand why men adhere to prostate cancer screening, and in a second time to improve their support. We interviewed men about their knowledge, their information seeking behaviour, and their implication in prostate cancer screening decision. This highlighted the necessity to create a new information tool to improve men’s knowledge, in particular regarding risks of the screening procedure. Finally, we investigate benefit risk trade-off with and without our information tool access. Results of this work shows that men are less favourable to a screening option after taking into account our information tool. However, benefit and risk of this screening appreciation was not changed. We need to continue efforts to allow men to make an informed choice
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Dellal, Hadjer. "Identification de nouveaux inhibiteurs de l'axe androgénique pour contourner la résistance à la castration des cancers de la prostate." Thesis, Montpellier, 2020. http://www.theses.fr/2020MONTT052.
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La résistance à la castration est l'une des principales causes de décès chez les patients atteints d'un cancer de la prostate. Elle est souvent liée à des mécanismes qui sont dépendent du récepteur des androgènes tels que l'amplification ou les mutations du récepteur, l'expression des variants d'épissage du RA, en particulier le RA-V7 qui est constitutivement actif car il ne possède pas de domaine de liaison au ligand, ou la surexpression de coactivateurs qui stimulent l'activité transcriptionnelle du RA. Les stratégies visant à contrer la résistance à la castration se sont principalement concentrées sur l'identification de nouveaux antagonistes plus spécifiques et plus puissants du RA, ce qui a conduit à l'approbation de l'enzalutamide ou du darolutamide. Cependant, peu d'études se sont intéressées aux autres mécanismes qui régulent l'activité transcriptionnelle du RA notamment ses coactivateurs, probablement parce qu'ils étaient considérés comme des cibles difficiles et en raison de leur nombre important.Notre objectif est d'identifier de nouvelles molécules qui peuvent altérer l'activité transcriptionnelle du RA ou du RA-V7 ou des cofacteurs en criblant des banques de molécules ou d’extraits. À cette fin, nous avons généré des lignées cellulaires exprimant de manière stable le RA ou le RA-V7 et un système rapporteur de luciférase permettant de quantifier l'activité transcriptionnelle du RA. Nous avons validé notre système de criblage à haut débit en identifiant le chlorhydrate d'harmol, produit naturel de la chimiothèque PRESTWICK phytochimique, comme un inhibiteur compétitif et sélectif du récepteur des androgènes. Nous avons également mis en place plusieurs modèles nous permettant de mesurer l'effet des coafacteurs sur l'activité du RA afin d'identifier des inhibiteurs spécifiques à ces derniers. Nous avons identifié FHL2, un coactivateur du RA et du RA-V7, comme cible thérapeutique potentielle.L'identification de nouveaux inhibiteurs de l'axe androgénique pourrait être utile pour potentialiser l'effet des antagonistes du RA actuellement utilisés en clinique pour contourner la résistance à la castrationResistance to castration is one of the major causes of death in prostate cancer patients. It is often linked to mechanisms that are dependent on the androgen receptor such as amplification or mutations of the receptor, expression of AR splice variants, in particular AR-V7 that are constitutively active because of a lack of the ligand binding domain, or overexpression of coactivators that stimulate AR transcriptional activity. Strategies to counteract resistance to castration have primarily focused on the identification of more specific and more potent AR antagonists leading to the approval of enzalutamide or darolutamide. However, fewer studies investigated other mechanisms that regulate AR transcriptional activity including the targeting of AR coactivators, probably because they were considered as undruggable targets and because of their extensive number.Our aims at the identification of new molecules that can impair the transcriptional activity of full-length AR or AR-V7 or cofactors by screening various libraries. For these purpose, we generated dedicated reporter cell lines stably expressing AR or AR-V7 and a luciferase reporter system allowing the quantification of AR transcriptional activity. We validated of our Highthrouput screening system by identifying harmol hydrochloride, natural product from PRESTWICK phytochemical library as competitive and selective inhibitor of androgen receptor. We also implemented several models allowing us to measure the effect of specific cofactors on AR activity in order to identify specific inhibitors of these cofactors. We identified FHL2 a coactivator of both AR and AR-V7 receptors, as a potential target.Identification of new inhibitors of the androgen axis may be useful to potentiate the effect of AR antagonists currently used in the clinic to overcome resistance to castration
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Yoose, Cora. "African American and Afro-Caribbean American Men’s Prostate Health Knowledge and Beliefs." FIU Digital Commons, 2015. http://digitalcommons.fiu.edu/etd/2272.
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Approximately one in every seven American men will be diagnosed with prostate cancer during his lifetime. Men of African descent have higher incidence and mortality rates than others. Prostate cancer screening is important because the five-year survival rate is only 31% post-metastasis. The purpose of this study was to assess the likelihood of action for and factors influencing choice regarding prostate screenings. It was also to determine if a relationship existed between ethnicity (African American and Afro-Caribbean American men) and knowledge of prostate health, self-efficacy, perceived barriers to and belief regarding prostate screening. Data collection methods included a focus group (n = 8) among African American and Afro-Caribbean American men (M = 53.8, 10.3) and self-administered surveys (n = 113) among African American (n = 49, 45.4%) and Afro-Caribbean American (n = 38, 35.2%) men (M = 59.5, 16.4) from churches in South Florida using convenience sampling and the Health Belief Model (HBM) as a framework. Knowledge was assessed using a combined version of the Knowledge and Practice of Prostate Health Questionnaire and Prostate Cancer Screening Education (PROCASE) Knowledge Index. Self-efficacy was measured as decisional conflict reported from the Low Literacy Decisional Conflict Scale. Barriers were identified from a Perceived Barriers Survey. Beliefs were measured as spiritual well-being and evaluated using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, a modified version for non-illness (FACIT-Sp Non-Illness). Almost half of African American (47.9%) and nearly a third (29%) of Afro-Caribbean American participants were unaware of participation or did not participate in prostate-specific antigen (PSA) testing. Findings indicated prostate screening concerns, inadequate knowledge, past negative experiences, and cost may contribute to low prostate screening rates. Both ethnicities did not differ in knowledge of prostate health or self-efficacy for making an informed decision regarding prostate screening. Potential targets for outreach efforts among these ethnic groups could include faith-based medical partnerships to diminish health disparities. Future intervention studies would benefit from a focus on diverse cultures and ethnicities in different settings and culturally appropriate strategies for nurses and other health professionals to use when assisting patients with informed decision making regarding prostate cancer screening.
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Carter, Mary Frances. "Beliefs, Costs, and Policies Influencing African American Men's Decisions on PSA Screening." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4605.
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Despite the growing concerns about routine prostate-specific antigen (PSA) screening in men, little is known about the societal and economic impact of screening among the African American population. The purpose of this qualitative case study was to explore beliefs among African American men about PSA screening, funding for screening, and the role of the United States Preventive Service Task Force in addressing the problem. Guided by rational choice theory, data collection consisted of completion of a health beliefs survey, face-to-face interviews, field notes taken during interview, and interview audio recording. The population for the study included African American men residing in a large metropolitan Midwestern city, who are between the ages of 45 and 65, and who have not been diagnosed with prostate cancer disease. Data were analyzed using NVivo10-© to identify themes and patterns. Results from the study show that the decision to participate in prostate screening for African American men is hindered due to concerns about access, cost, and affordability. These three factors should be further evaluated in a larger setting for a greater understanding of their roles in more effective screening programs and policies. Insights gained from this study may positively impact future policy by providing a deeper understanding of the beliefs held by African American men on the issue of prostate cancer screening that may eventually lead to developing and successfully implementing policies that can be cost effective.
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Gibson, Brendan John Joseph, and brendan gibson@health gov au. "From Transfer to Transformation: Rethinking the Relationship between Research and Policy." The Australian National University. National Centre for Epidemiology and Population Health, 2004. http://thesis.anu.edu.au./public/adt-ANU20040528.165124.
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The most common and enduring explanation for the way research is used (or abused or not used) in policy is the two communities theory. According to this theory, the problematic relationship between research and policy is caused by the different cultures inhabited by policy makers and researchers. The most common and enduring types of strategies that are put forward to increase research use in policy involve bridging or linking these two communities. This study challenges this way of thinking about the relationship between research and policy. Four case studies of national public health policy in Australiabreast cancer screening, prostate cancer screening, needle and syringe programs in the community, and needle and syringe programs in prisonsare used to present the context, events, processes, research, and actors involved in policy making. Three theories are deployed to explore the relationship between research and policy in each of the cases individually and across the cases as a whole. These theories bring different determinants and dynamics of the relationship to light and each is at least partially successful in increasing our understanding of the relationship between research and policy. The Advocacy Coalition Framework (ACF) understands the relationship in terms of a power struggle between competing coalitions that use research as a political resource in the policy process. The Policy Making Organisation Framework (PMOF) understands the relationship in terms of institutional and political factors that determine the way data is selected or rejected from the policy process. The Governmentality Framework (GF) understands the relationship in terms of the Foucauldian construct of power/knowledge that is created through discourse, regimes of truth and regimes of practices found in public health policy and research. This study has found that in three of the four case studies, public health policy was strongly influenced by research, the exception being NSP in prisons. In all cases, however, it is not possible to construct a robust and coherent account of the policy process or the policy outcome without considering the multifaceted role of research. When these theories are explored at a more fundamental level they support the argument that when research influences policy it is transformed into knowledge-for-policy by being invested with meaning and power. This process of transformation occurs through social and political action that mobilises ideal structures (such as harm minimisation and the World Health Organisations principles for evaluating screening programs) and material structures (such as medical journals and government advisory bodies) to resolve meta-policy problems (such as how to define complex public health problems in a way that makes them amenable to empirical research and practical action). This study provides good evidence that the notion of research transfer between two communities is a flawed way of understanding the researchpolicy relationship. Rethinking the relationship between research and policy involves building an enhanced theoretical repertoire for understanding this complex social interaction. This step is essential to the success of future efforts to make public health policy that is effective, just and emancipatory. This study makes a contribution to this task.
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Emele, Chikezie Daniel. "Examining health information source-selection, access, and use by men in rural areas of south-east Nigeria : mapping culturally appropriate health information provision." Thesis, Robert Gordon University, 2018. http://hdl.handle.net/10059/3113.
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The provision of accessible and usable health information is vital for making informed health decisions and embracing active and preventative health behaviours (such as reporting of symptoms, early screening and seeking medical help). Previous research in this area has focused on health-related information seeking behaviour and use of information by citizens of developed countries and within urban geographical locations. The common thread from existing research within the context of developing countries, particularly in Africa, is the need for health information to be provided in a way that considers the diverse cultural perspectives and characteristics of rural communities; regarding both the content and the design of health information services. Considering the cultural aspects is important. However, there is little or no work that has considered the provision of health information that is culturally and locally appropriate. This research aims to investigate the health information behaviour of men in rural Nigeria and explore the local sociocultural aspects that relate to the provision of prostate cancer information. The research extends the theoretical framework of Johnson’s Comprehensive Information Seeking model to include health-related information design heuristics that address aspects of cultural appropriateness within rural contexts and particularly within the setting of developing countries. A qualitative approach was adopted as it was considered appropriate for this research. The research utilised 35 semi-structured interviews and 5 focus group discussions with men (aged 35 or over) residing in rural areas of Nigeria. Participants shared their experiences with health-related information seeking and use, the barriers they encounter and the role that culture and rurality play in that process. Findings show that within rural Nigeria, culture and religion play a vital role in shaping the health information behaviour of men. There is a lack of knowledge about important health issues that affect men, such as prostate cancer. The study documents that internal, interpersonal sources and oral-based communication methods are preferred in rural communities. Based on the findings, a revised model of health information behaviour that extends the existing scholarly perspectives to include cultural context and information use component in rural communities in Nigeria was presented.
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Faria, Eliney Ferreira. "O estudo do impacto do rastreamento no estadiamento clínico dos portadores de câncer de próstata." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5155/tde-31082010-184822/.
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INTRODUÇÃO: O câncer de próstata (CAP) é a neoplasia mais comum em homens (excluindo câncer de pele não-melanoma) com mais de 190.000 casos novos esperados em 2010 nos Estados Unidos sendo que mais de 27.000 morrerão em desta doença. No Brasil, segundo o Instituto Nacional do Câncer, a estimativa é em torno de 50 mil casos novos de CAP para 2010. OBJETIVOS: Avaliar a experiência do rastreamento para CAP realizado pelo Hospital de Câncer de Barretos através de uma Unidade Móvel de Prevenção de Câncer (UMPC), e verificar qual o impacto deste rastreamento no estádio clínico em comparação com pacientes diagnosticados e/ou encaminhados ao HCB. MATERIAL E MÉTODO: De janeiro de 2004 a dezembro de 2007, realizou-se rastreamento de CAP em voluntários acima de 45 anos através da UMPC em localidades com difícil acesso à saúde. Foram convocados homens com pelo menos um destes três critérios a seguir: a) PSA sérico = 4,0 ng/ml, b) toque retal suspeito, ou c) PSA entre 2,5 e 4,0 ng/ml com relação PSA livre/total (rPSAl/t) = 15%. Para se avaliar o impacto do rastreamento no estádio clínico ao diagnóstico dos pacientes portadores de CAP, analisaram-se os dois grupos. O grupo I inclui casos de CAP diagnosticados de janeiro de 2005 a dezembro de 2007, através da UMPC. O grupo II inclui pacientes com CAP atendidos pelo HCB no mesmo período, que não haviam feito diagnóstico pela UMPC; e foram encaminhados ao HCB por médicos de especialidades diversas, devido a PSA elevado e/ou TR suspeito realizado na xvii localidade de origem ou a diagnóstico histológico confirmado de CAP. A revisão de prontuários para os grupos realizou-se no serviço de arquivo médico (SAME) e utilizou-se a mesma ficha de coleta de dados, priorizando TNM, PSA e escore de Gleason. Os grupos I e II foram comparados com relação a estadiamento (TNM), PSA e escore de Gleason e feita análise estatística destes dados. RESULTADOS: De janeiro de 2004 a dezembro de 2007, foram rastreados 17.571 homens de 231 cidades brasileiras. Destes, 71,4% nunca tinham feito toque retal e 70,9% nunca fizeram PSA anteriormente. Foram biopsiados 1.647, 904 devido a PSA = 4,0 ng/ml (54,9%), 324 devido a TR suspeito (19,7%), 117 devido a alteração simultânea de ambos os anteriores (7,1%) e 302 quando a relação foi = 15% com PSA entre 2,5 e 3,9 ng/ml (18,3%). Foram diagnosticados 652 casos de CAP (3,7%). Destes, 609 (93,4%) clinicamente localizados (T1-2) e 43 (6,6%) foram T3-4. Na avaliação radiológica e cintilográfica, 26 (4%) eram N1 e 18 (2,8%) eram M1. Comparando-se os grupos, observou-se valores de PSA mais baixos (p<0.001), estadiamento clínico mais favorável (p<0,001), e escore de Gleason com menor grau para o grupo I (p<0.001). CONCLUSÕES: A UMPC mostrou ser uma ferramenta importante para se rastrear populações com acesso médico precário em um país com grande extensão territorial e desigualdades socioeconômicas como o Brasil. O rastreamento mostrou melhoria estatisticamente significativa do estadiamento clínico ao diagnóstico em relação aos pacientes diagnosticados na rotina do Hospital de Câncer de BarretosBACKGROUND: Prostate cancer (PC) is as the most common neoplasm in men (excluding skin cancer non-melanoma) with more than 190,000 new cases expected in 2009 in the United States and more than 27,000 will die from the disease. In Brazil, according to the Brazilian National Cancer Institute, the estimate is almost 50.000 new cases for 2009. OBJECTIVES: To assess the experience of PC screening conducted by the Barretos Cancer Hospital (BCH) through a mobile cancer prevention unit (MCPU), and to verify the impact of screening on clinical stage compared with patients diagnosed and/or referred to the HCB. MATERIAL AND METHODS: From January 2004 to December 2007, a PC screening was applied to volunteers over 45 years old through a MCPU which reached Brazilian locations with difficult access to health. Men with at least one of the following three criteria were called for further evaluation: a) serum PSA level = 4.0 ng/ml, b) suspicious digital rectal examination (DRE), or c) PSA level of 2.5-4.0 ng/mL and a percent-free PSA (%fPSA) level =15%. To assess the impact of screening on clinical stage at diagnosis of patients screened and non-screened, the men were analyzed in two groups. The PC cases screened from January 2005 to December 2007 through the MCPU constituted Group I. Comprising group II, there was patients with PC treated by BCH in the same period, who hadnt been diagnosed by the MCPU. These patients in group II were referred to hospital by xix physicians of several specialties, mainly due to elevated serum PSA and/either suspicion DRE or histological diagnosis of PC. The data for both groups was held in the medical records and used the same form, prioritizing the data for the TNM staging, PSA and Gleason score. Groups I and II were compared with concern to staging (TNM), PSA and Gleason score and the statistical analysis of these data was performed. RESULTS: From January 2004 to December 2007, 17,571 men from 231 Brazilian cities were screened. Among them 71.4% had never been submitted to DRE examination and 70.9% never had a PSA test. 1,647 men were submitted to biopsy, 904 due to PSA = 4.0 ng/ml (54.9%), 324 due to suspicion DRE (19.7%), 117 due the simultaneous of both earlier (7.1%) and 302 with %fPSA level =15% and PSA between 2.5-3.9 ng/ml (18.3%). It were diagnosed 652 cases of PC (3.7%). Among them, 609 (93.4%) were clinically localized (T1- 2) and 43 (6.6%) were T3-4. In the image exams, 26 (4%) were N1 and 18 (2.8%) were M1. The comparison between both groups showed lower serum PSA values (p <0.001), more favorable clinical stage (p <0.001) and Gleason score in group I (p <0.001). CONCLUSIONS: The MCPU has proved to be an important tool in screening populations with poor medical access in a country with large territory and socioeconomic inequalities such as Brazil. The screening showed statistically significant improvement of clinical staging at diagnosis compared to patients diagnosed in the routine of the BCH
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Mori, Rafael Ribeiro. "Comparação dos critérios de agressividade do câncer de próstata diagnosticado por rastreamento no Brasil, em idades superior e inferior a 70 anos." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17137/tde-06062017-163928/.
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Introdução: O câncer de próstata é a neoplasia maligna não-cutânea mais frequente nos homens brasileiros. Seu rastreamento é tema controverso na literatura, e a maioria das entidades médicas não recomenda sua realização a partir dos 70 anos. Não existem estudos sobre suas características nessa faixa etária da população brasileira, que não é submetida a rastreamento ativo sistemático. Objetivos: Avaliar a prevalência e critérios de agressividade do câncer de próstata diagnosticado por rastreamento ativo em homens com idade inferior e superior a 70 anos no Brasil. Pacientes e métodos: Estudo transversal retrospectivo incluindo 17.571 voluntários no Brasil, submetidos a rastreamento ativo através de toque retal e dosagem sérica do antígeno prostático específico (PSA), entre janeiro de 2004 e dezembro de 2007. Os critérios de indicação para a biópsia foram: PSA>4,0ng/ml, ou PSA entre 2,5 e 4,0ng/ml com relação PSA livre/total <=15%, ou toque retal suspeito. Todos os homens rastreados foram divididos em dois grupos etários: grupo A, entre 45 e 69 anos; grupo B, acima de 70 anos. Os grupos foram comparados com relação a prevalência e critérios de agressividade da doença (valor do PSA sérico, escore de Gleason da biópsia e estadiamento clínico TNM). Resultados e discussão: A prevalência do câncer de próstata na nossa amostra foi de 3,71%. O grupo dos homens com mais de 70 anos apresentou prevalência da doença 2,9 vezes maior (RP 2,90; p <0,001), o valor médio de PSA foi mais elevado nos acometidos (17,28ng/ml no grupo B versus 9,54ng/ml no grupo A), assim como ocorreu maior chance de haver portadores de câncer com PSA acima de 10,0ng/ml (OR 2,63; p=0,003). No grupo de homens com mais de 70 anos também houve uma prevalência 3,59 vezes maior do padrão histológico mais agressivo (Gleason 8-10: RP 3,59; p<0,001) e maior prevalência de doença metastática (RP 4,95; p<0,05). Conclusão: O rastreamento do câncer de próstata nos homens com idade acima de 70 anos e expectativa de vida superior a 10 anos pode ser relevante no Brasil. Neste grupo etário detectamos uma maior prevalência desta doença, quando comparado ao grupo de idade entre 45 e 69 anos. Nosso estudo também demonstrou que o grupo de homens com mais de 70 anos possui maior probabilidade de apresentar doença de alto risco ao diagnóstico (PSA sérico mais elevado e em faixas de maior risco; escore de Gleason 8 a 10 e disseminação metastática à distância mais frequentes)Background: Prostate cancer (PC) is the leading non-cutaneous malignancy among Brazilian men. PC may present as an indolent or aggressive life-threatening disease. There is no consensus in the literature regarding PC screening, and most medical organizations do not recommend it over the age of 70 years old. There are no studies in the literature addressing this topic in the Brazilian population. Objectives: To compare the prevalence and the aggressiveness of prostate cancer diagnosed, by active screening, in men under and over 70 years. Patients and methods: We performed a retrospective cross-sectional study including 17,571 volunteers. Screening was performed by digital rectal examination and prostatespecific antigen (PSA) measurement. Individuals who met the criteria for PC suspicion (PSA>4.0ng/ml, or PSA 2.5-4.0ng/ml with free/total PSA ratio <=15%, or suspicious digital rectal examination) underwent prostate biopsy. Those diagnosed with cancer were staged. The screened men were stratified by age in two groups: group A, between 45 and 69 years old, and group B, over 70 years old. The groups were compared regarding PC prevalence and its aggressiveness criteria (seric PSA value, Gleason score from biopsy and TNM staging). Results and discussion: The prevalence of prostate cancer was 3.71% in all population. The group of men over 70 years old had disease prevalence 2.9 times higher (RP 2.90; p<0.001); higher mean PSA value in men diagnosed with prostate cancer (17.28ng/ml vs. 9.54ng/ml); and greater likelihood to present PC when PSA level was above 10.0ng/ml (OR 2.63; p=0.003), when compared with men between 45 and 69 years old. The group of men aged over 70 years also presented a prevalence of histologic aggressive disease 3.59 times higher (Gleason 8-10: RP 3.59, p<0.001) and greater prevalence of metastatic disease (RP 4,95; p<0,05). Conclusion: Our study reveals that men over 70 years old presented a higher prevalence of prostate cancer and a higher probability to present high-risk disease at diagnosis (higher PSA; Gleason score 8-10 and metastatic disease more frequent), when compared to men aged 45-69 years. Screening for prostate cancer in men aged over 70 years and life expectancy over 10 years may be relevant in Brazil
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Martins, Bruna Mónica Carreira. "Os rastreios e o cancro." Master's thesis, [s.n.], 2014. http://hdl.handle.net/10284/4414.
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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências FarmacêuticasAs doenças oncológicas são um dos principais problemas a nível mundial e, em Portugal, representam a segunda causa de morte. Os rastreios oncológicos têm como objetivo a deteção precoce de cancro permitindo a redução da mortalidade e, muitas vezes, da incidência. Não existe um rastreio único para todos os tipos de cancro, mas sim exames específicos para os diferentes tipos. A sua realização deve ter como base uma ponderação dos riscos e benefícios em conjunto com o médico. Em Portugal, atualmente, apenas existe consenso relativamente à utilidade da realização dos programas de rastreio do cancro do colo do útero, do cancro da mama e do cancro colo-retal. Este trabalho tem como objetivo a revisão dos diferentes rastreios oncológicos realizados em Portugal no que respeita aos tipos de cancro pertencentes ao Plano Oncológico Nacional 2001-2005. Dada a sua importância, também será referido o cancro da próstata, o cancro da pele e os marcadores tumorais. Cancer is a worldwide major problem, being the second cause of death in Portugal. Cancer screenings are aimed at early cancer detection allowing the reduction of mortality and also often incidence. There is no single screen for all types of cancer, but specific tests for the various types. Its achievement should be based regarding the risks according to the medical opinion. In Portugal, currently, there is only consensus regarding the usefulness of the screening programs for cervical cancer, breast cancer and colorectal cancer. The current study aims to review the different cancer screenings performed in Portugal according the National Oncological Plan 2001-2005. Due to its importance, it will be also exposed prostate cancer, skin cancer and tumor markers.
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Baptista, Ana Sofia Torres. "Shared Decision-Making in Prostate Cancer Screening." Tese, 2020. https://hdl.handle.net/10216/127018.
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Baptista, Ana Sofia Torres. "Shared Decision-Making in Prostate Cancer Screening." Doctoral thesis, 2020. https://hdl.handle.net/10216/127018.
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Yu, Kevin Kuo-Han. "Beyond prostate-specific antigen: alternatives for prostate neoplasm screening." Thesis, 2014. https://hdl.handle.net/2144/15307.
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Prostate adenocarcinoma (PCa) is one of the most prevalent cancers in the world. Second only to lung cancer, the key to its successful treatment is in its early detection. With the introduction of prostate-specific antigen in the early 1990s, a screening test involving measuring levels of this protein was developed to detect PCa in asymptomatic individuals. This test is also known as the PSA test. PCa-specific mortalities have been in decline since the test's introduction.
Despite this decline, recent studies have called the efficacy of the PSA test into question. Two large randomized controlled trials conducted in the US and Europe reveal contradicting results as to PSA's accuracy and usefulness. Concerns of overdiagnosis and overtreatment as the result of using PSA screening has led to many national organizations recommending caution or even recommending against its use. Through a thorough review of a large collection of current PCa literature, this study reviews the flaws of using PSA to screen for PCa and investigates alternative approaches currently being pursued through active research to make PCa early detection more accurate. These approaches include improving the accuracy of the PSA screen using PSA-derived testing methods, using PCa-induced epigenetic modifications as a new target for PCa screening, and using urine biomarkers. All of these methods were compared using area under the curve (AUC) values obtained via receiver operating characteristic analysis.
Each method has its own flaws but by comparing each of the different approaches, I was able to conclude that out of the currently available screening methods, screening for Engrailed-2 protein in urine is the most promising screening method with the highest AUC values compared to the other methods. Although this method has been introduced in the UK, it has not been introduced in the US yet. Epigenetic screening methods hold the most promise for accurate PCa screening in the future as it confers the highest accuracy in detecting PCa. However, as it hasn't been shown that epigenetic modifications can be easily obtained in the urine or blood serum for easy and accurate screening, I believe more work has to be done in order for it to be successful in being applied as a screening test. By determining the most promising screening type, we can focus resources and efforts towards finding a way to detect PCa early, allowing for successful treatment.
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Liu, Kuei-chun, and 劉貴群. "Anti-cancer drug screening by using prostate cancer cells PC-3." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/67xms7.
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碩士國立中山大學
生物科學系研究所
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Prostate cancer is one of the most malignant tumors in the world. It has been demonstrated that prostate cancer could metastasis to bones, bladder, rectum, and lymph nodes. It is the most common type of cancer found in adult males, and the mortality is elevated. From screening our chemical library of 398 small molecule compounds, we have found that TCH derivatives showed anti-proliferative activities using prostate cancer cell line PC-3. The results of MTT assay allow us to identify TCH-1038w as potential candidat for developing anticancer drug. Morphological investigation on PC-3 cells after TCH-1038w treatment showed that PC-3 cells rounded up and combined with cell shrinkage, abridge, membrane blebbing. Our results of flowcytometric analysis showed that TCH-1038w can cause the percentage increase of sub-G1 that indicated the DNA fragmention in TCH treated PC-3 cells. By DAPI staining , we observed that TCH-1038w can induce the DNA fragmentation in PC-3 cells. Moreover by immunoblotting analysis, we have demonstrated that procaspase 3 and PARP were cleavaged and activated after TCH treatment. These results indicsted TCH drugs can induce caspase activation, DNA fragmentation, and consequently cause apoptotic cell death. Together, TCH-1038w may serve as a potential chemotherapy candidate for treating prosate cancer in the future.
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McKinley, Gena MaLea Mullen Patricia D. Volk Robert J. Stock Thomas H. "Patient perceptions of balance in prostate cancer screening decision aids." 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1445112.
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Chen, Hsiao-Rong. "A network based approach to drug repositioning identifies candidates for breast cancer and prostate cancer." Thesis, 2016. https://hdl.handle.net/2144/19066.
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The high cost and the long time required to bring drugs into commerce is driving efforts to repurpose FDA approved drugs—to find new uses for which they weren’t intended, and to thereby reduce the overall cost of commercialization, and shorten the lag between drug discovery and availability. In comparison to traditional drug repositioning, which relies on serendipitous clinical discoveries, computational methods can systemize the drug search and facilitate the drug development timeline even further. In this dissertation, I report on the development, testing and application of a promising new approach to drug repositioning.
This novel computational drug repositioning method is based on mining a human functional linkage network for inversely correlated modules of drug and disease gene targets. Functional linkage network is an evidence-weighted network that provides a quantitative measure of the degree of functional association among any set of human genes. The method takes account of multiple information sources, including gene mutation, gene expression, and functional connectivity and proximity of within module genes.
The method was used to identify candidates for treating breast and prostate cancer. We found that (i) the recall rate for FDA approved drugs for breast and (prostate) cancer is 20/20 (10/11), while the rates for drugs in clinical trials were 131/154 and (82/106); (ii) the Area Under the ROC Curve performance substantially exceeds that of two comparable previously published methods; (iii) preliminary in vitro studies indicate that 5/5 identified breast cancer candidates have therapeutic indices superior to that of Doxorubicin in Luminal-A (MCF7) and Triple-Negative (SUM149) breast cancer cell lines. I briefly discuss the biological plausibility of the candidates at a molecular level in the context of the biological processes that they mediate.
In conclusion, our method provides a unique way of prioritizing disease causal genes and identifying drug candidates for repositioning, based on innovative computational method. The method appears to offer promise for the identification of multi-targeted drug candidates that can correct aberrant cellular functions. In particular the computational performance exceeded that of existing computational methods. The approach has the potential to provide a more efficient drug discovery pipeline.
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Whaley, Quandra M. "The relationship between perceived barriers and prostate cancer screening practices among African men." 2006. http://etd.lib.fsu.edu/theses/available/etd-11092006-161116.
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Thesis (Ph. D.)--Florida State University, 2006.Advisor: Laurie Grubbs, Florida State University, College of Nursing. Title and description from dissertation home page (viewed Jan. 22, 2007). Document formatted into pages; contains vi, 60 pages. Includes bibliographical references.
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Monawar, Hosain G. M. Strom Sara S. Sanderson Maureen Du Xianglin Chan Wenyaw. "Racial/ethnic differences in factors influencing screening and treatment among prostate cancer patients /." 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3315543.
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Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2008.Source: Dissertation Abstracts International, Volume: 69-07, Section: B, page: 4121. Advisers: Sara Strom; Maureen Sanderson. Includes bibliographical references.