2.Risk-based screening programmes for cancer diagnosis: A systematic review with narrative synthesis.
Yong Yi TAN ; Sara TASNIM ; Mohammad Fahmy Bin FADZIL ; Xin Rong NG ; Sabrina Kw WONG ; Jo-Anne Elizabeth MANSKI-NANKERVIS ; Joseph Jao-Yiu SUNG ; Joanne NGEOW
Annals of the Academy of Medicine, Singapore 2025;54(10):644-663
INTRODUCTION:
Risk-based screening (RBS) has emerged as a promising alternative to age-based cancer screening. However, evidence regarding real-world implementation outcomes remains fragmented. Thus, a systematic review was conducted to evaluate the implementation metho-dologies and outcomes of RBS programmes across different cancer types.
METHODS:
MEDLINE, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials and Scopus were systematically searched from their respective dates of inception up to 8 July 2024. Prospective and rando-mised controlled trials (RCTs), which implement the RBS of cancer in an asymptomatic population, or studies retrospectively evaluating the outcomes of the same were included. Geographic distribution, population characteristics, RBS methodology, diagnostic accuracy and clinical outcomes were narratively synthesised.
RESULTS:
Among the 33 included studies (i.e. 21 prospective cohort, 8 RCTs, 3 retrospective and 1 non-RCT), sample sizes ranged from 102 to 1,429,890 participants. Most RBS trials were conducted in China (n=7, 21.2%), followed by the Netherlands (n=4, 12.1%) then the US, Australia and Sweden (n=3, 9.8%). Studies predominantly examined colorectal (27.3%), breast (21.2%) and prostate cancer (18.2%). Three main stratification approaches emerged: algorithmic (48.5%), validated risk models (39.4%) and physician assessment (9.1%). Implementation outcomes showed higher uptake in moderate-risk (75.4%) compared to high-risk (71.3%) and low-risk groups (67.9%). Five studies demonstrated cost-effectiveness with increased quality-adjusted life years, while 12 studies showed superior or non-inferior cancer detection rates compared to traditional screening.
CONCLUSION
The RBS of cancer has the potential to optimise healthcare resource allocation while minimising harm and increasing receptiveness for patients. More work is needed to evaluate long-term outcomes prior to the scaling of RBS programmes.
Humans
;
Early Detection of Cancer/methods*
;
Neoplasms/diagnosis*
;
Risk Assessment
;
Mass Screening/methods*
5.Clinical application of next-generation sequencing in early screening of neonatal diseases.
Li-Hong JIANG ; Ben-Qing WU ; Zheng-Yan ZHAO
Chinese Journal of Contemporary Pediatrics 2025;27(4):432-437
OBJECTIVES:
To evaluate the clinical value of next-generation sequencing (NGS) in neonatal disease screening, particularly its advantages when combined with tandem mass spectrometry (MS/MS).
METHODS:
A prospective study was conducted involving blood samples from 1 999 neonates born at the Shenzhen Guangming District People's Hospital, between May and August 2021. All samples were initially screened using MS/MS and fluorescence immunoassay, followed by NGS to detect high-frequency variation sites in 135 related pathogenic genes. Suspected positive variants were validated using Sanger sequencing or multiplex ligation-dependent probe amplification in family studies.
RESULTS:
No confirmed positive cases were found in the MS/MS analysis of the 1 999 neonates. Genetic screening identified 58 positive cases (2.90%), 732 carriers of pathogenic genes (36.62%), and 1 209 negative cases (60.48%). One case of neonatal intrahepatic cholestasis was diagnosed (0.05%, 1/1 999). Fluorescence immunoassay identified 39 cases of glucose-6-phosphate dehydrogenase (G6PD) deficiency (1.95%, 39/1 999), while genetic screening identified 43 cases of G6PD deficiency (2.15%, 43/1 999). The fluorescence immunoassay also detected 6 cases of hyperthyrotropinemia (0.30%, 6/1 999), all of whom carried DUOX2 gene variants. The top ten pathogenic gene carrier rates were G6PD (12.8%), DUOX2 (8.7%), HBB (8.2%), ATP7B (6.6%), GJB2 (5.7%), SLC26A4 (5.6%), PAH (5.6%), ACADSB (4.6%), SLC25A13 (4.2%), and SLC22A5 (4.1%).
CONCLUSIONS
NGS can serve as an effective complement to MS/MS, significantly improving the detection rate of inherited metabolic disorders in neonates. When combined with family validation, it enables precise diagnosis, particularly demonstrating complementary advantages in screening for monogenic diseases such as G6PD deficiency.
Humans
;
Infant, Newborn
;
High-Throughput Nucleotide Sequencing/methods*
;
Neonatal Screening/methods*
;
Tandem Mass Spectrometry
;
Prospective Studies
;
Female
;
Male
;
Infant, Newborn, Diseases/diagnosis*
;
Genetic Testing
6.Research progress and optimization strategies for early screening of type 1 diabetes.
Chinese Journal of Contemporary Pediatrics 2025;27(11):1310-1316
The prevalence of type 1 diabetes (T1DM) is increasing annually, and its complications seriously impair the quality of life of affected children. Early screening for T1DM helps reduce the occurrence of diabetic ketoacidosis, protect β-cell function, and delay disease onset in high-risk populations. This article summarizes current domestic and international screening technologies for T1DM. Screening methods remain centered on detection of diabetes-related antibodies and glycometabolic markers, while factors related to disease pathogenesis hold promise as sensitive screening markers. Expanding T1DM screening in China is expected to improve early diagnosis and treatment.
Diabetes Mellitus, Type 1/diagnosis*
;
Humans
;
Early Diagnosis
;
Autoantibodies/blood*
;
Mass Screening/methods*
7.Validation of the Japanese version of MemScreen: a rapid screening tool for mild cognitive impairment.
Ai IKEDA ; Hadrien CHARVAT ; Takeshi TANIGAWA ; Nobuto SHIBATA ; Koutatsu MARUYAMA ; Kiyohide TOMOOKA ; Yukari ASAI ; Juna KAMIJIMA ; Qisheng LI ; Noemi ENDO ; Saori MIYAZAKI ; Archana SINGH-MANOUX ; Julien DUMURGIER
Environmental Health and Preventive Medicine 2025;30():96-96
This study was to examine the validity of the Japanese version of MemScreen (MemScreen-J), a touchscreen MCI screening test. 20 patients with MCI aged 65-90 years at the Juntendo Tokyo Koto Geriatric Medical Center were recruited as cases in December 2023. Non-cases were recruited from local residents in Toon City, Ehime Prefecture in February 2024 and 40 residents, without a medical history of MCI, aged 58-84 years were included in the present study. MemScreen-J test, a self-administered screening test in the form of a digital application, downloadable on a tablet, was administered to participants to assess their cognitive function. Defining the group at high risk of MCI based on a MemScreen-J test score of 28 or lower achieved the best Youden index in the study sample, with a sensitivity of 0.75 and a specificity of 0.98. MemScreen-J appeared to be a valid screening tool among persons at the prodromal stage of dementia, given reasonably high accuracy in detection of MCI. This innovative neuropsychological test could be the first step in a diagnostic approach to cognitive complaints in a community, identifying persons at the preclinical stage of dementia.
Humans
;
Cognitive Dysfunction/diagnosis*
;
Aged
;
Aged, 80 and over
;
Male
;
Female
;
Japan
;
Neuropsychological Tests
;
Middle Aged
;
Mass Screening/methods*
;
Sensitivity and Specificity
;
Reproducibility of Results
;
East Asian People
8.Feasibility of MAGIC pure tone screening in children aged 3 to 6 years.
Qingjia CUI ; Fang GE ; Renjie HAN ; Jin YAN ; Cheng WEN ; Yue LI ; Xin DAI ; Lihui HUANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(1):14-18
Objective:To explore the feasibility of the multiple-choice auditory graphical interactive check(MAGIC) screening module in childhood hearing screening in children aged 3 to 6 years. Methods:A hearing screening was conducted on 366 children(732 ears) aged between 3 and 6 years. The screening methods included MAGIC, DPOAE, and acoustic immittance.The cooperation, screening time, pass rate, and correlation of the three screening methods were compared. Results:There was a statistically significant difference in the degree of cooperation among the three screeningmethods(P=0.004).The MAGIC pure tone screening method was 98.6%, the screening DPOAE was 99.5%,and the acoustic immittance screening was 100%. For the screening duration, the MAGIC pure tone screening method was(116.3±59.1)s, the screening DPOAE was(27.2±19.7)s, and the acoustic impedance screening was(24.6±14.6)s. There was a significant statistical significance differences among the three or two groups(P<0.01). The passing rates of MAGIC pure tone screening,screening DPOAE and acoustic immittance screening were 64.7%, 65.4%, and 69.3%, respectively, and there was no significant statistical difference among the three or two groups(P>0.05). There was no significant difference between MAGIC pure tone screening method and screening DPOAE(P=0.827>0.05), and acoustic impedance(P=0.653>0.05), while the difference between screening DPOAE and acoustic impedance was statistically significant(P<0.01). Conclusion:MAGIC pure sound screening method has good feasibility, can comprehensively reflect the hearing level of screened children, and can be promoted for hearing screening in children aged between 3 and 6 years.
Humans
;
Child, Preschool
;
Child
;
Female
;
Male
;
Audiometry, Pure-Tone
;
Mass Screening/methods*
;
Feasibility Studies
;
Acoustic Impedance Tests/methods*
;
Hearing Loss/diagnosis*
;
Hearing Tests/methods*
9.Expert consensus on endocrine hypertension screening (2025 version).
Chinese Journal of Internal Medicine 2025;64(4):288-301
Endocrine hypertension is a common form of secondary hypertension. Affected patients often present without specific symptoms or signs, making the condition easy to overlook or misdiagnose. Early screening can greatly enhance the level of diagnosis while prompt treatment can improve the prognosis of patients. Based on clinical evidence and practice, the Chinese Endocrinologist Association and the Chinese Endocrine Hypertension Collaboration Group reached this consensus after extensive discussions on target populations, screening methods, interpretation of screening results, and other issues related to endocrine hypertension.
Humans
;
Hypertension/diagnosis*
;
Consensus
;
Mass Screening
10.Tandem mass spectrometry screening and genetic analysis of neonates with Urea cycle disorders.
Wei ZHOU ; Huizhong LI ; Li YANG ; Fang SHAO ; Maosheng GU
Chinese Journal of Medical Genetics 2025;42(1):26-33
OBJECTIVE:
To explore the results of four types of Urea cycle disorders (UCDs) in newborns from the Xuzhou region, assess the efficacy of newborn screening by tandem mass spectrometry (MS/MS), and analyze their genetic characteristics.
METHODS:
A retrospective analysis was performed using tandem mass spectrometry to screen for inherited metabolic disorders in 691 712 newborns at the Maternal and Child Health Care Hospital of Xuzhou from November 2015 to December 2023. Ten children (cases 1-10) were diagnosed with Ornithine transcarbamylase deficiency (OTCD), Carbamoylphosphate synthase 1 deficiency (CPS1D), Arginase deficiency (ARGD), and Argininosuccinate synthase deficiency (ASSD) based on MS/MS and genetic testing. This study was approved by the Medical Ethics Committee of Xuzhou Maternity and Child Health Care Hospital (Ethics No.XZFY2024-051K-01J).
RESULTS:
A total of 691 712 neonates were screened for UCDs using MS/MS, which identified 1 237, 1 237, 510, and 1 009 initial positive cases for OTCD, CPS1D, ASSD, and ARGD, respectively. After genetic testing, 1 case of OTCD, 1 case of CPS1D, 1 case of ASSD, and 7 cases of ARGD were confirmed. The overall positive predictive value for these four UCDs was 0.362%. Among the 10 diagnosed UCD cases, four novel variants were identified, which included OTC: c.1024C>A (p.L342M) and ASS1: c.826A>G (p.M276V), c.695C>T (p.P232L) and c.694C>T (p.P232S). Bioinformatic analysis has rated these as variants of uncertain clinical significance or likely pathogenic based on guidelines from the American College of Medical Genetics and Genomics (ACMG).
CONCLUSION
The incidence of four UCDs in neonates from the Xuzhou area is relatively low, and there is a correlation between genetic variants and clinical phenotypes. For novel variants with uncertain clinical significance or suspected pathogenicity, their pathogenicity should be clarified in conjunction with clinical and biochemical indicators. The four novel pathogenic variants of UCDs identified in this study have enriched the mutational spectrum of UCDs-associated genes in the Xuzhou region.
Humans
;
Infant, Newborn
;
Tandem Mass Spectrometry/methods*
;
Urea Cycle Disorders, Inborn/diagnosis*
;
Neonatal Screening/methods*
;
Genetic Testing/methods*
;
Female
;
Retrospective Studies
;
Male
;
Ornithine Carbamoyltransferase Deficiency Disease/diagnosis*
;
Mutation
;
Carbamoyl-Phosphate Synthase (Ammonia)/genetics*
;
Ornithine Carbamoyltransferase/genetics*


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