All-cause mortality as the primary endpoint for the GRAIL/National Health Service England multi-cancer screening trial

2021 ◽  
pp. 096914132110596
Author(s):  
David Carr ◽  
David Kent ◽  
H. Gilbert Welch
Keyword(s):  
Cancer Screening ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Large Fraction ◽  
Evaluation Standard ◽  
Cancer Screening Trial ◽  
All Cause Mortality ◽  
Service Collaboration ◽  
Healthy Participants

A randomized trial of the GRAIL GalleriTM multi-cancer screening test is being planned for the National Health Service in England, and will have 140,000 healthy participants aged 50–79: 70,000 exposed to screening and 70,000 unexposed. The test reportedly detects 50 different cancers and is expected to reduce all-cancer mortality by approximately 25%. Given this effect size—and that cancer deaths constitute a large fraction of all deaths—the trial is sufficiently large to test the effect on all-cause mortality. Because most patients believe cancer screening “saves lives”, the GRAIL/National Health Service collaboration could set the evaluation standard for multi-cancer screening.

scholarly journals Temporal changes in breast cancer screening coverage provided under the Brazilian National Health Service between 2008 and 2017

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Danielle Cristina Netto Rodrigues ◽  
Ruffo Freitas-Junior ◽  
Rosemar Macedo Sousa Rahal ◽  
Rosangela da Silveira Corrêa ◽  
Pollyana Alves Gouveia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
National Health Service ◽  
Health Service ◽  
Breast Cancer Screening ◽  
National Health ◽  
Temporal Changes ◽  
Screening Coverage

Colonoscopic perforations in the English National Health Service Bowel Cancer Screening Programme

Endoscopy ◽  
2018 ◽  
Vol 50 (09) ◽  
pp. 861-870 ◽  
Author(s):  
Edmund Derbyshire ◽  
Pali Hungin ◽  
Claire Nickerson ◽  
Matthew Rutter
Keyword(s):  
Cancer Screening ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Screening Programme ◽  
Bowel Cancer ◽  
Cancer Screening Programme ◽  
Bowel Cancer Screening ◽  
English National Health ◽  
English National Health Service

Abstract Background Perforation is the most serious adverse event associated with colonoscopy. In this study of data from the English National Health Service Bowel Cancer Screening Programme, we aimed to describe the presentation and management of perforations, and to determine factors associated with poorer outcomes post-perforation. Methods The medical records of patients with a perforation following the national screening colonoscopy were retrospectively examined. All colonoscopies performed from 02/08/2006 to 13/03/2014 were studied. Bowel Cancer Screening Centres across England were contacted and asked to complete a detailed dataset relating to perforation presentation, management, and outcome. Results 263 129 colonoscopies were analyzed, and the rate of perforation was 0.06 %. Complete data were reviewed for 117 perforations: 70.1 % of perforations (82/117) occurred during therapeutic colonoscopies; 54.9 % (62/113) of patients with perforations who were admitted to hospital and in whom data were complete underwent surgery; 26.1 % (30/115) of hospitalized patients left the hospital with a stoma and 19.1 % (22/115) developed post-perforation morbidity. Perforations not detected during colonoscopy were significantly more likely to require surgery (P = 0.03). Diagnostic perforations were significantly more likely to require surgery (P = 0.002) and were associated with higher rates of post-perforation morbidity (P = 0.01). At presentation, the presence of abdominal pain (P = 0.01), a pulse rate > 100 beats per minute (P = 0.049), and a respiratory rate > 20 breaths per minute (P = 0.01) were significantly associated with the patient having surgery. Conclusions This is the largest retrospective observational case series in Europe to describe post-perforation presentation, management, and outcomes. We have confirmed that perforation leads to surgical intervention, stoma formation, and post-perforation morbidity. Perforations not recognized during the colonoscopy were significantly more likely to require surgery. Diagnostic perforations were at greater risk of requiring surgery and developing post-perforation morbidity.

Advanced Nursing Practice in Großbritannien – eine persönliche Schilderung

Pflege ◽  
2010 ◽  
Vol 23 (6) ◽  
pp. 417-423
Author(s):  
Elke Keinath
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Nurse Practitioner ◽  
Nursing Practice ◽  
Advanced Nursing Practice

Im Artikel werden persönliche Erfahrungen als Advanced Nurse Practitioner (ANP) in der Thoraxchirurgie im National Health Service (NHS) in Großbritannien geschildert. Die tägliche Routine wurde von sieben Kompetenzdomänen bestimmt, nämlich: Management des Gesundheits- und Krankheitszustandes des Patienten, Beziehungen zwischen Pflegeperson und Patient, Lehren und Unterrichten, professionelle Rolle, Leitung und Führung innerhalb der Patientenversorgung, Qualitätsmanagement sowie kulturelle und spirituelle Kompetenzen. Diese Elemente wurden durch die Zusatzqualifikation, selbstständig Medikamente verschreiben und verordnen zu dürfen, erweitert, was dazu beitrug, eine nahtlose Erbringung von Pflege- und Serviceleistungen zu gewähren. Die Position wurde zur zentralen Anlaufstelle im multi-professionellen Team und stellte eine kontinuierliche Weiterführung der Pflege von Patienten und ihren Familien sicher – auch über Krankenhausgrenzen hinweg.

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