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Screening and early diagnosis of cancer have been important components of the comprehensive measures to reduce the incidence and mortality of malignant neoplasms worldwide for quite some time. Despite the widespread use of oncological screening in different countries, doubts persist about its feasibility, methods used, or frequency of examinations. Several studies provide data that oncological screening programs do lead to a reduction in mortality from cancer, but do not reduce overall mortality. The American Society of Clinical Oncology continues to support oncological screening as an effective tool to reduce mortality from malignant neoplasms, but acknowledges that not all individuals who undergo screening will benefit from it, not all individuals with established malignant neoplasms will be cured, and undergoing screening today is not a guarantee of protection against cancer in the future. It is important to note that approaches to screening for malignant neoplasms are dynamically revised as new scientifically substantiated data emerge, and the interpretation by leading groups of experts may differ even within one country. This scientific article presents methods for evaluating the effectiveness of screening programs implementation, such as sensitivity and specificity, ROC analysis, positive and negative predictive value of screening, and results of randomized studies. A brief overview of the main international principles of implementing screening programs and recommendations of international medical communities is provided.

Background. Nowadays, population generally has high contamination with herpes virus infections. Infection commonly is asymptomatic, and the virus persists in the human body over a lifetime. Excessive diagnosis of herpes virus infections as well as overestimation of their role in the genesis of various diseases in immunocompetent people are common in Russian pediatrics.Objective. The aim of the study is to assess the frequency and efficacy of serological testing in the suspected correlation of herpes virus infections and infectious and somatic diseases in a multidisciplinary hospital.Methods. The study included patients hospitalized in the multidisciplinary hospital in Moscow, who were assigned serological examination for herpes viruses. The laboratory study was carried out by enzyme-linked immunosorbent assay with the revealing the markers of herpes simplex virus type 1 and 2, Epstein-Barr virus, and cytomegalovirus. The results of the examination were analyzed according to the nosology and their role in diagnosis and management.Results. The identification of herpes virus infections’ markers was performed for 996 patients undergoing medical treatment in 17 different hospital departments within 2 months. Most commonly the examination was prescribed in infectious disease, pediatric, and hematological departments and covered more than 140 different nosologies. Acute respiratory infection, reactive arthritis, thrombocytopenia, infectious mononucleosis, acute tonsillitis, gastrointestinal pathology, acute bronchitis, and pneumonia were the most common nosologies. Positive markers of acute infection were revealed in 1.71% of cases for HSV-1/HSV-2, in 4.89% — for EBV, in 3.81% — for CMV. Moreover, positive results of serological examination were mostly noted in the cases of infectious diseases: infectious mononucleosis, tonsillitis, or acute respiratory infections. Tests were assigned for all three infections at the same time in most cases.Conclusion. Widespread examination for herpes virus infections is the typical variant of overdiagnosis and it is usually less informative. Generally positive markers are observed in typical course of herpes virus infections when clinical picture is enough for diagnosis verification.

On the basis of the linear no-threshold theory, the Chernobyl accident was predicted to result in an incidence increase of various malignancies. In fact, there has been no cancer increase proven to be a consequence of the radiation exposure after the accident except for thyroid carcinoma in people exposed at a young age. Prior to the accident, thyroid cancer had been rarely diagnosed in children and adolescents. The ability of screening to enhance the registered incidence of thyroid tumors is known. The screening after the accident detected not only small tumors but also large neglected ones, sometimes misclassified as aggressive radiogenic cancers, which contributed to the concept of their aggressive behavior and early metastasizing. This had consequences for the practice: some experts recommended a more radical surgical treatment of supposedly radiogenic thyroid cancers. Such recommendations are generally not in agreement with the international practice. In conclusion, the treatment of Chernobyl-related thyroid carcinoma should not be different from that of sporadic one.

Reactive arthritis (ReA) is one of the types of spondyloarthritis. According to the statistics reports by the Ministry of Health of Russia, the prevalence of ReA in 2013 was 42.8 per 100,000 adult population, 99, and 172.4 per 100,000 children aged 0–14 and 15–17 years, respectively. There is a wide scatter of ReA detection rates in both the federal districts and subjects of the Russian Federation, which may be associated with both the spread of sexually transmitted infections, asymptomatic trigger Chlamydia infection, and overdiagnosis of ReA.

After a brief analysis of the autism problem history in domestic and foreign literature, the authors clarifiy the concept of autism as a form of personality pathology. The major factor in the growth of the number of children diagnosed with Early Infantile Autism, from the point of view of the authors, is its overdiagnosis. This diagnosis is often mistakenly set for children with developmental delays and autistic-like behavior at early residual organic lesions of the central nervous system, in protracted neurotic and cyclothymic depressions occurring in infancy and preschool age and, of course, in early manifestation of schizophrenia. Error diagnoses are of general concern, not only because they grossly distort the statistics and generate chaos in scientific research, but primarily because they affect the treatment and correction strategy, determining education prognosis, vocational guidance, the quality of life. The article presents the main differential diagnostic features that allow to distinguish autism from clinically similar conditions.

Aim. Detection and analysis of factors of pulmonary artery thromboembolism (PATE) overdiagnosis in a prehospital setting. Material and methods. A total of 102 patients with prehospital diagnosis of PATE entered the study. Prehospital clinical and ECG picture was compared in groups of verified PATE (n=61) and rejected PATE (n=41). Clinical probability of PATE was assessed retrospectively according to Revised Geneva Score (RGS) scale. In 47 cases the analysis was made in dynamics (in 92±42.1 min, on the average). Results. In the group of patients with false-positive PATE diagnosis we significantly more frequently observed angina-like chest pain and satisfactory condition at examination, ECG evidence for right heart overloading (the most significant marker S I—Q III; p=0.009) occurred less often, mean heart rate was significantly lower than in patients with verified PATE (85 ± 23,8 and 100±23,0 b/min, respectively; р = 0,007). Low probability of PATE by the RGS scale was stated in 37% patients from the group with false-positive diagnosis and only in 8% patients with a verified diagnosis of PATE (р = 0.0005). Conclusion. Prehospital PATE overdiagnosis can be explained by non-specificity of clinical and ECG picture of the disease in acute period. Application of the RGS scale is effective for objective assessment of the condition and accurate diagnosis.

Objective: To evaluate the impact of treatment with Ipigrix on the dynamics of clinical symptoms, neurological status, and quality of life in patients with dorsalgia of the lumbosacral spine based on the DORISS non-interventional multicenter observational study., Material and Methods: A total of 3563 patients with verified diagnoses of low back pain in 200 clinical centers across the Russian Federation who received comparable baseline therapy according to nosological standards were examined, some of whom additionally received oral or staged administration of Ipigrix. The primary endpoint of the study was the description of clinical and sociodemographic parameters, the consumption of medical resources, and the search for optimization of dorsalgia diagnosis in contemporary Russian outpatient neurological practice., Results: The population of patients included in the study represents a homogeneous group of educated, overweight people of working age with average severity of low back pain and related dysfunction. In 91.6% of cases nonspecific mechanisms of pain syndrome development with a moderate neuropathic component prevail in the genesis of back pain, being a reason for seeking medical advice once every 2 months on average. The overdiagnosis of lumbar radiculopathies is discussed, which most probably is of combined nature due to overuse and straightforward interpretation of neuroimaging results, nonsyndromological diagnosis, and classification defects., Conclusion: Improving the methods of diagnosis and treatment of patients with PB will reduce the incidence and the number of relapses of pain syndrome.