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1. Risk Factors of Hepatitis Associated With Time to Adopting a New Cancer Screening Model Under Diffusion of Innovation Theory—A 10‐Year Cohort Study in Taiwan.

Author

Lien, Angela Shin‐Yu, Chiu, Sherry Yueh‐Hsia, Fann, Jean Ching‐Yuan, Chen, Sam Li‐Sheng, Yen, Amy Ming‐Fang, and Chen, Hsiu‐Hsi

Subjects
LIVER physiology, RISK assessment, LIFESTYLES, HABIT, PROTEINS, HEPATITIS, DIFFUSION of innovations, RESEARCH funding, BODY mass index, EARLY detection of cancer, QUESTIONNAIRES, BLOOD collection, MULTIPLE regression analysis, PSYCHOLOGICAL adaptation, CHI-squared test, MULTIVARIATE analysis, LONGITUDINAL method, MATHEMATICAL models, RESEARCH, STATISTICS, THEORY, ALCOHOL drinking, ALBUMINS, CONFIDENCE intervals, SURVIVAL analysis (Biometry), DATA analysis software, BIOMARKERS, PROPORTIONAL hazards models, DISEASE risk factors
Abstract

Background: Hepatitis is a serious global health issue. To reduce mortality, early screening for liver disease has been recommended in community health policies, particularly for asymptomatic individuals. Aim: This study explored the link between liver function biomarkers and how quickly people adopt a new multiple cancer screening program, using the diffusion of innovation (DOI) Theory. Methods: The study included 57,939 participants from a community‐based screening program in Keelung, Taiwan, between January 1, 2001, and December 31, 2010. Data on demographics and lifestyle habits were collected through questionnaires, and blood samples were analyzed to measure biomarkers related to liver function. Results: On average, participants took 3.48 years to accept the new screening program. People with healthier lifestyles, such as those who drank alcohol less often, were more likely to adopt the screening early. Additionally, those with higher levels of liver‐related biomarkers like albumin, total protein, and ALT joined even sooner. In conclusion, using DOI theory, the study found that personal lifestyle and liver function play a role in how quickly individuals adopt a new screening system. Conclusion: These insights can help healthcare providers improve early screening efforts, particularly for people at risk of hepatitis and liver cancer, potentially reducing related deaths. [ABSTRACT FROM AUTHOR]

Published
2025
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5. Screening for Helicobacter pylori to Prevent Gastric Cancer: A Pragmatic Randomized Clinical Trial.

Author

Lee, Yi-Chia, Chiang, Tsung-Hsien, Chiu, Han-Mo, Su, Wei-Wen, Chou, Kun-Ching, Chen, Sam Li-Sheng, Yen, Amy Ming-Fang, Fann, Jean Ching-Yuan, Chiu, Sherry Yueh-Hsia, Chuang, Shu-Lin, Chen, Yi-Ru, Chen, Shih-Dian, Hu, Tsung-Hui, Fang, Yi-Jen, Wu, Ming-Shiang, Chen, Tony Hsiu-Hsi, and Yeh, Yen-Po

Subjects
STOMACH cancer, HELICOBACTER pylori infections, CLINICAL trials, HELICOBACTER pylori, MEDICAL screening, COLON cancer, ORAL rehydration therapy
Abstract

Key Points: Question: Among people invited for colon cancer screening with fecal immunochemical testing (FIT), does adding a Helicobacter pylori stool antigen test to FIT reduce rates of gastric cancer incidence and gastric cancer mortality, compared with FIT alone? Findings: In a randomized clinical trial that included 152 503 people, there were no significant differences in incidence of gastric cancer or gastric cancer mortality between people invited to undergo screening with H pylori stool antigen and FIT compared with people invited to undergo FIT screening alone (0.032% vs 0.037%, respectively, for gastric cancer incidence and 0.015% vs 0.013%, respectively, for gastric cancer mortality). Meaning: An invitation to test for H pylori stool antigen in combination with FIT did not significantly reduce rates of gastric cancer, compared with an invitation for FIT alone, but results may have been affected by differences in screening participation and length of follow-up between the 2 groups. Importance: Effects of screening for Helicobacter pylori on gastric cancer incidence and mortality are unknown. Objective: To evaluate the effects of an invitation to screen for H pylori on gastric cancer incidence and mortality. Design, Setting, and Participants: A pragmatic randomized clinical trial of residents aged 50 to 69 years in Changhua County, Taiwan, eligible for biennial fecal immunochemical tests (FIT) for colon cancer screening. Participants were randomized to either an invitation for H pylori stool antigen (HPSA) + FIT assessment or FIT alone. The study was conducted between January 1, 2014, and September 27, 2018. Final follow-up occurred December 31, 2020. Intervention: Invitation for testing for H pylori stool antigen. Main Outcomes and Measures: The primary outcomes were gastric cancer incidence and gastric cancer mortality. All invited individuals were analyzed according to the groups to which they were randomized. Results: Of 240 000 randomized adults (mean age, 58.1 years [SD, 5.6]; 46.8% female), 63 508 were invited for HPSA + FIT, and 88 995 were invited for FIT alone. Of the 240 000 randomized, 38 792 who were unreachable and 48 705 who did not receive an invitation were excluded. Of those invited, screening participation rates were 49.6% (31 497/63 508) for HPSA + FIT and 35.7% (31 777/88 995) for FIT alone. Among 12 142 participants (38.5%) with positive HPSA results, 8664 (71.4%) received antibiotic treatment, and eradication occurred in 91.9%. Gastric cancer incidence rates were 0.032% in the HPSA + FIT group and 0.037% in the FIT-alone group (mean difference, −0.005% [95% CI, −0.013% to 0.003%]; P =.23). Gastric cancer mortality rates were 0.015% in the HPSA + FIT group and 0.013% in the FIT-alone group (mean difference, 0.002% [95% CI, −0.004% to 0.007%]; P =.57). After adjusting for differences in screening participation, length of follow-up, and patient characteristics in post hoc analyses, an invitation for HPSA + FIT was associated with lower rates of gastric cancer (0.79 [95% CI, 0.63-0.98]) but not with gastric cancer mortality (1.02 [95% CI, 0.73-1.40]), compared with FIT alone. Among participants who received antibiotics, the most common adverse effects were abdominal pain or diarrhea (2.1%) and dyspepsia or poor appetite (0.8%). Conclusions and Relevance: Among residents of Taiwan, an invitation to test for HPSA combined with FIT did not reduce rates of gastric cancer or gastric cancer mortality, compared with an invitation for FIT alone. However, when differences in screening participation and length of follow-up were accounted for, gastric cancer incidence, but not gastric cancer mortality, was lower in the HSPA + FIT group, compared with FIT alone. Trial Registration: ClinicalTrials.gov Identifier: NCT01741363 This randomized clinical trial evaluates the effects of Helicobacter pylori stool antigen assessment plus fecal immunochemical testing (FIT), vs FIT alone, on gastric cancer incidence and mortality among adults in Taiwan. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Supplementary Methods, Supplementary Figures 1-2, and Supplementary Tables 1-2. from Demand for Colonoscopy in Colorectal Cancer Screening Using a Quantitative Fecal Immunochemical Test and Age/Sex-Specific Thresholds for Test Positivity

Author

Chen, Sam Li-Sheng, primary, Hsu, Chen-Yang, primary, Yen, Amy Ming-Fang, primary, Young, Graeme P., primary, Chiu, Sherry Yueh-Hsia, primary, Fann, Jean Ching-Yuan, primary, Lee, Yi-Chia, primary, Chiu, Han-Mo, primary, Chiou, Shu-Ti, primary, and Chen, Hsiu-Hsi, primary

Published
2023
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26. Clarifying the debate on population-based screening for breast cancer with mammography: A systematic review of randomized controlled trials on mammography with Bayesian meta-analysis and causal model

Author

Chen, Tony Hsiu-Hsi, Yen, Amy Ming-Fang, Fann, Jean Ching-Yuan, Gordon, Paula, Chen, Sam Li-Sheng, Chiu, Sherry Yueh-Hsia, Hsu, Chen-Yang, Chang, King-Jen, Lee, Won-Chul, Yeoh, Khay Guan, Saito, Hiroshi, Promthet, Supannee, Hamashima, Chisato, Maidin, Alimin, Robinson, Fredie, and Zhao, Li-Zhong

Published
2017
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29. Community‐based multiple screening for metabolic syndrome by innovative theory: A longitudinal study

Author

Lien, Angela Shin‐Yu, primary, Chiu, Sherry Yueh‐Hsia, additional, Chen, Sam Li‐Sheng, additional, Fann, Jean Ching‐Yuan, additional, Yen, Amy Ming‐Fang, additional, Yeh, Mei Chang, additional, Lou, Meei‐Fang, additional, Huang, Kuo‐Chin, additional, Sheu, Wayne Huey‐Herng, additional, Chen, Hsiu‐Hsi, additional, and Gau, Bih‐Shya, additional

Published
2022
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31. Response to Miller et al.

Author

Tabár, László, Chen, Hsiu-Hsi, Yen, Amy Ming-Fang, Chen, Sam Li-Sheng, Fann, Jean Ching-Yuan, Chiu, Sherry Yueh-Hsia, Smith, Robert A., and Duffy, Stephen W.

Published
2015
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39. sj-pdf-1-msc-10.1177_0969141320986830 - Supplemental material for Classifying interval cancers as false negatives or newly occurring in fecal immunochemical testing

Author

Hsu, Wen-Feng, Hsu, Chen-Yang, Yen, Amy Ming-Fang, Chen, Sam Li-Sheng, Chiu, Sherry Yueh-Hsia, Fann, Jean Ching-Yuan, Yi-Chia Lee, Han-Mo Chiu, and Hsiu-Hsi Chen

Subjects
111708 Health and Community Services, FOS: Clinical medicine, 111402 Obstetrics and Gynaecology, FOS: Health sciences
Abstract

Supplemental material, sj-pdf-1-msc-10.1177_0969141320986830 for Classifying interval cancers as false negatives or newly occurring in fecal immunochemical testing by Wen-Feng Hsu, Chen-Yang Hsu, Amy Ming-Fang Yen, Sam Li-Sheng Chen, Sherry Yueh-Hsia Chiu, Jean Ching-Yuan Fann, Yi-Chia Lee, Han-Mo Chiu and Hsiu-Hsi Chen in Journal of Medical Screening

Published
2021
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40. Early detection of breast cancer rectifies inequality of breast cancer outcomes

Author

Tabar, Laszlo, Chen, Tony Hsiu-Hsi, Yen, Amy Ming-Fang, Dean, Peter B., Smith, Robert A., Jonsson, Håkan, Törnberg, Sven, Chen, Sam Li-Sheng, Chiu, Sherry Yueh-Hsia, Fann, Jean Ching-Yuan, Ku, May Mei-Sheng, Wu, Wendy Yi-Ying, Hsu, Chen-Yang, Chen, Yu-Ching, Svane, Gunilla, Azavedo, Edward, Grundström, Helene, Sundén, Per, Leifland, Karin, Frodis, Ewa, Ramos, Joakim, Epstein, Birgitta, Åkerlund, Anders, Sundbom, Ann, Bordás, Pál, Wallin, Hans, Starck, Leena, Björkgren, Annika, Carlson, Stina, Fredriksson, Irma, Ahlgren, Johan, Öhman, Daniel, Holmberg, Lars, Duffy, Stephen W., Tabar, Laszlo, Chen, Tony Hsiu-Hsi, Yen, Amy Ming-Fang, Dean, Peter B., Smith, Robert A., Jonsson, Håkan, Törnberg, Sven, Chen, Sam Li-Sheng, Chiu, Sherry Yueh-Hsia, Fann, Jean Ching-Yuan, Ku, May Mei-Sheng, Wu, Wendy Yi-Ying, Hsu, Chen-Yang, Chen, Yu-Ching, Svane, Gunilla, Azavedo, Edward, Grundström, Helene, Sundén, Per, Leifland, Karin, Frodis, Ewa, Ramos, Joakim, Epstein, Birgitta, Åkerlund, Anders, Sundbom, Ann, Bordás, Pál, Wallin, Hans, Starck, Leena, Björkgren, Annika, Carlson, Stina, Fredriksson, Irma, Ahlgren, Johan, Öhman, Daniel, Holmberg, Lars, and Duffy, Stephen W.

Abstract

Objectives: To explain apparent differences among mammography screening services in Sweden using individual data on participation in screening and with breast cancer-specific survival as an outcome. Methods: We analysed breast cancer survival data from the Swedish Cancer Register on breast cancer cases from nine Swedish counties diagnosed in women eligible for screening. Data were available on 38,278 breast cancers diagnosed and 4312 breast cancer deaths. Survival to death from breast cancer was estimated using the Kaplan-Meier estimate, for all cases in each county, and separately for cases of women participating and not participating in their last invitation to screening. Formal statistical comparisons of survival were made using proportional hazards regression. Results: All counties showed a reduction in the hazard of breast cancer death with participation in screening, but the reductions for individual counties varied substantially, ranging from 51% (95% confidence interval 46-55%) to 81% (95% confidence interval 74-85%). Survival rates in nonparticipating women ranged from 53% (95% confidence interval 40-65%) to 74% (95% confidence interval 72-77%), while the corresponding survival in women participating in screening varied from 80% (95% confidence interval 77-84%) to 86% (95% confidence interval 83-88%), a considerably narrower range. Conclusions: Differences among counties in the effect of screening on breast cancer outcomes were mainly due to variation in survival in women not participating in screening. Screening conferred similarly high survival rates in all counties. This indicates that the performance of screening services was similar across counties and that detection and treatment of breast cancer in early-stage reduces inequalities in breast cancer outcome.

Published
2021
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42. Long-term effectiveness of faecal immunochemical test screening for proximal and distal colorectal cancers

Author

Chiu, Han-Mo, primary, Jen, Grace Hsiao-Hsuan, additional, Wang, Ying-Wei, additional, Fann, Jean Ching-Yuan, additional, Hsu, Chen-Yang, additional, Jeng, Ya-Chung, additional, Yen, Amy Ming-Fang, additional, Chiu, Sherry Yueh-Hsia, additional, Chen, Sam Li-Sheng, additional, Hsu, Wen-Feng, additional, Lee, Yi-Chia, additional, Wu, Ming-Shiang, additional, Wu, Chien-Yuan, additional, Jou, Yann-Yuh, additional, and Chen, Tony Hsiu-Hsi, additional

Published
2021
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44. Incidence and Long-Term Outcomes of Interval Colorectal Cancers in a Fecal Immunochemical Test Screening Program

Author

Hsu, Wen-Feng, primary, Chang, Wei-Jung, additional, Hsu, CY, additional, Yen, Amy, additional, Chen, Sam Li-Sheng, additional, Chiu, Sherry Yueh-Hsia, additional, Fann, Jean Ching-Yuan, additional, Lee, Yi-Chia, additional, Hsu, Tsui-Hsia, additional, Lin, Li-Ju, additional, Chia, Shu-Li, additional, Wu, Ming-Shiang, additional, Chen, Hsiu-Hsi, additional, and Chiu, Han-Mo, additional

Published
2021
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45. Impact of treatment delay on survival of oral/oropharyngeal cancers: Results of a nationwide screening program

Author

Su, William Wang‐Yu, primary, Lee, Yi‐Huah, additional, Yen, Amy Ming‐Fang, additional, Chen, Sam Li‐Sheng, additional, Hsu, Chen‐Yang, additional, Chiu, Sherry Yueh‐Hsia, additional, Fann, Jean Ching‐Yuan, additional, Lee, Yi‐Chia, additional, Chiu, Han‐Mo, additional, Hsiao, Shu‐Chun, additional, Hsu, Tsui‐Hsia, additional, and Chen, Hsiu‐Hsi, additional

Published
2020
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46. Mass eradication ofHelicobacter pylorito reduce gastric cancer incidence and mortality: a long-term cohort study on Matsu Islands

Author

Chiang, Tsung-Hsien, primary, Chang, Wei-Jung, additional, Chen, Sam Li-Sheng, additional, Yen, Amy Ming-Fang, additional, Fann, Jean Ching-Yuan, additional, Chiu, Sherry Yueh-Hsia, additional, Chen, Yi-Ru, additional, Chuang, Shu-Ling, additional, Shieh, Chun-Fu, additional, Liu, Cheng-Ying, additional, Chiu, Han-Mo, additional, Chiang, Hung, additional, Shun, Chia-Tung, additional, Lin, Ming-Wei, additional, Wu, Ming-Shiang, additional, Lin, Jaw-Town, additional, Chan, Chang-Chuan, additional, Graham, David Y, additional, Chen, Hsiu-Hsi, additional, and Lee, Yi-Chia, additional

Published
2020
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47. Precision Science on Incidence and Progression of Early-Detected Small Breast Invasive Cancers by Mammographic Features

Author

Chang, Rene Wei-Jung, primary, Chuang, Shu-Lin, additional, Hsu, Chen-Yang, additional, Yen, Amy Ming-Fang, additional, Wu, Wendy Yi-Ying, additional, Chen, Sam Li-Sheng, additional, Fann, Jean Ching-Yuan, additional, Tabar, Laszlo, additional, Smith, Robert A., additional, Duffy, Stephen W., additional, Chiu, Sherry Yueh-Hsia, additional, and Chen, Hsiu-Hsi, additional

Published
2020
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48. Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women

Author

Duffy, Stephen W., primary, Tabár, László, additional, Yen, Amy Ming‐Fang, additional, Dean, Peter B., additional, Smith, Robert A., additional, Jonsson, Håkan, additional, Törnberg, Sven, additional, Chen, Sam Li‐Sheng, additional, Chiu, Sherry Yueh‐Hsia, additional, Fann, Jean Ching‐Yuan, additional, Ku, May Mei‐Sheng, additional, Wu, Wendy Yi‐Ying, additional, Hsu, Chen‐Yang, additional, Chen, Yu‐Ching, additional, Svane, Gunilla, additional, Azavedo, Edward, additional, Grundström, Helene, additional, Sundén, Per, additional, Leifland, Karin, additional, Frodis, Ewa, additional, Ramos, Joakim, additional, Epstein, Birgitta, additional, Åkerlund, Anders, additional, Sundbom, Ann, additional, Bordás, Pál, additional, Wallin, Hans, additional, Starck, Leena, additional, Björkgren, Annika, additional, Carlson, Stina, additional, Fredriksson, Irma, additional, Ahlgren, Johan, additional, Öhman, Daniel, additional, Holmberg, Lars, additional, and Chen, Tony Hsiu‐Hsi, additional

Published
2020
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49. Early detection of breast cancer rectifies inequality of breast cancer outcomes

Author

Tabár, László, primary, Chen, Tony Hsiu-Hsi, additional, Yen, Amy Ming-Fang, additional, Dean, Peter B, additional, Smith, Robert A, additional, Jonsson, Håkan, additional, Törnberg, Sven, additional, Chen, Sam Li-Sheng, additional, Chiu, Sherry Yueh-Hsia, additional, Fann, Jean Ching-Yuan, additional, Ku, May Mei-Sheng, additional, Wu, Wendy Yi-Ying, additional, Hsu, Chen-Yang, additional, Chen, Yu-Ching, additional, Svane, Gunilla, additional, Azavedo, Edward, additional, Grundström, Helene, additional, Sundén, Per, additional, Leifland, Karin, additional, Frodis, Ewa, additional, Ramos, Joakim, additional, Epstein, Birgitta, additional, Åkerlund, Anders, additional, Sundbom, Ann, additional, Bordás, Pál, additional, Wallin, Hans, additional, Starck, Leena, additional, Björkgren, Annika, additional, Carlson, Stina, additional, Fredriksson, Irma, additional, Ahlgren, Johan, additional, Öhman, Daniel, additional, Holmberg, Lars, additional, and Duffy, Stephen W, additional

Published
2020
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50. Mammography screening reduces rates of advanced and fatal breast cancers : Results in 549,091 women

Author

Duffy, Stephen W., Tabar, Laszlo, Yen, Amy Ming-Fang, Dean, Peter B., Smith, Robert A., Jonsson, Hakan, Tornberg, Sven, Li-Sheng, Sam, Chiu, Sherry Yueh-Hsia, Fann, Jean Ching-Yuan, Mei-Sheng, May, Wu, Wendy Yi-Ying, Hsu, Chen-Yang, Chen, Yu-Ching, Svane, Gunilla, Azavedo, Edward, Grundstrom, Helene, Sunden, Per, Leifland, Karin, Frodis, Ewa, Ramos, Joakim, Epstein, Birgitta, Akerlund, Anders, Sundbom, Ann, Bordas, Pal, Wallin, Hans, Starck, Leena, Bjorkgren, Annika, Carlson, Stina, Fredriksson, Irma, Ahlgren, Johan, Ohman, Daniel, Holmberg, Lars, Chen, Tony Hsiu-Hsi, Duffy, Stephen W., Tabar, Laszlo, Yen, Amy Ming-Fang, Dean, Peter B., Smith, Robert A., Jonsson, Hakan, Tornberg, Sven, Li-Sheng, Sam, Chiu, Sherry Yueh-Hsia, Fann, Jean Ching-Yuan, Mei-Sheng, May, Wu, Wendy Yi-Ying, Hsu, Chen-Yang, Chen, Yu-Ching, Svane, Gunilla, Azavedo, Edward, Grundstrom, Helene, Sunden, Per, Leifland, Karin, Frodis, Ewa, Ramos, Joakim, Epstein, Birgitta, Akerlund, Anders, Sundbom, Ann, Bordas, Pal, Wallin, Hans, Starck, Leena, Bjorkgren, Annika, Carlson, Stina, Fredriksson, Irma, Ahlgren, Johan, Ohman, Daniel, Holmberg, Lars, and Chen, Tony Hsiu-Hsi

Abstract

Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death. Methods Among 549,091 women, covering approximately 30% of the Swedish screening-eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression. Results Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51-0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66-0.84 [P < .001]). Conclusions Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.

Published
2020
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