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  1. Article ; Online: Effectiveness of tailored talks between a cancer screening specialist and general practitioners to improve the uptake of colorectal cancer screening in Ancona (Italy) during the pandemic period.

    Acuti Martellucci, Cecilia / Giacomini, Giusi / Flacco, Maria Elena / Manzoli, Lamberto / Morettini, Margherita / Martellucci, Mosè / Rosati, Sara / Bizzarri, Silvia / Palmer, Matthew / Pascucci, Lidia / Uncini, Marco / Pasqualini, Francesca

    The European journal of general practice

    2024  Volume 30, Issue 1, Page(s) 2340672

    Abstract: Background: Colorectal cancer (CRC) screening uptake in many countries has been low and further impacted by the COVID-19 pandemic. General Practitioners (GPs) are key facilitators, however research on their impact on organised CRC screening is still ... ...

    Abstract Background: Colorectal cancer (CRC) screening uptake in many countries has been low and further impacted by the COVID-19 pandemic. General Practitioners (GPs) are key facilitators, however research on their impact on organised CRC screening is still limited.
    Objectives: To evaluate the effectiveness of tailored talks with GPs to increase population uptake of the long-established CRC screening programme in Ancona province, Italy.
    Methods: In this prospective cohort study, one-to-one tailored talks were organised in January 2020 between the GPs of one county of the province (with GPs from other counties as controls) and the screening programme physician-in-chief to discuss the deployment and effectiveness of organised screening. Data was extracted from the National Healthcare System datasets and linear regression was used to assess the potential predictors of CRC screening uptake.
    Results: The mean CRC screening uptake remained stable from 39.9% in 2018-19 to 40.8% in 2020-21 in the 22 GPs of the intervention county, whereas it statistically significantly decreased from 38.7% to 34.7% in the 232 control GPs. In multivariate analyses, belonging to the intervention county was associated with an improved uptake compared to the control counties (+5.1%; 95% Confidence Intervals - CI: 2.0%; 8.1%).
    Conclusion: Persons cared for by GPs who received a tailored talk with a cancer screening specialist avoided a drop in CRC screening adherence, which characterised all other Italian screening programmes during the COVID-19 emergency. If future randomised trials confirm the impact of tailored talks, they may be incorporated into existing strategies to improve population CRC screening uptake.
    MeSH term(s) Humans ; COVID-19/diagnosis ; Early Detection of Cancer ; General Practitioners ; Italy ; Neoplasms ; Pandemics/prevention & control ; Prospective Studies
    Language English
    Publishing date 2024-04-15
    Publishing country England
    Document type Evaluation Study ; Journal Article
    ZDB-ID 1281338-2
    ISSN 1751-1402 ; 1381-4788
    ISSN (online) 1751-1402
    ISSN 1381-4788
    DOI 10.1080/13814788.2024.2340672
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Delivering cervical cancer screening during the COVID-19 emergency.

    Acuti Martellucci, Cecilia / Morettini, Margherita / Flacco, Maria Elena / Manzoli, Lamberto / Palmer, Matthew / Giacomini, Giusi / Pasqualini, Francesca

    BMJ sexual & reproductive health

    2021  Volume 47, Issue 4, Page(s) 296–299

    MeSH term(s) COVID-19 ; Early Detection of Cancer ; Female ; Humans ; Papillomavirus Infections ; SARS-CoV-2 ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/epidemiology
    Language English
    Publishing date 2021-04-29
    Publishing country England
    Document type Journal Article
    ISSN 2515-2009
    ISSN (online) 2515-2009
    DOI 10.1136/bmjsrh-2021-201099
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Wide variability in colorectal cancer screening uptake by general practitioner: Cross-sectional study.

    Martellucci, Cecilia Acuti / Flacco, Maria E / Morettini, Margherita / Giacomini, Giusi / Palmer, Matthew / Fraboni, Stefania / Pasqualini, Francesca

    Journal of medical screening

    2021  Volume 29, Issue 1, Page(s) 21–25

    Abstract: Objectives: Despite several interventions, colorectal cancer (CRC) screening uptake remains below acceptable levels in Italy. Among the potential determinants of screening uptake, only a few studies analysed the role of general practitioners (GPs). The ... ...

    Abstract Objectives: Despite several interventions, colorectal cancer (CRC) screening uptake remains below acceptable levels in Italy. Among the potential determinants of screening uptake, only a few studies analysed the role of general practitioners (GPs). The aim was to evaluate the variation in screening uptake of the clusters of subjects assisted by single GPs.
    Setting: Ancona province, Central Italy.
    Methods: Cross-sectional study, including all residents aged 50-69 years, who were offered the public screening programme with biannual faecal immunochemical tests. Demographic (of all GPs) and screening data (of all eligible residents) for years 2018-2019 were collected from the official electronic datasets of the Ancona Local Health Unit. The potential predictors of acceptable screening uptake, including GP's gender, age, and number of registered subjects, were evaluated using random-effect logistic regression, with geographical area as the cluster unit.
    Results: The final sample consisted of 332 GP clusters, including 120,178 eligible subjects. The overall province uptake was 38.0% ± 10.7%. The uptake was lower than 30% in one-fifth of the GP clusters, and higher than 45% in another fifth. At multivariable analysis, the significant predictors of uptake were younger GP age (
    Conclusions: The wide variation across GPs suggests they might substantially influence screening uptake, highlighting a potential need to increase their commitment to CRC screening. Further research is needed to confirm the role of the number of registered subjects.
    MeSH term(s) Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/prevention & control ; Cross-Sectional Studies ; Early Detection of Cancer ; General Practitioners ; Humans ; Mass Screening ; Occult Blood
    Language English
    Publishing date 2021-08-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 1235253-6
    ISSN 1475-5793 ; 0969-1413
    ISSN (online) 1475-5793
    ISSN 0969-1413
    DOI 10.1177/09691413211035795
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Impact of a Human Papillomavirus Vaccination Program within Organized Cervical Cancer Screening: Cohort Study.

    Martellucci, Cecilia Acuti / Morettini, Margherita / Brotherton, Julia M L / Canfell, Karen / Manzoli, Lamberto / Flacco, Maria Elena / Palmer, Matthew / Rossi, Paolo Giorgi / Martellucci, Mosè / Giacomini, Giusi / D'Errico, Marcello Mario / Pasqualini, Francesca

    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

    2022  Volume 31, Issue 3, Page(s) 588–594

    Abstract: Background: We assessed the effectiveness of an HPV (human papillomavirus) vaccination program in lowering cervical abnormality risk, and conferring herd protection.: Methods: Retrospective cohort study using linked screening and vaccination ... ...

    Abstract Background: We assessed the effectiveness of an HPV (human papillomavirus) vaccination program in lowering cervical abnormality risk, and conferring herd protection.
    Methods: Retrospective cohort study using linked screening and vaccination administrative health data of the general population of Ancona Province, Italy. We included all female residents born in 1990-1993, eligible for catch-up HPV vaccination up to age 25 years, and adhering to organized screening in 2015-2020 (n = 4,665). Cervical abnormalities rates were compared between: Vaccinated and unvaccinated women, and cohorts with high and low vaccination uptake. Analyses were adjusted for age, country of birth, screening tests number, laboratory, and municipality average income. Main outcomes were ASC-US+ or LSIL+ Pap smears, and CIN1+ or CIN2+ histology.
    Results: Mean screening age was 26.6±1.5 years, and 1,118 screened women (24.0%) were vaccinated (mean vaccination age 19.2±1.5 years). The diagnosed cervical abnormalities were: 107 LSIL+ (2.3%), 70 CIN1+ (1.5%), and 35 CIN2+ (0.8%). The adjusted odds ratios of LSIL+, CIN1+, and CIN2+ among vaccinated versus unvaccinated women were, respectively: 0.55 [(95% confidence interval (CI), 0.33-0.91)], 0.43 (95% CI, 0.22-0.86), and 0.31 (95% CI, 0.11-0.91). Among the unvaccinated, those in the highest-uptake (45.3%) 1993 cohort, versus the last pre-vaccination 1990 cohort, showed AORs of LSIL+ and CIN1+ of 0.23 (95% CI, 0.10-0.50), and 0.22 (95% CI, 0.07-0.69), respectively.
    Conclusions: In the first evaluation from Central Italy, catch-up HPV vaccination considerably reduced the risk of all cervical abnormalities diagnosed within organized screening, and conferred an elevated degree of herd protection among unvaccinated women.
    Impact: The high protection conferred by HPV vaccination suggests the need to update cervical screening.
    MeSH term(s) Adolescent ; Adult ; Alphapapillomavirus ; Cohort Studies ; Early Detection of Cancer ; Female ; Humans ; Papillomaviridae ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines/therapeutic use ; Retrospective Studies ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/prevention & control ; Vaccination ; Young Adult
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2022-01-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1153420-5
    ISSN 1538-7755 ; 1055-9965
    ISSN (online) 1538-7755
    ISSN 1055-9965
    DOI 10.1158/1055-9965.EPI-21-0895
    Database MEDical Literature Analysis and Retrieval System OnLINE

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