(PDF) Public Health Screening Programs

Population Health
Screening

Table of Contents
INTRODUCTION...........................................................................................................................1
BACKGROUND.............................................................................................................................1
MAIN SECTION.............................................................................................................................4
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8
.........................................................................................................................................................9

INTRODUCTION
Screening refers to a process of measuring health of an individual or population, that
might at risk of disease. Early, in 19th century, due to improper sanitation, impure water and
inappropriate diet, were the main leading causes of death, that arise infectious disease. But today,
as per PHE (Public Health England) analysis, the most occurring diseases that increase death rate
and reduce life expectancy are non-communicable one. It includes cancer, heart disease, stroke,
influence, leukaemia, dementia and Alzhemier's disease etc. Therefore, to improve life
expectancy, it is essential to measure health of an individual and a population group, so that
causes behind same can be reduced to prevent others (Finn and et. al., 2016). Under the present
report, a case study is taken on a 65-year old woman, who is suffering from breast cancer. For
measuring health of this patient, an analysis is done on regarding potential threat of cancer, by
taking a group of population of older age. This would help medical professionals to find and treat
types of cancer early, before it causes symptoms and lead to death. For this purpose,
Mammography test is used to screen breast cancer, where early detection helps in reducing death
of females over 40 to 74 years. But during ongoing test of screening, some results shown that a
person is having cancer even when they don't have same. Such tests procedures could be harmful
for health of a person as well, that makes them unnecessarily anxious and stressed.
BACKGROUND
Health refers to a state of being free from injury or illness. According to World Health
Organisation (WHO), health can be defined as state of proper mental and physical condition, not
merely any absence of disease. Concerning on this definition of health, measuring well-being
condition of a person early, helps in providing better and less treatment before a disease spreads.
Along with this, it would aid professionals in reassuring a person if report is normal. For this
purpose, through national demographic and health surveys, some factors like increasing death
rate at early age due to some disease, infant mortality rate, etc. shows indicators of health and
disease of a population. Similarly, high or low blood pressure, obesity, uneasiness, low birth
weight shows signs to measure health before occurrence of a severe disease (Mavaddat and et.
al., 2015). To identify health risks and trends in UK, a data is taken from health profile of
England 2017, that is conducted by PHE, as shown below –
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Leading causes of death rates in England (2015) –
Leading causes of death vary by age in males (2015) –
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Leading causes of death vary by age in females (2015) -
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It has been interpreted from the above data, that in 2015, death rates of males are mainly
caused by heart disease, while dementia and Alzheimer disease causes death in females in
England. In the youngest group of age i.e. 1 to 4 years, diseases that leads to death of population
are Perinatal & Congential; Influenza & Penumonia; and other respiratory diseases. While,
leukaemia & lymphomas causes death of both males and female population of age 5 to 19. In
addition to this, majority of deaths mainly occur at older ages, where more than 2/3rd occur at
ages 75 and over. This is due to prolonged cancer and heart disease issues, that lead causes of all
deaths occurring in both population of females and males over the age of 65 (Chapter 2: major
causes of death and how they have changed, 2017). Along with this, older age group of 50 to 79,
diseases like heart and brain stroke, cancers causes death. While younger adults are at higher risk
of leukaemia and lymphomas.
MAIN SECTION
In context with present case, a women of 65 years, having no previous medical history of
breast cancer, has been referred to the medical oncology clinic, due to newly diagnosed
symptoms of metastatic breast cancer. The lady was not having any kind of past medical
background of any associated disease. 3 months back, the lady has realised breast (Left) pain.
For identifying the causes, Mammograph and ultrasound test was conducted which have later
revealed that there is a 6.2 cm breast mass including large ipsilateral axillary lymph node.
Practitioners have further recommended her to for biopsy of pulmonary nodules. This biopsy
have later confirmed that the lady is suffering from metastatic breast cancer.
It has been analysed that the patient have initially identified that she is not feeling good.
While asking for the health issue the lady has stated that suffering from any breathing issues,
fatigue or pain. This lady does not even has any sort of medication or medical history.
Professionally she is a teacher and also has strong energy record at workplace. None of the
family member has past history of ovarian, breast or other sort of cancer (Mertins and et. al.,
2016). In other associated details she have specified to medical practitioners that her menopause
was at 50 and menarche was when she was 11 years old. Her first pregnancy was at 29 and she
has two children.
Physical health: Influence of this disease on her physical health can be seen in the form
of shortness of breath, fatigue or pain. In context to current stated case, it has been identified that
this disease directly leads to huge fluctuation in weight of the lady, excessive hair fall, lowered
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bone density, fatigue, bodypain, breast size of the patient started changing, also there was the
blood discharge from nipple area thrice a week. All of these has influenced physical health of the
patient and unable her perform daily based activities which were performed by her earlier
effectively without any issue.
Mental health: Breast cancer have also placed impact over mental health of this lady as
she was now feeling that this disease have left her dependent on other because she is not able to
perform work like earlier (Tao and et. al., 2015). This leads to initiation of depression among
patient because cancer patient's have to go through numerous of therapies which generates,
higher level of depression, some kind of cognitive impairment, fatigue, mental fog etc. Apart
from this, it can also be said that treatment of cancer also holds emotional influence over patients
as it brings fear among patient that they might die in future. This also creates anxiety among
patients. Excessive concern about future and self image might affect their health condition more
worsely.
Social health: Cancer is now days becoming popular disease across the world. This
disease have numerous of myths which influences interest people in negative manner towards
the one who is suffering from the same. In context to current case, it has been seen that social
impact of breast cancer for this lady was quiet weird as her hobbies started changing. At the
initial time she was highly devoted towards her work but when she got to know about her illness
it left her with aloneness as patient does feels comfortable in teaching students now. The main
reason behind change in her hobby was that she believes that everyone will stare her due to
cancer. This have dropped down confidence level that leads to change in hobby. While talking
about family and friends, it has been analysed that children of this lady were very supportive and
corporative. This support of family members and close friends have supported this patient in
recovering faster (Turner and et. al., 2015). Friends and colleagues of this patient have also
advised numerous of solutions and ways by which she can divert her mind from disease and
move forward towards recovery in quick manner.
As per the above specified image, it has been analysed that women belonging to age
group of 60 mainly suffers from cancer that is mostly seen in lungs as well as breast. Here, lungs
cancer are identified as first number disease which has analysed among women. Whereas breast
cancer belongs to 2nd number, heart disease, chronic lower respiratory diseases, Cirrhosis and
liver disease are ranked later in the same sequential manner. The overall information depicts that
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cancer is most identifiable disease among women which is affecting their health negatively.
Apart from this, it has been identified that sequence of disease among male are completely
different as due to gender disorder. While comparing disease list with the similar age group of
male are Heart disease, lung cancer, Cirrhosis and other liver disease, Colorectal and chronic
lower respiratory diseases (Arrossi and et. al., 2015). It has been identified that in males mainly
heart disease is identified as the first occurred disease among males. Whereas, these most
lowered ranked disease in this age group is chronic lower respiratory diseases. This simply
states that types of disease and their occurrence sequence is different among male and female.
With reference to current case scenario, it has been identified that more than 1.5 million
of women are suffering from breast cancer among which around 60% are identified as HR
positive. In addition to this, it has been identified that the main problem with the old lady was
that she was aware about the problem. This have impacted negatively on her as late recognition
about breast cancer has made her case more severe. It can be said that if this lady has got to
know about this healthcare issue then there are probable chances that her case didn't get that
much severe. This situation happens with most of female patients. In order to overcome this
issue healthcare practitioners have revealed for detecting breast cancer at earlier stage, it is
essential for individual to go through Mammography test in order to identify this at initial level.
Mammography refers to the procedure of taking use of x-ray machine for diagnosing human
breast. The main purpose of this x-ray machine is to identify breast cancer at early stage.
Advantages and disadvantages of using this technology are described as below:
Advantages:
Decreases chances of chemotherapy: Screening at initial stage helps women to allow
women to detect cancer at initial stage only. Thus, early detection allows them in securing
themselves from chemotherapy.
Allows individual about the health of their breast: It is helpful for women in
improving their knowledge about the health of breast as if they do additional examination allows
them to know about actual status of breast (Asaria and et. al., 2015)(. This simply aware them
about any breast related issue at earlier level.
Minimises death of women because of breast cancer: earlier knowledge of about
breast cancer directly secures patients life because they can easily access to treatment in starting
time. This ultimately leads to reducing number of death among women due to breast cancer.
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Disadvantages:
The main drawback of this technique is that people who go through this diagnosis might
affect patient health of life because they starts taking stress about health and its associated
consequences from early time only.
CONCLUSION
From the above described report, it has been identified that screening is a effective
procedure that is helpful in measuring health of patient which could affect them in future. It has
been identified that maximum number of women belonging to the age group of 50-60 or above
majorly suffers from breast cancer which leads to death also. The main initiative taken by
healthcare practitioners to detect this disease is mammography which supports in detective issue
in earlier manner.
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REFERENCES
Books and Journals
Arrossi, S. and et. al., 2015. Effect of self-collection of HPV DNA offered by community health
workers at home visits on uptake of screening for cervical cancer (the EMA study): a
population-based cluster-randomised trial. The Lancet Global Health. 3(2). pp.e85-e94.
Asaria, M. and et. al., 2015. Distributional cost‐effectiveness analysis of health care
programmes–a methodological case study of the UK bowel cancer screening
programme. Health economics. 24(6). pp.742-754.
Batterham, R. W. and et. al., 2016. Health literacy: applying current concepts to improve health
services and reduce health inequalities. Public health. 132. pp.3-12.
Garg, A., Boynton-Jarrett, R. and Dworkin, P. H., 2016. Avoiding the unintended consequences
of screening for social determinants of health. Jama. 316(8). pp.813-814.
Grönberg, H. and et. al., 2015. Prostate cancer screening in men aged 50–69 years (STHLM3): a
prospective population-based diagnostic study. The lancet oncology. 16(16). pp.1667-
1676.
Konerman, M. A. and et. al., 2017. Impact of an electronic health record alert in primary care on
increasing hepatitis c screening and curative treatment for baby
boomers. Hepatology. 66(6). pp.1805-1813.
Lagerlund, M. and et. al., 2015. Health-related lifestyle factors and mammography screening
attendance in a Swedish cohort study. European Journal of Cancer Prevention. 24(1).
pp.44-50.
Woo, S. Y. and et. al., 2017. Prevalence and risk factors for atherosclerotic carotid stenosis and
plaque: a population-based screening study. Medicine. 96(4).
Breast Cancer
Books & Journals
Finn, R. S. and et. al., 2016. Palbociclib and letrozole in advanced breast cancer. New England
Journal of Medicine. 375(20). pp.1925-1936.
Mavaddat, N. and et. al., 2015. Prediction of breast cancer risk based on profiling with common
genetic variants. JNCI: Journal of the National Cancer Institute. 107(5).
Mertins, P and et. al., 2016. Proteogenomics connects somatic mutations to signalling in breast
cancer. Nature. 534(7605). p.55.
Tao, Z. and et. al., 2015. Breast cancer: epidemiology and etiology. Cell biochemistry and
biophysics. 72(2). pp.333-338.
Turner, N. C. and et. al., 2015. Palbociclib in hormone-receptor–positive advanced breast
cancer. New England Journal of Medicine. 373(3). pp.209-219.
Online
Chapter 2: major causes of death and how they have changed. 2017. [Online] Available
Through:<https://www.gov.uk/government/publications/health-profile-for-england/
chapter-2-major-causes-of-death-and-how-they-have-changed>.
National Cancer Institute. 2018. [Online] Available Through:
<https://www.cancer.gov/types/breast/patient/breast-screening-pdq>.
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Benefits and limitations of regular cancer screening. <https://www.cancer.ca/en/prevention-and-
screening/reduce-cancer-risk/find-cancer-early/screening-for-cancer/benefits-and-
limitations-of-regular-cancer-screening/?region=on>.
Advantages, Disadvantages and Limitations of Mammography. 2019. [Online] Available
Through: <https://www.quebec.ca/en/health/advice-and-prevention/screening-and-
carrier-testing-offer/breast-cancer-screening/advantages-disadvantges-and-limitations-
of-mammography/>.
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