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Screening for Advanced Hepatic Fibrosis Related to NAFLD/NASH

Hepatic fibrosis is the most important determinant of liver and non-liver outcomes in patients with nonalcoholic fatty liver disease (NAFLD). Therefore, identifying patients with clinically significant hepatic fibrosis (fibrosis stage 2 or higher) is important for targeted efforts at preventing disease progression.
Nonalcoholic steatohepatitis (NASH), a subtype of NAFLD characterized by inflammation, ballooning, and Mallory’s hyaline on liver biopsy, can lead to hepatic fibrosis, cirrhosis, and hepatocellular cancer (HCC). Both NAFLD and NASH are also associated with an increased risk of cardiovascular disease, cardiovascular and liver-related mortality, and impaired health-related quality of life.

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Initial Screening for Hereditary Breast and Ovarian Cancer Syndrome

The initial screening for hereditary breast and ovarian cancer syndrome should include specific questions about the patient’s personal and family history of breast and ovarian cancers, risk assessment, education, and counseling.
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Cervical-Cancer Screening Guidelines

The incidence of cervical cancer, as well as mortality rates from the disease, has decreased over the past 30 years because of widespread screening with cervical cytology. The American College of Obstetricians and Gynecologists (ACOG) recently published a clinical management guideline on cervical cytology screening.
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American Diabetes Association Recommendations for the Screening of Asymptomatic Persons for Diabetes

The American Diabetes Association (ADA) and the Veterans Health Administration (VHA) recommend diabetes screening beginning at 45 years of age; the ADA advises earlier screening in patients with risk factors.
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Prostate-Cancer Screening Guidelines

The rationale for screening is that early detection and treatment of asymptomatic cancers could extend life, as compared with treatment at the time of clinical diagnosis. The introduction of prostate-specific antigen (PSA) testing has nearly doubled the lifetime risk of receiving a diagnosis of prostate cancer.
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Criteria for Evaluating the Effectiveness of Screening for a Risk Factor

Characteristics of the disease

1. Disease has serious consequences

2. Screening population has a high incidence* of disease

3. Risk factor is a good predictor of disease

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