NURS 8310 Discussion: Screening for Disease SOLUTION

Sample Answer for NURS 8310 Discussion: Screening for Disease SOLUTION

Throughout the course of this discussion a summarization of a selected article from the learning assignment will be reviewed. The ethical considerations and whether or not the recommendations are justified will be reviewed. Next, a description of the epidemiological evidence in support of this position will reviewed. An Identification on whether the screening program reviewed is population-based or high-risk based and how that influences this assessment. Last, how the reported data can be used to move policy forward for improving population health around this issue.

In this discussion board the article that has been selected is “Mortality results from the Göteborg randomised population-based prostate-cancer screening trial” by Hugosson, et al, 2010.  In this article a study had been performed regarding the mortality rate among those being tested for prostate cancer.  Prostate cancer is one of the most common cancers among men worldwide.  One strategy to decrease the risk of death from this disease is screening with prostate-specific antigen (PSA); however, the extent of benefit and harm with such screening is under continuous debate (Hugosson, et al, 2010).  For this reason, a study was performed on whether or not the screening for prostate cancer can reduce the mortality rate with those men diagnosed.  In December, 1994, 20 000 men born between 1930 and 1944, randomly sampled from the population register, were randomised by computer in a 1:1 ratio to either a screening group invited for PSA testing every 2 years (n=10 000) or to a contr

ol group not invited (n=10 000) (Hugosson, et al, 2010). During a median follow-up of 14 years, 1138 men in the screening group and 718 in the control group were diagnosed with prostate cancer, resulting in a cumulative prostate-cancer incidence of 12·7% in the screening group and 8·2% in the control group (hazard ratio 1·64; 95% CI 1·50–1·80; p<0·0001) (Hugosson, et al, 2010).

The rate ratio of death from prostate cancer for attendees compared with the control group was 0·44 (95% CI 0·28–0·68; p=0·0002). Overall, 293 (95% CI 177–799) men needed to be invited for screening and 12 to be diagnosed to prevent one prostate cancer death (Hugosson, et al, 2010). The study did reveal that the mortality rate for prostate cancer patients had been reduced by half during a 14 year time period. However, the risk of over-diagnosis is substantial and the number needed to treat is at least as high as in breast-cancer screening programmes. The benefit of prostate-cancer screening compares favourably to other cancer screening programs (Hugosson, et al, 2010).  The rate ratio for death from prostate cancer was 0·56 (95% CI 0·39–0·82; p=0·002) in the screening compared with the control group (Hugosson, et al, 2010).  The recommendations were consistent with the need to screen for prostate cancer once males are within the appropriate age limits.  Those with positive screening are then advised to continue to diagnostic testing including prostate biopsy and digital rectal exams.  This was shown to reduce the risk of death in those with positive results.

The recommendations are justified in this test for the purpose to reduce mortality which could occur with those with prostate cancer. If the disease of interest is fatal, the appropriate end point would be differences in mortality between the two groups (Friis, R. H., & Sellers, T. A., 2021).  Within the study of 14 years the participants were evaluated, and the end date of the study consisted of the participants mortality or when they had succeeded the prostate cancer.  The ability to test the large quantity of participants who were followed by their family providers to be able to monito them closely.  A family medicine physician facilitated the development of a cross-clinic improvement team that included medial assistants, nurses, physicians, receptionists, and support personnel (e.g. information technology) (Nash, et al, 2021, p. 227).

This population based study was able to study men and their risks for prostate cancer as well as the prevalence for those with a positive PSA and the risks associated with them.

How the reported data can be used to move policy forward for improving population health around this issue would include educating those to continue to be tested and monitored for prostate cancer. The benefit of prostate-cancer screening compares favourably to other cancer screening programs (Hugosson, et al, 2010).

References

Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.

Hugosson, J., Carlsson, S., Aus, G., Bergdahl, S., Khatami, A., Lodding, P., & … Lilja, H. (2010). Mortality results from the Göteborg randomised population-based prostate-cancer screening trial prostate-cancer screening trial. prostate-cancer screening trial. Lancet Oncology, 11(8), 725–732, 11(8), 725–732.

Nash, D. B., Sloufalos, A., Fabius, R. J., & Oglesby, W. H. (2021). Population Health: Creating a Culture of Wellness (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Sample Answer 2 for NURS 8310 Discussion: Screening for Disease SOLUTION

Epidemiologic Data for or against screening program

Screening for disease helps detect potential health conditions in individuals who do not show any significant disease symptoms. The US Preventive Service Task Force Screen for colon cancer for all adults ages 45 and continues with regular screening through 75 years. Colon cancer is considered the nation’s third leading cause of cancer death in people (USPSTF. 2021). The risk is modified and non-modified factors. The modified factors are lifestyle changes such as diet, weight, exercise, long-term smoking, and unhealthy alcohol use.

In contrast, non-modified risk factors include age, family history, history of inflammatory bowel disease (Ulcerative colitis and Crohn’s disease), lynch syndrome, race, ethnic background, and type 2 diabetes (American Cancer Society, 2021). It also recommends that it should be an individual decision to start screening. Age is one of the most vital risk factors for colorectal cancer, with incidence rates increasing with age and 94% of new cases of colorectal cancer occurring in adults 45 years or older (National Cance Institute, 2021). Individuals ranging from 45 years or older must consult with healthcare professionals regarding when to start screening, even if the risk factors are absent. Leading ethical considerations associated with the USPSTF recommendation include patient autonomy and beneficence. Ubel et al. (2018) argue that it is important to respect an individual’s decision as required by the law. However, respecting patients’ autonomy should give them choices and disclose various risks and benefits of screening. The epidemiologist must assess if the screening benefits outweigh its risk. Thus, recommendations are justified for colorectal cancer screening. It also endorses that the decision to start screening should be independent.

Epidemiologic data to formulate policy for improving health

Screening tools are considered helpful in improving health outcomes and reducing healthcare costs by ensuring early interventions (Friss& Sellers, 2020). Screening for colorectal cancer presents a critical health burden; the possibility for prevention by removing precursors and early detection of CRC results in lowering morbidity and mortality because CRC can attractively target population screening. Colorectal cancer screening is available globally, and stool-based and direct visualization screening test is the gold standard of CRC screening. It is fundamental to improving health, and early detection improves prognosis, and fewer colorectal cancer death occurs when screening begins at 45 years vs. 50 years (USPSTF, 2018).

Cancer intervention & Surveillance modeling Network (CISNET) suggests screening should stop for adults aged 76-85 years due to health statuses such as life expectancy and comorbid conditions. There is also the risk versus benefits from perforation and increased bleeding from colonoscopy (Lin, Perdue, Henrikson, et al., 2021).

Black adults have the highest incidence of and mortality from colorectal cancer than other races/ethnicities. From 2013 to 2017, incidence rates for colorectal cancer were 43.6 cases per 100,000 Black adults, 39.0 cases per 100,000 American Indian/Alaska Native adults, 37.8 cases per 100,000 White adults, 33.7 cases per 100,000 Hispanic/Latino adults, and 31.8 cases per 100,000 Asian/Pacific Islander adults (Howlan, Noon, Krapcho et al. 2017).

Social impact in addressing the population health problem

Some social impact of addressing colon cancer screening may be a lack of awareness. It may prohibit the patient from completing prescreening assessment forms. Sometimes lack of knowledge of the preparation protocol for a colonoscopy may also be a barrier. And sometimes, patients fear positive test results, so it delays screening. Another social impact may be mistrust for the health care provider either from other individual experience or their own experience. And most importantly, health disparities are caused by inequalities to access to healthcare and quality CRC screening and treatment. Despite these trends, Black adults across all ages, including those younger than 50 years, continue to have a higher incidence of and mortality from colorectal cancer than white adults.

Health Interventions.

The screening program reviewed is populated-based, and its conclusive findings can be applied to the general population. Additionally, conclusive data can be utilized to improve health policy. Lastly, the screening program provides an opportunity for researchers to investigate further screening recommendations for adults aged 45-75 years.

 

References

Cancer stat facts: colorectal cancer. National Cancer Institute. Accessed March 30, 2021. https://seer.cancer.gov/statfacts/html/colorect.html

Friis, R. H., & Sellers, T. A. (2020). Epidemiology for public health practice (6th ed.). Jones & Bartlett.

Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2017. National Cancer Institute. Published April 15, 2020. Accessed March 30, 2021. https://seer.cancer.gov/csr/1975_ 2017/

Lin JS, Perdue LA, Henrikson NB, Bean SI, Blasi PR. Screening for Colorectal Cancer: An Evidence Update for the US Preventive Services Task Force. Evidence Synthesis No. 202. Agency for Healthcare Research and Quality; 2021. AHRQ publication 20-05271-EF-1.

Ubel, P. A., Scherr, K. A., & Fagerlin, A. (2018). Autonomy: What’s shared decision making have to do with it? The American Journal of Bioethics, 18(2), W11–W12. https://doi.org/10.1080/15265161.2017.140984

United States Preventive Taskforce (2021): Colorectal Cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS:  NURS 8310 Discussion: Screening for Disease SOLUTION

Lopes Write Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource