Core biopsy (CB) has now largely replaced fine-needle aspiration cytology (FNAC) in the preoperative assessment of breast cancer in the UK. We studied the contribution of FNAC and CB in the preoperative diagnosis of screen-detected breast carcinoma. Data were prospectively collected on 150 840 women who underwent breast screening over a 4-year period from 1999 to 2003. Data on women who had both FNAC and CB taken from the same lesion preoperatively and in whom surgical excision of the lesion subsequently confirmed malignancy was analysed. In 763 cancers, FNAC was inadequate (C1) in 8% and benign (C2) in 10%. Most of these cases presented with microcalcification (25% were C1 or C2). Core biopsy was not representative (B1) or benign (B2) in 7%. The absolute and complete sensitivities were 65 and 82% for FNAC and 80 and 93% for CB in the diagnosis of cancer. Core biopsy was abnormal (B3 or above) in 86% of the cancers missed by FNAC and FNAC was abnormal (C3 or above) in 65% of those missed by CB. Core biopsy is better than FNAC at preoperative diagnosis of screen-detected breast cancer as it missed fewer cancers. However, combining FNAC resulted in a better preoperative diagnosis rate. The National Health Service Breast Screening Programme (NHSBSP) was introduced in the United Kingdom in 1987, following publication of the findings of an expert committee the previous year. At present, all women aged 50 -70 years are offered two-view screening mammography every 3 years. Patients with radiologically suspicious lesions are recalled for further assessment that may include clinical examination, special mammographic views, ultrasound and collection of tissue for pathological assessment by fine-needle aspiration cytology (FNAC), core biopsy (CB), or more recently, by wide bore vacuum biopsy.In the early stages of NHSBSP, FNAC was the test used in the assessment. Core biopsy was introduced in the assessment process in late 1990s. The experience with this technique has improved considerably and CB is now considered to be the standard. The preoperative diagnosis rate of screen-detected carcinoma has been improving with increasing use of CB. Correspondingly, the use of FNAC is in decline and a number of screening units in the UK have abandoned it completely (Britton et al, 1997).At the Bedfordshire and Hertfordshire Breast Screening Unit, CB was introduced in the assessment of screen-detected breast lesions in 1997, but we continued to perform FNAC in addition in the majority of patients with suspicious lesions. The aim of this study was to assess the performance of FNAC and CB in the preoperative diagnosis of screen-detected breast carcinoma. MATERIALS AND METHODSData were prospectively collected on all women who attended the Bedfordshire and Hertfordshire Breast Screening Unit, England. We reviewed a 4-year period from April 1999 to March 2003. This period was chosen to ensure that operators had gained sufficient expertise in the use of CB, which was introduced in 1997. We selected, for detailed analysis, the women who had ...

Objective Empowerment is critical for cancer patients to make informed choices, to manage medication, and to navigate through the oncological care system. Cancer peer support provides patients with information, emotional relief and may promote empowerment. This paper provides a systematic review of the literature examining the impact of cancer peer support interventions on psychological empowerment. Methods PubMed, Web of Science, CINAHL, Cochrane Library, PsycINFO and PSYNDEX databases were systematically searched from inception until December 2020. We included quantitative studies, published in English or German, which examined peer‐led cancer support interventions and their impact on the three components of psychological empowerment (intrapersonal, interactional and behavioural) among participating cancer patients. Results Database searches and screening of relevant reference lists identified 2336 potentially relevant articles. A total of 29 studies were included in the review. Active coping, self‐efficacy and knowledge were the most prominent dimensions of empowerment in these studies. The majority of studies revealed that peer support led to a small to medium, significant increase in psychological empowerment, and was associated with further patient‐reported benefits. Conclusions The existing evidence suggests a weak to moderate, positive association between cancer peer support and the three components of psychological empowerment among cancer patients. Peer support groups should be seen as an important element in cancer care and clinical practice and, thus, be more systematically involved in cancer care.

The aim of the study was to investigate the relationship between specific known dietary patterns and the prevalence of periodontal disease in a northern population-based cohort study. We evaluated data from 6209 participants of the Hamburg City Health Study (HCHS). The HCHS is a prospective cohort study and is registered at ClinicalTrial.gov (NCT03934957). Dietary intake was assessed with the food frequency questionnaire (FFQ2). Periodontal examination included probing depth, gingival recession, plaque index, and bleeding on probing. Descriptive analyses were stratified by periodontitis severity. Ordinal logistic regression models were used to determine the association. Ordinal regression analyses revealed a significant association between higher adherence to the DASH diet/Mediterranean diet and lower odds to be affected by periodontal diseases in an unadjusted model (OR: 0.92; 95% CI: 0.87, 0.97; p < 0.001/OR: 0.93; 95% CI: 0.91, 0.96; p < 0.001) and an adjusted model (age, sex, diabetes) (OR: 0.94; 95% CI: 0.89, 1.00; p < 0.0365/OR: 0.97; 95% CI: 0.94, 1.00; p < 0.0359). The current cross-sectional study identified a significant association between higher adherence to the DASH and Mediterranean diets and lower odds to be affected by periodontal diseases (irrespective of disease severity). Future randomized controlled trials are needed to evaluate to which extent macro- and micronutrition can affect periodontitis initiation/progression.

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Cultural background influences how migrants and ethnic minority populations view and assess health. Poor oral health literacy (OHL) may be a hindrance in achieving good oral health. This systematic review summarizes the current quantitative evidence regarding OHL of migrants and ethnic minority populations. The PubMed database was searched for original quantitative studies that explore OHL as a holistic multidimensional construct or at least one of its subdimensions in migrants and ethnic minority populations. 34 publications were selected. Only 2 studies specifically addressed OHL in migrant populations. Generally, participants without migration background had higher OHL than migrant and ethnic minority populations. The latter showed lower dental service utilization, negative oral health beliefs, negative oral health behavior, and low levels of oral health knowledge. Due to its potential influence on OHL, oral health promoting behavior, attitudes, capabilities, and beliefs as well as the cultural and ethnic background of persons should be considered in medical education and oral health prevention programs.

While the effects of dietary patterns on cardiovascular risk and diabetes have been well studied, the evidence is scarce as to which diet has the greatest anti-inflammatory potential and how dietary patterns are associated with periodontitis. In the Hamburg City Health Study (HCHS), we developed an anti-inflammatory dietary score using a data-driven approach based on the relationship of relevant selected food groups with inflammatory biomarkers (hsCRP and IL-6). The aim of this cross-sectional study was to evaluate the association between the anti-inflammatory dietary score and the incidence of periodontitis in Hamburg, Germany. A total of n = 5642 participants fit the required inclusion criteria and were selected for analysis. Periodontal disease was assessed using probing depth, gingival recession, and bleeding on probing. Dietary intake was measured using a food frequency questionnaire (FFQ). A self-developed anti-inflammatory dietary score served as the key explanatory variable. Higher scores reflected lower inflammatory processes (measured through the biomarkers hsCRP and IL-6). Several covariates were included in the regression analysis. Regressions revealed that a higher anti-inflammatory dietary score was significantly associated with lower odds to be affected by periodontal disease in an unadjusted model (OR 0.86, 95% CI 0.82–0.89, p < 0.001) and in an adjusted model (age, sex, smoking, diabetes, hypertension, and physical activity) (OR 0.93, 95% CI 0.89–0.98, p = 0.003). Our study demonstrated a significant inverse association between an anti-inflammatory dietary score and periodontitis. Individuals with higher intake of proinflammatory nutrition should be specifically addressed to avoid periodontitis.

Zusammenfassung Hintergrund Erste Studien heben den Migrationshintergrund von Menschen in Deutschland als eigenständigen Risikofaktor für eine mangelhafte Mundgesundheit hervor. Ein wichtiger Einflussfaktor könnte hierbei eine niedrigere Mundgesundheitskompetenz von Menschen mit Migrationshintergrund sein. Ziel In diesem Artikel werden Ergebnisse zur Mundgesundheitskompetenz und Mundgesundheit aus der MuMi-Studie (Förderung der Mundgesundheit und Mundgesundheitskompetenz von Menschen mit Migrationshintergrund) vorgestellt. Material und Methoden In 40 Hamburger Zahnarztpraxen wurden von Patient*innen mit und ohne Migrationshintergrund Daten zu Soziodemografie, Mundgesundheit und Mundgesundheitskompetenz erhoben. Der Zusammenhang zwischen Mundgesundheitskompetenz und Mundgesundheit wurde mittels logistischer Regressionen berechnet. Potenzielle Einflussfaktoren wurden schrittweise in die Berechnungsmodelle eingefügt. Ergebnisse Die Gruppen mit und ohne Migrationshintergrund unterschieden sich signifikant hinsichtlich ihrer Mundgesundheitskompetenz und ausgewählter klinischer Parameter ihrer Mundgesundheit (Approximalraum-Plaqueindex und Kariessanierungsgrad). Die logistischen Regressionsanalysen zeigen einen deutlichen Zusammenhang zwischen Migrationshintergrund, Mundgesundheitskompetenz und Mundhygiene auch unter Berücksichtigung von Bildung und sozioökonomischem Status. Diskussion Der Migrationshintergrund stellt einen eigenständigen Indikator für eine niedrige Mundgesundheitskompetenz und schlechtere Mundgesundheit dar. Dieser Umstand sollte stärker in den Fokus von Forschung und politischen Entscheidungen rücken, um die mundgesundheitliche Chancengleichheit in Deutschland zu erhöhen.

Background There is limited knowledge regarding the association between oral health and mental health in terms of depressive symptoms and particularly anxiety symptoms. Therefore, our aim was to close this gap in knowledge. Methods Cross‐sectional data were used from wave 5 of the pan‐European Survey of Health Ageing, and Retirement in Europe (SHARE) (n = 62 358 observations). The Beck Anxiety Inventory was used to quantify anxiety symptoms and the Euro‐D was used to measure depressive symptoms. Oral health was quantified based on the presence of missing natural teeth, the number of missing natural teeth and the extent of replaced teeth. It was adjusted for several covariates in regression analysis. Results Multiple linear regressions revealed that the presence of missing natural teeth was associated with higher anxiety symptoms (β = 0.11, P < 0.001) and higher depressive symptoms (β = 0.22, P < 0.001) among the total sample. Among individuals with at least one missing natural tooth, the number of missing natural teeth was positively associated with higher anxiety symptoms (β = 0.02, P < 0.001) and higher depressive symptoms (β = 0.02, P < 0.001) – and fully replaced teeth (compared to not at all replaced teeth) were associated with lower anxiety symptoms (β = −0.35, P < 0.001) and lower depressive symptoms (β = −0.36, P < 0.001). Conclusion Our study stresses the association between lower oral health and lower mental health among older adults in Europe. Future studies based on longitudinal data are required.