Screening for undescended testes

Article Abstract:

Cryptorchidism, failure of the testes to descend into the scrotum, is a risk factor for testicular cancer and is associated with reduced fertility and testicular torsion (twisting). Physicians generally agree that cryptorchidism should be detected and surgically treated by age five. However, the condition is often only detected and treated at much older ages, probably because of being missed during screening and examination of young children. The effectiveness of screening for undescended testes in one English locality was evaluated. In the four-year study period, 313 operations on undescended testes were performed. The number of patients in three age groups, one to four years, five to six years, and over six years, were similar. In the locality studied, newborn examinations were performed by physicians, development screening of children under five was done by health visitors (social workers trained in medical screening who visit the home), and school exams were done by a physician. Testicular examination was not part of the formal content of health visitors' screening programs. Detection rates under age five were low, about 18 percent for doctors and half that for health visitors. School doctors had a higher referral rate, and parents sought medical care for the condition in 43 percent of the cases. The report suggests that increasing the awareness of health visitors and education of parents about cryptorchidism should reduce late detection of the condition. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Cryptorchism, Undescended testes

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Preschool vision screening in Cornwall: performance indicators of community orthoptists

Article Abstract:

The aim of preschool vision screening programs is usually to identify children with visual defects such as strabismus or amblyopia ('lazy eye') early, when treatment is most likely to be successful. The cost-effectiveness of these screening programs have not been well studied, however. One such program in Cornwall (England) used community-based orthoptists (optometrists) to screen all children over three and a half years of age. Any children found to have visual problems were referred to ophthalmologists and the family physician was notified. The effectiveness of the program in screening two groups of children, 298 born in 1980 and 300 born in 1982, was evaluated. All but 157 children were actually tested. Of 20 children with squints referred from the 1980 group, three were misdiagnosed, while no false positive squinting occurred in the 1982 group. More children who squinted were detected by school medical personnel, all of which were false positives. The orthoptists in the program detected about 90 percent of children with visual defects and were 99 percent accurate in excluding children without defects. The report suggests that direct screening by community orthoptists is more efficient than testing of children by home health visitors who refer children with potential problems only secondarily to orthoptists. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Vision, Vision tests

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