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Clinical Gastroenterology and... Jul 2019
Topics: Chlamydia trachomatis; Diagnosis, Differential; Homosexuality, Male; Humans; Lymphogranuloma Venereum; Male; Middle Aged; Proctitis; Rectum; Sigmoidoscopy
PubMed: 30081010
DOI: 10.1016/j.cgh.2018.06.019 -
Seminars in Oncology Feb 2017This review will comprise a general overview of colorectal cancer (CRC) screening. We will cover the impact of CRC, CRC risk factors, screening modalities, and guideline... (Review)
Review
This review will comprise a general overview of colorectal cancer (CRC) screening. We will cover the impact of CRC, CRC risk factors, screening modalities, and guideline recommendations for screening in average-risk and high-risk individuals. Based on this data, we will summarize our approach to CRC screening.
Topics: Colonoscopy; Colorectal Neoplasms; Cost-Benefit Analysis; Early Detection of Cancer; Feces; Humans; Occult Blood; Practice Guidelines as Topic; Risk; Sigmoidoscopy; Tomography, X-Ray Computed
PubMed: 28395761
DOI: 10.1053/j.seminoncol.2017.02.002 -
Journal of Cancer Research and Clinical... Feb 2016Colorectal cancer (CRC) is one of the major health problems worldwide and is often diagnosed at late stage. There is growing body of evidence in early detection of this... (Review)
Review
PURPOSE
Colorectal cancer (CRC) is one of the major health problems worldwide and is often diagnosed at late stage. There is growing body of evidence in early detection of this disease with novel screening modalities to reduce compliance and increase specificity of available methods. The aim of current review is to give an overview on currently available screening methods (e.g., fecal occult blood testing (FOBT), flexible sigmoidoscopy, and colonoscopy), with their own merits and disadvantages, and new genetic/epigenetic/protein markers, as novel screening modalities.
RESULT
There are several serum and fecal biomarkers that can predict CRC and polyps. Overall sensitivities for detection by fecal DNA markers ranged from 53 to 87%, while a panel of serum protein markers provides a sensitivity/specificity up to 85% for CRC. In particular, DNA methylation markers (e.g., SEPT9, SFRP2, and ALX4), circulating microRNAs (e.g., microRNA21), SNPs in microRNAs binding site (e.g., rs4596 located within a target region of the predicted miR-518a-5p and miR-527), protein markers (e.g., carcinoembryonic antigen, N-methyltransferase), or microsatellites instability in tumors with deficient mismatch repair of some genes are among the most interesting and promising biomarkers.
CONCLUSION
Increasing evidence supports the use of combined fecal and serum biomarkers with sigmoidoscopy and colonoscopy screening in order to maximize the benefits and reduce the number of false-positive tests and patients undergoing invasive methods, which in turn could overcome the limitations of the current screening methods for early detection of CRC and adenomas.
Topics: Biomarkers, Tumor; Colonoscopy; Colorectal Neoplasms; Early Detection of Cancer; Feces; Humans; Sigmoidoscopy
PubMed: 25687380
DOI: 10.1007/s00432-015-1928-z -
ANZ Journal of Surgery Jan 2018Colonoscopic surveillance in patients with a personal or family history of colorectal carcinoma or colonic polyps represents a significant workload for endoscopy... (Review)
Review
Colonoscopic surveillance in patients with a personal or family history of colorectal carcinoma or colonic polyps represents a significant workload for endoscopy services. Effective colonoscopic surveillance relies on quality endoscopic examination and appropriate surveillance interval. This review will discuss quality in colonoscopy and review guidelines for surveillance.
Topics: Adult; Aged; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Humans; Middle Aged; Population Surveillance; Practice Guidelines as Topic; Sigmoidoscopy
PubMed: 28803452
DOI: 10.1111/ans.14141 -
The American Journal of Gastroenterology Dec 2018In "Contrasting Effectiveness and Cost-Effectiveness of Colorectal Cancer (CRC) Screening under Commercial Insurance vs. Medicare", Ladabaum et al. model different CRC...
In "Contrasting Effectiveness and Cost-Effectiveness of Colorectal Cancer (CRC) Screening under Commercial Insurance vs. Medicare", Ladabaum et al. model different CRC screening scenarios that vary the combination of payer, perspective, screening ages, and time horizons. Fecal occult blood testing (FOBT), fecal immunochemical testing (FIT), colonoscopy and flexible sigmoidoscopy were all cost effective compared to no screening, even if initiating or stopping at age 65 years. Assuming perfect adherence, FIT and FOBT were cost saving and dominated colonoscopy. Screening between ages 50 and 64 years appeared relatively costly if only a limited time horizon was considered since the benefits accrue after age 65 years under Medicare.
Topics: Aged; Colonoscopy; Colorectal Neoplasms; Cost-Benefit Analysis; Early Detection of Cancer; Humans; Insurance Carriers; Mass Screening; Medicare; Middle Aged; Occult Blood; Sigmoidoscopy; United States
PubMed: 30374119
DOI: 10.1038/s41395-018-0386-z -
World Journal of Gastroenterology Jul 2015Colorectal cancer (CRC) is the third leading cause of death worldwide and represents a clinical challenge. Family members of patients affected by CRC have an increased... (Review)
Review
Colorectal cancer (CRC) is the third leading cause of death worldwide and represents a clinical challenge. Family members of patients affected by CRC have an increased risk of CRC development. In these individuals, screening is strongly recommended and should be started earlier than in the population with average risk, in order to detect neoplastic precursors, such as adenoma, advanced adenoma, and nonpolypoid adenomatous lesions of the colon. Fecal occult blood test (FOBT) is a non invasive, widespread screening method that can reduce CRC-related mortality. Sigmoidoscopy, alone or in addition to FOBT, represents another screening strategy that reduces CRC mortality. Colonoscopy is the best choice for screening high-risk populations, as it allows simultaneous detection and removal of preneoplastic lesions. The choice of test depends on local health policy and varies among countries.
Topics: Biomarkers, Tumor; Colonoscopy; Colorectal Neoplasms; Genetic Predisposition to Disease; Genetic Testing; Heredity; Humans; Mass Screening; Occult Blood; Pedigree; Phenotype; Predictive Value of Tests; Prognosis; Risk Factors; Sigmoidoscopy
PubMed: 26185367
DOI: 10.3748/wjg.v21.i26.7944 -
PloS One 2023Physical harm from Colorectal Cancer Screening tends to be inadequately measured and reported in clinical trials. Also, studies of ongoing Colorectal Cancer Screening... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Physical harm from Colorectal Cancer Screening tends to be inadequately measured and reported in clinical trials. Also, studies of ongoing Colorectal Cancer Screening programs have found more frequent and severe physical harm from screening procedures, e.g., bleeding and perforation, than reported in previous trials. Therefore, the objectives of the study were to systematically review the evidence on the risk of bleeding and perforation in Colorectal Cancer Screening.
DESIGN
Systematic review with descriptive statistics and random-effects meta-analyses.
METHODS
We systematically searched five databases for studies investigating physical harms related to Colorectal Cancer Screening. We assessed the internal and the external validity using the ROBINS-I tool and the GRADE approach. Harm estimates was calculated using mixed Poisson regression models in random-effect meta-analyses.
RESULTS
We included 89 studies. Reporting and measurement of harms was inadequate in most studies. In effect, the risk of bias was critical in 97.3% and serious in 98.3% of studies. All GRADE ratings were very low. Based on severe findings with not-critical risk of bias and 30 days follow-up, the risk of bleedings per 100,000 people screened were 8 [2;24] for sigmoidoscopy, 229 [129;408] for colonoscopy following fecal immunochemical test, 68 [39;118] for once-only colonoscopy, and 698 [443;1045] for colonoscopy following any screening tests. The risk of perforations was 88 [56;138] for colonoscopy following fecal immunochemical test and 53 [25;112] for once-only colonoscopy. There were no findings within the subcategory severe perforation with long-term follow-up for colonoscopy following any screening tests and sigmoidoscopy.
DISCUSSION
Harm estimates varied widely across studies, reporting and measurement of harms was mostly inadequate, and the risk of bias and GRADE ratings were very poor, collectively leading to underestimation of harm. In effect, we consider our estimates of perforation and bleeding as conservative, highlighting the need for better reporting and measurement in future studies.
TRIAL REGISTRATION
PROSPERO registration number: CRD42017058844.
Topics: Humans; Sigmoidoscopy; Early Detection of Cancer; Colorectal Neoplasms; Colonoscopy; Mass Screening; Hemorrhage; Occult Blood
PubMed: 37906565
DOI: 10.1371/journal.pone.0292797 -
Lakartidningen May 2018Convincing data demonstrate that screening reduces mortality in colorectal cancer. International organizations and national authorities recommend implementation of... (Review)
Review
Convincing data demonstrate that screening reduces mortality in colorectal cancer. International organizations and national authorities recommend implementation of colorectal cancer screening programs. There are several different primary methods for screening, including tests of blood in feces, sigmoidoscopy and colonoscopy, all with their inherent advantages and disadvantages. The majority of programs utilizes fecal occult blood test as primary screening method followed by colonoscopy. Colonoscopy as a primary screening method has the advantage of directly removing precancerous lesions and ongoing studies evaluates the role of colonoscopy as a primary screening method for colorectal cancer. Challenges for implementation of screening in Sweden include limited access to colonoscopy resources and problems to reassure quality control. This article summarizes current evidence for colorectal cancer screening, as well as methods and requirements for implementation.
Topics: Colonoscopy; Colorectal Neoplasms; Early Detection of Cancer; Evidence-Based Medicine; Health Plan Implementation; Humans; Mass Screening; Occult Blood; Sigmoidoscopy; Sweden
PubMed: 29809270
DOI: No ID Found -
Current Oncology (Toronto, Ont.) Nov 2022Colorectal cancer (CRC) is the third most prevalent cancer, and the second most common cancer-related cause of death in the United States (USA). Timely screening reduces...
Colorectal cancer (CRC) is the third most prevalent cancer, and the second most common cancer-related cause of death in the United States (USA). Timely screening reduces both CRC incidence and mortality. Understanding population behaviors and factors that influence CRC screening is important for directing interventions targeted at reducing CRC rates. The 1997-2018 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed for trends in colonoscopy and sigmoidoscopy utilization for CRC screening among adults in Georgia, USA. Overall, in Georgia, there has been an increase in the prevalence of colonoscopy and sigmoidoscopy utilization from 48.1% in 1997 to 71.2% in 2018 (AAPC = 2.30, < 0.001). Compared nationally, this increase was less pronounced (from 41.0% in 1997 to 73.7% in 2018 (AAPC = 2.90, < 0.001) overall for USA). Logistic regression analysis of the 2018 BRFSS data, adjusting for sociodemographic factors, shows that sex (female vs. male [aOR = 1.20, C.I. = 1.05, 1.38]); marital status (couple vs. single [aOR = 1.20, C.I. = 1.04, 1.39]); healthcare coverage (yes vs. no [aOR = 3.86, C.I. = 3.05, 4.88]); age (60-69 years [aOR = 2.38, C.I. = 2.02, 2.80], 70-79 [aOR = 2.88, C.I. = 2.38, 3.48] vs. 50-59 years); education (high school [aOR = 1.32, C.I. = 1.05, 1.65], some post high school [aOR= 1.63, C.I. = 1.29, 2.06], college graduate [aOR = 2.08, C.I. = 1.64, 2.63] vs. less than high school); and income ($25,000-$49,999 [aOR = 1.24, C.I. = 1.01, 1.51], $50,000+ [aOR = 1.56, C.I. = 1.27, 1.91] vs. <$25,000) were all significantly associated with colonoscopy and sigmoidoscopy utilization. In Georgia, a significant increase over time in colonoscopy and sigmoidoscopy utilization for CRC screening was observed pertaining to the associated sociodemographic factors. The findings from this study may help guide tailored programs for promoting screening among underserved populations.
Topics: Male; Female; United States; Humans; Middle Aged; Aged; Sigmoidoscopy; Early Detection of Cancer; Georgia; Colonoscopy; Colorectal Neoplasms
PubMed: 36421356
DOI: 10.3390/curroncol29110703 -
European Journal of Cancer Care May 2015This random-effects meta-analysis investigates the accuracy of self-reported colorectal cancer screening history as a function of screening mode (colonoscopy, flexible... (Meta-Analysis)
Meta-Analysis Review
This random-effects meta-analysis investigates the accuracy of self-reported colorectal cancer screening history as a function of screening mode (colonoscopy, flexible sigmoidoscopy, faecal occult blood testing - FOBT, double-contrast barium enema - DCBE) and survey mode (written, telephone, face-to-face). Summary estimates of sensitivity, specificity, positive predictive value (PPV) and area under the receiver operating characteristic curve (AUC) were calculated. Medical record data were used as reference. We included 23 studies comprising 11,592 subjects. Colonoscopy yielded higher AUC [0.948, 95% confidence interval (CI) = 0.918, 0.968] than flexible sigmoidoscopy (0.883, 95% CI = 0.849, 0.911) and FOBT (0.869, 95% CI = 0.833, 0.898). Colonoscopy showed the highest sensitivity (0.888, 95% CI = 0.835, 0.931), whereas specificity was comparable between screening modes (ranging from 0.802 for FOBT to 0.904 for DCBE). AUC was not significantly different between survey modes. Prevalence of screening history correlated positively with sensitivity and negatively with specificity, possibly because of errors in the medical records. In conclusion, the accuracy of self-reported cancer screening is generally moderate, and higher for colonoscopy than for sigmoidoscopy and FOBT.
Topics: Area Under Curve; Colonoscopy; Colorectal Neoplasms; Early Detection of Cancer; Humans; Mass Screening; Predictive Value of Tests; Self Report; Sensitivity and Specificity; Sigmoidoscopy
PubMed: 24754544
DOI: 10.1111/ecc.12204