scholarly journals Epidemiologic Disparities in Colon Cancer Screening and Adherence during the COVID-19 Pandemic: A Retrospective Cohort Analysis

2022 ◽  
Author(s):  
Eugene Chiemeka Nwankwo ◽  
Christian Hendrix ◽  
Kelvin Pollard ◽  
Chad Kallal ◽  
Tim Cruschiel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
African Americans ◽  
Cohort Analysis ◽  
Screening Methods ◽  
Chi Square ◽  
Screening Programs ◽  
Crc Screening ◽  
Testing Uptake ◽  
Chi Square Analysis ◽  
The Impact

Abstract Background: Colorectal cancer (CRC) is the second-leading cause of death in the US. Despite the National Colorectal Roundtable goal of achieving 80% adherence, CRC screening remains underutilized, especially in the underinsured populations. Screening programs have been heavily disrupted during the COVID-19 pandemic. Aim: This research was performed to explore the impact of the pandemic on the existing ethnic and gender disparities prevalent in CRC screening. Methods: Patients were identified 1 year before and after COVID-19 precautions began, using March 1, 2020, as the inflection point. For each year, the primary inclusion criterion was an ordered colonoscopy. The outcome of interest was a colonoscopy performed. Differences by year and race were assessed using Chi-square analysis. A cohort of 1413 patients between age 45 and 75 for whom a colonoscopy was ordered was selected from EHR at a single large institution. 897 patients were in the pre-COVID group, and 516 were in the post-COVID group. Results: There was a 51% reduction in screening colonoscopies performed. White patients had a decrease of 49%, and African Americans had a 55% reduction. Stool testing increased from 47% prior to the pandemic to 94% during the pandemic representing a greater than 100% increase in stool testing uptake. Conclusion: The true impact of COVID-19 on colorectal cancer is yet to be uncovered as future mortality estimates from CRC are ongoing. Due to the widespread closure of endoscopy centers and delay in screening, we believe that the pandemic worsened the screening disparities most prevalent among minority populations. Our retrospective analysis over the last two years points to the drastic reduction of screening for all races, and especially for African Americans. As life gradually returns to normal, it would be interesting to see how the past year has impacted the incidence and prevalence of CRC.

scholarly journals Towards Novel Non-Invasive Colorectal Cancer Screening Methods: A Comprehensive Review

2021 ◽  
Author(s):  
Allegra Ferrari ◽  
Isabelle Neefs ◽  
Sarah Hoeck ◽  
Marc Peeters ◽  
Guido Van Hal
Keyword(s):  
Colorectal Cancer ◽  
Early Stage ◽  
Screening Tests ◽  
Screening Methods ◽  
Exhaled Breath ◽  
Sample Collection ◽  
Screening Programs ◽  
Crc Screening ◽  
Low Sensitivity ◽  
Standard Colonoscopy

Colorectal cancer (CRC) is one of the leading cancer-related causes of death in the world. Since the 70s, many countries have adopted different CRC screening programs which has resulted in a decrease in mortality. However, current screening test options still present downsides. The commercialized stool-based tests present high false-positive rates and low sensitivity, which negatively affects the detection of early stage carcinogenesis. The gold standard colonoscopy has low uptake due to its invasiveness and the perception of discomfort and embarrassment that the procedure may bring.In this review, we collected and described the latest data about alternative CRC screening techniques that can overcome these disadvantages. Web of Science and PubMed were employed as search engines for studies reporting on CRC screening tests and future perspectives. The searches generated 555 articles, of which 93 titles were selected. Finally, a total of 50 studies, describing 14 different CRC alternative tests, were included. Among the investigated techniques the main feature that could have an impact on CRC screening perception and uptake was the ease of sample collection. Urine, exhaled breath and blood-based tests promise to achieve good diagnostic performance (sensitivity of 63-100%, 90-95%, 47-97%, respectively) while minimizing stress and discomfort for the patient.

scholarly journals Using fecal immunochemical tubes for the analysis of the gut microbiome has the potential to improve colorectal cancer screening

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kertu Liis Krigul ◽  
Oliver Aasmets ◽  
Kreete Lüll ◽  
Tõnis Org ◽  
Elin Org
Keyword(s):  
Colorectal Cancer ◽  
Public Health Problem ◽  
16S Rrna Gene Sequencing ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Rrna Gene ◽  
Screening Programs ◽  
Crc Screening ◽  
Fresh Frozen ◽  
The Impact

AbstractColorectal cancer (CRC) is a challenging public health problem which successful treatment depends on the stage at diagnosis. Recently, CRC-specific microbiome signatures have been proposed as a marker for CRC detection. Since many countries have initiated CRC screening programs, it would be useful to analyze the microbiome in the samples collected in fecal immunochemical test (FIT) tubes for fecal occult blood testing. Therefore, we investigated the impact of FIT tubes and stabilization buffer on the microbial community structure evaluated in stool samples from 30 volunteers and compared the detected communities to those of fresh-frozen samples, highlighting previously published cancer-specific communities. Altogether, 214 samples were analyzed by 16S rRNA gene sequencing, including positive and negative controls. Our results indicated that the variation between individuals was greater than the differences introduced by the collection strategy. The vast majority of the genera were stable for up to 7 days. None of the changes observed between fresh-frozen samples and FIT tube specimens were related to previously identified CRC-specific bacteria. Overall, we show that FIT tubes can be used for profiling the microbiota in CRC screening programs. This circumvents the need to collect additional samples and can possibly improve the sensitivity of CRC detection.

Patient navigation (PN) for colorectal cancer screening (CRC): Experience in program implementation for underserved neighborhoods of Cleveland, Ohio.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 147-147
Author(s):  
Katherine Glass ◽  
Aqeel Seals
Keyword(s):  
Colorectal Cancer ◽  
Program Implementation ◽  
Patient Navigation ◽  
Underserved Populations ◽  
Screening Method ◽  
Screening Methods ◽  
Community Members ◽  
Crc Screening ◽  
The Impact ◽  
Cleveland Ohio

147 Background: Cleveland, Ohio has high rates of colorectal cancer (CRC). 50% of CRC in Cleveland is late stage, and rates of CRC screening in Cleveland are low. Colonoscopy is a screening method for CRC, but barriers exist for the underserved population of Cleveland. The Fecal Immunohistochemical Test (FIT) is a less-costly and non-invasive CRC screening method that has demonstrated increased uptake in CRC screening for underserved populations. Previous literature has demonstrated that Patient Navigation (PN) can increase screening rates in underserved populations through education and assistance to overcome barriers to care. Little, however, has been published about the impact of pairing PN with a program that encourages either colonoscopies or FIT utilization to complete screening. Methods: Community members were educated about both colonoscopies and FIT in a neutral manner. After education, interested participants provided preference for screening type. Participants received follow-up calls from patient navigators. Navigators provided encouragement to complete screening and collected information about barriers. Results: N = 612 patients received PN for CRC. 72% of the population (n = 442) were Black. 47% (n = 290) chose colonoscopy, and n = 322 chose FIT. 44% (n = 263) completed a screening. 19% (n = 55) of those choosing colonoscopy completed screening. 66% (n = 213) choosing FIT completed screening. Women who chose FIT were more likely than men who chose FIT to complete screening (86% vs. 45%, p < 0.001). Barriers to screening included appointment coordination, transportation, and insurance. Conclusions: When offered PN and choice of CRC screening, community members in Cleveland equally chose colonoscopy vs. FIT. Those that chose FIT were more likely to complete screening (p < 0.001). Barriers suggest access and use of healthcare remain challenging for underserved communities. The simplicity of FIT paired with PN may remove barriers for this population and increase screening uptake. More research needs to be done to understand the impact of PN on sustained rate of completion.

scholarly journals Towards Novel Non-Invasive Colorectal Cancer Screening Methods: A Comprehensive Review

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1820
Author(s):  
Allegra Ferrari ◽  
Isabelle Neefs ◽  
Sarah Hoeck ◽  
Marc Peeters ◽  
Guido Van Hal
Keyword(s):  
Colorectal Cancer ◽  
Early Stage ◽  
Screening Tests ◽  
Screening Methods ◽  
Exhaled Breath ◽  
Sample Collection ◽  
Screening Programs ◽  
Crc Screening ◽  
Low Sensitivity ◽  
Standard Colonoscopy

Colorectal cancer (CRC) is one of the leading cancer-related causes of death in the world. Since the 70s, many countries have adopted different CRC screening programs, which has resulted in a decrease in mortality. However, current screening test options still present downsides. The commercialized stool-based tests present high false-positive rates and low sensitivity, which negatively affects the detection of early stage carcinogenesis. The gold standard colonoscopy has low uptake due to its invasiveness and the perception of discomfort and embarrassment that the procedure may bring. In this review, we collected and described the latest data about alternative CRC screening techniques that can overcome these disadvantages. Web of Science and PubMed were employed as search engines for studies reporting on CRC screening tests and future perspectives. The searches generated 555 articles, of which 93 titles were selected. Finally, a total of 50 studies, describing 14 different CRC alternative tests, were included. Among the investigated techniques, the main feature that could have an impact on CRC screening perception and uptake was the ease of sample collection. Urine, exhaled breath, and blood-based tests promise to achieve good diagnostic performance (sensitivity of 63–100%, 90–95%, and 47–97%, respectively) while minimizing stress and discomfort for the patient.

scholarly journals National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1129
Author(s):  
Audrius Dulskas ◽  
Tomas Poskus ◽  
Inga Kildusiene ◽  
Ausvydas Patasius ◽  
Rokas Stulpinas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Assurance ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Histopathological Examination ◽  
Insurance Fund ◽  
Crc Screening ◽  
Cancer Screening Program ◽  
The Impact

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.

scholarly journals Colorectal cancer screening using a stool DNA-based SDC2 methylation test: a multicenter, prospective trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Woo Kim ◽  
Hyunjin Kim ◽  
Hyoung Rae Kim ◽  
Bong-Hyeon Kye ◽  
Hyung Jin Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Early Detection ◽  
Prospective Trial ◽  
Screening Colonoscopy ◽  
Quantitative Detection ◽  
Screening Programs ◽  
Crc Screening ◽  
Stool Dna ◽  
Dna 2

Abstract Background Prevention and early detection of colorectal cancer (CRC) is a global priority, with many countries conducting population-based CRC screening programs. Although colonoscopy is the most accurate diagnostic method for early CRC detection, adherence remains low because of its invasiveness and the need for extensive bowel preparation. Non-invasive fecal occult blood tests or fecal immunochemical tests are available; however, their sensitivity is relatively low. Syndecan-2 (SDC2) is a stool-based DNA methylation marker used for early detection of CRC. Using the EarlyTect™-Colon Cancer test, the sensitivity and specificity of SDC2 methylation in stool DNA for detecting CRC were previously demonstrated to be greater than 90%. Therefore, a larger trial to validate its use for CRC screening in asymptomatic populations is now required. Methods All participants will collect their stool (at least 20 g) before undergoing screening colonoscopy. The samples will be sent to a central laboratory for analysis. Stool DNA will be isolated using a GT Stool DNA Extraction kit, according to the manufacturer’s protocol. Before performing the methylation test, stool DNA (2 µg per reaction) will be treated with bisulfite, according to manufacturer’s instructions. SDC2 and COL2A1 control reactions will be performed in a single tube. The SDC2 methylation test will be performed using an AB 7500 Fast Real-time PCR system. CT values will be calculated using the 7500 software accompanying the instrument. Results from the EarlyTect™-Colon Cancer test will be compared against those obtained from colonoscopy and any corresponding diagnostic histopathology from clinically significant biopsied or subsequently excised lesions. Based on these results, participants will be divided into three groups: CRC, polyp, and negative. The following clinical data will be recorded for the participants: sex, age, colonoscopy results, and clinical stage (for CRC cases). Discussion This trial investigates the clinical performance of a device that allows quantitative detection of a single DNA marker, SDC2 methylation, in human stool DNA in asymptomatic populations. The results of this trial are expected to be beneficial for CRC screening and may help make colonoscopy a selective procedure used only in populations with a high risk of CRC. Trial registration: This trial (NCT04304131) was registered at ClinicalTrials.gov on March 11, 2020 and is available at https://clinicaltrials.gov/ct2/show/NCT04304131?cond=NCT04304131&draw=2&rank=1.

scholarly journals To do or not to do – a survey study on factors associated with participating in the Danish screening program for colorectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jesper Bo Nielsen ◽  
Gabriele Berg-Beckhoff ◽  
Anja Leppin
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Demographic Data ◽  
Survey Study ◽  
Stepwise Logistic Regression ◽  
Willingness To Participate ◽  
Cross Sectional Survey ◽  
Screening Programs ◽  
Crc Screening ◽  
Screening Participation

Abstract Background Screening programs for colorectal cancer (CRC) exist in many countries, and with varying participation rates. The present study aimed at identifying socio-demographic factors for accepting a cost-free screening offer for CRC in Denmark, and to study if more people would accept the screening offer if the present fecal test was replaced by a blood test. Methods We used a cross-sectional survey design based on a representative group of 6807 Danish citizens aged 50–80 years returning a fully answered web-based questionnaire with socio-demographic data added from national registries. Data were analyzed in STATA and based on bivariate analyses followed by regression models. Results Danes in general have a high level of lifetime participation (+ 80%) in the national CRC screening program. The results of the stepwise logistic regression model to predict CRC screening participation demonstrated that female gender, higher age, higher income, and moderate alcohol intake were positively associated with screening participation, whereas a negative association was observed for higher educational attainment, obesity, being a smoker, and higher willingness to take health risks. Of the 1026 respondents not accepting the screening offer, 61% were willing to reconsider their initial negative response if the fecal sampling procedure were replaced by blood sampling. Conclusion The CRC screening program intends to include the entire population within a certain at-risk age group. However, individual factors (e.g. sex, age obesity, smoking, risk aversity) appear to significantly affect willingness to participate in the screening program. From a preventive perspective, our findings indicate the need for a more targeted approach trying to reach these groups.

scholarly journals Selection of patients for large mailed fecal immunochemical test colorectal cancer screening outreach programs: A systematic review

2021 ◽  
pp. 096914132199748
Author(s):  
Andrew Wang ◽  
Briton Lee ◽  
Shreya Patel ◽  
Evans Whitaker ◽  
Rachel B Issaka ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Health Care ◽  
Cancer Screening ◽  
Patient Selection ◽  
Implementation Strategies ◽  
Screening Programs ◽  
Crc Screening ◽  
Key Informant ◽  
Immunochemical Test

Objective Digital health care offers an opportunity to scale and personalize cancer screening programs, such as mailed outreach for colorectal cancer (CRC) screening. However, studies that describe the patient selection strategy and process for CRC screening are limited. Our objective was to evaluate implementation strategies for selecting patients for CRC screening programs in large health care systems. Methods We conducted a systematic review of 30 studies along with key informant surveys and interviews to describe programmatic implementation strategies for selecting patients for CRC screening. PubMed and Embase were searched since inception through December 2018, and hand searches were performed of the retrieved reference lists but none were incorporated ( n = 0). No language exclusions were applied. Results Common criteria for outreach exclusion included: being up-to-date with routine CRC screening ( n = 22), comorbidities ( n = 20), and personal history ( n = 22) or family history of cancer ( n = 9). Key informant surveys and interviews were performed ( n = 28) to understand data sources and practices for patient outreach selection, and found that 13 studies leveraged electronic medical care records, 10 studies leveraged a population registry (national, municipal, community, health), 4 studies required patient opt-in, and 1 study required primary care provider referral. Broad ranges in fecal immunochemical test completion were observed in community clinic ( n = 8, 31.0–59.6%), integrated health system ( n = 5, 21.2–82.7%), and national regional CRC screening programs ( n = 17, 23.0–64.7%). Six studies used technical codes, and four studies required patient self-reporting from a questionnaire to participate. Conclusion This systematic review provides health systems with the diverse outreach practices and technical tools to support efforts to automate patient selection for CRC screening outreach.

scholarly journals Geographical Variation and Factors Associated with Colorectal Cancer Mortality in a Universal Health Care System

2014 ◽  
Vol 28 (4) ◽  
pp. 191-197 ◽  
Author(s):  
Mahmoud Torabi ◽  
Christopher Green ◽  
Zoann Nugent ◽  
Salaheddin M Mahmud ◽  
Alain A Demers ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Geographical Variation ◽  
Geographical Area ◽  
Capital City ◽  
Universal Health Care ◽  
Screening Programs ◽  
Crc Screening ◽  
Factors Associated ◽  
Universal Health

OBJECTIVE: To investigate the geographical variation and small geographical area level factors associated with colorectal cancer (CRC) mortality.METHODS: Information regarding CRC mortality was obtained from the population-based Manitoba Cancer Registry, population counts were obtained from Manitoba’s universal health care plan Registry and characteristics of the area of residence were obtained from the 2001 Canadian census. Bayesian spatial Poisson mixed models were used to evaluate the geographical variation of CRC mortality and Poisson regression models for determining associations with CRC mortality. Time trends of CRC mortality according to income group were plotted using joinpoint regression.RESULTS: The southeast (mortality rate ratio [MRR] 1.31 [95% CI 1.12 to 1.54) and southcentral (MRR 1.62 [95% CI 1.35 to 1.92]) regions of Manitoba had higher CRC mortality rates than suburban Winnipeg (Manitoba’s capital city). Between 1985 and 1996, CRC mortality did not vary according to household income; however, between 1997 and 2009, individuals residing in the highest-income areas were less likely to die from CRC (MRR 0.77 [95% CI 0.65 to 0.89]). Divergence in CRC mortality among individuals residing in different income areas increased over time, with rising CRC mortality observed in the lowest income areas and declining CRC mortality observed in the higher income areas.CONCLUSIONS: Individuals residing in lower income neighbourhoods experienced rising CRC mortality despite residing in a jurisdiction with universal health care and should receive increased efforts to reduce CRC mortality. These findings should be of particular interest to the provincial CRC screening programs, which may be able to reduce the disparities in CRC mortality by reducing the disparities in CRC screening participation.

Sampling bias created by ampicillin in isolation media forAeromonas

2007 ◽  
Vol 53 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Jennifer R Huddleston ◽  
John C Zak ◽  
Randall M Jeter
Keyword(s):  
Sampling Bias ◽  
Aeromonas Species ◽  
Aquatic Environments ◽  
Selective Agent ◽  
Opportunistic Pathogens ◽  
Chi Square ◽  
Isolation Medium ◽  
Ability To Act ◽  
Chi Square Analysis ◽  
The Impact

Members of the bacterial genus Aeromonas are widely isolated from aquatic environments and studied in part for their ability to act as opportunistic pathogens in a variety of animals. All aeromonads, with the exception of Aeromonas trota, are generally thought to be resistant to ampicillin, so the antibiotic is frequently added to isolation medium as a selective agent. In this study, 282 aeromonads from environmental sources were isolated on a medium without ampicillin and their resistance to ampicillin determined. Of the 104 of these isolates that were judged to be independent (nonredundant), 18 (17.3%) were susceptible to ampicillin. A chi-square analysis was performed to determine the impact of ampicillin use on enumerating Aeromonas species from environmental samples. Our results indicate that, when ampicillin is used as a selective agent, a significant portion of the aeromonad population in at least some environ ments can be omitted from isolation.Key words: Aeromonas, ampicillin, selective media.

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