scholarly journals Low rate of follow-up colonoscopy after positive results of colorectal cancer screening in a Chinese urban core district

2019 ◽  
Author(s):  
Yawen Guo ◽  
Qingwu Jiang ◽  
Tetsuya Tanimoto ◽  
Masahiro Kami ◽  
Peng Peng ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rural Areas ◽  
Municipal Government ◽  
Precancerous Lesions ◽  
Population Based ◽  
Registry Data ◽  
Crc Screening ◽  
Incidence And Mortality ◽  
The Status

AbstractColorectal cancer (CRC) is one of the most common cancers in China. In 2003, a systematic CRC registry that enables the determination of CRC incidence and mortality and a CRC screening project were introduced in the Jing’an district of Shanghai by the municipal government. This study assessed the registry data to determine the status of CRC and CRC screening rates in the core district of an urban area of China. Data were retrieved from the Official registry information systems of Jing’an district Shanghai Cance. The incidence and mortality of CRC, as well as population-based CRC screening rates, were analysed. Individuals who screened positive for CRC based upon results of a high-risk factor questionnaire (HRFQ) and a faecal immunochemical test (FIT) were selected for follow-up colonoscopy (CSPY). From the registry data collected between 2003 and 2013, the standardized incidence rate was 26.44/105, with a significant gender difference. The CRC standardized mortality rate was 10.08/105. In 2013, 17,866 individuals (21.6%) enrolled for CRC screening among the 82,602 candidate residents. The positive screening rate was 16.28% (2909/17866). Among the 2909 positives, 508 (17.5%) underwent follow-up CSPY. In 41.3% of these individuals (210/508), abnormal lesions were detected. Of these, 8 (1.57%) lesions were diagnosed as CRC, and 142 (28.0%) were identified as precancerous lesions. During the assessment period, both the incidence and mortality of CRC in the Jing’an district were determined in the area of high CRC prevalence in Chin. Nevertheless, the rate of participation in CRC screening was low (21.6%), and the rate of participation in follow-up CSPY for individuals who screened positive was only 17.5%. Improved participation in CRC screening and follow-up CSPY is expected to lower the incidence and mortality of CRC significantly in the rural areas of China. (288)

scholarly journals The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ane Sørlie Kværner ◽  
Einar Birkeland ◽  
Cecilie Bucher-Johannessen ◽  
Elina Vinberg ◽  
Jan Inge Nordby ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Gut Microbiome ◽  
Precancerous Lesions ◽  
Colorectal Carcinogenesis ◽  
Screening Tools ◽  
Screening Methods ◽  
Crc Screening ◽  
Link Type ◽  
Incidence And Mortality

Abstract Background Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions. Methods The CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50–74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period. Discussion The CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome-based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high. Trial registration ClinicalTrials.gov Identifier: NCT01538550.

scholarly journals A Survey of Provider Attitudes, Beliefs, and Perceived Barriers Regarding a Centralized Direct-Mail Colorectal Cancer Screening Approach at Community Health Centers

2019 ◽  
Vol 10 ◽  
pp. 215013271989095
Author(s):  
Jamie H. Thompson ◽  
Jennifer L. Schneider ◽  
Jennifer S. Rivelli ◽  
Amanda F. Petrik ◽  
William M. Vollmer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Population Based ◽  
Direct Mail ◽  
Provider Attitudes ◽  
Beliefs And Practices ◽  
Screening Programs ◽  
Crc Screening

Background: Colorectal cancer screening (CRC) rates are low, particularly among individuals with low socioeconomic status. Organized CRC screening programs have demonstrated success in increasing screening rates. Little is known about provider attitudes, beliefs, and practices related to CRC screening or how they are influenced by an organized CRC screening program. Methods: In 2014 and 2016, providers from 26 safety net clinics in Oregon and Northern California were invited to complete baseline and follow-up online surveys for the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC) study. The provider survey link was sent electronically to primary care providers serving adult patients. Providers were sent reminders every 2 weeks via email to complete the survey, up to 3 reminders total. In this article, we describe learnings about provider attitudes, beliefs, and practices related to CRC screening after implementation of the STOP CRC program. Results: A total of 166 unique providers completed baseline and/or follow-up surveys, representing 228 responses. Main themes included (1) favorable shifts in attitude toward fecal immunochemical test (FIT) and direct-mail cancer screening programs, (2) changes in provider perception of key barriers, and (3) growing interest in centralized automated systems for identifying patients due for CRC screening and eligible for population-based outreach. Discussion: Providers are interested in improved information systems for identifying patients due for CRC screening and delivering population-based outreach (ie, to distribute FIT kits outside of the clinic visit) to help reduce health system- and patient-level barriers to screening. Trial Registration: National Clinical Trial (NCT) Identifier NCT01742065.

scholarly journals The CRCbiome study: a large prospective cohort study examining the role of lifestyle and the gut microbiome in colorectal cancer screening participants

2020 ◽  
Author(s):  
Ane Sørlie Kværner ◽  
Einar Birkeland ◽  
Cecilie Bucher-Johannessen ◽  
Elina Vinberg ◽  
Jan Inge Nordby ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Gut Microbiome ◽  
Precancerous Lesions ◽  
Colorectal Carcinogenesis ◽  
Screening Tools ◽  
Screening Methods ◽  
Crc Screening ◽  
Link Type ◽  
Incidence And Mortality

AbstractBackgroundColorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions.MethodsThe CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50-74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period.DiscussionThe CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome- based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high.Trial RegistrationClinicalTrials.gov Identifier: NCT01538550

scholarly journals Reduction of Colorectal Cancer Mortality and Advanced Stage Cancer Incidence After 10 Years of Fecal Immunochemical Test Screening

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 206s-206s
Author(s):  
R.-C. Chen ◽  
H.-M. Chiu ◽  
Y.-W. Wang ◽  
J.C.-Y. Fann ◽  
A.M.-F. Yen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Advanced Cancer ◽  
Cancer Incidence ◽  
Screening Program ◽  
Population Based ◽  
Study Cohort ◽  
Adjusted Relative Risk ◽  
Advanced Stage ◽  
Incidence And Mortality

Background and aims: Colorectal cancer (CRC) is a leading cause of cancer deaths worldwide, and fecal immunochemical testing (FIT) is most widely used for population-based screening. Reduced long-term CRC mortality has been reported only scarcely in response to early detection with FIT screening. We aimed to elucidate whether and how FIT screening led to overall and site-specific reduction of advanced stage CRC incidence and mortality after the first decade of Taiwan's screening program, which offers biennial FIT screening for people aged 50-69 years. Method: The study cohort comprised eligible subjects who did (screened group) and did not (unscreened group) participate in FIT screening during the inaugural 5 years (2004-2009) with follow up until 2014. FIT-positive subjects were offered colonoscopy as a confirmatory exam. The primary outcome was incidence of advanced stage CRC and CRC mortality. Results: Among 5,417,699 eligible subjects, 3,072,164 (56.6%) had at least once FIT screening, and 1,605,200 (52.3%) received 2 or more screenings during the study period. During mean follow-up of 9.78 years, 5716 screened and 20,962 unscreened subjects developed incident advanced stage cancers [adjusted relative risk (aRR) = 0.76; 95% CI, 0.72-0.79] after controlling for self-selection to attend screening and increasing CRC incidence. CRC deaths during follow-up included 3077 screened and 15,550 unscreened subjects (aRR = 0.56, 95% CI, 0.53-0.59). Effectiveness was greater for distal cancers (advanced cancer incidence aRR = 0.68, 95% CI, 0.65-0.71); mortality aRR = 0.52 95% CI, 0.49-0.55) than for proximal cancers (advanced cancer incidence aRR = 0.99 95% CI, 0.92-1.07; mortality aRR = 0.69 95% CI, 0.63-0.75). Conclusion: FIT screening effectively reduces risk of advanced stage CRC and CRC mortality, with effectiveness consistently stronger for distal CRC than proximal CRC.

Predicting the effectiveness of the Finnish population-based colorectal cancer screening programme

2017 ◽  
Vol 24 (4) ◽  
pp. 182-188 ◽  
Author(s):  
Sherry Yueh-Hsia Chiu ◽  
Nea Malila ◽  
Amy Ming-Fang Yen ◽  
Sam Li-Sheng Chen ◽  
Jean Ching-Yuan Fann ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Natural History ◽  
Screening Programme ◽  
Relative Rate ◽  
Occult Blood ◽  
Population Based ◽  
Finnish Population ◽  
Crc Screening ◽  
Natural History Model

Objective Because colorectal cancer (CRC) has a long natural history, estimating the effectiveness of CRC screening programmes requires long-term follow-up. As an alternative, we here demonstrate the use of a temporal multi-state natural history model to predict the effectiveness of CRC screening. Methods In the Finnish population-based biennial CRC screening programme using faecal occult blood tests (FOBT), which was conducted in a randomised health services study, we estimated the pre-clinical incidence, the mean sojourn time (MST), and the sensitivity of FOBT using a Markov model to analyse data from 2004 to 2007. These estimates were applied to predict, through simulation, the effects of five rounds of screening on the relative rate of reducing advanced CRC with 6 years of follow-up, and on the reduction in mortality with 10 years of follow-up, in a cohort of 500,000 subjects aged 60 to 69. Results For localised and non-localised CRC, respectively, the MST was 2.06 and 1.36 years and the sensitivity estimates were 65.12% and 73.70%. The predicted relative risk of non-localised CRC and death from CRC in the screened compared with the control population was 0.86 (95% CI: 0.79–0.98) and 0.91 (95% CI: 0.85–1.02), respectively. Conclusion Based on the preliminary results of the Finnish CRC screening programme, our model predicted a 9% reduction in CRC mortality and a 14% reduction in advanced CRC.

scholarly journals Evaluating Outreach Methods for Multi-Target Stool DNA Test for Colorectal Cancer Screening Among an Employer Population

2021 ◽  
Vol 12 ◽  
pp. 215013272110378
Author(s):  
Martha E. Shepherd ◽  
Ashlee Lecorps ◽  
Jon Harris-Shapiro ◽  
Lesley-Ann Miller-Wilson
Keyword(s):  
Colorectal Cancer ◽  
Public Awareness ◽  
Office Visit ◽  
Population Based ◽  
Economic Benefits ◽  
Completion Rate ◽  
Average Risk ◽  
Crc Screening ◽  
Stool Dna

Introduction/Objectives: Despite compelling evidence of clinical and economic benefits, adherence to colorectal cancer (CRC) screening remains low. Increasing public awareness through various outreach methods may improve screening uptake. The objective of this study was to evaluate the uptake of non-invasive multi-target stool DNA (mt-sDNA) by different outreach methods in an average-risk employer population. Methods: This retrospective observational study included CRC screening-eligible individuals aged ≥50 years insured by the Metropolitan Nashville Public Schools (MNPS) employee healthcare plan. The study intervention arms included population-based outreach and office visit-based interaction. The mt-sDNA completion rate (proportion of individuals who return the mt-sDNA kit after consenting to have it shipped to their home), proportion of patients who performed follow-up colonoscopy after a positive test, and time to follow-up colonoscopy were assessed. Results: A total of 167 mt-sDNA kits were shipped to eligible participants (aged 50-64 years) in the population-based outreach arm. In the office visit-based interaction arm, a total of 132 mt-sDNA kits were shipped to eligible participants (aged ≥50 years). The mt-sDNA completion rate was significantly higher for office visit-based interaction as compared to population-based outreach (76.8% vs 53.5%; P < .001) among those aged 50 to 64 years. While all patients aged 50 to 64 years with a positive mt-sDNA result received a follow-up colonoscopy in both arms, the median time to follow-up colonoscopy was shorter among the population-based outreach (55 vs 136 days; P < .05). Conclusions: Office visit-based interaction was associated with a higher mt-sDNA completion rate as compared to the population-based outreach among average-risk, CRC screening-eligible individuals aged 50 to 64 years old.

Anorectal Malformations and the Risk of Colorectal Cancer—Is Early Routine Endoscopic Screening Indicated?

2020 ◽  
Author(s):  
Anna Svenningsson ◽  
Anna Gunnarsdottir ◽  
Tomas Wester
Keyword(s):  
Colorectal Cancer ◽  
Early Adulthood ◽  
Anorectal Malformations ◽  
Population Based ◽  
Observational Period ◽  
Endoscopic Screening ◽  
Medical Birth Register ◽  
National Patient ◽  
And Gender

Abstract Introduction Colorectal cancer (CRC) has been reported in early adulthood in patients with anorectal malformation (ARM), and therefore, the need of endoscopic controls has been discussed. The aim of this study was to assess the risk of CRC in patients with ARM. Materials and Methods This was a nationwide population-based study with data from Swedish national health care registers. All patients diagnosed with ARM born in Sweden between 1964 and 1999 were identified in the National Patient Register. The same group was followed up in the Swedish Cancer Register from birth to December 31, 2014, for occurrences of CRC. Five age- and gender-matched individuals randomly selected from the Medical Birth Register served as controls for each ARM patient born between 1973 and 1999. Results A total of 817 patients (474 males) with ARM were included and followed up from birth to the end of observational period. Time of follow-up ranged from 15 to 50 years (mean: 28 years). None of the patients was diagnosed with CRC during the observational period. One case of rectal cancer and one case of sigmoid cancer were detected among the 3,760 controls. Conclusion In our study, the risk of CRC in early adulthood in patients with ARM is low. Our result does not support routine endoscopic follow-up for patients with ARM during the first decade of life.

scholarly journals A microRNA panel compared to environmental and polygenic scores for colorectal cancer risk prediction

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Janhavi R. Raut ◽  
Ben Schöttker ◽  
Bernd Holleczek ◽  
Feng Guo ◽  
Megha Bhardwaj ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Prediction ◽  
Risk Score ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Population Based ◽  
Polygenic Risk Score ◽  
Nucleotide Polymorphisms ◽  
Polygenic Scores

AbstractCirculating microRNAs (miRNAs) could improve colorectal cancer (CRC) risk prediction. Here, we derive a blood-based miRNA panel and evaluate its ability to predict CRC occurrence in a population-based cohort of adults aged 50–75 years. Forty-one miRNAs are preselected from independent studies and measured by quantitative-real-time-polymerase-chain-reaction in serum collected at baseline of 198 participants who develop CRC during 14 years of follow-up and 178 randomly selected controls. A 7-miRNA score is derived by logistic regression. Its predictive ability, quantified by the optimism-corrected area-under-the-receiver-operating-characteristic-curve (AUC) using .632+ bootstrap is 0.794. Predictive ability is compared to that of an environmental risk score (ERS) based on known risk factors and a polygenic risk score (PRS) based on 140 previously identified single-nucleotide-polymorphisms. In participants with all scores available, optimism-corrected-AUC is 0.802 for the 7-miRNA score, while AUC (95% CI) is 0.557 (0.498–0.616) for the ERS and 0.622 (0.564–0.681) for the PRS.

Initial participation as a predictor for continuous participation in population-based colorectal cancer screening

2017 ◽  
Vol 25 (3) ◽  
pp. 126-133 ◽  
Author(s):  
Deborah Saraste ◽  
Daniel J Öhman ◽  
Marika Sventelius ◽  
K Miriam Elfström ◽  
Johannes Blom ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Strong Predictor ◽  
Participation Rate ◽  
Occult Blood ◽  
Population Based ◽  
Faecal Occult Blood Testing ◽  
Faecal Occult

Objectives To assess patterns and probabilities of participation in multiple rounds of colorectal cancer screening. Methods All individuals who were invited to participate in population-based colorectal cancer screening in the Stockholm-Gotland region in Sweden between 1 January 2008 and 30 September 2015 were included in the study. Guaiac-based faecal occult blood testing was used. All individuals invited to the three first consecutive screening rounds were included in the analysis. Results There were 346,168 individuals eligible for invitation to screening. The average participation rate during the follow-up period was 60%. Eligible individuals could be invited 1–4 times, depending on age at first invitation. Of 48,959 individuals invited to the three first consecutive rounds of screening, 71% participated at least once, and 50% participated in all three rounds. Participation at first invitation was a predictor for participation in subsequent rounds, and the likelihood of continuous participation following participation in the first round was 84%. Of those who attended the first and second rounds, 93% also participated in the third round. Similar patterns of consistency were seen among non-participants. For individuals not participating in the first screening round, the likelihood of consistent non-participation was 71. Conclusions Participation in the first round of screening is a strong predictor for participation in subsequent rounds. Therefore, reducing barriers for initial participation is a key for achieving consistent participation over several rounds in organized colorectal cancer screening programmes.

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