Quality indicators for screening colonoscopy and colonoscopist performance and the subsequent risk of interval colorectal cancer

2019 ◽  
Vol 17 (11) ◽  
pp. 2265-2300 ◽  
Author(s):  
Martin Lund ◽  
Mette Trads ◽  
Sisse Helle Njor ◽  
Rune Erichsen ◽  
Berit Andersen
Keyword(s):  
Colorectal Cancer ◽  
Quality Indicators ◽  
Screening Colonoscopy ◽  
Interval Colorectal Cancer ◽  
Subsequent Risk

Interval colorectal cancer despite screening colonoscopy: A single-center experience.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 401-401
Author(s):  
Gudrun Resch ◽  
Christian Mallinger ◽  
Walter Schauer ◽  
Josef Thaler ◽  
Peter Knoflach
Keyword(s):  
Colorectal Cancer ◽  
Screening Method ◽  
Interval Cancer ◽  
Colorectal Adenomas ◽  
Screening Colonoscopy ◽  
Newly Diagnosed ◽  
Technical Problems ◽  
Single Center Experience ◽  
Interval Colorectal Cancer ◽  
Inadequate Bowel Preparation

401 Background: Colonoscopy is recommended as the primary screening method for colorectal cancer (CRC) and polypectomy is considered effective for preventing cancer. CRCs which occur within 5 years of screening colonoscopy are defined as interval cancer. Despite regular colonoscopy and complete polypectomy interval colorectal cancer may occur. Methods: All patients undergoing a colonoscopy were recorded in a colonoscopy registry, all CRC-patients who underwent colectomy were recorded in a surgery registry and all patients with newly diagnosed CRC were recorded in a tumor registry at the Klinikum Wels-Grieskirchen. In this retrospective analysis all patients with newly diagnosed CRC since the year 2000 were evaluated if a screening colonoscopy was done before the diagnosis of CRC at our institution. Results: Overall, 1.102 patients with CRC were evaluated. 939 patients underwent tumorectomy/colectomy at our department of surgery. In 65.8% (n=725) CRC was detected by colonoscopy at our institution and 85 out of these patients had a previous screening colonoscopy (range 14-176 months, median 55 months) at our institution. Interval cancers, which occur within 5 years since screening colonoscopy, were detected in 45 patients. Six patients could be identified with complete negative colonoscopy, 2 patients had inadequate bowel preparation, in 7 patients colonoscopy was not complete because of technical problems, 26 patients had a history of colorectal adenomas and 4 patients had inflammatory bowel disease. In 16 out of 26 patients with adenomas a CRC was detected distant from the side of the previous polypectomy. Conclusions: More emphasis and short-term control of incomplete and inadequately prepared colonoscopies, as well as a re-call system for post-polypectomy controls could reduce the number of so called interval CRSs.

scholarly journals Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients

2020 ◽  
Vol 08 (10) ◽  
pp. E1423-E1428
Author(s):  
Monica Riegert ◽  
Monica Nandwani ◽  
Bonny Thul ◽  
Angela Chang Chiu ◽  
Simon C. Mathews ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Indicators ◽  
Nurse Practitioners ◽  
Task Force ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Screening Colonoscopy ◽  
Crc Screening ◽  
Adenoma Detection

Abstract Background and study aims The demand for screening colonoscopy has continued to rise over the past two decades. As a result, the current workforce of gastroenterologists is unable to meet the needs for colorectal cancer (CRC) screening. Therefore, solutions are needed to improve this disparity, with non-physician endoscopists being a potential option. However, current literature on the performance of non-physicians in endoscopy is limited. The aim of this study was to assess the quality of colonoscopy performed by three gastrointestinal fellowship-trained nurse practitioners (NPs). Methods This was a retrospective study performed at a single tertiary academic medical center. Colonoscopies performed by three gastrointestinal-specialized NPs after having completed training of at least 140 supervised colonoscopies were reviewed for analysis. Inclusion criteria were patients undergoing colonoscopy for colorectal cancer screening purposes. Outcomes included colonoscopy quality indicators as defined by the American Society for Gastrointestinal Endoscopy/American College of Gastroenterology Taskforce (ASGE/ACG) Taskforce. Results The study included 1,012 subjects (mean age 56.2 years, female 51.5 %, African American 73.9 %) who underwent screening colonoscopies by three NPs. Cecal intubation was successful in 997 subjects (98.5 %). Mean adenoma detection rate was 35.6 %. Mean withdrawal time was 18.9 minutes. There were no adverse events including colonic perforations or delayed post-polypectomy bleeding. Conclusions Three fellowship-trained NPs in colonoscopy in the United States satisfied the quality indicators proposed by the ASGE/ACG Task force, demonstrating that adequately trained NPs can perform colonoscopy safely and effectively. With the demand for colonoscopy exceeding the supply, non-physicians could be part of the solution to meet the demands for CRC screening.

Sedation and gender differences in screening colonoscopy - Impact on quality indicators

2011 ◽  
Vol 49 (05) ◽  
Author(s):  
C Bannert ◽  
K Reinhart ◽  
D Dunkler ◽  
M Trauner ◽  
W Weiss ◽  
...  
Keyword(s):  
Gender Differences ◽  
Quality Indicators ◽  
Screening Colonoscopy ◽  
And Gender

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 Surveillance of Colorectal Cancer (CRC) in Cystic Fibrosis (CF) Patients

2021 ◽  
Vol 3 (2) ◽  
pp. 84-95
Author(s):  
Fabio Ingravalle ◽  
Giovanni Casella ◽  
Adriana Ingravalle ◽  
Claudio Monti ◽  
Federica De Salvatore ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cystic Fibrosis ◽  
General Population ◽  
Genetic Disorder ◽  
The United States ◽  
Screening Colonoscopy ◽  
Transmembrane Conductance Regulator ◽  
Transmembrane Conductance ◽  
Increased Risk ◽  
Speciality Training

Cystic Fibrosis (CF) is the commonest inherited genetic disorder in Caucasians due to a mutation in the gene CFTR (Cystic Fibrosis Transmembrane Conductance Regulator), and it should be considered as an Inherited Colorectal Cancer (CRC) Syndrome. In the United States, physicians of CF Foundation established the “Developing Innovative Gastroenterology Speciality Training Program” to increase the research on CF in gastrointestinal and hepatobiliary diseases. The risk to develop a CRC is 5–10 times higher in CF patients than in the general population and even greater in CF patients receiving immunosuppressive therapy due to organ transplantation (30-fold increased risk relative to the general population). Colonoscopy should be considered the best screening for CRC in CF patients. The screening colonoscopy should be started at the age of 40 in CF patients and, if negative, a new colonoscopy should be performed every 5 years and every 3 years if adenomas are detected. For transplanted CF patients, the screening colonoscopy could be started at the age of 35, in transplanted patients at the age of 30 and, if before, at the age of 30. CF transplanted patients, between the age of 35 and 55, must repeat colonoscopy every 3 years. Our review draws attention towards the clinically relevant development of CRC in CF patients, and it may pave the way for further screenings and studies.

Strong Reduction of Colorectal Cancer Incidence and Mortality After Screening Colonoscopy

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Feng Guo ◽  
Chen Chen ◽  
Bernd Holleczek ◽  
Ben Schöttker ◽  
Michael Hoffmeister ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Incidence ◽  
Screening Colonoscopy ◽  
Strong Reduction ◽  
Incidence And Mortality ◽  
Colorectal Cancer Incidence
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