Patients Undergoing Colorectal Cancer Screening Underestimate Their Cancer Risk and Delay Presentation for Screening

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in Canada. Screening guidelines recommend that first-time screening should occur at 50 years of age for average-risk individuals and at 40 years of age for those with a family history of CRC.OBJECTIVE: To examine whether persons with a positive CRC family history were achieving screening at 40 years of age and whether average-risk persons were achieving screening at 50 years of age.METHODS: The present study was a cross-sectional analysis of subjects who entered a colon cancer screening program and were undergoing CRC screening for the first time.RESULTS: A total of 778 individuals were enrolled in the present study: 340 (174 males) with no family history of CRC, and 438 (189 males) with a positive family history of CRC. For the group with a positive family history, the mean (± SD) age for primary screening was 54.4±8.5 years, compared with 58.2±6.4 years for the group with no family history. On average, those with a positive family history initiated screening 3.8 years (95% CI 2.8 to 4.8; P<0.05) earlier than those without. Adenoma polyp detection rate for the positive family history group was 20.8% (n=91) compared with 23.5 % (n=80) for the group with no family history.CONCLUSIONS: Individuals with a positive CRC family history are initiating screening approximately four years earlier than those without a family history; nevertheless, both groups are undergoing screening well past current guideline recommendations.

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Self-Reported Questionnaire Detects Family History of Cancer in a Pancreatic Cancer Screening Program

Journal of Genetic Counseling ◽

10.1007/s10897-016-0057-4 ◽

2016 ◽

Vol 26 (4) ◽

pp. 806-813 ◽

Cited By ~ 1

Author(s):

Aimee L. Lucas ◽

Adam Tarlecki ◽

Kellie Van Beck ◽

Casey Lipton ◽

Arindam RoyChoudhury ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cancer Screening ◽

Family History ◽

Screening Program ◽

Family History Of Cancer ◽

Pancreatic Cancer Screening ◽

Cancer Screening Program ◽

History Of ◽

History Of Cancer

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Screeners vs. Non-screeners for Colorectal Cancer among People over 50 Years of Age: Factual and Psychological Discriminants

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-2263 ◽

2020 ◽

Author(s):

Andrada Ciucă ◽

Ramona Moldovan ◽

Sebastian Pintea ◽

Dan Dumitrașcu ◽

Adriana Băban

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Positive Family History ◽

Psychosocial Interventions ◽

The Elderly ◽

Roc Curve Analysis ◽

Convenience Sample ◽

Colonoscopy Screening ◽

History Of ◽

D Values

Background and Aims: Colorectal cancer (CRC) is the third most frequent form of cancer worldwide, and approximately one third of cases have a positive family history of CRC or associated cancers. Colonoscopy is one of the most effective methods of screening for CRC. Uptake of colonoscopy is suboptimal, and many countries lack a national screening programme. Our study aims at exploring and ranking several factual and psychological variables according to their accuracy in discriminating between screeners and non-screeners for CRC in a convenience sample of people over 50 years of age. Methods: The study included 103 individuals aged over 50 years, recruited from day centres for the elderly. We explored socio-demographic variables, frequency of colonoscopy, previous recommendations for screening, health literacy and family history of cancer. Receiver operating characteristic (ROC) analysis was used to establish the discriminative value for each variable between the positive and negative decision for colonoscopy screening. Areas under the curve (AUC) and their equivalent Cohen‘s d values were calculated. Results: Almost a quarter (25.75%) of participants reported previous colonoscopy screening. ROC curve analysis shows that colonoscopy uptake is best discriminated by perceived benefits of screening (AUC=0.71, d=0.78, p<0.001), previous recommendations for screening (AUC=0.68, d=0.69, p<0.001) and previous recommendations for preventive measures (AUC=0.67, d=0.64, p<0.001). Conclusions: Recommendations from healthcare professionals lead to improved colonoscopy uptake when emphasising the benefits of screening. Results can further inform psychosocial interventions by bringing empirical evidence to emphasize screening benefits and explicit recommendations for individuals at risk for CRC cancer.

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Screening of Patients with a Positive Family History of Colorectal Cancer

Gastrointestinal Endoscopy Clinics of North America ◽

10.1016/s1052-5157(18)30323-4 ◽

1997 ◽

Vol 7 (1) ◽

pp. 65-79 ◽

Cited By ~ 23

Author(s):

Randall W. Burt

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Positive Family History ◽

History Of

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The Effect of Ranitidine on Olanzapine-Induced Weight Gain

BioMed Research International ◽

10.1155/2013/639391 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Fatemeh Ranjbar ◽

Alireza Ghanepour ◽

Homayoun Sadeghi-Bazargani ◽

Mahbob Asadlo ◽

Amineh Alizadeh

Keyword(s):

Weight Gain ◽

Family History ◽

Positive Family History ◽

First Episode ◽

Long Run ◽

Combined Use ◽

History Of ◽

History Of Obesity ◽

Baseline Bmi ◽

First Time

Induced weight gain is a disturbing side effect of Olanzapine that affects the quality of life in psychotic patients. The aim of this study was to assess the efficacy of Ranitidine in attenuating or preventing Olanzapine-induced weight gain. A parallel 2-arm clinical trial was done on 52 patients with schizophrenia, schizoaffective and schizophreniform disorders who received Olanzapine for the first time. All these were first-episode admitted patients. They were randomly allocated to receive either Ranitidine or placebo. The trend of body mass index (BMI) was compared between groups over 16-week course of treatment. Mean weight was 62.3 (SD: 9.6) kg at baseline. Thirty-three subjects (63.5%) had positive family history of obesity. The average BMI increment was 1.1 for Ranitidine group and 2.4 for the placebo group. The multivariate analysis showed this effect to be independent of sex, family history of obesity, and baseline BMI value. The longitudinal modeling after controlling for baseline values failed to show the whole trend slope to be different. Although the slight change in trend’s slope puts forward a hypothesis that combined use of Ranitidine and Olanzapine may attenuate the weight gain long run, this needs to be retested in future larger scale long-term studies. This trial is registered with IRCT.ir201009112181N5.

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Positive family history of colorectal cancer in a general practice setting [FRIDA.Frankfurt]: study protocol of a of a cross-sectional study

BMC Cancer ◽

10.1186/s12885-015-1600-7 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 2

Author(s):

Andrea Siebenhofer ◽

Jasper Plath ◽

Maja Taubenroth ◽

Susanne Singer ◽

Marlene Hechtner ◽

...

Keyword(s):

Colorectal Cancer ◽

General Practice ◽

Family History ◽

Study Protocol ◽

Positive Family History ◽

Cross Sectional Study ◽

Practice Setting ◽

Sectional Study ◽

Cross Sectional ◽

History Of

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An alternative approach to identify women at risk for colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1513 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1513-1513

Author(s):

Amanda S. Bruegl ◽

Bojana Djordjevic ◽

Shannon Neville Westin ◽

Pamela T. Soliman ◽

Amanda C. Brandt ◽

...

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Mismatch Repair ◽

Dna Mismatch Repair ◽

Gynecologic Oncology ◽

Positive Family History ◽

Dna Mismatch ◽

Increased Risk ◽

History Of ◽

Mlh1 Methylation

1513 Background: Hereditary colorectal cancer (CRC) is preventable; however, identification of individuals at sufficiently high risk to warrant heightened surveillance is difficult. Lynch Syndrome (LS) is an inherited cancer syndrome due to germline mutation in a DNA mismatch repair gene. For women with LS, the lifetime risk of endometrial cancer (EC) is 64% and CRC is 54%. Fifty percent of women with LS will present with EC or ovarian cancer prior to CRC. Therefore, women with LS associated EC represent an ideal group for CRC prevention. The optimal method to identify women with LS associated EC is not known. The purpose of this study was to determine the utility of Amsterdam II and Society of Gynecologic Oncology (SGO) Criteria (modified Bethesda criteria that use EC as the sentinel cancer) in identifying women with LS associated EC. Our ultimate goal is to identify women at increased risk of CRC. Methods: Immunohistochemistry (IHC) for DNA mismatch repair proteins and MLH1 methylation analyses were used to identify LS associated EC among 388 women. EC was designated as LS if there was loss of mismatch repair protein expression. Absence of MLH1 methylation was required to confirm LS in tumors with MLH1 protein loss. Results: Fifty-nine (15.2%) of the EC patients tested had LS. These patients are summarized in the table. Conclusions: Clinical criteria to detect LS identify 17/59 (29%) - 44/59 (74%) of women who present with EC first. EC with MSH2 loss is most likely to occur in younger women and women with positive family history of EC and CRC, features classically associated with LS. In general, the MSH6 mutation is associated with older age at diagnosis and fewer familial CRCs, however, we found a large number of MLH1 (50%) and PMS2 (86%) cases diagnosed at greater than 50 years with no family history of CRC. Our data suggest that classic clinical screening criteria are inadequate to detect patients with LS who present with EC, potentially missing up to 25% of these patients. [Table: see text]

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Do fears of getting cancer and family history of cancer influence participation in opportunistic screening or organized screening for gastric cancer?

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e13045 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e13045-e13045

Author(s):

Myung-Il Hahm ◽

Kui Son Choi ◽

Hoo-Yeon Lee ◽

Mina Suh ◽

Yoon Young Lee ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Screening ◽

Family History ◽

Screening Program ◽

Opportunistic Screening ◽

Screening Programs ◽

Family History Of Cancer ◽

History Of ◽

Gastric Cancer Screening ◽

History Of Cancer

e13045 Background: Cancer is the leading cause of death in Korea. Individuals with a family history of cancer might overestimate their personal risk for getting cancer and report high cancer-related worry or concern. Those factors could positively or negatively influence on cancer screening behavior. Although Korea has a universal screening program for common cancers, some people still choose opportunistic screening program with out-of-pocket costs. This study was to identify association between fears of getting cancer and participation on opportunistic anc organized screening programs for cancer. Methods: The study population was derived from the Korean National Cancer Screening Survey 2013, which is annual survey conducted by National Cancer Center of Korea in order to investigate trends of participation rates among general population in cancer screening. 3,004 individuals aged over 40 years were finally selected as study subjects. Chi-square tests and multinomial logistic regression model were used to identify factors associated with being screened for gastric cancer. Results: A total of 2,078 of the subjects (69.2%) underwent gastric cancer screening, of which 311 individuals (10.4%) participated in opportunistic and 1,767 individuals (58.8%) participated in organized screening programs. After adjusting socio-demographic factors and health behaviors, worry and concern about cancer were identified as factors positively associated with being screened for gastric cancer. ORs for undergoing gastric cancer screening were elevated for both screening programs according to the level of worry and concern about cancer (p for trend < 0.05). We did not found relationship between family history of gastric cancer and participation. Conclusions: The results of this study suggest that fears of getting cancer such as worry and concerned about cancer had a stronger influence on participation in not only organized screening program but also opportunistic screening program. We could identify that ORs for undergoing the opportunistic screening were slightly higher than those for undergoing the organized screening in terms of cancer worry and cancer concern.

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Prospective assessment of the risk for colorectal neoplasia in a Mexican population according to risk categories.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e15158 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e15158-e15158

Author(s):

Vanessa Rosas Camargo ◽

Edgar Omar Martos Armendariz ◽

Mauricio Rivera Aguilar ◽

Jorge Humberto Hernandez-Felix ◽

Monica Lily Cordon ◽

...

Keyword(s):

Family History ◽

High Risk ◽

Screening Program ◽

Smoking Status ◽

Colorectal Neoplasia ◽

Asia Pacific ◽

Screening Colonoscopy ◽

Average Risk ◽

Prospective Assessment ◽

History Of

e15158 Background: General population screening can reduce colorectal cancer (CRC) mortality. International guidelines recommend CRC screening for asymptomatic people over 50 years. There is no established national screening program in Mexico. Even in countries with low incidence of CRC such as Mexico, targeted screening of subjects at high risk could decrease resource utilization and cost. Our aim was to describe the distribution among an average-risk population based on risk for colorectal neoplasia (CRN). Methods: We performed a prospective assessment of the risk for CRN among asymptomatic people over 50 years at Instituto Nacional de Ciencias Médicas y Nutrición between 2017-2018. The inclusion was competitive consistent with our age-sex pyramid. We included workers, non-family attendants and patients (internal medicine consultation). Each subject answered a standardized questionnaire, which included information on their age, gender, family history of CRC, diabetes, body mass index (BMI), smoking status and drinking habits. In order to stratify the population according to their risk for CRN, we used the Asia-Pacific Colorectal Screening (APCS) score. Results: We included 256 subjects. Median age was 59 y/o (50-93), 52% were female. 5% had a first-degree relative with CRC. 44% were current or ex-smoker and 9% reported alcohol consumption. 21% had diabetes. The median BMI was 27.3 (17-51). According to the APCS score, 60% were assigned as average risk (AR) and 40% as high risk (HR) for CRN. We observed a higher proportion of HR compared to our previous retrospective data (Table). Conclusions: We prospectively confirmed that using basic clinical information (age, gender, smoking status, family history of CRC, BMI and diabetes), it is possible to identify a subset of asymptomatic subjects at high risk for CRN in whom screening strategies should be prioritized. In developing countries with limited resources, a focus on high risk groups could improve cost effectiveness of screening colonoscopy. Risk stratification based on APCS score. [Table: see text]

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