scholarly journals Registered Nurse-Performed Flexible Sigmoidoscopy in Ontario: Development and Implementation of the Curriculum and Program

2014 ◽  
Vol 28 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Mary Anne Cooper ◽  
Jill Margaret Tinmouth ◽  
Linda Rabeneck
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Registered Nurses ◽  
Colorectal Cancer Screening ◽  
Cancer Detection ◽  
Simulation Training ◽  
Flexible Sigmoidoscopy ◽  
Average Risk ◽  
Incidence And Mortality ◽  
Proper Training

Although colorectal cancer is a leading cause of death in Canada, it is curable if detected in the early stages. Flexible sigmoidoscopy has been shown to reduce the incidence and mortality of colorectal cancer in patients who are at average risk for this disease and, therefore, is an appropriate screening intervention. Moreover, it may be performed by nonphysicians. A program to enable registered nurses to perform flexible sigmoidoscopy to increase colorectal cancer screening capacity in Ontario was developed. This program incorporated practical elements learned from other jurisdictions as well as specific regional considerations to fit within the health care system of Ontario. The nurses received structured didactic and simulation training before performing sigmoidoscopies on patients under physician supervision. After training, nurses were evaluated by two assessors for their ability to perform complete sigmoidoscopies safely and independently. To date, 17 nurses have achieved independence in performing flexible sigmoidoscopy at 14 sites. In total, nurses have screened >7000 Ontarians, with a cancer detection rate of 5.1 per 1000 screened, which is comparable with rates in other jurisdictions and with sigmoidoscopy performed by gastroenterologists, surgeons and other trained nonphysicians. We have shown, therefore, that with proper training and program structure, registered nurses are able to perform flexible sigmoidoscopy in a safe and thorough manner resulting in a significant increase in access to colorectal cancer screening.

scholarly journals Modeling Individual Patient Preferences for Colorectal Cancer Screening Based on Their Tolerance for Complications Risk

2016 ◽  
Vol 37 (3) ◽  
pp. 204-215 ◽  
Author(s):  
Glen B. Taksler ◽  
Adam T. Perzynski ◽  
Michael W. Kattan
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Life Expectancy ◽  
Colorectal Cancer Screening ◽  
Flexible Sigmoidoscopy ◽  
Screening Method ◽  
Screening Strategy ◽  
Screening Methods ◽  
Average Risk ◽  
National Guidelines

Introduction. Recommendations for colorectal cancer screening encourage patients to choose among various screening methods based on individual preferences for benefits, risks, screening frequency, and discomfort. We devised a model to illustrate how individuals with varying tolerance for screening complications risk might decide on their preferred screening strategy. Methods. We developed a discrete-time Markov mathematical model that allowed hypothetical individuals to maximize expected lifetime utility by selecting screening method, start age, stop age, and frequency. Individuals could choose from stool-based testing every 1 to 3 years, flexible sigmoidoscopy every 1 to 20 years with annual stool-based testing, colonoscopy every 1 to 20 years, or no screening. We compared the life expectancy gained from the chosen strategy with the life expectancy available from a benchmark strategy of decennial colonoscopy. Results. For an individual at average risk of colorectal cancer who was risk neutral with respect to screening complications (and therefore was willing to undergo screening if it would actuarially increase life expectancy), the model predicted that he or she would choose colonoscopy every 10 years, from age 53 to 73 years, consistent with national guidelines. For a similar individual who was moderately averse to screening complications risk (and therefore required a greater increase in life expectancy to accept potential risks of colonoscopy), the model predicted that he or she would prefer flexible sigmoidoscopy every 12 years with annual stool-based testing, with 93% of the life expectancy benefit of decennial colonoscopy. For an individual with higher risk aversion, the model predicted that he or she would prefer 2 lifetime flexible sigmoidoscopies, 20 years apart, with 70% of the life expectancy benefit of decennial colonoscopy. Conclusion. Mathematical models may formalize how individuals with different risk attitudes choose between various guideline-recommended colorectal cancer screening strategies.

scholarly journals Public Awareness of Colorectal Cancer Screening: Knowledge, Attitudes, and Interventions for Increasing Screening Uptake

ISRN Oncology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Antonio Z. Gimeno Garcia ◽  
Noemi Hernandez Alvarez Buylla ◽  
David Nicolas-Perez ◽  
Enrique Quintero
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Public Awareness ◽  
Target Population ◽  
Average Risk ◽  
Willingness To Participate ◽  
Screening Uptake ◽  
Screening Participation ◽  
Incidence And Mortality

Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancer screening has proven its benefit in terms of incidence and mortality reduction in randomized controlled trials. In fact, it has been recommended by medical organizations either in average-risk or family-risk populations. Success of a screening campaign highly depends on how compliant the target population is. Several factors influence colorectal cancer screening uptake including sociodemographics, provider and healthcare system factors, and psychosocial factors. Awareness of the target population of colorectal cancer and screening is crucial in order to increase screening participation rates. Knowledge about this disease and its prevention has been used across studies as a measurement of public awareness. Some studies found a positive relationship between knowledge about colorectal cancer, risk perception, and attitudes (perceived benefits and barriers against screening) and willingness to participate in a colorectal cancer screening campaign. The mentioned factors are modifiable and therefore susceptible of intervention. In fact, interventional studies focused on average-risk population have tried to increase colorectal cancer screening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancer screening and interventions targeting participants for increasing screening uptake.

scholarly journals Cross-cultural Validation of Stool Based Colorectal Cancer Screening Methods in the North West of Iran

2021 ◽  
Author(s):  
Roya Dolatkhah ◽  
Mohammad Hossein Somi ◽  
Saeed Dastgiri ◽  
Mohammad Asghari Jafarabadi ◽  
Hossein Mashhadi Abdolahi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Diagnostic Accuracy ◽  
Colorectal Cancer Screening ◽  
Cancer Detection ◽  
Cross Cultural ◽  
Screening Methods ◽  
Lower Sensitivity ◽  
Predictive Values ◽  
Incidence And Mortality

Abstract PurposeGlobally, colorectal cancer (CRC) is the third most common cancer and the second leading cause of death from cancer. Incidence and mortality from CRC both can be reduced and prevented using screening and early detection programs. The current study aimed to assess the feasibility of the colorectal cancer screening program in Northwest of Iran.MethodsThe study designed as a cross-cultural analytic study, to evaluate the diagnostic accuracy of stool-based tests compared with colonoscopy, during 2016-2020. All individuals first were assessed with our CRC risk assessment tool, then eligible volunteers entered the study. Colonoscopy was performed on all participants, also stool- based tests including traditional guaiac, high-sensitivity guaiac-based, fecal immunochemical test (FIT), and multitarget stool DNA (Mt-sDNA) panel tests were performed. ResultsMt-sDNA test panel had a sensitivity of 77.8% (95% CI: 40-97.2) for detecting colorectal cancer with a specificity of 91.2% (95% CI: 85.4-95.2). The FIT test alone had a lower sensitivity (66.7%; 95% CI: 29.9-92.5) and almost the same specificity of 93.9% (95% CI: 88.7-97.2) for cancer detection. Mt-sDNA test had better diagnostic accuracy than the FIT (AUC=0.85 vs 0.80), and is a more useful screening test. Positive and negative predictive values for cancer detection for both Mt-sDNA and FIT tests were almost the same results, however Mt-sDNA test had better NPV results than the FIT test alone.ConclusionOur results showed that both Mt-sDNA panel and the FIT test had acceptable cut-off points for cancer detection, however, Mt-sDNA test had better diagnostic accuracy.

scholarly journals Effects of cancer screening restart strategies after COVID-19 disruption

2021 ◽  
Vol 124 (9) ◽  
pp. 1516-1523
Author(s):  
Lindy M. Kregting ◽  
Sylvia Kaljouw ◽  
Lucie de Jonge ◽  
Erik E. L. Jansen ◽  
Elleke F. P. Peterse ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Catching Up ◽  
Incidence And Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Catch Up ◽  
Microsimulation Models ◽  
The Impact

Abstract Background Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Methods Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. Results The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Conclusions Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.

scholarly journals A Population-Based Study of Prevalence and Adherence Trends in Average Risk Colorectal Cancer Screening, 1997 to 2008: Figure 1.

2011 ◽  
Vol 21 (2) ◽  
pp. 347-350 ◽  
Author(s):  
Pamela S. Sinicrope ◽  
Ellen L. Goode ◽  
Paul J. Limburg ◽  
Sally W. Vernon ◽  
Joseph B. Wick ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Population Based ◽  
Average Risk ◽  
Population Based Study
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