Clinical yield of screening colonoscopies in Jamaica

2021 ◽  
pp. 004947552110395
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Milton Arthurs
Keyword(s):  
Colorectal Cancer ◽  
Screening Programme ◽  
Colorectal Polyps ◽  
Screening Colonoscopy ◽  
Opportunistic Screening ◽  
Precursor Lesions ◽  
Invasive Adenocarcinoma ◽  
Policy Makers ◽  
Therapeutic Outcomes ◽  
Cancer Screening Programme

There is still no organised national screening programme for colorectal cancer in Jamaica. We sought to evaluate the detection of colorectal cancer precursor lesions in patients who underwent opportunistic screening over three years. Patients with colorectal polyps were selected for further study. In 431 procedures, there were 84 (19.5%) patients with colorectal polyps identified at screening colonoscopy, which gave a 19.5% sensitivity to identify patients with polyps at risk of developing colorectal cancer, 9.5% being <50 years of age. At the time of examination, 16.7% had already developed invasive adenocarcinoma. We conclude that it is time for policy makers to develop a national colorectal cancer screening programme to diagnose patients early and improve their therapeutic outcomes.

scholarly journals A prospective study of faecal immunochemical testing following polypectomy in a colorectal cancer screening population

2017 ◽  
Vol 9 (4) ◽  
pp. 295-299 ◽  
Author(s):  
David J Gibson ◽  
Blathnaid Nolan ◽  
Joanna Rea ◽  
Maire Buckley ◽  
Gareth Horgan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Clinical Findings ◽  
Adenomatous Polyps ◽  
Screening Colonoscopy ◽  
Cancer Screening Programme ◽  
Advanced Adenomas

Introduction52% of faecal immunohistochemistry test (FIT)-positive clients in the Irish National Colorectal Cancer Screening Programme (BowelScreen) have adenomatous polyps identified at colonoscopy in round 1. Although it is known that advanced adenomas and cancers cause an elevated FIT, it is not known if small (<5 mm) adenomas cause a positive FIT.AimsDetermine if removal of small polyps in an FIT-based colorectal cancer (CRC) screening programme is associated with a negative FIT on follow-up.MethodsA single-centre prospective observational study of consecutive participants attending for first round screening colonoscopy who had a positive FIT (>45 µg Hb/g) as part of the Irish Colorectal Cancer Screening Programme. Subjects were consented at the time of colonoscopy and were sent a repeat FIT 4–6 weeks later. Precolonoscopy and postcolonoscopy FITs were compared and correlated with clinical findings and endoscopic intervention.Results112 consecutive first round participants were recruited. Eight (7%) had cancer, 75 (67%) adenomatous polyps, 17 (15%) a normal colonoscopy and 12 (11%) other pathology. There was a clear difference in median FIT levels between the four groups (P=0.006). Advanced pathology (tumour or adenomatous polyp >1 cm) was associated with higher FIT than non-advanced pathology (median FIT 346 vs 89 P=0.0003). 83% (86/104) of subjects completed a follow-up FIT. Follow-up FIT remained positive in 20% (17/86). Polypectomy was associated with a reduction in FIT from a median of 100 to 5 µg Hb/g (P<0.0001). Removal of polyps >5 mm was the only factor independently associated with a negative follow-up FIT on multivariate analysis (OR 3.9 (1.3–11.9, P=0.04)).ConclusionFIT is a sensitive test and levels increase with advanced colonic pathology. Polypectomy of advanced adenomas is associated with a negative follow-up FIT. However, alternative causes for a positive FIT should be considered in patients who have adenomas less than 5 mm detected or a normal colonoscopy.

Correlation between Faecal Tumour M2 Pyruvate Kinase and Colonoscopy for the Detection of Adenomatous Neoplasia in a Secondary Care Cohort

2016 ◽  
Vol 25 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Ashley D. Bond ◽  
Michael D. Burkitt ◽  
David Sawbridge ◽  
Bernard M. Corfe ◽  
Chris S. Probert
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Pyruvate Kinase ◽  
Predictive Value ◽  
Screening Programme ◽  
Occult Blood ◽  
Faecal Occult ◽  
Faecal Samples ◽  
Cancer Screening Programme ◽  
Bowel Cancer Screening

Background & Aims: Colorectal cancer screening programmes that target detection and excision of adenomatous colonic polyps have been shown to reduce colorectal cancer related mortality. Many screening programmes include an initial faecal occult blood test (FOBt) prior to colonoscopy. To refine the selection of patients for colonoscopy other faecal-based diagnostic tools have been proposed, including tumour M2-pyruvate kinase (tM2-PK). To determine whether tM2-PK quantification may have a role in diverse settings we have assessed the assay in a cohort of patients derived from both the England bowel cancer screening programme (BCSP) and symptomatic individuals presenting to secondary care. Method. Patients undergoing colonoscopy provided faecal samples prior to bowel preparation. Faecal tM2-PK concentrations were measured by ELISA. Sensitivity, specificity, positive predictive value, negative predictive value and ROC analyses were calculated. Results. Ninety-six patients returned faecal samples: 50 of these with adenomas and 7 with cancer. Median age was 68. Median faecal tM2-PK concentration was 3.8 U/mL for individuals without neoplastic findings at colonoscopy, 7.7 U/mL in those with adenomas and 24.4 U/mL in subjects with colorectal cancer (both, p=0.01). ROC analysis demonstrated an AUROC of 0.66 (sensitivity 72.4%, specificity 48.7%, positive predictive value 67.7%, negative predictive value 36.7%). Amongst BCSP patients with a prior positive FOBt faecal tM2-PK was more abundant (median 6.4 U/mL, p=0.03) and its diagnostic accuracy was greater (AUROC 0.82). Conclusion. Our findings confirm that faecal tM2-PK ELISA may have utility as an adjunct to FOBt in a screening context, but do not support its use in symptomatic patients. Abbreviations: BCSP: Bowel cancer screening programme; EMR: Endoscopic mucosal resection; FAP: Familial adenomatous polyposis; FOBt: Faecal occult blood testing; NHS: National Health Service; tM2-PK: tumour M2-pyruvate kinase.

S1154 National Colorectal Cancer Screening Programme in the Czech Republic

2010 ◽  
Vol 138 (5) ◽  
pp. S-192
Author(s):  
Stepan Suchanek ◽  
Miroslav Zavoral ◽  
Ondrej Majek ◽  
Ladislav Dusek ◽  
Premysl Fric
Keyword(s):  
Colorectal Cancer ◽  
Czech Republic ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
The Czech Republic ◽  
Cancer Screening Programme

scholarly journals Interval cancers after negative immunochemical test compared to screen and non-responders’ detected cancers in Slovenian colorectal cancer screening programme

2018 ◽  
Vol 52 (4) ◽  
pp. 413-421 ◽  
Author(s):  
Dominika Novak Mlakar ◽  
Tatjana Kofol Bric ◽  
Ana Lucija Škrjanec ◽  
Mateja Krajc
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Test ◽  
Screening Programme ◽  
Interval Cancers ◽  
Faecal Immunochemical Test ◽  
Test Sensitivity ◽  
Cancer Screening Programme ◽  
Immunochemical Test

Abstract Background We assessed the incidence and characteristics of interval cancers after faecal immunochemical occult blood test and calculated the test sensitivity in Slovenian colorectal cancer screening programme. Patients and methods The analysis included the population aged between 50 to 69 years, which was invited for screening between April 2011 and December 2012. The persons were followed-up until the next foreseen invitation, in average for 2 years. The data on interval cancers and cancers in non-responders were obtained from cancer registry. Gender, age, years of schooling, the cancer site and stage were compared among three observed groups. We used the proportional incidence method to calculate the screening test sensitivity. Results Among 502,488 persons invited for screening, 493 cancers were detected after positive screening test, 79 interval cancers after negative faecal immunochemical test and 395 in non-responders. The proportion of interval cancers was 13.8%. Among the three observed groups cancers were more frequent in men (p = 0.009) and in persons aged 60+ years (p < 0.001). Comparing screen detected and cancers in non-responders with interval cancers more interval cancers were detected in persons with 10 years of schooling or more (p = 0.029 and p = 0.001), in stage III (p = 0.027) and IV (p < 0.001), and in right hemicolon (p < 0.001). Interval cancers were more frequently in stage I than non-responders cancers (p = 0.004). Test sensitivity of faecal immunochemical test was 88.45%. Conclusions Interval cancers in Slovenian screening programme were detected in expected proportions as in similar programmes. Test sensitivity was among the highest when compared to similar programmes and was accomplished using test kit for two stool samples.

scholarly journals Risk stratification for colorectal neoplasia detection in the Flemish colorectal cancer screening programme

2018 ◽  
Vol 56 ◽  
pp. 90-96 ◽  
Author(s):  
Wessel van de Veerdonk ◽  
Guido Van Hal ◽  
Marc Peeters ◽  
Isabel De Brabander ◽  
Geert Silversmit ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Risk Stratification ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Colorectal Neoplasia ◽  
Cancer Screening Programme

scholarly journals Colorectal Serrated Neoplasia: An Institutional 12-Year Review Highlights the Impact of a Screening Programme

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
A. J. McCarthy ◽  
S. M. O’Reilly ◽  
J. Shanley ◽  
R. Geraghty ◽  
E. J. Ryan ◽  
...  
Keyword(s):  
Screening Programme ◽  
Colorectal Polyps ◽  
Left Colon ◽  
Serrated Adenoma ◽  
Serrated Polyps ◽  
Cancer Screening Programme ◽  
Serrated Lesions ◽  
The Right ◽  
The Impact

Background. As the malignant potential of sessile serrated lesions/polyps (SSL/Ps) and traditional serrated adenomas (TSAs) has been clearly demonstrated, it is important that serrated polyps are identified and correctly classified histologically. Aim. Our aim was to characterize the clinicopathological features of a series of SSL/Ps & TSAs, to assess the accuracy of the pathological diagnosis, the incidence, and the rate of dysplasia in SSL/Ps & TSAs. Methods. We identified all colorectal serrated polyps between 01/01/2004 and 31/05/2016, by searching the laboratory information system for all cases assigned a “serrated adenoma” SNOMED code. All available and suitable slides were reviewed by one pathologist, who was blinded to the original diagnosis and the site of the polyp. Subsequently discordant cases, SSL/Ps with dysplasia, and all TSAs were reviewed by a second pathologist. Results. Over a 149-month period, 759 “serrated adenoma” polyps were identified, with 664 (from 523 patients) available for review. 41.1% were reviewed by both pathologists; 15.1% (100/664) were reclassified, with the majority being changed from SSL/P to hyperplastic polyp (HYP) (66/664; 9.9%). 80.3% of these HYPs were located in the left colon, and the majority exhibited prolapse effect. There were 520 SSL/Ps (92.2%) & 40 TSAs (7.1%). The majority of SSL/Ps were in the right colon (86.7%) and were small (64.5% <1 cm), while most TSAs were in the left colon (85.7%) and were large (73.1%≥1 cm). 6.7% of SSL/Ps exhibited dysplasia, the majority of which were large (66.7%≥1 cm). Following consensus review, 13/520 (2.5%) SSL/Ps were downgraded from SSL/P with dysplasia to SSL/P without dysplasia. Detection of SSL/Ps peaked in the most recent years reviewed (87.5% reported between 2013 and 2016, inclusive), coinciding with the introduction of “BowelScreen” (the Irish FIT-based colorectal cancer screening programme). Conclusions. Awareness of, and adherence to, diagnostic criteria is essential for accurate classification of colorectal polyps.

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