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 An Overview of Colorectal Cancer Screening

2008 ◽  
Vol 53 (4) ◽  
pp. 31-37 ◽  
Author(s):  
SA Goodbrand ◽  
RJC Steele
Keyword(s):  
Colorectal Cancer ◽  
United Kingdom ◽  
Cancer Screening ◽  
High Risk ◽  
Colorectal Cancer Screening ◽  
Current Practice ◽  
Screening Methods ◽  
Average Risk ◽  
The United Kingdom

Colorectal cancer ranks highly amongst all cancer sites in incidence and contributes to a substantial number of cancer related deaths in the United Kingdom. However, screening of average risk individuals has been shown to reduce both disease associated mortality and incidence. This paper provides an overview of both current and future screening methods for colorectal cancer, as well as current practice for screening in both average and high risk individuals.

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 Scope of Artificial Intelligence in Screening and Diagnosis of Colorectal Cancer

2020 ◽  
Vol 9 (10) ◽  
pp. 3313 ◽  
Author(s):  
Hemant Goyal ◽  
Rupinder Mann ◽  
Zainab Gandhi ◽  
Abhilash Perisetti ◽  
Aman Ali ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Narrow Band Imaging ◽  
Screening Methods ◽  
Polyp Detection ◽  
Mortality And Morbidity ◽  
Magnifying Chromoendoscopy

Globally, colorectal cancer is the third most diagnosed malignancy. It causes significant mortality and morbidity, which can be reduced by early diagnosis with an effective screening test. Integrating artificial intelligence (AI) and computer-aided detection (CAD) with screening methods has shown promising colorectal cancer screening results. AI could provide a “second look” for endoscopists to decrease the rate of missed polyps during a colonoscopy. It can also improve detection and characterization of polyps by integration with colonoscopy and various advanced endoscopic modalities such as magnifying narrow-band imaging, endocytoscopy, confocal endomicroscopy, laser-induced fluorescence spectroscopy, and magnifying chromoendoscopy. This descriptive review discusses various AI and CAD applications in colorectal cancer screening, polyp detection, and characterization.

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

scholarly journals Colorectal Cancer Screening: Knowledge and Practice among Private General Practitioners in Northeast Peninsular Malaysia

2021 ◽  
Vol 13 (1) ◽  
pp. 43-55
Author(s):  
Masliza Yusoff ◽  
Faridah Mohd Zin ◽  
Norwati Daud ◽  
Harmy Mohamed Yusoff ◽  
Nani Draman
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
General Practitioners ◽  
Good Practice ◽  
Occult Blood ◽  
Peninsular Malaysia ◽  
Average Risk ◽  
Current Recommendation ◽  
Knowledge And Practice

Colorectal cancer screening is an important screening to detect colorectal cancer. Thus, the aim of this study is to determine the knowledge, practice and its associated factors of colorectal cancer screening among private general practitioners (PGPs) in Northeast Peninsular Malaysia. Crosssectional study was conducted involving 127 PGPs in Kelantan. The study used a validated selfadministrated questionnaire that contained three domains. The domains were sociodemographic, knowledge and practice of colorectal cancer screening. The inclusion criterion was doctors working in a private clinic for more than six months, while the exclusion criteria were non-residential doctors and doctors practicing in private specialised clinics. Only 21.3% of PGPs had good knowledge and 3.9% had good practice on colorectal cancer screening. The duration of practice as a PGP was significantly associated with good practice for colorectal cancer screening. Only 58.3% were aware of the current recommendation on colorectal cancer screening. Most PGPs would refer patients for a colonoscopy, but screening with faecal occult blood test (FOBT) in average-risk patients was low. Only 4% of PGPs followed the recommended guidelines for colorectal cancer screening. The main reasons for not offering FOBT screening were patients’ refusal, patients were not regular patients of the doctor and the referral system for colonoscopy was found to be difficult. This study noted that knowledge and practice of colorectal cancer screening among PGPs were inadequate. Overcoming barriers for screening is important to promote colorectal cancer screening.

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