Association between Charlson-Deyo Score and delay to colonoscopy in veterans subsequently diagnosed with colorectal cancer.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 288-288
Author(s):  
Thi Khuc ◽  
Christian Jackson
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Study Cohort ◽  
Fecal Occult ◽  
Final Study ◽  
Increased Risk ◽  
History Of

288 Background: Colorectal cancer (CRC) is the second most common cause of cancer deaths in the United States and expected to cause 51,020 deaths in 2019. Early detection with yearly fecal occult blood test (FOBT) has been proven to decrease CRC mortality. A 30-day delay from positive FOBT to colonoscopy is associated with increased risk of CRC. The Veterans Affairs Health System (VAHS) treats approximately 11% of CRCs in the United States. The effects of an aging population, physician shortage, and increased military personnel entering the VAHS may increase demands on VAHS resources. The primary aim of this study was to determine risk factors that caused delay to colonoscopy. Methods: We retrospectively reviewed records of 600 patients referred for colonoscopy from January 1999 to January 2009, who were subsequently diagnosed with CRC. Patients with a prior CRC diagnosis were excluded. The final study cohort consisted of 530 patients. We analyzed the relationship between 10 variables and delay in time from initial consultation to colonoscopy. Variables consisted of age, sex, race, ethnicity, CRC location, marital status, history of mental health diagnosis, tobacco use, substance abuse, Charlson/Deyo (C/D) score and season of referral for colonoscopy. A delay in time was defined as 30 days or greater. Logistic regression analysis adjusted for age, race, CRC location and C/D score. Results: A total of 87.17% of patients experienced a delay in time from initial consultation to colonoscopy. When analyzed with a predictive variable of delay to colonoscopy, C/D score of ≥ 2 versus 0, was associated with higher odds of delay in time to colonoscopy (OR = 2.18, p = 0.02). African American race and Hispanic ethnicity was associated with a higher odds of delay in time to colonoscopy, but was not statistically significant (OR = 1.47, p = 0.47, OR = 1.37, p = 0.48). Conclusions: Patients with a C/D score ≥ 2 were 218% more likely to have delay in time from initial consult to colonoscopy, resulting in a delayed CRC diagnosis. C/D score may be used to determine which patients should have more frequent reminders to schedule their colonoscopy to prevent delays in care. Randomized and prospective studies will need to be performed.

Colorectal Cancer Screening Clinical Practice Guidelines

2006 ◽  
Vol 4 (4) ◽  
pp. 384 ◽  
Author(s):  
_ _
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Fecal Occult ◽  
Colon And Rectal Cancer ◽  
Colorectal Cancer Prevention

Colorectal cancer is the third most frequently diagnosed cancer in men and women in the United States. An estimated 104,950 new cases of colon cancer and 40,340 new cases of rectal cancer will occur in the United States in 2005. During the same year, an estimated 56,290 people will die from colon and rectal cancer. Because patients with localized colon cancer have a 90% 5-year survival rate, screening is a critical and particularly effective procedure for colorectal cancer prevention. Screening options include colonoscopy; combined fecal occult blood test (FOBT) and sigmoidoscopy; sigmoidoscopy alone; or double-contrast barium enema. For the most recent version of the guidelines, please visit NCCN.org

A critical analysis of the largest reported mass fecal occult blood screening program in the united states

1991 ◽  
Vol 161 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Jon B. Morris ◽  
Thomas A. Stellato ◽  
Barbara B. Guy ◽  
Nahida H. Gordon ◽  
Nathan A. Berger
Keyword(s):  
United States ◽  
Critical Analysis ◽  
Screening Program ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Fecal Occult ◽  
Blood Screening

Evaluating cancer outcomes of outpatient colonoscopies in elderly patients older than 85 years of age.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15079-e15079
Author(s):  
Joy A Lee ◽  
Xia Bi ◽  
Connie Y Huang ◽  
Walter Coyle
Keyword(s):  
Colorectal Cancer ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Cancer Outcomes ◽  
Moderate Sedation ◽  
Patient Demographics ◽  
Colon Cancers ◽  
Fecal Occult ◽  
Overall Mortality

e15079 Background: With increasing life expectancy, the incidence of colorectal cancer increases. Currently, there are few studies on cancer outcomes of outpatient colonoscopy in patients older than 85 years of age. Methods: The database at Scripps was queried for all outpatient colonoscopies performed under moderate sedation between April 1, 2012 to March 31, 2017 on patients aged 85 years and older. Patient demographics, indication for procedure, and endoscopic findings were obtained. Variables including location and stage of tumor, subsequent treatments, and overall mortality were analyzed. Results: 322 outpatient colonoscopies were reviewed. Median age was 86 years. 53% were females. Screening colonoscopies accounted for 2.1% of procedures. 40 (12.4%) colon cancers were detected. 38 (95%) were adenocarcinomas and 2 (5%) were neuroendocrine tumors. 26 (65%) were right sided colon cancers. Among those diagnosed with cancer, anemia was the most common indication followed by positive fecal occult blood test (FOBT). 20 (50%) of these patients had a FOBT within the past year. Of those FOBTs, 18 (90%) were positive. Median age of patients with colon cancer was 88 years. 70% were females. 12 (30%) patients had never had a colonoscopy. 19 (47.5%) were diagnosed at an advanced stage (stage III or IV). 32 (80%) pursued surgery, 10 (25%) received chemotherapy, and 5 (12.5%) received radiation. 3 (7.5%) patients received supportive care only. 1-year mortality was 22.5% and 3-year mortality was 40% from the time of diagnosis. Conclusions: To date, this is the first study in the United States that examines cancer outcomes in an elderly population undergoing an outpatient colonoscopy. Overall, patients over the age of 85 with colorectal cancer have good outcomes that are comparable to that of the general population and colonoscopies should be considered for appropriate candidates.

scholarly journals Colorectal cancer screening and prevention: A brief review of the current guidelines and modalities

2021 ◽  
Vol 7 (2) ◽  
pp. 097-103
Author(s):  
Ashan T Hatharasinghe ◽  
Ike R Ogbu ◽  
Abdul G Gheriani ◽  
George A Trad ◽  
Andre E Manov
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Occult Blood ◽  
Fecal Occult Blood Testing ◽  
The United States ◽  
Alternative Methods ◽  
Fecal Occult Blood ◽  
Fecal Occult ◽  
Preventative Measures ◽  
Screening And Prevention

Colorectal cancer (CRC) remains a frequently addressed topic in primary care. Recent studies have been published detailing modifiable risk factors for CRC, as well as preventative measures. Providers must be up to date on screening recommendations and modalities. Colonoscopy is the preferred method of screening for CRC, and the screening recommendations in the United States were recently updated in 2020. It is also common for the practitioner to encounter patients who refuse colonoscopy but are willing to undergo alternative methods of testing. The COVID pandemic has also placed a burden on hospital resources, and colonoscopy may not be logistically feasible in some healthcare settings. Therefore, awareness of the guidelines for the various alternative modalities, along with their respective guidelines for frequency of screening is critical. This article provides a brief review of the risk factors associated with colon cancer, the screening modalities (including colonoscopy, sigmoidoscopy, CT colonography, fecal immunohistochemical testing (FIT), guaiac-based fecal occult blood testing (gFOBT), multi target stool DNA testing (MTs-DNA), and others) and the most recent screening recommendations for the general population.

Screening for Colorectal Cancer

1996 ◽  
Vol 3 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Bernard Levin
Keyword(s):  
Colorectal Cancer ◽  
Early Detection ◽  
Cost Effective ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Mortality And Morbidity ◽  
Screening Guidelines ◽  
Fecal Occult ◽  
Asymptomatic Stage

Colorectal cancer is a major cause of morbidity and mortality in the United States. Early detection of the disease at an asymptomatic stage by screening holds promise for lowering the incidence of colorectal cancer deaths, yet compliance with screening guidelines is poor. Evidence in support of the use of screening techniques for colorectal cancer is accumulating, however, and screening for this disease with fecal occult blood tests and flexible sigmoidoscopy can increase the likelihood of early detection, can decrease mortality and morbidity, and can be cost effective.

Colorectal Cancer Prevention

2005 ◽  
Vol 23 (2) ◽  
pp. 378-391 ◽  
Author(s):  
Ernest T. Hawk ◽  
Bernard Levin
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Colorectal Neoplasia ◽  
Hormone Replacement ◽  
The United States ◽  
Colorectal Adenomas ◽  
Fecal Occult Blood ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Colorectal cancer is the second leading cause of mortality in the United States. In the United States, the cumulative lifetime risk of developing colorectal cancer for both men and women is 6%. Despite advances in the management of this disease, the 5-year survival rate in the United States in only 62%. Because only 38% of patients are diagnosed when the cancers are localized to the bowel wall, it is likely that widespread implementation of screening could significantly improve the outcome. Colorectal cancer screening is cost effective, irrespective of the methods used. In addition to currently available methods (fecal occult blood, flexible sigmoidoscopy, colonoscopy, and double contrast barium enema), computed tomographic colonography (virtual colonoscopy) and stool-based molecular screening are under development.Four classes of chemopreventive compounds have demonstrated efficacy in reducing recurrent colorectal adenomas and/or cancer in randomized, controlled trials. They are selenium, calcium carbonate, hormone replacement therapy, and nonsteroidal anti-inflammatory drugs. The mechanisms of action of nonsteroidal anti-inflammatory drugs include inhibition of the cyclooxygenase system as well as cyclooxygenase-independent effects. Considerable effort is being expended to define chemopreventive activity, optimal dose, administration schedule, and toxicity for the coxibs in adenoma recurrence prevention trials. The threshold for tolerating toxicities is very low in asymptomatic individuals at minimally increased risk for colorectal neoplasia.

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