scholarly journals Reduction of Colorectal Cancer Mortality and Advanced Stage Cancer Incidence After 10 Years of Fecal Immunochemical Test Screening

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 206s-206s
Author(s):  
R.-C. Chen ◽  
H.-M. Chiu ◽  
Y.-W. Wang ◽  
J.C.-Y. Fann ◽  
A.M.-F. Yen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Advanced Cancer ◽  
Cancer Incidence ◽  
Screening Program ◽  
Population Based ◽  
Study Cohort ◽  
Adjusted Relative Risk ◽  
Advanced Stage ◽  
Incidence And Mortality

Background and aims: Colorectal cancer (CRC) is a leading cause of cancer deaths worldwide, and fecal immunochemical testing (FIT) is most widely used for population-based screening. Reduced long-term CRC mortality has been reported only scarcely in response to early detection with FIT screening. We aimed to elucidate whether and how FIT screening led to overall and site-specific reduction of advanced stage CRC incidence and mortality after the first decade of Taiwan's screening program, which offers biennial FIT screening for people aged 50-69 years. Method: The study cohort comprised eligible subjects who did (screened group) and did not (unscreened group) participate in FIT screening during the inaugural 5 years (2004-2009) with follow up until 2014. FIT-positive subjects were offered colonoscopy as a confirmatory exam. The primary outcome was incidence of advanced stage CRC and CRC mortality. Results: Among 5,417,699 eligible subjects, 3,072,164 (56.6%) had at least once FIT screening, and 1,605,200 (52.3%) received 2 or more screenings during the study period. During mean follow-up of 9.78 years, 5716 screened and 20,962 unscreened subjects developed incident advanced stage cancers [adjusted relative risk (aRR) = 0.76; 95% CI, 0.72-0.79] after controlling for self-selection to attend screening and increasing CRC incidence. CRC deaths during follow-up included 3077 screened and 15,550 unscreened subjects (aRR = 0.56, 95% CI, 0.53-0.59). Effectiveness was greater for distal cancers (advanced cancer incidence aRR = 0.68, 95% CI, 0.65-0.71); mortality aRR = 0.52 95% CI, 0.49-0.55) than for proximal cancers (advanced cancer incidence aRR = 0.99 95% CI, 0.92-1.07; mortality aRR = 0.69 95% CI, 0.63-0.75). Conclusion: FIT screening effectively reduces risk of advanced stage CRC and CRC mortality, with effectiveness consistently stronger for distal CRC than proximal CRC.

scholarly journals Yogurt consumption and colorectal cancer incidence and mortality in the Nurses’ Health Study and the Health Professionals Follow-Up Study

2020 ◽  
Vol 112 (6) ◽  
pp. 1566-1575
Author(s):  
Karin B Michels ◽  
Walter C Willett ◽  
Rita Vaidya ◽  
Xuehong Zhang ◽  
Edward Giovannucci
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Cancer Incidence ◽  
Proximal Colon ◽  
Health Study ◽  
Follow Up Study ◽  
Incidence And Mortality ◽  
Colorectal Cancer Incidence ◽  
Colorectal Cancer Mortality

ABSTRACT Background Yogurt is a commonly consumed fermented food. Regular yogurt consumption may contribute to a favorable gut microbiome and gut health, but few epidemiologic studies have considered the relation between regular yogurt consumption and the incidence of and mortality from colorectal cancer. Objectives We used data from 2 large, prospective cohort studies, the Nurses’ Health Study and the Health Professionals Follow-Up Study, to examine the role of yogurt consumption on colorectal cancer incidence and mortality. Methods During 32 years of follow-up in 83,054 women (mean age at baseline, 45.7 years) and 26 years of follow-up in 43,269 men (mean age at baseline, 52.3 years), we documented a total of 2666 newly diagnosed cases of colorectal cancer in these cohorts. We modeled yogurt consumption at baseline and cumulatively updated it throughout follow-up. Results: Baseline yogurt consumption was associated with a reduced risk of colon cancer in age-adjusted analyses (P for trend < 0.001). Associations remained statistically significant after adjusting for potential confounders, including calcium and fiber intake (P for trend = 0.03), and were restricted to proximal colon cancer. The consumption of 1 + servings per week of yogurt at baseline, compared to no yogurt consumption, was associated with a multivariable HR of 0.84 (95% CI, 0.70–0.99; P trend = 0.04) for the proximal colon cancer incidence. Latency analyses suggested that the most important window of opportunity for regular yogurt consumption to prevent colorectal cancer was 16–20 years in the past. When yogurt consumption was cumulatively updated, associations attenuated and were no longer significant. No statistically significant inverse trend was observed between yogurt consumption and the colorectal cancer mortality. Conclusions In these large cohorts, the frequency of yogurt consumption was associated with a reduced risk of proximal colon cancer with a long latency period. No significant inverse trend was observed for colorectal cancer mortality.

Estrogen and colorectal cancer incidence and mortality in the Women's Health Initiative clinical trial.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3594-3594
Author(s):  
Sayeh Moazami Lavasani ◽  
Rowan T. Chlebowski ◽  
Ross L Prentice ◽  
Ikuko Kato ◽  
Jean Wactawski-Wende ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Trial ◽  
Waist Circumference ◽  
Cancer Incidence ◽  
Conjugated Equine Estrogen ◽  
Health Initiative ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Colorectal Cancer Incidence

3594 Background: The preponderance of observational studies associate estrogen alone use with lower colorectal cancer incidence. In contrast, no difference in colorectal cancer incidence was seen in the Women's Health Initiative (WHI) randomized, controlled trial (RCT) of estrogen versus placebo after 7.1 years mean intervention. We now assess the influence of estrogen alone use on longer-term colorectal cancer incidence and mortality after an additional 5.6 years post-intervention follow-up. Methods: The WHI study was a randomized, double-blind, placebo-controlled clinical trial involving 10,739 postmenopausal women who had undergone prior hysterectomy and who were randomly assigned to receive daily 0.625 conjugated equine estrogen (n = 5279) or matching placebo (n = 5409). Colorectal cancer diagnosis rates and mortality were assessed after a mean of 7.1 years (standard deviation [SD] 1.1) of intervention and 12.7 years follow-up. Results: Colorectal cancer incidence in the treatment and control groups were almost equivalent, 0.15% diagnoses/year v 0.13% in the estrogen therapy arm and the placebo group, respectively (Hazard ratio [HR], 1.12; 95% Confidence Interval [CI], 0.83-1.52; P = 0.46). Bowel screening examinations were comparable in both groups throughout. For women age 70-79 at study entry, hormone therapy was associated with an increased risk of colorectal cancer, HR 1.71; 95% CI, (1.02-2.86). For women age 50-59 and 60-69, the respective HR’s and 95% CI were 0.86 (0.43-1.71) and 0.98 (0.64-1.49), p-interaction 0.165. For women with a waist circumference of > 88 cm, there was an increased risk of colorectal cancer, HR 1.53; 95% CI, 0.95-2.45 compared to 0.95 (0.66-1.39) for waist circumference of < 88 cm, p-interaction 0.124. Although not statistically significant, there was a higher number of colorectal cancer deaths in the hormone therapy arm (33 v 24 deaths; 0.05% v 0.04%; HR, 1.42; 95% CI, 0.84-2.41; P = 0.19). Conclusions: There were no significant differences in colorectal cancer incidence or mortality after long-term follow-up in the WHI RCT of conjugated equine estrogen. There was a suggestion of an elevation in colorectal cancer risk among older women randomized to estrogen. Clinical trial information: NCT00000611.

SCREENING FOR COLORECTAL CANCER USING THE FECAL OCCULT BLOOD TEST: AN ACTUARIAL ASSESSMENT OF THE IMPACT OF A POPULATION-BASED SCREENING PROGRAM IN CANADA

2003 ◽  
Vol 19 (4) ◽  
pp. 715-723 ◽  
Author(s):  
Paul J. Villeneuve ◽  
Ann Coombs
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Occult Blood ◽  
Population Based ◽  
Fecal Occult Blood ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Fecal Occult ◽  
The Impact

Objectives:A series of randomized controlled trials have demonstrated that screening for colorectal cancer (CRC) using the fecal occult blood (FOB) test can decrease mortality from this disease. These findings were used to develop an actuarial model to estimate the impact that a FOB screening program for colorectal cancer would have on the Canadian population.Methods:The mortality experience of the year 2000 cohort of Canadians fifty to seventy-four years of age, with follow-up extending to 2010, was modelled according to three scenarios: no screening, annual screening, biennial screening. The primary screening tool was the FOB test using unrehydrated samples, with follow-up of positive test results using colonoscopy. The framework of the model was developed based on published findings from the relevant randomized controlled trials, available data, and a literature review that yielded parameter values for some model items.Results:During the 10-year follow-up of the cohort, we estimated that 4,444 and 2,827 deaths would be averted with annual and biennial FOB screening, respectively. We estimated that for an annual FOB screening program, approximately 3,400 FOB tests would be required to prevent one death, whereas 2,700 tests would be required within a biennial program.Conclusions:Our analysis documents the population health impact of using the FOB test to screen for CRC. Additional information on the natural history of the disease, and Canadian pilot data are needed to better model the effectiveness of population-based FOB screening programs.

164 EFFECTIVENESS OF ONE-TIME ENDOSCOPIC SCREENING PROGRAM IN PREVENTION OF ESOPHAGEAL CANCER IN CHINA: A MULTI-CENTER POPULATION-BASED COHORT STUDY

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
R Chen ◽  
Y Liu ◽  
G Song ◽  
B Li ◽  
D Zhao ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cohort Study ◽  
High Risk ◽  
Cancer Incidence ◽  
Screening Program ◽  
Population Based ◽  
Control Group ◽  
Endoscopic Screening ◽  
Incidence And Mortality ◽  
Risk Areas

Abstract   Esophageal cancer is one of the most common cancers worldwide and half of all new cases occurred in China. Population-based endoscopic screening has been carried out in some high-risk areas in China since 2005, but previous evidence was based predominately on small-sample, single-center studies. We undertook a population-based, multi-center cohort study to estimate the effectiveness of endoscopic screening program in reducing the incidence and mortality of esophageal in high risks areas in China. Methods This study was conducted in six areas in China from 2005 to 2015. All permanent residents aged 40–69 yeas were identified as target subjects. We defined those who were invited and undertook endoscopic screening as the screened group, and those who refused screening as the non-screened group. The target subjects who were not invited to screening was assigned to the control group. The effectiveness of endoscopic screening and screening program were evaluated by comparing the reductions in the incidence and mortality from esophageal cancer in those screened or those invited to screening with reductions in the control group, respectively. Results Our cohort analysis included 637 500 people: 299 483 in the control group and 338 017 in the invited to screening group, 113 340 (33.53%) of whom were screened eventually. Compared with subjects in the control group, esophageal cancer incidence and mortality were reduced by 26% (relative risk(RR) 0.74, 95% confidence interval(CI), 0.69–0.79) and 60% (0.40, 0.36–0.45) respectively in those screened, and they were reduced by 15% (0.85, 0.82–0.89) and 33% (0.67, 0.63–0.71) respectively in those invited to screening. Conclusion Among individuals aged 40–69 years in high risk areas of esophageal cancer, one-time endoscopic screening program was associated with a significant decrease in esophageal cancer incidence and mortality.

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