Screening for colorectal cancer

2002 ◽  
Vol 39 (4) ◽  
pp. 351-365 ◽  
Author(s):  
Bryan J Starkey
Keyword(s):  
Colorectal Cancer ◽  
Screening Method ◽  
Point Mutations ◽  
Occult Blood ◽  
Crc Screening ◽  
Faecal Occult Blood ◽  
Faecal Occult ◽  
The Uk ◽  
Visualization Techniques ◽  
Stool Analysis

Colorectal cancer (CRC) causes 20 000 deaths per annum in the UK alone. Screening has been shown to reduce mortality but debate exists as to which approach to use. Direct visualization of the colorectum has the advantage that it detects lesions most effectively and is required at less frequent intervals, but the procedure is invasive and at present too costly for screening purposes. Faecal occult blood measurement, despite its limitations, is currently the recommended screening method, with follow-up of positive tests by colonoscopy or other visualization techniques. This strategy has been shown to reduce mortality from CRC by about 20% and screening trials directed towards individuals in the over 50 years age group are underway in the UK and elsewhere. Future developments in CRC screening include colorectal visualization by computed colonography - a less-invasive alternative to colonoscopy. Developments in stool analysis are also occurring. Examination of faecal samples for cellular products derived from neoplasms (e.g. calprotectin) may prove more sensitive and specific than faecal occult blood measurements. In addition, detection of altered DNA in faeces is being investigated by molecular biology techniques. Using a multi-target assay panel to detect point mutations and other neoplasia-associated DNA abnormalities may be an effective strategy for CRC screening in the future.

scholarly journals Colorectal cancer screening: Barriers to the faecal occult blood test (FOBT) and colonoscopy in Singapore

2016 ◽  
Vol 25 (4) ◽  
pp. 207-214 ◽  
Author(s):  
Sook Kwin Yong ◽  
Whee Sze Ong ◽  
Gerald Choon-Huat Koh ◽  
Richard Ming Chert Yeo ◽  
Tam Cam Ha
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Blood Test ◽  
Screening Method ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Screening Methods ◽  
Occult Blood Test ◽  
Crc Screening ◽  
Faecal Occult

Introduction: This study aims to identify the barriers to adopting faecal occult blood test (FOBT) and colonoscopy as colorectal cancer (CRC) screening methods among the eligible target population of Singapore. Materials and methods: This study was previously part of a randomised controlled trial reported elsewhere. Data was collected from Singapore residents aged 50 and above, via a household sample survey. The study recruited subjects who were aware of CRC screening methods, and interviewed them about the barriers to screening that they faced. Collected results on barriers to each screening method were analysed separately. Results: Out of the 343 subjects, 85 (24.8%) recruited knew about FOBT and/or colonoscopy. Most of the respondents (48.9%) cited not having symptoms as the reason for not using the FOBT. This is followed by inconvenience (31.1%), not having any family history of colon cancer (28.9%), lack of time (28.9%) and lack of reminders/recommendation (28.9%). Of the respondents who indicated not choosing colonoscopy as a screening method, more than one-half (54.8%) identified not having any symptoms as the main barrier for them, followed by not having any family history (38.7%) and having a healthy/low-risk lifestyle (29.0%). There was no difference between the reported barriers to each of the screening methods and the respondents’ dwelling types. Conclusions: Lack of knowledge, particularly the misconceptions of not having symptoms and being healthy, were identified as the main barriers to FOBT and colonoscopy as screening methods. Interventions to increase the uptake of CRC screening in this population should be tailored to address this misconception.

Incidence of faecal occult blood test interval cancers in population-based colorectal cancer screening: a systematic review and meta-analysis

Gut ◽  
2018 ◽  
Vol 68 (5) ◽  
pp. 873-881 ◽  
Author(s):  
Els Wieten ◽  
Eline H Schreuders ◽  
Esmée J Grobbee ◽  
Daan Nieboer ◽  
Wichor M Bramer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Incidence Rate ◽  
Occult Blood ◽  
Incidence Rates ◽  
Cochrane Library ◽  
Average Risk ◽  
Crc Screening ◽  
Faecal Occult Blood ◽  
Faecal Occult ◽  
Test Result

ObjectiveFaecal immunochemical tests (FITs) are replacing guaiac faecal occult blood tests (gFOBTs) for colorectal cancer (CRC) screening. Incidence of interval colorectal cancer (iCRC) following a negative stool test result is not yet known. We aimed to compare incidence of iCRC following a negative FIT or gFOBT.DesignWe searched Ovid Medline, Embase, Cochrane Library, Science Citation Index, PubMed and Google Scholar from inception to 12 December 2017 for citations related to CRC screening based on stool tests. We included studies on FIT or gFOBT iCRC in average-risk screening populations. Main outcome was pooled incidence rate of iCRCs per 100 000 person-years (p-y). Pooled incidence rates were obtained by fitting random-effect Poisson regression models.ResultsWe identified 7 426 records and included 29 studies. Meta-analyses comprised data of 6 987 825 subjects with a negative test result, in whom 11 932 screen-detected CRCs and 5 548 gFOBT or FIT iCRCs were documented. Median faecal haemoglobin (Hb) positivity cut-off used was 20 (range 10–200) µg Hb/g faeces in the 17 studies that provided FIT results. Pooled incidence rates of iCRC following FIT and gFOBT were 20 (95% CI 14 to 29; I2=99%) and 34 (95% CI 20 to 57; I2=99%) per 100 000 p-y, respectively. Pooled incidence rate ratio of FIT versus gFOBT iCRC was 0.58 (95% CI 0.32 to 1.07; I2=99%) and 0.36 (95% CI 0.17 to 0.75; I2=10%) in sensitivity analysis. For every FIT iCRC, 2.6 screen-detected CRCs were found (ratio 1:2.6); for gFOBT, the ratio between iCRC and screen-detected CRC was 1:1.2. Age below 60 years and the third screening round were significantly associated with a lower iCRC rate.ConclusionA negative gFOBT result is associated with a higher iCRC incidence than a negative FIT. This supports the use of FIT over gFOBT as CRC screening tool.

Adherence to and predictors of participation in colorectal cancer screening with faecal occult blood testing in Spain, 2009–2011

2015 ◽  
Vol 24 (4) ◽  
pp. 305-312 ◽  
Author(s):  
Isa Ricardo-Rodrigues ◽  
Rodrigo Jiménez-García ◽  
Valentín Hernández-Barrera ◽  
Pilar Carrasco-Garrido ◽  
Isabel Jiménez-Trujillo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Occult Blood ◽  
Faecal Occult Blood Testing ◽  
Blood Testing ◽  
Faecal Occult Blood ◽  
Faecal Occult

scholarly journals Exploring the Barriers Toward Colorectal Cancer Screening: A Literature Review

2021 ◽  
Vol 15 (2) ◽  
Author(s):  
Rolla Hamdan ◽  
Jessie Johnson ◽  
Maryam Fatemi ◽  
Kathleen Benjamin ◽  
Afrah Moosa
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Blood Test ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Primary Health ◽  
Faecal Occult ◽  
Bowel Cancer Screening

Background: Colorectal cancer is the third most common cancer and the second leading cause of death worldwide. Bowel cancer screening helps prevent colon cancer by early detection of polyps, leading to efficient treatment and reduced mortality. Within Qatar, primary health facilities promote bowel screening by using the faecal occult blood test. However, the popularity and use of this test is still low. Aim: The aim of this literature review is to explore barriers related to colorectal cancer bowel screening using the faecal occult blood test in primary health care settings to facilitate colorectal cancer screening in Qatar. Method: Cronin’s five step framework for literature reviews was utilized for this paper. This review included nine articles that were peer-reviewed and published between 2009 and 2019. The nine articles were appraised by using the Mixed Methods Appraisal Tool. This tool has separate criteria to assess the quality of the qualitative, quantitative, and mixed-method studies. Result: Three main barriers to bowel cancer screening included knowledge deficit, personal beliefs and organizational barriers. Conclusion: The main barriers are related to the patients’ lack of knowledge and personal beliefs. Overcoming these barriers is essential to raising awareness about this issue among all nurses, physicians, and patients. It is necessary to involve stakeholders in order to mitigate barriers. Developing educational activities for healthcare professionals will provide information that they can share with patients to encourage screening and decrease the fear of the test. Developing a pamphlet to increase patient awareness will also encourage screening and work toward decreasing fear. Key words: faecal occult blood test, faecal immunochemical test, barriers

scholarly journals Cost Analysis in a Population Based Screening Programme for Colorectal Cancer: Comparison of Immunochemical and Guaiac Faecal Occult Blood Testing

1997 ◽  
Vol 4 (3) ◽  
pp. 142-146 ◽  
Author(s):  
G Castiglione ◽  
M Zappa ◽  
G Grazzini ◽  
C Sani ◽  
A Mazzotta ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Programme ◽  
Cost Effective ◽  
Occult Blood ◽  
Recall Rate ◽  
Population Based ◽  
Faecal Occult Blood Testing ◽  
Faecal Occult Blood ◽  
Blood Tests ◽  
Faecal Occult

Objective— To compare the costs of colorectal cancer (CRC) screening by two faecal occult blood tests (FOBT)—namely, Hemoccult (guaiac based) and reversed passive haemagglutination (RPHA) tests. RPHA was interpreted according to two positivity thresholds (+ or +/-). Methods— Attenders performed both tests. Subjects with a positive FOBT test were invited to have a complete exploration of the colon. The total costs for every 10 000 screened subjects and costs for each unit of result (screened subject, or patient with adenoma/s or cancer detected) were calculated for both tests. Results— 8353 subjects were enrolled. A total of 2109 repeated screening after two years. RPHA(+ and +/-) showed the highest and RPHA(+) the lowest positivity rate at first screening. The Hemoccult positivity rate was highest at repeat screening. Total costs of screening by RPHA(+ and +/-) were highest as this method had the highest recall rate. Screening by RPHA(+) was the least costly. Costs for each screened subject were highest for RPHA(+ and +/-) and lowest for RPHA(+). Costs for each cancer detected were lowest for RPHA(+) and highest for Hemoccult or RPHA(+ and +/-) in subjects aged > 49 or < 50, respectively. Costs for subjects with detected adenoma/s of > 9 mm were lowest for RPHA(+ and +/-) and highest for Hemoccult. At repeat screening total costs of RPHA(+ and +/-) were lower than at first screening, whereas for each subject with cancer or adenoma/s costs were increased. Conclusions— Our data confirm that screening by RPHA is more cost effective than by Hemoccult.

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