scholarly journals The Roadmap of Colorectal Cancer Screening

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1101
Author(s):  
Enea Ferlizza ◽  
Rossella Solmi ◽  
Michela Sgarzi ◽  
Luigi Ricciardiello ◽  
Mattia Lauriola
Keyword(s):  
Colorectal Cancer ◽  
Participation Rate ◽  
Occult Blood ◽  
Fecal Microbiota ◽  
Fecal Occult Blood ◽  
Screening Programs ◽  
Crc Screening ◽  
Fecal Occult ◽  
Incidence And Mortality ◽  
Improving Accuracy

Colorectal cancer (CRC) is the third most common form of cancer in terms of incidence and the second in terms of mortality worldwide. CRC develops over several years, thus highlighting the importance of early diagnosis. National screening programs based on fecal occult blood tests and subsequent colonoscopy have reduced the incidence and mortality, however improvements are needed since the participation rate remains low and the tests present a high number of false positive results. This review provides an overview of the CRC screening globally and the state of the art in approaches aimed at improving accuracy and participation in CRC screening, also considering the need for gender and age differentiation. New fecal tests and biomarkers such as DNA methylation, mutation or integrity, proteins and microRNAs are explored, including recent investigations into fecal microbiota. Liquid biopsy approaches, involving novel biomarkers and panels, such as circulating mRNA, micro- and long-non-coding RNA, DNA, proteins and extracellular vesicles are discussed. The approaches reported are based on quantitative PCR methods that could be easily applied to routine screening, or arrays and sequencing assays that should be better exploited to describe and identify candidate biomarkers in blood samples.

scholarly journals Colorectal Cancer Screening: Have We Addressed Concerns and Needs of the Target Population?

2021 ◽  
Vol 3 (4) ◽  
pp. 173-203
Author(s):  
Thuy Ngan Tran ◽  
Allegra Ferrari ◽  
Sarah Hoeck ◽  
Marc Peeters ◽  
Guido Van Van Hal
Keyword(s):  
Colorectal Cancer ◽  
Perceived Risk ◽  
Blood Test ◽  
Occult Blood ◽  
Target Population ◽  
Fecal Occult Blood ◽  
Screening Programs ◽  
Crc Screening ◽  
Fecal Occult ◽  
Experience Education

Despite the recognized benefits of colorectal cancer (CRC) screening, uptake is still suboptimal in many countries. In addressing this issue, one important element that has not received sufficient attention is population preference. Our review provides a comprehensive summary of the up-to-date evidence relative to this topic. Four OVID databases were searched: Ovid MEDLINE® ALL, Biological Abstracts, CAB Abstracts, and Global Health. Among the 742 articles generated, 154 full texts were selected for a more thorough evaluation based on predefined inclusion criteria. Finally, 83 studies were included in our review. The general population preferred either colonoscopy as the most accurate test, or fecal occult blood test (FOBT) as the least invasive for CRC screening. The emerging blood test (SEPT9) and capsule colonoscopy (nanopill), with the potential to overcome the pitfalls of the available techniques, were also favored. Gender, age, race, screening experience, education and beliefs, the perceived risk of CRC, insurance, and health status influence one’s test preference. To improve uptake, CRC screening programs should consider offering test alternatives and tailoring the content and delivery of screening information to the public’s preferences. Other logistical measures in terms of the types of bowel preparation, gender of endoscopist, stool collection device, and reward for participants can also be useful.

scholarly journals Immunochemical Fecal Occult Blood Test for Detection of Advanced Colonic Adenomas and Colorectal Cancer: Comparison with Colonoscopy Results

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Bianca Rosa Viana Freitas ◽  
Cristiane Kibune Nagasako ◽  
Celia Regina Pavan ◽  
Sônia Letícia Silva Lorena ◽  
Fabio Guerrazzi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Sensitivity And Specificity ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Screening Programs ◽  
Fecal Occult ◽  
Colonic Adenomas ◽  
Lack Of Information ◽  
Risk Patients ◽  
Advanced Adenomas

Background. Fecal immunochemical tests (FITs) have been used for colorectal cancer (CRC) screening in several countries. There is lack of information concerning diagnostic performances of this method in Brazil.Methods. Patients scheduled for elective colonoscopy provided one stool sample one week before colonoscopy. The accuracy of a qualitative FIT for detection of CRC and advanced adenomas was determined.Results. Overall 302 patients completed the study. Among them, 53.5% were high risk patients referred for screening or surveillance. Nine (3%) CRCs and 11 (3.6%) advanced adenomas were detected by colonoscopy. Sensitivity and specificity for CRC were, respectively, 88.9% and 87.6%. For advanced adenomas, sensitivity was 63.6% and specificity 87.6%.Conclusion. Our results showed good sensitivity and specificity of the FIT for detecting advanced neoplasias. This method may be a valuable tool for future screening programs in Brazil.

scholarly journals Clinical Validation Results of an Innovative Non-Invasive Device for Colorectal Cancer Preventive Screening through Fecal Exhalation Analysis

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1471
Author(s):  
Giulia Zonta ◽  
Cesare Malagù ◽  
Sandro Gherardi ◽  
Alessio Giberti ◽  
Alessandro Pezzoli ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Low Cost ◽  
Occult Blood ◽  
Machine Learning Techniques ◽  
Fecal Occult Blood ◽  
Clinical Validation ◽  
Non Invasive ◽  
Fecal Occult ◽  
Incidence And Mortality

Screening is recommended to reduce both incidence and mortality of colorectal cancer. Currently, many countries employ fecal occult blood test (FOBT). In Emilia-Romagna (Italy), since 2005, FOBT immunochemical version (FIT) is performed every two years on people aged between 50 and 69 years. A colonoscopy is then carried out on those who are FIT positive. However, FIT shows approximately 65% false positives (non-tumoral bleedings), leading to many negative colonoscopies. The use of an economic and easy-to-use method to check FOBT-positives will improve screening effectiveness, reducing costs to the national health service. This work illustrates the results of a three-year clinical validation protocol (started in 2016) of a patented device composed of a core of nanostructured gas sensors. This device was designed to identify CRC presence by fecal volatile compounds, with a non-invasive, in vitro and low-cost analysis. Feces are, in fact, affected by tumor-volatile biomarkers, produced by cellular peroxidation and metabolic alterations. The protocol consisted in the analysis of fecal samples of FIT-positive subjects, using colonoscopy as a gold standard. A total of 398 samples were analyzed with machine learning techniques, leading to a sensitivity and specificity of 84.1% and 82.4%, respectively, and a positive predictive value of 72% (25–35% for FIT).

scholarly journals Cause of Death, Mortality and Occult Blood in Colorectal Cancer Screening

Cancers ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 246
Author(s):  
Lasse Kaalby ◽  
Issam Al-Najami ◽  
Ulrik Deding ◽  
Gabriele Berg-Beckhoff ◽  
Robert J. C. Steele ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cause Of Death ◽  
Blood Test ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Time Varying ◽  
Hemoglobin F ◽  
Crc Screening ◽  
Fecal Occult ◽  
Hazard Ratios

Fecal hemoglobin (f-Hb) detected by the guaiac fecal occult blood test (gFOBT) may be associated with mortality and cause of death in colorectal cancer (CRC) screening participants. We investigated this association in a randomly selected population of 20,694 participants followed for 33 years. We followed participants from the start of the Hemoccult-II CRC trial in 1985–1986 until December 2018. Data on mortality, cause of death and covariates were retrieved using Danish national registers. We conducted multivariable Cox regressions with time-varying exposure, reporting results as crude and adjusted hazard ratios (aHRs). We identified 1766 patients with at least one positive gFOBT, 946 of whom died in the study period. Most gFOBT-positive participants (93.23%) died of diseases unrelated to CRC and showed higher non-CRC mortality than gFOBT-negative participants (aHR: 1.20, 95% CI 1.10–1.30). Positive gFOBT participants displayed a modest increase in all-cause (aHR: 1.28, 95% CI: 1.18–1.38), CRC (aHR: 4.07, 95% CI: 3.00–5.56), cardiovascular (aHR: 1.22, 95% CI: 1.07–1.39) and endocrine and hematological mortality (aHR: 1.58, 95% CI: 1.19–2.10). In conclusion, we observed an association between positive gFOBT, cause of death and mortality. The presence of f-Hb in the gFOBT might indicate the presence of systemic diseases.

Overall evaluation of an immunological latex agglutination system for fecal occult blood testing in the colorectal cancer screening program of Florence

2012 ◽  
Vol 27 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Tiziana Rubeca ◽  
Benedetta Peruzzi ◽  
Massimo Confortini ◽  
Stefano Rapi
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Occult Blood ◽  
Fecal Occult Blood Testing ◽  
Latex Agglutination ◽  
Fecal Occult Blood ◽  
Detection Rates ◽  
Screening Programs ◽  
Fecal Occult ◽  
Advanced Adenomas

Several immunological fecal occult blood tests (FOBT) are currently available for colorectal cancer (CRC) screening. We compared the HM Jack (Jack) (Kiowa, Japan), with the OC-Hemodia (OC) (Eiken, Japan) in use in the Florence screening program. Aims of the study were: (i) to investigate the diagnostic performance and the best cutoff value for Jack; (ii) to evaluate the handiness of sampling tubes; (iii) to compare costs. A total of 5,044 subjects were screened with both tests. Sampling tube investigation was performed running each sample on both instruments. A number of 352 subjects positive for at least one test (175 OC, 310 Jack) were selected for further investigations, while 46 subjects refused further assessments. Analysis of costs related to the assessment phase was performed on the basis of Tuscany region's fares. Amongst the 306 subjects investigated, 9 CRC and 67 advanced adenomas (AdA) were detected. Detection rates (DR) were 1.4‰ for CRC and 9.6‰ for AdA. After Jack cutoff optimization, DR for CRC+AdA resulted in 11.1‰ for OC and 13.3‰ for Jack (p=0.041). Sensitivity of the methods was 73.7 for OC and 88.2 for Jack; specificity was 97.6 for OC and 96.0 for Jack, resulting in an increase of the required assessments from 3.5% to 5.1%. No differences were observed between sampling methods. Despite the lower specificity of Jack, its greater sensitivity makes the method attractive for screening programs. An increase of the costs of 30% for every subject investigated for pathological lesion (CRC+AdA) may be thus foreseen.

scholarly journals Using fecal immunochemical tubes for the analysis of the gut microbiome has the potential to improve colorectal cancer screening

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kertu Liis Krigul ◽  
Oliver Aasmets ◽  
Kreete Lüll ◽  
Tõnis Org ◽  
Elin Org
Keyword(s):  
Colorectal Cancer ◽  
Public Health Problem ◽  
16S Rrna Gene Sequencing ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Rrna Gene ◽  
Screening Programs ◽  
Crc Screening ◽  
Fresh Frozen ◽  
The Impact

AbstractColorectal cancer (CRC) is a challenging public health problem which successful treatment depends on the stage at diagnosis. Recently, CRC-specific microbiome signatures have been proposed as a marker for CRC detection. Since many countries have initiated CRC screening programs, it would be useful to analyze the microbiome in the samples collected in fecal immunochemical test (FIT) tubes for fecal occult blood testing. Therefore, we investigated the impact of FIT tubes and stabilization buffer on the microbial community structure evaluated in stool samples from 30 volunteers and compared the detected communities to those of fresh-frozen samples, highlighting previously published cancer-specific communities. Altogether, 214 samples were analyzed by 16S rRNA gene sequencing, including positive and negative controls. Our results indicated that the variation between individuals was greater than the differences introduced by the collection strategy. The vast majority of the genera were stable for up to 7 days. None of the changes observed between fresh-frozen samples and FIT tube specimens were related to previously identified CRC-specific bacteria. Overall, we show that FIT tubes can be used for profiling the microbiota in CRC screening programs. This circumvents the need to collect additional samples and can possibly improve the sensitivity of CRC detection.

scholarly journals Fecal Immunochemical Tests Compared with Guaiac Fecal Occult Blood Tests for Population-Based Colorectal Cancer Screening

2012 ◽  
Vol 26 (3) ◽  
pp. 131-147 ◽  
Author(s):  
Linda Rabeneck ◽  
R Bryan Rumble ◽  
Frank Thompson ◽  
Michael Mills ◽  
Curtis Oleschuk ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Blood Test ◽  
Fecal Occult Blood Test ◽  
Present Report ◽  
Occult Blood ◽  
Advanced Adenoma ◽  
Fecal Occult Blood ◽  
Occult Blood Test ◽  
Fecal Occult ◽  
Incidence And Mortality

Colorectal cancer (CRC) is the second most common cause of cancer deaths in Canadian men and women – accounting for almost 12% of all cancer deaths. In Ontario, it is estimated that 8100 persons were diagnosed with CRC in 2011, and 3250 died from the disease. CRC incidence and mortality rates in Ontario are among the highest in the world. Screening offers the best opportunity to reduce this burden of disease. The present report describes the findings and recommendations of Cancer Care Ontario’s Fecal Immunochemical Tests (FIT) Guidelines Expert Panel, which was convened in September 2010 by the Program in Evidence-Based Care. The purpose of the present guideline is to evaluate the existing evidence concerning FIT to inform the decision on how to replace the current guaiac fecal occult blood test with FIT in the Ontario ColonCancerCheck Program. Eleven articles were included in the present guideline, comprising two systematic reviews, five articles reporting on three randomized controlled trials and reports of four other studies. Additionally, one laboratory study was obtained that reported on several parameters of FIT tests that helped to inform the present recommendation. The performance of FIT is superior to the standard guaiac fecal occult blood test in terms of screening participation rates and the detection of CRC and advanced adenoma. Given greater specimen instability with the use of FIT, a pilot study should be undertaken to determine how to implement the FIT in Ontario.

scholarly journals Colorectal cancer screening

2000 ◽  
Vol 55 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Frederico Ferreira Novaes de Almeida ◽  
Sérgio Eduardo Alonso Araujo ◽  
Fábio Pires de Souza Santos ◽  
Cláudio José Castro da Silva Franco ◽  
Vinicius Rocha Santos ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cost Effective ◽  
Occult Blood ◽  
Risk Groups ◽  
Target Population ◽  
Morbidity And Mortality ◽  
Fecal Occult Blood ◽  
Screening Methods ◽  
Crc Screening ◽  
Fecal Occult

Colorectal cancer (CRC) is the third most common cancer in the world, and mortality has remained the same for the past 50 years, despite advances in diagnosis and treatment. Because significant numbers of patients present with advanced or incurable stages, patients with pre-malignant lesions (adenomatous polyps) that occur as result of genetic inheritance or age should be screened, and patients with long-standing inflammatory bowel disease should undergo surveillance. There are different risk groups for CRC, as well as different screening strategies. It remains to be determined which screening protocol is the most cost-effective for each risk catagory. The objective of screening is to reduce morbidity and mortality in a target population. The purpose of this review is to analyze the results of the published CRC screening studies, with regard to the measured reduction of morbidity and mortality, due to CRC in the studied populations, following various screening procedures. The main screening techniques, used in combination or alone, include fecal occult blood tests, flexible sigmoidoscopy, and colonoscopy. Evidence from the published literature on screening methods for specific risk groups is scanty and frequently does not arise from controlled studies. Nevertheless, data from these studies, combined with recent advances in molecular genetics, certainly lead the way to greater efficacy and lower cost of CRC screening.

Cost-effectiveness of screening for colorectal cancer in France using a guaiac test versus an immunochemical test

2010 ◽  
Vol 26 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Catherine Lejeune ◽  
Vincent Dancourt ◽  
Patrick Arveux ◽  
Claire Bonithon-Kopp ◽  
Jean Faivre
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Participation Rate ◽  
Occult Blood ◽  
Sensitivity Analyses ◽  
Screening Tests ◽  
Fecal Occult Blood ◽  
Fecal Occult ◽  
Immunochemical Test

Objectives: The aim of this study was to compare the cost and the effectiveness of two biennial fecal occult blood screening tests for colorectal cancer: a guaiac nonrehydrated test (G-FOBT) and an immunochemical test (I-FOBT) with the absence of screening.Methods: A Markov model was developed to compare these strategies in a general population of subjects aged 50 to 74 over a 20-year period.Results: Compared with the absence of screening, G-FOBT and I-FOBT were associated with a decrease in colorectal cancer mortality of 17.4 percent and 25.2 percent, respectively. With regard to cost-effectiveness, expressed as cost per life-year gained, I-FOBT was the most effective and most costly alternative. Compared with no screening, G-FOBT and I-FOBT presented similar discounted incremental cost-effectiveness ratios: €2,739 and €2,819 respectively per life-year gained. When compared with G-FOBT, I-FOBT presented an incremental cost-effectiveness ratio of €2,988 per life-year gained. Sensitivity analyses showed the strong influence of the I-FOBT lead time, of the participation rate to screening for I-FOBT, and of the purchase price of the I-FOBT on the discounted incremental cost-effectiveness ratios.Conclusions: Compared with the absence of screening and with G-FOBT, the biennial two-stool immunochemical test can be considered a promising method for mass screening for colorectal cancer.

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