scholarly journals Adenoma to Colorectal Cancer Estimated Transition Rates Stratified by BMI Categories—A Cross-Sectional Analysis of Asymptomatic Individuals from Screening Colonoscopy Program

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 62
Author(s):  
Piotr Spychalski ◽  
Jarek Kobiela ◽  
Paulina Wieszczy ◽  
Marek Bugajski ◽  
Jaroslaw Reguła ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Screening Colonoscopy ◽  
Advanced Adenoma ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Colonoscopy Screening ◽  
Advanced Lesion ◽  
Advanced Adenomas ◽  
Sectional Analysis

Most colorectal cancers (CRC) assumedly develop from precursor lesions, i.e., colorectal adenomas (adenoma-carcinoma sequence). Epidemiological and clinical data supporting this hypothesis are limited. Therefore, the aim of the present study is to estimate relative dynamics of colorectal adenoma-carcinoma sequence for groups of screenees stratified by BMI (body mass index) based on prevalence data from Polish Colonoscopy Screening Program (PCSP). We performed a cross-sectional analysis of database records of individuals who entered the national opportunistic colonoscopy screening program for CRC in Poland. We calculated prevalence of adenomas and CRCs adjusted for sex, 5-year age group, family history of CRC, smoking, diabetes and use of aspirin, hormonal therapy and proton-pump inhibitors use. Thereafter we calculated estimated transition rate (eTR) with confidence intervals (CIs) defined as adjusted prevalence of more advanced lesion divided by adjusted prevalence of less advanced lesion. All analyzes were stratified according to the BMI categories: normal (BMI 18.0 to <25.0), overweight (BMI 25.0 to <30.0) and obese (BMI ≥ 30.0). Results are reported in the same respective order. After exclusions we performed analyses on 147 385 individuals. We found that prevalence of non-advanced adenomas is increasing with BMI category (12.19%, 13.81%, 14.70%, respectively; p < 0.001). Prevalence of advanced adenomas was increasing with BMI category (5.20%, 5.77%, 6.61%, respectively; p < 0.001). Early CRCs prevalence was the highest for obese individuals (0.55%) and the lowest for overweight individuals (0.44%) with borderline significance (p = 0.055). For advanced CRC we found that prevalence seems to be inversely related to BMI category, however no statistically significant differences were observed (0.35%, 0.31%, 0.28%; p = 0.274). eTR for non-advanced adenoma to advanced adenoma is higher for obese individuals than for overweight individuals with bordering CIs (42.65% vs. 41.81% vs. 44.95%) eTR for advanced adenoma to early CRC is highest for normal individuals, however CIs are overlapping with remaining BMI categories (9.02% vs. 7.67% vs. 8.39%). eTR for early CRC to advanced CRC is lower for obese individuals in comparison to both normal and overweight individuals with marginally overlapping CIs (73.73% vs. 69.90% vs. 50.54%). Obese individuals are more likely to develop adenomas, advanced adenomas and early CRC but less likely to progress to advanced CRC. Therefore, this study provides new evidence that obesity paradox exists for colorectal cancer.

scholarly journals Detection of cancers and advanced adenomas in asymptomatic participants in colorectal cancer screening: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048183
Author(s):  
Anna Lisa Schult ◽  
Edoardo Botteri ◽  
Geir Hoff ◽  
Kristin R Randel ◽  
Eirin Dalén ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Bleeding ◽  
Cross Sectional Study ◽  
Advanced Adenoma ◽  
Sectional Study ◽  
Cross Sectional ◽  
Crc Screening ◽  
Bowel Symptoms ◽  
Bowel Habits ◽  
Advanced Adenomas

ObjectivesTo assess detection rates for colorectal cancer (CRC) and advanced adenomas in asymptomatic CRC screening participants and bowel symptoms in association with CRC and advanced adenoma.DesignCross-sectional study.SettingTwo screening centres.Participants42 554 men and women, aged 50–74 years, participating in a randomised CRC screening trial. 36 059 participants underwent a sigmoidoscopy (and follow-up colonoscopy if positive sigmoidoscopy) and 6495 underwent a colonoscopy after a positive faecal immunochemical test (FIT).Primary and secondary outcome measuresProportion of asymptomatic participants diagnosed with CRC or advanced adenomas. Prevalence of bowel symptoms (rectal bleeding, change in bowel habits, diarrhoea, constipation, bloating, alternating bowel habits, general symptoms, other bowel symptoms) recorded by the endoscopist and their association with CRC and advanced adenomas.ResultsAmong sigmoidoscopy participants, 7336 (20.3%) reported at least one symptom. 120 (60%) out of 200 individuals with screen-detected CRC and 1301 (76.5%) out of 1700 with advanced adenoma were asymptomatic. Rectal bleeding was associated with detection of CRC and advanced adenoma (OR 4.3, 95% CI 3.1 to 6.1 and 1.8, 95% CI 1.5 to 2.1, respectively), while change in bowel habits only with CRC detection (OR 3.8, 95% CI 2.4 to 6.1). Among the FIT positives, 2173 (33.5%) reported at least one symptom. Out of 299 individuals with screen-detected CRC and 1639 with advanced adenoma, 167 (55.9%) and 1 175 (71.7%) were asymptomatic, respectively. Detection of CRC was associated with rectal bleeding (OR 1.8, 95% CI 1.4 to 2.3), change in bowel habits (OR 2.2, 95% CI 1.4 to 3.5) and abdominal pain (OR 1.8, 95% CI 1.2 to 2.7).ConclusionsSome bowel symptoms increased the likelihood of being diagnosed with CRC or advanced adenoma. However, the majority of individuals with these findings were asymptomatic. Asymptomatic individuals should be encouraged to participate in CRC screening.Trial registration numberClinicaltrials.gov Identifier: NCT01538550.

scholarly journals Insight into hepatitis B prevalence and risk factors among Vietnamese Americans: a cross-sectional analysis of data from a community-based screening program

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029616 ◽  
Author(s):  
Alice W Lee ◽  
Wura Jacobs ◽  
Elena Chan ◽  
Becky Nguyen ◽  
Dung N Hua ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Southern California ◽  
Screening Program ◽  
Vietnamese Americans ◽  
Hepatitis B Vaccination ◽  
Community Based ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Increased Risk ◽  
Sectional Analysis

ObjectivesThe aims of our study were to describe current hepatitis B prevalence among Vietnamese Americans and to examine predictors of hepatitis B risk in this specific ethnic community.DesignCross-sectional analysis of data from a community-based screening program.SettingThis analysis was based on hepatitis screening community events in Southern California.Participants2508 Vietnamese Americans in Southern California.Outcome measuresSerological tests for hepatitis B surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody were used to classify participants as one of four hepatitis B infection statuses: currently infected, previously infected, susceptible, or immune due to a previous hepatitis B vaccination.ResultsAcross 2508 participants, 9.0% were currently infected with hepatitis B and 17.7% were at risk for hepatitis B. Females and those reporting a previous hepatitis B vaccination were at significant decreased risk of hepatitis B (OR=0.48, 95% CI 0.33 to 0.69 and OR=0.53, 95% CI 0.31 to 0.93, respectively) whereas those born outside of the USA and with a family history of the disease showed substantial increased risk (OR=13.36, 95% CI 1.62 to 110.05 and OR=4.68, 95% CI 2.66 to 8.22, respectively). Among those who reported a previous hepatitis B vaccination, less than half (42.9%) possessed the protective antibodies that result from a hepatitis B vaccination.ConclusionsVietnamese Americans remain disproportionately burdened by hepatitis B. Public health efforts that focus on improving hepatitis B awareness and vaccination knowledge and that are tailored to specific high-risk subgroups, such as immigrants and those with infected family members, could help in addressing the disease’s burden in this high-prevalence population.

scholarly journals Impact of restrictions due to COVID-19 on a quality-assured screening colonoscopy program

2021 ◽  
Vol 09 (09) ◽  
pp. E1315-E1320
Author(s):  
Anna Hinterberger ◽  
Lena Jiricka ◽  
Elisabeth A. Waldmann ◽  
Daniela Penz ◽  
Barbara Majcher ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Screening Colonoscopy ◽  
Rank Test ◽  
Chi Square ◽  
Period 2 ◽  
Cancer Screening Program ◽  
Chi Square Test ◽  
Advanced Adenomas ◽  
The Impact

Abstract Background and study aims On February 25, 2020, the first patient was diagnosed with COVID-19 in Austria. On March 16, 2020, the Austrian government imposed restrictions and subsequently the Austrian Medical Association recommended minimizing screening examinations in compliance with government restrictions. The aims of this study were to evaluate the impact of this recommendation on the number of colonoscopies performed weekly and detection of non-advanced adenomas, advanced adenomas (AA) and colorectal cancer (CRC) and to calculate how many undetected adenomas could have developed into CRC. Methods We analyzed the number of colonoscopies and pathological findings within a quality assured national colorectal cancer screening program before the COVID-19 pandemic (March 1,t 2019 to September 1, 2019, Period 1) and compared those rates to months during which access to colonoscopy was limited (March 1, 2020 and September 1, 2020, Period 2) with a Wilcoxon-rank-test and a chi-square test. Results A total of 29,199 screening colonoscopies were performed during Period 1 and 24,010 during Period 2. The mean rate of colonoscopies per week during Period 1 was significantly higher than during Period 2 (808,35 [SD = 163,75] versus 594,50 [SD = 282,24], P = 0.005). A total of 4,498 non-advanced adenomas were detected during Period 1 versus 3,562 during Period 2 (P < 0.001). In total 1,317 AAs and 140 CRCs were detected during Period 1 versus 919 AAs and 106 CRCs during Period 2. These rates did not differ significantly (P = 0.2 and P = 0.9). Conclusions During the COVID-19 crisis, the number of colonoscopies performed per week was significantly lower compared to the year before, but there was no difference in the detection of CRCs and AAs.

scholarly journals Different Screening Definitions have Little Impact on Polypectomy Rate Estimates

2012 ◽  
Vol 26 (11) ◽  
pp. 791-794 ◽  
Author(s):  
Mengzhu Jiang ◽  
Maida J Sewitch ◽  
Lawrence Joseph ◽  
Alan N Barkun
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Quality Indicator ◽  
Screening Colonoscopy ◽  
Hospital Level ◽  
Cross Sectional ◽  
Physician Billing ◽  
History Of ◽  
Definition Of ◽  
Sectional Analysis

BACKGROUND: Polypectomy rate is a surrogate quality indicator for screening colonoscopy. Various methods for identifying screening colonoscopies have been used and it is unclear how different definitions affect the estimated polypectomy rate.OBJECTIVE: To estimate polypectomy rates and how they vary according to the definition of a screening colonoscopy, using patient- and endoscopist-reported indications.METHODS: A cross-sectional analysis of endoscopists and their patients 50 to 75 years of age who underwent colonoscopy was conducted. Based on questionnaire responses, four patient indications were derived: perceived screening; perceived nonscreening; medical history indicating nonscreening; and combination of the three indications. Endoscopist indication was derived from a questionnaire completed immediately after colonoscopy. Polypectomy status was obtained from provincial physician billing records. Polypectomy rates were computed, while accounting for physician and hospital level clustering, using all four patient indications, endoscopist indication, and the agreement between patient and endoscopist indications. The effect of indications on polypectomy rate was estimated adjusting for age, sex and family history of colorectal cancer.RESULTS: A total of 2134 patients and 45 endoscopists were included. The proportion of colonoscopies classified as screening according to the nine indications ranged from 32.2% to 70.9%. Polypectomy rates ranged between 22.6% and 26.2% for screening colonoscopy, and between 27.1% and 30.8% for nonscreening colonoscopy. Adjusted ORs for indication ranged between 0.74 and 0.94.DISCUSSION: Although the proportion of colonoscopies identified as screening varied considerably among the indications, the estimated polypectomy rates were similar.CONCLUSION: The findings suggest that the way screening is defined does not greatly affect the estimates of polypectomy rate.

scholarly journals Genetic testing in families with hereditary colorectal cancer in British Columbia and Yukon: a retrospective cross-sectional analysis

CMAJ Open ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. E637-E642
Author(s):  
Vivienne K. Beard ◽  
Angela C. Bedard ◽  
Jennifer Nuk ◽  
Petra W.C. Lee ◽  
Quan Hong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
British Columbia ◽  
Genetic Testing ◽  
Hereditary Colorectal Cancer ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis
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