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 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.

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

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.

scholarly journals Trends and Predictors for the Uptake of Colon Cancer Screening Using the Fecal Occult Blood Test in Spain from 2011 to 2017

2020 ◽  
Vol 17 (17) ◽  
pp. 6222
Author(s):  
José Javier Zamorano-Leon ◽  
Ana López-de-Andres ◽  
Ana Álvarez-González ◽  
Clara Maestre-Miquel ◽  
Paloma Astasio-Arbiza ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Blood Test ◽  
Fecal Occult Blood Test ◽  
Occult Blood ◽  
Fecal Occult Blood ◽  
Occult Blood Test ◽  
Crc Screening ◽  
Screening Uptake ◽  
Fecal Occult

Background: In Spain, colorectal cancer screening using the fecal occult blood test, targeted towards the 50–69 age bracket, was implemented on different dates. We aim to assess the temporal trend of colorectal cancer (CRC) screening uptake according to the year of screening implementation in each region and to identify predictors for the uptake of CRC screening. Methods: A cross-sectional study with 12,657 participants from the Spanish National Health Surveys 2011 and 2017 was used. Uptake rates were analyzed according to the date that the screening program was implemented. Results: For regions with programs implemented before 2011, the uptake rate increased 3.34-fold from 2011 to 2017 (9.8% vs. 32.7%; p < 0.001). For regions that implemented screening within the 2011–2016 period, the uptake rose from 4.3% to 13.2% (3.07-fold; p < 0.001), and for regions that implemented screening after 2016, the uptake increased from 3.4% to 8.8% (2.59-fold; p < 0.001). For the entire Spanish population, the uptake increased 3.21-fold (6.8% vs. 21.8%; p < 0.001). Positive predictors for uptake were older age, Spanish nationality, middle-to-high educational level, suffering chronic diseases, non-smoking and living in regions where screening programs were implemented earlier. Conclusions: The different periods for the implementation of CRC screening as well as sociodemographic and health inequalities may have limited the improvement in the screening uptake from 2011 to 2017 in Spain.

scholarly journals Physician Barriers to Population-Based, Fecal Occult Blood Test-Based Colorectal Cancer Screening Programs for Average-Risk Patients

2010 ◽  
Vol 24 (6) ◽  
pp. 359-364 ◽  
Author(s):  
S Elizabeth McGregor ◽  
Robert J Hilsden ◽  
Huiming Yang
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Blood Test ◽  
Occult Blood ◽  
Population Based ◽  
Perceived Barriers ◽  
Fecal Occult Blood ◽  
Screening Programs ◽  
Crc Screening ◽  
Fecal Occult

BACKGROUND: Colorectal cancer (CRC) screening is an efficacious but underused means to reduce the burden of CRC. Population-based CRC screening programs are currently being implemented in Canada and physicians are key partners in increasing screening uptake. The current study identified physician attitudes and barriers that need to be addressed by provincial programs.METHODS: A mailed survey of primary care physicians in Alberta.RESULTS: The survey response rate was 42.4% (806 of 1903). The majority of physicians suggested CRC screening as part of a routine periodic examination; however, the approach to test selection and the type of tests recommended varied by geographical region. The majority of physicians agreed (48%) or strongly agreed (36%) that a province-wide screening program is the best approach to reducing mortality from CRC. However, there were many serious concerns identified – the most common was endoscopic capacity for follow-up of patients with a positive fecal occult blood test (FOBT), which was cited by 55% to 69% of the physicians surveyed. The barriers to three commonly available tests (FOBT, flexible sigmoidoscopy and colonoscopy) varied according to health region, and the types of barriers identified varied according to the specific test.INTERPRETATION: Screening for CRC is gradually being accepted among primary care physicians in Alberta. A key finding of the present descriptive study was the regional variation in practices, perceived barriers and concerns about provincial population-based screening programs based on FOBT as the primary screening test. Provincial programs will need to address the issue of endoscopic capacity and perceived barriers to FOBT to gain primary care physician acceptance of FOBT-based CRC screening programs.

scholarly journals Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012–2018: Evidence from Claims Data of a Large Insurance

2021 ◽  
Vol 66 ◽  
Author(s):  
Rémi Schneider ◽  
Markus Näpflin ◽  
Lamprini Syrogiannouli ◽  
Sarah Bissig ◽  
Kali Tal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Claims Data ◽  
Occult Blood ◽  
Target Population ◽  
Fecal Occult Blood ◽  
Logistic Regression Models ◽  
Crc Screening ◽  
Testing Rate ◽  
Fecal Occult ◽  
Over Time

Objectives: Guidelines recommend colorectal cancer (CRC) screening by fecal occult blood test (FOBT) or colonoscopy. In 2013, Switzerland introduced reimbursement of CRC screening by mandatory health insurance for 50-69-years-olds, after they met their deductible. We hypothesized that the 2013 reimbursement policy increased testing rate.Methods: In claims data from a Swiss insurance, we determined yearly CRC testing rate among 50-75-year-olds (2012–2018) and the association with socio-demographic, insurance-, and health-related covariates with multivariate-adjusted logistic regression models. We tested for interaction of age (50–69/70–75) on testing rate over time.Results: Among insurees (2012:355′683; 2018:348′526), yearly CRC testing rate increased from 2012 to 2018 (overall: 8.1–9.9%; colonoscopy: 5.0–7.6%; FOBT: 3.1–2.3%). Odds ratio (OR) were higher for 70–75-year-olds (2012: 1.16, 95%CI 1.13–1.20; 2018: 1.05, 95%CI 1.02–1.08). Deductible interacted with changes in testing rate over time (p &lt; 0.001). The increase in testing rate was proportionally higher among 50-69-years-olds than 70-75-year-olds over the years.Conclusions: CRC testing rate in Switzerland increased from 2012 to 2018, particularly among 50-69-years-olds, the target population of the 2013 law. Future studies should explore the effect of encouraging FOBT or waiving deductible.

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