Provinciale responsverschillen in het Vlaamse Bevolkingsonderzoek Dikkedarmkanker: inzichten uit gemeentelijke socio-demografische en gezondheidsgerelateerde kenmerken

Author(s):  
T.N. TRAN ◽  
G. VAN HAL ◽  
M. PEETERS ◽  
S. JIDKOVA ◽  
S. HOECK

Municipal characteristics associated with response rate to organised colorectal cancer screening in Flanders Introduction In Flanders (Belgium), the response rate to organised colorectal cancer (CRC) screening is still suboptimal (~ 50%). We studied the characteristics of municipalities in the Flemish provinces with the highest and lowest response rates to explore factors that might be associated with the response rate to organised CRC screening. Methods The response rates of municipalities in 5 Flemish provinces and the characteristics of municipalities in the provinces with the highest and lowest response rates were compared to the average measures of Flanders (data 2017) using an unpaired two-sample Wilcoxon test. Results The municipal response rates in Limburg and Antwerp were significantly higher, and those in West Flanders and Flemish Brabant significantly lower compared to Flanders. Further analyses of Limburg (highest response rate) and Flemish Brabant (lowest response rate) suggested that municipalities with higher response rates had more men and people aged 60-64 in the target population, more jobseekers and more people who contacted GPs/specialists frequently, but fewer people aged 70-74 in the target population and with a lower average income compared to Flanders. In contrast, municipalities with lower response rates had fewer men in the target population, fewer people having a partner, fewer jobseekers and fewer people having a global medical file, but more people with a non-Dutch or non-Belgian nationality and a higher average income (p-values < 0.01). Conclusion This exploratory study identifies certain demographic, socioeconomic and health‑related municipal characteristics that may be related to the response rate to CRC screening in Flanders. These findings can guide future research and investigations with the aim to improve the response rate to CRC 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 ◽  
...  

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.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ane Sørlie Kværner ◽  
Einar Birkeland ◽  
Cecilie Bucher-Johannessen ◽  
Elina Vinberg ◽  
Jan Inge Nordby ◽  
...  

Abstract Background Colorectal cancer (CRC) screening reduces CRC incidence and mortality. However, current screening methods are either hampered by invasiveness or suboptimal performance, limiting their effectiveness as primary screening methods. To aid in the development of a non-invasive screening test with improved sensitivity and specificity, we have initiated a prospective biomarker study (CRCbiome), nested within a large randomized CRC screening trial in Norway. We aim to develop a microbiome-based classification algorithm to identify advanced colorectal lesions in screening participants testing positive for an immunochemical fecal occult blood test (FIT). We will also examine interactions with host factors, diet, lifestyle and prescription drugs. The prospective nature of the study also enables the analysis of changes in the gut microbiome following the removal of precancerous lesions. Methods The CRCbiome study recruits participants enrolled in the Bowel Cancer Screening in Norway (BCSN) study, a randomized trial initiated in 2012 comparing once-only sigmoidoscopy to repeated biennial FIT, where women and men aged 50–74 years at study entry are invited to participate. Since 2017, participants randomized to FIT screening with a positive test result have been invited to join the CRCbiome study. Self-reported diet, lifestyle and demographic data are collected prior to colonoscopy after the positive FIT-test (baseline). Screening data, including colonoscopy findings are obtained from the BCSN database. Fecal samples for gut microbiome analyses are collected both before and 2 and 12 months after colonoscopy. Samples are analyzed using metagenome sequencing, with taxonomy profiles, and gene and pathway content as primary measures. CRCbiome data will also be linked to national registries to obtain information on prescription histories and cancer relevant outcomes occurring during the 10 year follow-up period. Discussion The CRCbiome study will increase our understanding of how the gut microbiome, in combination with lifestyle and environmental factors, influences the early stages of colorectal carcinogenesis. This knowledge will be crucial to develop microbiome-based screening tools for CRC. By evaluating biomarker performance in a screening setting, using samples from the target population, the generalizability of the findings to future screening cohorts is likely to be high. Trial registration ClinicalTrials.gov Identifier: NCT01538550.


Author(s):  
Cristine D. Delnevo ◽  
Binu Singh

Abstract Background: Achieving a high response rate for physicians has been challenging and with response rates declining in recent years, innovative methods are needed to increase rates. An emerging concept in survey methodology has been web-push survey delivery. In this delivery method, contact is made by mail to request a response by web. This study explored the feasibility of a web-push survey on a national sample of physicians. Methods: 1000 physicians across six specialties were randomly assigned to a mail only or web-push survey delivery. Each mode consisted of four contacts including an initial mailing, reminder postcard, and two additional follow-ups. Response rates were calculated using AAPOR’s response rate 3 calculation. Data collection occurred between Febuary – April 2018 and analyzed March 2019. Results: Overall reponse rates for the mail only vs. web-push survey delivery were comparable (51.2% vs. 52.8%). Higher response rates across all demographics were seen in the web-push delivery with the exception of pulmonary/critical care and physicians over the age of 65. The web-push survey yielded a greater response after the first mailing requiring fewer follow-up contacts resulting in a more cost-effective delivery. Conclusions: A web-push mail survey is effective in achieveing a comparable response rate to traditional mail only delivery for physicians. The web-push survey was more efficient in terms of cost and in receiving responses in a more timely manner. Future research should explore the efficiency of a web-push survey delivery across various health care provider populations.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Aydoğan ◽  
S Metintaş ◽  
M F Önsüz

Abstract Background The aim of the study was to perform a systematic review and meta-analysis of studies about the proportion of recognition of fecal occult blood test (FOBT) and colonoscopy (CS) methods and participation to them in any period of life for colorectal cancer (CRC) screening in Turkey. Methods PubMed, Web of Science, Google Scholar, Turkey Citation Index and YOK Thesis Center databases were screened both in Turkish and English language to identify relevant studies and key words ’colorectal cancer’, ’colon cancer’, ’cancer screening’, ’information’, ’attitude’, ’behavior’, ’awareness’ and ’Turkey’ were. Criteria for inclusion in the analysis were; conducted in Turkey, original and cross-sectional, conducted CRC risky groups (having CRC in the first degree patients and 50 and above age), studies that give the number of participants and number of taking FOBT and CS screening in any period of their lives and/or the number of knowing them. The studies that met the criteria were read as double blind. The data were entered into the Open Meta Analyst demo program. Because of p &lt; 0.001 in the heterogeneity test, random effects model was used in group analysis of the articles. The proportion and 95% confidence interval of knowing and taking FOBT and CS were calculated from the total number of cases. Results A total of 1176 articles were reached in first review. Duplications and inappropriated studies were eliminated, and 52 studies were selected. Eight studies about recognition FOBT, 16 about participation FOBT, 9 about recognition CS and 17 about participation CS were taken in analysis. After analysis it was found that 1315 of 4334 individuals (19.3%, 95%CI:6.6-32.1) recognized to FOBT, 1174 of 6825 individuals (13.2%, 8.0-18.5) participated to FOBT, 2197 of 5728 individuals (31.7%, 18.2-45.2) recognized to CS and 913 of 8860 individuals (10.0%, 8.1-12.0) participated to CS. Conclusions The proportion of recognition and participation to FOBT and CS were found less than expected. Key messages The proportion of recognition and participation CRC screening methods is low in risky groups. Awareness and participation of screening should be increased in risky groups.


2019 ◽  
Vol 50 (3) ◽  
pp. 263-267
Author(s):  
Jill A Hancock ◽  
Glen A Palmer

Abstract Background Single-vial fecal immunochemical testing (FIT) is an accepted method of colorectal cancer (CRC) screening. The available 3-vial FIT data set allows for comparison of colonoscopy results using various screening methods. Objective To determine the optimal number of vials for a strong FIT-screening program by examining whether using only a single vial impacts the use of colonoscopy for CRC screening. Methods Patients were given 3-vial FIT collection kits that were processed with a positive hemoglobin cut-off detection level of 100 ng per mL. If FIT results were positive, colonoscopy testing was performed using standard practices. Results Detection of CRC and precursor adenoma was examined in 932 patients, with a positive colonoscopy sensitivity of 56.2% and 3.0% CRC detection after 3-vial FIT; after single-vial screening, those values were 60.9% and 4.7%, respectively. Conclusions Prescreening patients with FIT testing before colonoscopy allows colonoscopy testing to be targeted to higher-risk patients. Implementing use of only a single vial from the 3-vial FIT screening kit would reduce the colonoscopy reflex rate, colonoscopy complication numbers, facility costs, and patient distress by more than 40%, compared with 3-vial screening.


2019 ◽  
pp. 1-10
Author(s):  
Gregory C. Knapp ◽  
Olusegun I. Alatise ◽  
Olalekan O. Olasehinde ◽  
Ademola Adeyeye ◽  
Omobolaji O. Ayandipo ◽  
...  

PURPOSE The global burden of colorectal cancer (CRC) will continue to increase for the foreseeable future, largely driven by increasing incidence and mortality in low- and middle-income countries (LMICs) such as Nigeria. METHODS We used the Wilson-Jungner framework (1968) to review the literature relevant to CRC screening in Nigeria and propose areas for future research and investment. RESULTS Screening is effective when the condition sought is both important and treatable within the system under evaluation. The incidence of CRC is likely increasing, although the exact burden of disease in Nigeria remains poorly understood and access to definitive diagnosis and treatment has not been systematically quantified. In high-income countries (HICs), CRC screening builds on a well-known natural history. In Nigeria, a higher proportion of CRC seems to demonstrate microsatellite instability, which is dissimilar to the molecular profile in HICs. Prospective trials, tissue banking, and next-generation sequencing should be leveraged to better understand these potential differences and the implications for screening. Fecal immunochemical test for hemoglobin (FIT) is recommended for LMICs that are considering CRC screening. However, FIT has not been validated in Nigeria, and questions about the impact of high ambient temperature, endemic parasitic infection, and feasibility remain unanswered. Prospective trials are needed to validate the efficacy of stool-based screening, and these trials should consider concomitant ova and parasite testing. CONCLUSION Using the Wilson-Jungner framework, additional work is needed before organized CRC screening will be effective in Nigeria. These deficits can be addressed without missing the window to mitigate the increasing burden of CRC in the medium to long term.


2015 ◽  
Vol 11 (2) ◽  
pp. 130-146 ◽  
Author(s):  
Joanne Crawford ◽  
Farah Ahmad ◽  
Dorcas E. Beaton ◽  
Arlene S. Bierman

Purpose – The purpose of this paper is to gain an in-depth understanding of beliefs, attitudes, and reasons for decision making about colorectal cancer (CRC) screening among South Asian (SA) immigrants. Design/methodology/approach – Six focus groups conducted in English, Punjabi, and Urdu were held with 42 SA immigrants, 50-74 years old and at average risk for CRC, from November 2012 to May 2013. All focus group discussions were audio-taped and transcribed verbatim. Data analysis used an inductive and systematic approach employing constant comparison techniques. Findings – Three dominant themes emerged. Beliefs and attitudes towards cancer and screening represented SA immigrant’s perceptions that early detection was beneficial; screening was not necessary in the absence of symptoms; cancer was scary; and the loss of previously established bowel practices upon immigration as potential risks for CRC. Knowledge and awareness focused on unscreened participants’ cancer stories; screened participants’ knowledge of CRC, risk factors, and screening; experiential learning from focus groups; and screened participants’ strategies to promote screening. Support and accessibility concentrated on physician support and responsibility to provide information, explanation, and recommend screening to facilitate access. Originality/value – Findings provide novel insights on socio-cultural context, beliefs, and barriers to CRC screening among SA immigrants. Culturally appropriate community-based strategies included story-telling, the use of social networks, and greater physician engagement. Enhancing collaborative partnerships with physicians and public health may minimize structural barriers and reduce health disparities. Future research could explore effectiveness of outreach strategies including these collaborations.


Author(s):  
Allegra Ferrari ◽  
Isabelle Neefs ◽  
Sarah Hoeck ◽  
Marc Peeters ◽  
Guido Van Hal

Colorectal cancer (CRC) is one of the leading cancer-related causes of death in the world. Since the 70s, many countries have adopted different CRC screening programs which has resulted in a decrease in mortality. However, current screening test options still present downsides. The commercialized stool-based tests present high false-positive rates and low sensitivity, which negatively affects the detection of early stage carcinogenesis. The gold standard colonoscopy has low uptake due to its invasiveness and the perception of discomfort and embarrassment that the procedure may bring.In this review, we collected and described the latest data about alternative CRC screening techniques that can overcome these disadvantages. Web of Science and PubMed were employed as search engines for studies reporting on CRC screening tests and future perspectives. The searches generated 555 articles, of which 93 titles were selected. Finally, a total of 50 studies, describing 14 different CRC alternative tests, were included. Among the investigated techniques the main feature that could have an impact on CRC screening perception and uptake was the ease of sample collection. Urine, exhaled breath and blood-based tests promise to achieve good diagnostic performance (sensitivity of 63-100%, 90-95%, 47-97%, respectively) while minimizing stress and discomfort for the patient.


Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4345
Author(s):  
Dmitrii Shek ◽  
Liia Akhuba ◽  
Matteo S. Carlino ◽  
Adnan Nagrial ◽  
Tania Moujaber ◽  
...  

Background. Colorectal cancer (CRC) is the fourth most deadly cancer worldwide. Unfortunately, a quarter of the patients are diagnosed at late stages, when surgical options are limited. Targeted therapies, particularly immune-checkpoint inhibitors (ICIs), are the latest addition and have been studied herein regarding their efficacy outcomes. Methods. Clinical studies were identified through the PubMed, Scopus and Cochrane databases. Any trial that evaluated ICIs in patients with metastatic CRC (mCRC) and reported the objective response rate was deemed eligible. Data analysis was performed by employing the random-effects model in STATA v.17. Results. A total of 461 articles were identified; 13 clinical trials were included, encompassing a total cohort of 1209 patients. Our study determined that a single PD-1/PD-L1 checkpoint blockade provides durable clinical response in mCRC patients with high microsatellite instability (MSI-H). The combinatorial therapy of CTLA-4 + PD-1 inhibitors also showed high response rates in pre-treated MSI-H patients. The single-arm REGONIVO trial reported durable clinical response in patients with microsatellite stable (MSS) status. Conclusions. Our study surmises that PD-1/PD-L1 inhibitors as well as combination therapy with CTLA-4 and PD-1 inhibitors show encouraging response rates in mCRC patients, albeit exclusively in patients with cancer that are of MSI-H status. A single study suggests that nivolumab + regorafenib can reach a durable response rate in MSS patients; however, further studies in larger randomized settings are required.


2020 ◽  
pp. 193896552094309 ◽  
Author(s):  
Faizan Ali ◽  
Olena Ciftci ◽  
Luana Nanu ◽  
Cihan Cobanoglu ◽  
Kisang Ryu

In this paper, we examine published research in six top-tier hospitality journals to explore response rates for different survey distribution methods across specific characteristics like research context, respondents, and geographical regions. Data were analyzed from 1,389 papers published from January 2001 to December 2019. By looking at a large set of published response rates, distribution and enhancing methods and type of respondents, findings from this study will aid researchers in designing more effective surveys and successfully collecting necessary data. The implications for response rate in hospitality research are also presented.


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