Non-invasive colorectal cancer screening

Colorectal cancer (CRC) is a major cause of morbidity and mortality throughout the world and is the second most common cause of Canadian cancer-related deaths in men and the third most common in women. Most CRC appears to arise from the gradual development and advancement of colonic adenomatous polyps to cancerous tissue. This developmental process of CRC is the rationale for screening programs which aim to reduce CRC-related morbidity and mortality by early detection and removal of adenomatous polyps, specifically advanced adenomas. Although both the gFOBT and FIT function to detect occult bleeding in asymptomatic patients at average risk for CRC development, the mechanisms of these screening tests are distinct. gFOBT works by detecting the peroxidase activity of heme whereas FIT selectively detects human hemoglobin. The sensitivity in detecting CRC is higher for the FIT, with sensitivity of 0.79 compared to gFOBT with sensitivity of 0.36, they have similar specificities of 0.94 and 0.96, respectively. Currently, both the gFOBT and FIT are strongly recommended across Canada, with all provinces using the FIT, apart from Ontario and Manitoba which currently use the gFOBT to screen asymptomatic patients for CRC. A newer test, the sDNA test, identifies mutations in DNA that are shed by both adenomatous polyps and CRC cells. The sDNA test is more sensitive (0.92 95% CI 0.83-0.98) than both the gFOBT and FIT, however, is less specific and more expensive. Further data surrounding the sDNA test will be required prior to its implementation and recommendation for population based CRC screening in Canada.

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Methylated SEPTIN9 plasma test for colorectal cancer detection may be applicable to Lynch syndrome

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2019-000299 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000299 ◽

Cited By ~ 1

Author(s):

Megan P Hitchins ◽

Ingrid P Vogelaar ◽

Kevin Brennan ◽

Sigurdis Haraldsdottir ◽

Nianmin Zhou ◽

...

Keyword(s):

Colorectal Cancer ◽

Lynch Syndrome ◽

Preliminary Evidence ◽

Circulating Tumor Dna ◽

Screening Tests ◽

Advanced Adenoma ◽

Control Group ◽

Average Risk ◽

Colorectal Mucosa ◽

Advanced Adenomas

ObjectiveThe plasma-based methylated SEPTIN9 (mSEPT9) is a colorectal cancer (CRC) screening test for adults aged 50–75 years who are at average risk for CRC and have refused colonoscopy or faecal-based screening tests. The applicability of mSEPT9 for high-risk persons with Lynch syndrome (LS), the most common hereditary CRC condition, has not been assessed. This study sought preliminary evidence for the utility of mSEPT9 for CRC detection in LS.DesignFirstly, SEPT9 methylation was measured in LS-associated CRC, advanced adenoma, and subject-matched normal colorectal mucosa tissues by pyrosequencing. Secondly, to detect mSEPT9 as circulating tumor DNA, the plasma-based mSEPT9 test was retrospectively evaluated in LS subjects using the Epi proColon 2.0 CE assay adapted for 1mL plasma using the “1/1 algorithm”. LS case groups included 20 peri-surgical cases with acolonoscopy-based diagnosis of CRC (stages I-IV), 13 post-surgical metastatic CRC, and 17 pre-diagnosis cases. The control group comprised 31 cancer-free LS subjects.ResultsDifferential hypermethylation was found in 97.3% (36/37) of primary CRC and 90.0% (18/20) of advanced adenomas, showing LS-associated neoplasia frequently produce the mSEPT9 biomarker. Sensitivity of plasma mSEPT9 to detect CRC was 70.0% (95% CI, 48%-88%)in cases with a colonoscopy-based CRC diagnosis and 92.3% (95% CI, 64%-100%) inpost-surgical metastatic cases. In pre-diagnosis cases, plasma mSEPT9 was detected within two months prior to colonoscopy-based CRC diagnosis in 3/5 cases. Specificity in controls was 100% (95% CI 89%-100%).ConclusionThese preliminary findings suggest mSEPT9 may demonstrate similar diagnostic performance characteristics in LS as in the average-risk population, warranting a well-powered prospective case–control study.

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Comparison between Enzyme Immunoassays Performed on Samples of Dried Blood and Serum for Toxoplasmosis Prenatal Screening: Population-based Study

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0041-1730285 ◽

2021 ◽

Vol 43 (05) ◽

pp. 351-356

Author(s):

Bárbara Araújo Marques ◽

Ericka Vianna Machado Carellos ◽

Vânia Maria Novato Silva ◽

Fernando Henrique Pereira ◽

Maria Regina Lage Guerra ◽

...

Keyword(s):

Pregnant Women ◽

Prenatal Screening ◽

Dried Blood Spots ◽

Population Based ◽

Minas Gerais ◽

Immunoglobulin M ◽

Screening Tests ◽

Reference Test ◽

Screening Programs ◽

Blood Spots

Abstract Objective Most prenatal screening programs for toxoplasmosis use immunoassays in serum samples of pregnant women. Few studies assess the accuracy of screening tests in dried blood spots, which are of easy collection, storage, and transportation. The goals of the present study are to determine the performance and evaluate the agreement between an immunoassay of dried blood spots and a reference test in the serum of pregnant women from a population-based prenatal screening program for toxoplasmosis in Brazil. Methods A cross-sectional study was performed to compare the immunoassays Imunoscreen Toxoplasmose IgM and Imunoscreen Toxoplasmose IgG (Mbiolog Diagnósticos, Ltda., Contagem, Minas Gerais, Brazil)in dried blood spots with the enzyme-linked fluorescent assay (ELFA, BioMérieux S.A., Lyon, France) reference standard in the serum of pregnant women from Minas Gerais Congenital Toxoplasmosis Control Program. Results The dried blood spot test was able to discriminate positive and negative results of pregnant women when compared with the reference test, with an accuracy of 98.2% for immunoglobulin G (IgG), and of 95.8% for immunoglobulin M (IgM). Conclusion Dried blood samples are easy to collect, store, and transport, and they have a good performance, making this a promising method for prenatal toxoplasmosis screening programs in countries with continental dimensions, limited resources, and a high prevalence of toxoplasmosis, as is the case of Brazil.

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A Population-Based Study of Prevalence and Adherence Trends in Average Risk Colorectal Cancer Screening, 1997 to 2008: Figure 1.

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-11-0818 ◽

2011 ◽

Vol 21 (2) ◽

pp. 347-350 ◽

Cited By ~ 12

Author(s):

Pamela S. Sinicrope ◽

Ellen L. Goode ◽

Paul J. Limburg ◽

Sally W. Vernon ◽

Joseph B. Wick ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Population Based ◽

Average Risk ◽

Population Based Study

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

Gastroenterology Research and Practice ◽

10.1155/2013/384561 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

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.

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Colorectal Cancer Surveillance after Index Colonoscopy: Guidance from the Canadian Association of Gastroenterology

Canadian Journal of Gastroenterology ◽

10.1155/2013/232769 ◽

2013 ◽

Vol 27 (4) ◽

pp. 224-228 ◽

Cited By ~ 14

Author(s):

Desmond Leddin ◽

Robert Enns ◽

Robert Hilsden ◽

Carlo A Fallone ◽

Linda Rabeneck ◽

...

Keyword(s):

Colorectal Cancer ◽

Task Force ◽

Cancer Surveillance ◽

Screening Tests ◽

Average Risk ◽

Health Care Environment ◽

Canadian Association ◽

The Us ◽

Colonoscopy Surveillance

BACKGROUND: Differences between American (United States [US]) and European guidelines for colonoscopy surveillance may create confusion for the practicing clinician. Under- or overutilization of surveillance colonoscopy can impact patient care.METHODS: The Canadian Association of Gastroenterology (CAG) convened a working group (CAG-WG) to review available guidelines and provide unified guidance to Canadian clinicians regarding appropriate follow-up for colorectal cancer (CRC) surveillance after index colonoscopy. A literature search was conducted for relevant data that postdated the published guidelines.RESULTS: The CAG-WG chose the 2012 US Multi-Society Task Force (MSTF) on Colorectal Cancer to serve as the basis for the Canadian position, primarily because the US approach was the simplest and comprehensively addressed the issue of serrated polyps. Aspects of other guidelines were incorporated where relevant. The CAG-WG recommendations differed from the US MSTF guidelines in three main areas: patients with negative index colonoscopy should be followed-up at 10 years using any of the appropriate screening tests, including colonos-copy, for average-risk individuals; among patients with >10 adenomas, a one-year interval for subsequent colonoscopy is recommended; and for long-term follow-up, patients with low-risk adenomas on both the index and first follow-up procedures can undergo second follow-up colonos-copy at an interval of five to 10 years.DISCUSSION: The CAG-WG adapted the US MSTF guidelines for colonoscopy surveillance to the Canadian health care environment with a few modifications. It is anticipated that the present article will provide unified guidance that will enhance physician acceptance and encourage appropriate utilization of recommended surveillance intervals.

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Preferences of Iranian average risk population for colorectal cancer screening tests

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa-08-2017-0151 ◽

2019 ◽

Vol 32 (4) ◽

pp. 677-687

Author(s):

Vajiheh Ramezani_Doroh ◽

Alireza Delavari ◽

Mehdi Yaseri ◽

Sara Emamgholipour Sefiddashti ◽

Ali Akbarisari

Keyword(s):

Colorectal Cancer ◽

Health Status ◽

Discrete Choice ◽

Choice Model ◽

Screening Tests ◽

Average Risk ◽

Risk Population ◽

Content Type ◽

Crc Screening ◽

Complication Risk

Purpose The purpose of this paper is to explore the preferences of the average risk Iranian population for colorectal cancer (CRC) screening tests. Design/methodology/approach A standard stated-preferences method with discrete choice models was used to identify the preferences. Data about socio-demographic status, health status and preferences for CRC screening tests were collected by a structured questionnaire that was completed by 500 people aged 50–75 years. Mixed logit model was used to analyze the preferences. Findings The regression model showed that the test process, pain, place, frequency, preparation, sensitivity, complication risk, mortality rate and cost were the final attributes; that had a statistically significant correlation with the preferences of the people in choosing CRC screening tests. The socio-demographic and health status of participants had no significant correlation with the individuals’ preferences. Practical implications This study provides insight into how different characteristics of a CRC screening test might influence the preferences of individuals about that test. Originality/value This was the first study of this type in Iran to elicit the preferences of the average risk population for CRC screening tests using a discrete choice model.

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Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Viruses ◽

10.3390/v10120729 ◽

2018 ◽

Vol 10 (12) ◽

pp. 729 ◽

Cited By ~ 42

Author(s):

Andreas Chrysostomou ◽

Dora Stylianou ◽

Anastasia Constantinidou ◽

Leondios Kostrikis

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Hpv Vaccination ◽

Screening Method ◽

Population Based ◽

Screening Tests ◽

Screening Methods ◽

Hpv Testing ◽

Screening Programs

Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.

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Aggressive Colorectal Cancer in the Young

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0040-1713747 ◽

2020 ◽

Vol 33 (05) ◽

pp. 298-304

Author(s):

Blake Read ◽

Patricia Sylla

Keyword(s):

Colorectal Cancer ◽

Late Onset ◽

Tumor Biology ◽

Population Based ◽

Average Risk ◽

Future Directions ◽

Screening Guidelines ◽

Treatment And Prevention ◽

Rising Incidence ◽

Related Mortality

AbstractDespite the steady decline in the incidence of colorectal cancer (CRC) and cancer-related mortality in Americans of 50 years and older over the last few decades, there has been a disturbing trend of steadily rising incidence in early-onset colorectal cancer (EOCRC), defined as CRC in those younger than 50 years. With the incidence of EOCRC increasing from 4.8 per 100,000 in 1988 to 8.0 per 100,000 in 2015, and with the decreased rates in those older than 50 years largely attributed to improved screening in the older population, new screening recommendations have recently lowered the age for screening average-risk individuals from 50 to 45. EOCRC has been found to present differently from late-onset CRC, with a higher proportion of patients presenting with left-sided and rectal cancer, more aggressive histological features, and more advanced stage at the time of diagnosis. This article reviews the most recent evidence from population-based studies and institutional series, as well as the newest screening guidelines, and provides an up-to-date summary of our current understanding of EOCRC, from clinical presentation to tumor biology and prognosis, and future directions in treatment and prevention.

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Value of Serum NEUROG1 Methylation for the Detection of Advanced Adenomas and Colorectal Cancer

Diagnostics ◽

10.3390/diagnostics10070437 ◽

2020 ◽

Vol 10 (7) ◽

pp. 437

Author(s):

Olalla Otero-Estévez ◽

María Gallardo-Gomez ◽

María Páez de la Cadena ◽

Francisco Javier Rodríguez-Berrocal ◽

Joaquín Cubiella ◽

...

Keyword(s):

Colorectal Cancer ◽

Cpg Island ◽

Family Risk ◽

Liquid Biopsies ◽

Age And Gender ◽

Screening Programs ◽

Aberrant Dna Methylation ◽

And Gender ◽

Asymptomatic Individuals ◽

Advanced Adenomas

Aberrant DNA methylation detected in liquid biopsies is a promising approach for colorectal cancer (CRC) detection, including premalignant advanced adenomas (AA). We evaluated the diagnostic capability of serum NEUROG1 methylation for the detection of AA and CRC. A CpG island in NEUROG1 promoter was assessed by bisulfite pyrosequencing in a case-control cohort to select optimal CpGs. Selected sites were evaluated through a nested methylation-specific qPCR custom assay in a screening cohort of 504 asymptomatic family-risk individuals. Individuals with no colorectal findings and benign pathologies showed low serum NEUROG1 methylation, similar to non-advanced adenomas. Contrarily, individuals bearing AA or CRC (advanced neoplasia—AN), exhibited increased NEUROG1 methylation. Using >1.3518% as NEUROG1 cut-off (90.60% specificity), 33.33% of AN and 32.08% of AA were identified, detecting 50% CRC cases. Nonetheless, the combination of NEUROG1 with fecal immunochemical test (FIT), together with age and gender through a multivariate logistic regression resulted in an AUC = 0.810 for AN, and 0.796 for AA, detecting all cancer cases and 35–47% AA (specificity 98–95%). The combination of NEUROG1 methylation with FIT, age and gender demonstrated a convenient performance for the detection of CRC and AA, providing a valuable tool for CRC screening programs in asymptomatic individuals.

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